HSAs and HRAs show growth over the past two years

According to the Employee Benefit Research Institute (EBRI), a nonpartisan and nonprofit research group, both health savings accounts (HSAs) and health reimbursement arrangements (HRAs) are having a period of renewed growth after a drop during the economic recession. The average account balance has increased over the past two years, as well. Results from the 2012 EBRI-sponsored Consumer Engagement in Health Care Survey indicated that the average account balances for HSAs and HRAs were level between 2008 and 2009 but fell in 2010. Having increased in 2011 through to 2012, the survey reports that the average rebound was up a full 9% increase from 2010 into 2011 and a further 4% in 2012. Meanwhile, 2012 brought $17.8 billion in HSAs and HRAs across approximately 11.6 million accounts – up from 2006 when the numbers were 1.3 million accounts and $873.4 million in balances.

According to the EBRI, HSAs and HRAs are relatively new types of tax-advantaged accounts, only appearing in the workplace a little over a decade ago. Considering “consumer-driven” health plans, they give holders better control over funding for health care services, leading to what proponents call more responsible spending. Interestingly, the EBRI found that certain health behaviors had very little to do with how high account balances were for HSAs and HRAs. For instance, Paul Fronstin, the author of the EBRI report, noted that some smokers had more money in their accounts than those who didn’t smoke. Exercise had little discernable effect.

Alongside an effective workplace wellness program, an HSA – which are paired with a high deductible health plan (HDHP) – could inspire both better health and health responsibility in workers. A HDHP features higher deductibles than traditional health plans, according to the U.S. Office of Personnel Management, but workers are able to offset that cost with the funds in their HSA.

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Celebrate American Heart Month through your workplace wellness program

Hearts aren’t just for Valentine’s this February. American Heart Month marks a time of year when citizens of the United States should take some time to think about their own heart health as well as that of their loved ones. As the Centers for Disease Control and Prevention (CDC) reports, cardiovascular disease is the leading cause of death in the U.S. In fact, one in every three deaths occurring within the states is due to either heart disease or stroke. That works out to 2,200 deaths per day. The CDC also points out that in 2010, the cost of heart disease and stroke-related hospitalizations totaled more than $444 billion in healthcare expenses. Considering that cardiovascular health is of the utmost importance, there’s no reason not to fight for it, and the very first step is education.

Employers especially should utilize workplace wellness programs to draw attention to cardiovascular health, and American Heart Month is the perfect opportunity to do so. Not only can workplace wellness programs reduce medical costs by an average of more than 18% per employee, according to a report from the American College of Occupational and Environmental Medicine, recent Gallup studies indicate a correlation between healthier lifestyles and more engaged employees.

Wellness programs that incorporate gym opportunities, prescription management, dietary assistance or other innovative healthcare management solutions could improve employee health and help reduce the overwhelming number of cardiovascular-related deaths each year. Employers should start by informing workers about proper heart health care – physical activity for at least half an hour more than three days a week, the necessity of a diet rich in fruits and vegetables, regularly getting ones blood pressure and cholesterol checked, the possible benefits of daily aspirin and – of course – giving up smoking. All of these are key tenets of good cardiovascular health, according to the CDC.

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General population confused about self insurance

With the nation still debating about private and public health insurance, you would expect more business owners to consider self-funded health insurance, wherein employers take direct responsibility for their employees health coverage. Surprisingly, a market research survey released in late June indicates that the bulk of American business owners with less than 100 employees are unfamiliar with this alternative health insurance paradigm.

The study was orchestrated by ORC International and funded by small business insurance company Employers. Out of the 501 business leaders who participated, 73 percent had “little or no knowledge” of the mechanisms of self insured groups.

According to Life Health Pro, self insurance could be used by employers to avoid some regulations of the Patient Protection and Affordable Care Act, which was signed in 2010 and  recently upheld by the US Supreme Court. Self insurance should not be seen as a quick cash grab, as reported by the news outlet. Instead, it should be considered an option for business people looking out for the best interests of their employees.

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Care Management Solutions | Public still wants reform, even if ACA is struck down

Some of the care management solutions  enacted as part of the Affordable Care Act may be unpopular with the public, but that does not necessarily mean that people are against healthcare reform entirely.

A recent poll conducted by the Associated Press and GfK research indicates that the vast majority of Americans want the President and Congress to immediately get to work on a new bill if the Supreme Court decides to invalidate the entire law, the AP reported.

The results of the poll show that 75 percent of Americans want policymakers to start working on a new bill if the Affordable Care Act is ruled unconstitutional. Even 60 percent of people who identified themselves as supporters of the Tea Party said they would like to see a new health reform bill enacted.

The high cost of care is likely one of the main reasons why people continue to want some type of reform. A report issued last month by PricewaterhouseCoopers projected that healthcare costs will increase by 7.5 percent in 2013. While this growth rate is extremely low by historic standards, it is substantially higher than the rate of inflation.

