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Tuesday President Obama gave the State of the Union annual address. He spoke on health care stating, "Instead of re-fighting the battles of the last two years, let's fix what needs fixing and move forward." He challenged Republicans to help him improve the health care law; and, offered to help them make two changes, adding medical malpractice reform eliminating an unpopular paperwork requirement for small businesses.  Medical malpractice reform has been in the works for a while, with Republicans and Democrats butting heads on whether to have fixed caps on damages or not. However, both agree that something has to be done for the approximately 98,000 people a year who die from preventable medical errors. Also, with Obama’s suggested changes, small businesses would no longer have to file 1099 forms for payments $600 or more.

He insisted he’ll fight repeals to prevent going "back to the days when insurance companies could deny someone coverage because of a pre-existing condition" and he explained how the law is already helping seniors pay for their prescriptions and young adults continue to be on their parent’s policies. President Obama also stated he is open to small changes and will consider new ideas to bring down health care costs, urging that repealing the law would increase the federal deficit by $230 billion over the next ten years. Also, during the State of the Union, the President called for more cost-cutting in Medicare and Medicaid. Critics fear Obama is not listening to what Americans want which is repeal, not just small changes. While still others commended him for saying he is open for changes.

How do you feel about President Obama’s stand on health care reform in the State of the Union? Do you think he is open enough for change?

Berwick Renominated to Continue to Head CMS

Wednesday the White House issued a renomination of Dr. Don Berwick as the head of the Center for Medicare and Medicaid Services. Republicans, who strongly opposed him being nominated last year, dislike his controversial view in support of the British health system, supplying “eyes open or closed,” and question his qualifications and background. However, Berwick has received strong support from most major medical associations. Berwick will face a hearing in the Finance Committee as well as a confirmation by the full Senate before he becomes the head of the CMS. So far, it looks to be a difficult nomination process for him.

Do you like Dr. Don Berwick for the head of the CMS? Do you think he will pass the nomination process?

Medicare Toaster by John Hambrock

by John Hambrock for The Cartoonist Group from "The Brilliant Mind of Edison Lee"

2011 Supply Requisition

If you were busy in 2010, 2011 will be even busier! Make sure you have the right tools. Update your Med Supp materials for Mutual of Omaha, Forethought Life, Gerber Life, Sentinel Life, and Woodmen of the World/Assured Life to reflect the 2011 co-pays and deductibles.

Sources: KHN, Politico, The Associated Press

The Center for Medicare and Medicaid Innovation (CMMI) launched a set of initiatives to improve medical care and lower the cost of services and care provided by medical professionals. The CMMI is also committed to quickly assessing the projects at hand and putting them to use promptly if proven successful. This initiative comes after finding evidence that the current healthcare system has rising costs because patients are not getting the care they need. Also, they found that one out of seven Medicare patients are suffering from medical error, due to lacks in care. With 90 million Americans relying on Medicare and Medicaid, studies show that when doctors work together patients are hospitalized less often, recover more quickly, and have fewer complications. The initiative also hopes to reduce hospital infection and help ensure seniors take the medications prescribed to them by their doctor in order to stabilize their condition and/or get well quicker. The CMMI believes that by giving financial incentives to doctors and hospitals who work together unnecessary tests will be eliminated and chronic health conditions treated before they become larger illnesses, and end up costing Medicare more money that could have been saved. The Center for Medicare and Medicaid Innovation is starting this new plan in eight states, comprised of: Maine, Rhode Island, New York, Pennsylvania, North Carolina, Michigan, and Minnesota. In these states, teams of doctors will work together in "medical homes" on patient care. Also, next year the Center for Medicare and Medicaid will offer $1 million dollar grants for states to develop programs to coordinate care between doctors and hospitals. Some critics dismiss the effort, saying the CMMI is aimlessly throwing ideas out, hoping one will work; yet, some big companies are eager to move with a partnership with the government.

