HealthNews March 2015
Computers and Your Vision
According to a recent report for the Vision Council, more than 60 percent of adults spend five or more hours on digital devices each day. In addition, the report states that office workers who spend significant time in front of computer screens experience eye strain and undergo changes in tear fluid similar to people with dry eye disease. Prevent Blindness, the nation’s oldest volunteer eye health and safety group, has declared March Workplace Eye Wellness Month and has provided these steps to help prevent eyestrain and fatigue:
- Visit an eye doctor for a dilated eye exam to make sure you are seeing clearly
- Place your screen 20 to 26 inches away from your eyes
- Use a document holder placed next to your computer screen to avoid swinging your head and changing focus
- Adjust the text size to a comfortable level
- Change your lighting to lower glare and harsh reflections
- Use a chair that is adjustable
- Choose screens that can tilt and swivel
- Dust and wipe digital screens to help reduce glare
- The Vision Council recommends the 20-20-20 break: every 20 minutes take a 20 second break and look at something 20 feet away.
FMLA Rights Extended to Same Sex Couples
The US Labor Department issued a press release announcing a rule change to the Family Medical Leave Act : “Workers in legal, same-sex marriages, regardless of where they live, will now have the same rights as those in opposite-sex marriages to federal job protected leave under the Family and Medical Leave Act to care for a spouse with a serious health condition.” This rule change was announced to keep with the U.S. Supreme Court ruling which struck down the Federal Defense of Marriage Act provision that interpreted “marriage” and “spouse” to be limited to opposite-sex marriage for the purposes of federal law. This will allow an employee to take FMLA leave regardless of whether the employee lives in a state that recognizes their marital status.
The FMLA regulations since inception has stated the term “spouse” was to be defined according to the law of the state in which an employee resides, as opposed to the jurisdiction where the marriage was entered. This distinction became very significant after the US Supreme Court’s decision in United States v. Windsor which struck down Section 3 of the Defense of Marriage Act as unconstitutional. Federal FMLA leave was generally not available to same-sex married couples even in states that recognized gay marriage. Windsor effectively extended FMLA rights to same-sex married couples, but only if they resided in a state that recognized same-sex marriages, even if they were legally married in another state. In June of 2014, the Department of Labor adopted a proposed “state of celebration” rule, in which a spousal status for the purpose of FMLA is determined not on the state in which the employee currently resides, but instead, on the state where the employee was married. After issuing its proposed rule in 2014, the agency now has announced that, the new final rule will be in issuance to take effect March 27.2015. This final rule provides that the “spouse” is determined by the state in which the marriage was entered into. As the DOL points out, “a place of celebration rule allows all legally married couples, whether opposite-sex or same-sex, or married under common law, to have consistent federal family leave rights regardless of where they live.”
For questions on this new FMLA rule including information as well as fact sheets on the revisions, please visit:
Colorectal Cancer Awareness Month
Colorectal cancer is the second leading cause of cancer deaths in the United States. It is estimated that in 2014, the total diagnosed cases will be 136,830, and deaths from this type of cancer will be 50,310. The number of new cases in U.S. has been dropping slightly, and the number of colorectal cancer – related deaths has been decreasing. The risk of this type of cancer tends to increase after the age of 40.
The colon and rectum are part of the large intestine, which is part of the digestive system. Tumors found in the colon or rectum may be benign (non-cancerous) growths called polyps, however, there is also a chance they could be malignant. Malignant growths of tissue are cancerous and can spread to other parts of the body.
Some common symptoms of colorectal cancer can include:
- A change in bowel habits
- Diarrhea, constipation or feeling that the bowel does not empty completely
- Blood (either bright red or very dark) in the stool
- General stomach discomfort (including bloating, fullness, and/or cramps and frequent gas pains)
- Weight loss for no known reason
- Constant tiredness
If you start to experience any of these symptoms, please call your doctor.
Colorectal Cancer Screening
Several screening tests have been developed to help find this cancer early. Early detection of colorectal cancer gives a greater chance that it may be treatable. People aged 50 and above are recommended to have regular screenings which can include: fecal occult blood tests (FOBT), sigmoidoscopy, or colonoscopy. People who may be at increased risk because of a family history of colorectal cancer, polyps or because they have inflammatory bowel disease, may be advised to start screening before age 50 and/or have more frequent screenings. Consult your doctor for intervals and types of screening based on your risk factors.