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Government looks to mobile technology for improved efficiency

Mobile technologies have revolutionized the way people communicate, shop and entertain themselves. Now, the White House is hoping these same devices will lead to innovative healthcare management solutions.

President Barack Obama recently issued a memo to the heads of executive departments and agencies directing each department to make two of its services available on mobile devices.

The Department of Health and Human Services, which administers many programs, including Medicare and the government’s efforts to encourage physician adoption of electronic health records, is included in the order. U.S. chief technology officer Todd Park said this could lead to major healthcare innovation.

“The initiatives we’re launching today will make government data resources even more accessible to the public and to entrepreneurs who can turn these data into services that can help Americans find the best doctor for their family,” Park said.

Ultimately, government officials hope that opening up federal data and services to access through mobile devices will lead to lower costs and greater efficiency, two things that are needed in this era of belt tightening.

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If You Work in Healthcare, You Live in Interesting Times

How Will the Supreme Court Rule on Healthcare Reform?

In March, the U.S. Supreme Court heard oral arguments on the Patient Protection and Affordable Care Act (PPACA). The ultimate issue that the Court is grappling with is the constitutional authority of the federal government to require individuals to purchase health insurance or pay a penalty. The arguments for both sides can be summarized as follows:

Those in favor of PPACA believe the mandate is a valid use of congressional power to regulate interstate commerce. This would mean that Congress has the authority to implement a tax or penalty to help pay for healthcare.

Those opposing the individual mandate believe the act of requiring individuals to purchase insurance exceeds Congress’s authority and would essentially open the door to allow Congress to require individuals to buy any type of good.

The oral arguments lasted for three days. Most agree that the Justices appeared skeptical that the mandate could be considered constitutional. Justice Scalia even went so far as to wonder if Congress has the constitutional authority to require everyone to purchase health insurance, can Congress also force all of us to buy broccoli, too?

The Issues at Stake

1. The Anti-Injunction Act ― This Act says that a tax cannot be challenged until it is actually paid. When PPACA was passed, supporters said that the penalty for not obeying the individual mandate was a “fine” and not a “tax.” However, the Administration reversed course during oral arguments, suggesting that the penalty is only a “tax” (and thus, the Court cannot rule on the individual mandate until 2014). If the Court agreed with this theory, it could have used it as a reason not to decide the entire case (leaving us with two more years of uncertainty).  Interestingly, the Court rejected imposing the Anti-Injunction Act.

2. Tax vs. Fine ― The Obama Administration argued that the fine associated with the individual mandate is definitely a “tax” for purposes of the Anti-Injunction Act. However, the Administration later changed course and said it was a “tax,” which means the mandate would be constitutional. The Justices, however, didn’t seem to buy this argument.

3. Severability ― The authors of PPACA forgot to include a severability clause. Severability clauses are used to prevent an entire law from being struck down in the event one part of the law is found to be unconstitutional. Because it lacks a severability clause, the Justices could strike down PPACA altogether if they decide the individual mandate is unconstitutional.

The Supreme Court will rule in June 2010, which will no doubt be a landmark decision. Most believe that the Court will take an all or nothing approach ― either PPACA (as a whole) will be constitutional and stand as-is or the Court will strike down the entire law.

How do you think the Justices will rule?  Do you think PPACA will be ruled unconstitutional?

(by Sarah A. Bittner)

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More small businesses look to self-funded health insurance

Self-funded health insurance was once solely the domain of large employers. Most businesses believed that they would have to have massive resources at their disposal to offer such health plans. However, smaller companies are increasingly looking to self-funded options as a way to control rapid increases in healthcare costs.

Under a self-funded health insurance plan, businesses pay the cost of their workers’ healthcare directly, while still maintaining stop-loss coverage that kicks in if expenses start to run too high. This gives businesses greater control over what they pay for than typical insurance plans, where premiums rise every year with little control from the employer.

The New Jersey Star-Ledger recently reported that statewide enrollment in the small employer insurance market has dropped in recent years. Officials from the state’s Department of Banking and Insurance said they believe one reason for this is that more small businesses are moving to self-funded plans.

A 2008 report from the Congressional Research Service revealed that 55 percent of adults covered by private insurance are enrolled in self-insured plans, which marked an increase over previous years.

For more information, please visit our website at www.healthsmart.com.

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10 Ways to Enjoy More Fruits and Vegetables

Everyone wants to eat more fruits and vegetables, but not everyone knows how to easily incorporate them into their diet. So we’ve found 10 ways to enjoy more fruits and vegetables! To see the complete “20 Ways to Enjoy More Fruits and Vegetables,” visit the American Dietetic Association’s website here.

