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Mercer

When employers are asked how they plan to control health benefit cost over the long term, they talk about improving employee health. This focus on employee health is one factor fueling growth in worksite clinics. Last year, Mercer’s National Survey of Employer-Sponsored Health Plans found that 29% of employers with 5,000 or more employees provided an onsite or near-site clinic offering primary care services, up from 24% in the prior year. Mercer followed up with these employers in a new, targeted survey on worksite clinics. Of the 134 respondents, 72% of those whose clinics provide general medical services said that managing employee health risk and chronic conditions is an important objective for the clinic.

 

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Much has been written recently about President-Elect Trump’s nominee for Secretary of Health & Human Services, Rep. Tom Price (R-GA). A former orthopedic surgeon from suburban Atlanta, Price has served six terms in the House and is currently Chairman of the House Budget Committee. A recent article in The Washington Post reports Congressman Price "got into government to get government off his back."  

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This week the Senate took the first step toward repealing the ACA. Here’s what you need to know:

 

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Since the Presidential election, many have commented on expected legal and regulatory changes. One of them being  prescription drug pricing. It seems that Republicans and Democrats can all agree on the need for more transparency into the cost of drugs. As far as doing something to lower the cost, initially it seemed that with Republicans dominating both Congress and the White House, we might not see much action in this area. But Trump made it clear in his press conference yesterday that he plans to go after drug costs. While no specific plan has been announced, relief for rising drug costs would be welcomed by employers -- provided that pressure applied on Medicare drug costs does not mean cost shifting to private payers. We are keeping close tabs on this issue.

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A few weeks ago, President Obama signed the 21st Century Cures Act into law, allocating $6.3 billion in new spending over the next decade on medical innovation, including $1.8 billion for cancer research.  The bill also streamlines the approval process for new drugs and medical devices and includes support for Electronic Health Records, precision medicine, interoperability, and mental health. 

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Earlier this week, we posted a challenge to our readers to find the 17 Star Wars references in the blog post below. You may have noticed the first reference ("There Is Another...") in the headline. Check out the others below.

 

As the winter weather is finally upon us (can someone say brrr!) cold and flu season also strikes back this time of year, causing many employees to take time off to seek care.  Some employees may want to rush to their nearest doctor to make sure they’ve gotten their flu shot, while others may try to be a trooper and just hope to avoid any illness this season. Holiday travel in crowded airports increases your odds of getting sick, especially if you make your return on the redeye and don’t get enough rest to boot! Getting an end of year appointment can be a menace, but employees have a new hope with retail health clinics. A long time ago, these may have been met with luke-warm reception, but now the retail health market is stronger than you could possibly imagine; many CVS and Walgreens stores operate these clinics, so they’re probably not far, far away from your home or office. Most clinics have a computer kiosk where you can enter your insurance information upfront and get an appointment time; some locations will even send you a text letting you know you’re next patient - advances in e-health sure has made access to care seem like an e-walk in the park! However, if your retail health clinic can’t provide the services you were looking for, don’t feel you have to go it solo in finding appropriate care.  Employees don’t need to go rogue to find the right doctor; they can utilize health advocacy services, to laser in on specific providers to get the specific care they need.  Employers – be sure to communicate these options to employees, so they can maintain their health and productivity during this season and you can ensure your workforce is with you.

 

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We were saddened today to hear about the loss of Carrie Fisher, best known for her role as Princess Leia in the Star Wars film franchise. As a tribute to the joy she brought us over the years, we’ve prepared a Star Wars themed challenge for our readers. Try to find all 17 Star Wars references below -- ask a fan if you need help! Then be sure to check back later this week -- the answers will be posted on Friday.

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GOP’s ‘Obamacare’ repeal path worries health care industry

Ricardo Alonso-Zaldivar, AP (Published by The Washington Post)

  • Don’t overlook the concerns raised by key healthcare industry stakeholders. Within the healthcare system nothing happens in isolation, and repealing and replacing the ACA will certainly have an impact on employer-sponsored plans. *A must read*

 

An Obamacare ‘Delay’ Plan Could Backfire

Margot Sanger-Katz, The New York Times

  • The Republican’s ACA repeal and delay plan assumes the sustainability of the current healthcare system while they put a replacement plan in place. This article questions that assumption and warns that even a carefully planned delay may result in an unintentional quick repeal for some Americans. *Worth the time*

 

Why It Will Be Hard To Repeal Obamacare

Haeyoun Park and Troy Griggs, The New York Times

  • If your employees have questions about repealing the ACA, give them this link. It’s the simplest explanation that we’ve found. *Quick and easy*

 

Leading Republican proposals signal possible shape of ACA replacement plan

Mercer’s Washington Resource Group

  • House Republican leaders, President-elect Trump, and HHS nominee Tom Price have all have ACA repeal and replace proposals. This article compares the proposals' key features, which offer some indication of what a final ACA replacement plan may look like. *Skim this one* (Mercer Select Intelligence membership required. Not a member? Learn more)

 

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While it’s far from clear where the incoming administration and Congress will land on the “replace” part of “repeal and replace” with regard to the Affordable Care Act, they are signaling interest in promoting the use of health savings accounts by expanding eligibility and allowing funds to be used for more purposes. High-deductible HSA-eligible plans already feature in many employer health benefit programs. In 2016, 21% of all covered employees were enrolled in an HSA-eligible plan. Enrollment has been rising over the past decade as employers -- especially large employers (500+ employees) -- have added HSA-eligible plan choices to their health programs. The threat of the excise tax was a big motivator for employers to move employees into lower-cost plans; while the excise tax may go by the wayside, there is now discussion of capping the individual tax exclusion for employer-provided health coverage, which could still drive cost pressure on employer-sponsored health plans.

 

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Final Department of Labor (DOL) rules require ERISA plans processing disability claims to treat coverage rescissions like benefit denials, impose more detailed denial notices written in a "culturally and linguistically appropriate manner," and expand claimants' response and litigation rights. The new rules generally apply for claims filed on or after Jan. 1, 2018, but transitional notice requirements apply for claims filed from Jan. 18, 2017 -- the final regulations' effective date -- through Dec. 31, 2017. While the new administration or Congress might delay, change, or even try to overturn the disability regulations, employers should still plan their next steps as the rules may remain intact.

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While it’s an exciting time to be in our business, staying on top of all the news about the Trump transition and Republican priorities for the 115th Congress can be a little overwhelming. We’d like to help you with that by periodically posting links to key articles. Here’s the first list to keep you up to date -- with our thoughts on which articles to make a priority.

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When your boss asks about how the election will affect your benefit program, your response could be as easy as "It all depends." But you might want to provide more of an answer, and if so we'd like to help you out.

 

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Congress has passed legislation to increase enforcement of mental health and substance abuse parity rules and require health plans to apply parity standards to eating disorder benefits as part of a sweeping bill intended to spur development of new drugs and medical devices. The 21st Century Cures Act also includes provisions to let small employers use health reimbursement accounts (HRAs) to cover employees' costs for individual-market health insurance on a tax-free basis. The measure is expected to be signed into law by President Obama.

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