Colorectal Cancer Prevention
Diet and lifestyle: Diet and obesity have been associated with colorectal cancer risk. Populations that consume a high amount of fat, calories, alcohol, and meat but a low amount of calcium and folate, are more likely to develop this type of cancer as opposed to diets that are low in fat and high in fiber.
Adding calcium rich foods including milk, yogurt, cheese, kale, and broccoli are recommended. Folate rich foods include: brussel spouts, asparagus, and dark green leafy vegetable like spinach and lettuce as well as oranges, bananas, cantaloupe and papaya are also helpful.
A diet low in Vitamin D may also increase the risk of colorectal cancer. Vitamin D is made in the body after exposure to sunlight and boosts your body’s ability to absorb calcium. Smoking and an inactive lifestyle are also shown to be risk factors for this type of cancer as well.
Studies have shown that nonsteroidal anti-inflammatory drugs (NSAIDs) and removing polyps found in the colon may reduce the risk of colorectal cancer.
Save Money by Taking Medication Exactly as Prescribed
The population health company, Healthentic, found nearly half of people taking prescription medications will not take them as prescribed. The cost of non-adherence to medication orders was between $100 and $289 billion every year in direct costs.
Three major disease conditions were studied: diabetes, high blood pressure, and high cholesterol. The study found that 50 percent of patients do not take their medications as directed. Those that followed their prescription regimen at least 80 percent of the time were considered to be adherent.
Looking at the 50 percent or less population in the data base, Healthentic listed the following projected implications over a full year for this sample group’s non adherence:
- 128 avoidable hospitalizations for diabetes, totaling over $2.1 million in avoidable costs.
- 243 avoidable hospitalizations for high blood pressure, totaling over $4 million in avoidable costs.
- 150 avoidable hospitalizations for high cholesterol, totaling almost $2.5 million in avoidable costs.
“Compared to the adherent patients who took their medication 80 percent of the time or more, the non-adherent patients who took medication 40-59 percent of the time had significantly higher rates of hospitalization,” Healthentic said. It released the following statistics:
- Among diabetics the rate was 134 percent higher.
- For those with high blood pressure the rate was 59 percent higher.
- And for patients with high cholesterol the rate was 39 percent higher.
Healthentic projected that $100 billion to $289 billion in unnecessary medical bills occurs annually. Healthentic encourages employers to take the following steps:
- Identify health plans with lower out-of-pocket costs for prescription medications
- Look for health care systems with a patient-centered, team approach to care
- Target outreach to non-adherent employees with programs that have shown success for their specific conditions.
Greater Transparency Required of Narrow Networks
An analysis of 2014 exchange plans by McKinsey & Company found that nearly half of the 2,366 unique provider networks qualified as narrow networks. Narrow network is defined as less than 70% of hospitals in a coverage area are included in the network. Greater transparency about the provider’s networks is needed to help consumers understand their health insurance and understand which doctors and hospitals they can go to without paying out-of-network fees. Employees are highly encouraged to always verify the providers they are seeing or being referred to, are within their network.
Narrow network plans were a primary focus last month at the FTC’s summit on healthcare competition in Washington, co-sponsored by the FTC and the Justice Department’s Antitrust Division. The general consensus was that tailored or narrow networks are becoming a fixture within the insurance industry. Opinions differed, however, on the best way in which to inform consumers about said networks so they would have what they needed to make informed choices to get the insurance products that will meet their needs.
James Landman, Director of healthcare finance policy at the Healthcare Financial Management Association, stated that consumers can be stuck with very high medical bills for out-of-network costs that they could never have avoided. For example, a surgeon at a hospital might be in network for the patient but the anesthesiologist might not be. Hospital bills look remarkably different when the doctors are in network vs. out-of-network.
The National Association of Insurance Commissioners is in the process of creating a model law that will guide the states on regulating provider networks. Health and Human Services has also expressed concern about the adequacy of networks for the health plans offered on both the state and the federal exchanges. HHS has indicated, however, that it will hold off on introducing any additional regulations until the NAIC has concluded its processes.
HHS is also trying to address the issue with new exchange marketplace rules for 2016. The agency is requiring insurers to continuously update their lists of providers.The agency is also requiring that the provider networks be made available in “machine-readable” formats and are easily accessible. This way, independent organizations will be able to get the information easily and be of help to the consumer to guide them to not only the right plan and the right network.
With great respect,
Douglas-McCarty Insurance Services