1. Variety abounds when using vegetables as pizza topping. Try broccoli, spinach, green peppers, tomatoes, mushrooms and zucchini. 
2. Mix up a breakfast smoothie made with low-fat milk, frozen strawberries and a banana.
3. Make a veggie wrap with roasted vegetables and low-fat cheese rolled in a whole-wheat tortilla.
4. Try crunchy vegetables instead of chips with your favorite low-fat salad dressing for dipping.
5. Grill colorful vegetable kabobs packed with tomatoes, green and red peppers, mushrooms and onions.
6. Add color to salads with baby carrots, grape tomatoes, spinach leaves of mandarin oranges.
7. Keep cut vegetables handy for mid-afternoon snacks, side dishes, lunch box additions or a quick nibble while waiting for dinner. Ready-to-eat favorites: red, green or yellow peppers, broccoli or cauliflower florets, carrots, celery sticks, cucumbers, snap peas or whole radishes.
8. Place colorful fruit where everyone can easily grab something for a snack-on-the-run. Keep a bowl of fresh, just ripe whole fruit in the center of your kitchen or dining table.
9. Get saucy with fruit. Puree apples, berries, peaches or pears in a blender for a thick, sweet sauce on grilled or broiled seafood or poultry, or on pancakes, French toast or waffles.
10. Stuff an omelet with vegetables. Turn any omelet into a heart with broccoli, squash, carrots, peppers, tomatoes or onions with low-fat sharp cheddar cheese.

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Everyday Eating for a Healthier You

In honor of National Nutrition Month, The American Dietetic Association has outlined these basic principles for getting balanced nutrition by eating right.

Balancing your daily calorie intake with the amount of physical activity you perform is the first step to a healthy eating pattern.

The Dietary Guidelines for Americans recommends incorporating more whole grains, vegetables, fruits, low-fat or fat-free dairy, vegetable oils and seafood into your diet in order to get the nutrients you need and stay within your daily recommended calorie intake. 

On the other hand, the Dietary Guidelines for Americans suggests REDUCING the following: added sugars, solid fats including trans fat, refined grains and sodium. More than one-third of all calories consumed by American are solid fats and added sugars, so you have to watch out for them as a part of having good nutrition.

To read more about the Dietary Guidelines, visit the ADA website here.

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Heart Health Month – An Important Reminder

By Timi Gustafson, R.D.February is “Heart Health Month.” Health advocacy groups and organizations like the American Heart Association (AHA), the National Heart Lung and Blood Institute (NHLBI) and the Centers for Disease Control and Prevention (CDC) want to remind us that heart disease is the most common cause of death in America and deserves more of our attention. 

Sadly, heart disease has become nothing short of a national crisis in this country. “Heart disease takes the lives of far too many people in this country,” said Department of Health and Human Services (HHS) Secretary Kathleen Sebelius. “With more than two million heart attacks and strokes a year, and 800,000 deaths, just about all of us have been touched by someone who has had heart disease, a heart attack, or a stroke.”

Heart disease is also very expensive to treat. Cardiovascular disease and stroke hospitalizations have cost nearly $450 billion in health care expenses and lost productivity in 2010 alone.

“The sad truth is that these ailments are usually preventable, and in a perfect world I would be out of a job,” said Mehmet Oz, MD, a cardiothoracic surgeon and host of  “The Dr. Oz Show.” “Unfortunately, I’m busier than ever,” he added.

Raising awareness is a crucial way to fight back against the spreading disease. In 2011, the HHS, in collaboration with the CDC and other government agencies as well as private organizations, has launched a program named “Million Hearts,” a nationwide initiative aimed at preventing one million heart attacks and strokes over the next five years. Among its many goals, the program wants to “empower Americans to make healthy choices,” such as avoiding tobacco use and reducing the amount of sodium and trans for they eat, and to “improve care for people who need treatment” by encouraging them to take steps to better control their blood pressure, cholesterol levels and other major risk factors for cardiovascular disease and stroke.

“Million Hearts” is not the only awareness movement in the country. “Go Red for Women” is a nationwide program by AHA “to fight heart disease as the number one killer of women in America.” Observers can express their support by wearing red clothing or pins. “Choose to Move” is another AHA project dedicated to women’s heart health through physical exercise.

Sending the right messages is vitally important, especially for women, said Dr. Oz. “Many women and their health care providers believe that heart disease is less serious in women than in men. This is simply not true. Studies show that more women than men die within a year of having a first heart attack. Women are two to three times more likely than men to die following heart-bypass surgery, and more women than men die each year from congestive heart failure.

In fact, women may suffer from a completely different type of heart disease than men, according to Noel Bairey Merz, MD, director of the Women’s Heart Center at Cedars-Sinai Medical Center in Los Angeles, which is not yet fully understood and harder to detect, and therefore can often remain undiagnosed until it is too late. The good news is that there are only a few causes of heart disease that are out of our control, such as genetic predisposition, family history and aging. The rest is a matter of choice. Even small lifestyle improvements can make a significant difference. Weight control, good nutrition, regular exercise and stress reduction are all a part of that. Each one of these is fully achievable for everyone with enough commitment and willingness to make the necessary efforts. Raising awareness is a good start, but it doesn’t end there.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter (http://twitter.com/TimiGustafsonRD) and on Facebook.

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