Rivlin-Domenici Proposed Losses for Medicare

On Wednesday Rivlin-Domenici released their proposal to reduce the deficit and it is more generous than the proposal released last week by the Presidential Fiscal Commission. Their proposal places a cap on government Medicare spending for seniors with more of the cost burden on the senior's shoulders. The plan gives very little help from the government to purchase health insurance and a choice from either traditional fee-for-service or from private firms offering plans similar to how Medicare Advantage is today. The committee predicts more seniors will opt for private insurance due to cost. The plan also includes making higher co-payments for Medicare Part B, up to 35% from the current 25%, which would save Medicare $123 billion through 2018. Starting in 2018, a cap would be put in place to limit the increase in spending on Medicare beneficiaries to economic growth rate of 1% each year. The other major element of in the plan eliminates the tax exclusion for employer-provided insurance. Capping and eventually eliminating the tax exclusion for employer-sponsored insurance could slow health care costs from increasing and would raise $10 trillion. There are speculation on whether both parties would ever be able to agree on the plan as it was proposed this week, Democrats are against cuts in benefits and Republicans are against benefit cuts as well and the large increase of out-of-pocket costs.

Presidential Fiscal Commission Update

On Thursday, the Presidential Fiscal Commission ended a three-day closed session without a consensus. The panel's co-chairmen, Democrat Erskine Bowles and former Senator Republican Alan Simpson released their own proposal last week but the group remains at odds on deciding how to slow down and eliminate some health care cost. The panel reconvenes on November 30th, with a deadline to submit to Congress on December 1st.

Nebraska Woodmen of the World/Assured Life New Rates and Plan N

Effective December 1, 2010, new rates and Plan N are released for Nebraska. Please see the new rates and notification for Nebraska.

Sources: KHN, The Fiscal Times, The LA Times, PBS, WSJ

Kaiser Health News in collaboration with The Washington Post published a very interesting article focusing on how more and more Medicare beneficiaries are finding they are not being classified as “admitted - inpatient” when staying at a hospital. Instead, they are being classified as “under observation.” Though the level of care doesn’t vary between either classification, the latter means Medicare beneficiaries will have to pay significantly more out-of-pocket for their total care.

One example given in the article is about Ed Timmins (88) who spent four days in the hospital for extreme back pain and other issues. The whole time he was never admitted, so Medicare isn’t going to cover his $23,864 nursing home bill. The hospital where he received treatment would not discuss his case, but implied that he did not meet Medicare’s “medical necessity” requirement to be in an inpatient status.

According to the Centers for Medicare and Medicaid Services, claims from hospitals for observation care have increased over the last several years. Observation care claims rose from 828,000 in 2006 to more than 1.1 million in 2009. Additionally, observation care claims regarding stays more than two days tripled to 83,183. The article states several reasons for the increase, but focuses on the fact that Medicare is being more aggressive in their audits in order to reduce costs. Click here to read the full article. Also, you may want to forward this useful link to your clients that explains what to do if they are classified as “under observation.”

Selling More with Jeffrey Gitomer

This month’s issue of InsuranceNewsNet has an in-depth interview with Jeffrey Gitomer who wrote The Sales Bible. Here is a list what he believes insurance agents should and should not do to increase their sales.

• Do communicate with your existing customers once a week, once every two weeks, or at the very least once a month. E-blasts are an excellent way to accomplish this and build trust.
• Do learn how to take rejection
• Do give a referral before asking for one
• Don’t spend too much time cold-calling – Mr. Gitomer believes it’s on “life support”
• Do speak publically as often as possible, or at least meet people in your target market as often as possible
• Do write articles and publish them in as many places as possible – Mr. Gitomer says every penny he has made since 1992 started from one of his articles
• Do join your local Toastmasters organization to hone your presentation skills
• Do develop a website and brand it with your name, not your company name
• Do weekly e-blasts
• Do maintain a blog
• Do maintain a Facebook fan page
• Do take your most important clients to networking functions, and network at least 4 to 6 hours a week, and have a 1-year networking plan each year
• Sales formula: 1/3 product knowledge, 1/3 presentation skills, 1/3 personal development

Google Implements New “Instant” Feature

Since many of you are beginning to utilize search engine optimization as a method of attracting more customers to your business, you will want to know that on Wednesday, Google implemented a new feature they call “Google Instant.” This feature automatically attempts to complete your search terms as you type them. As you are typing Google starts to stream results. These results change dynamically as you further refine your search term. Google says this new feature will reduce search times by two to five seconds. The change will also have a significant impact on SEO strategy. Now you will want to start optimizing for search terms that Google automatically generates. Also, this feature appears to only be available on the most recent browsers, so if you are still using older browsers such as IE 6 or 7, you’ll need to upgrade to use this new feature.

Sources: KHN, Washington Post, InsuranceNewsNet, ComputerWorld