America's Healthcare Challenge America's Healthcare Challenge

Each year insurance companies who participate in the ACA marketplace are required to post their proposed rate increases or their block of business in each state they operate in.

These rates have been shown to vary widely depending on the year, however, they have stabilized for the most part recently.

This segment breaks down the rate increases, informs you of how the companies determine these numbers and what you should do if you are in a situation where you are facing an undesirable rate increase.

Two heavyweights will be duking it out in the court system over problems with access to claim information as Kraft Heinz is suing Aetna over lack of access to critical data.

Most large companies often self-insure their health plan. This means that they are responsible for paying claims up to a certain amount before separate insurance often kicks in called stop-loss. Since most businesses are not in the business of insurance they often partner with what is called a Third Party Administrator (TPA) to process and pay claims.

Large insurance companies often also offer TPA services since they have the infrastructure in place. In order for this relationship to be successful it has to have transparency on both sides.

Employers who are concerned about their healthcare costs will want to look at their claims history to see if there are any areas where they can control costs. The problem is when they are unable to get this information there is nothing they can do.

This seems to be the heart of the issue between these two companies as Kraft Heinz is alleging that Aetna is withholding this important data.

You can read more here...
https://www.jdsupra.com/legalnews/kraft-heinz-sues-aetna-raising-novel-8183158/
https://www.benefitspro.com/2023/07/05/kraft-heinz-accuses-aetna-of-fiduciary-breaches-412-150903/

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We have reported previously on the ensuing crisis we face with regard to looming healthcare worker shortages. The biggest driver for this is demographics in that the baby boomer generation was much larger than other generations and as they continue to retire there may not be enough new workers to replace them.

The system has failed to train more and now more angst from healthcare workers after the pandemic could exacerbate this problem even worse. We discuss these factors in this segment.

Here is a link to the previous segment with more on this topic:
https://soundcloud.com/americascanary/healthcare-clinicians-are-burned-out

Here is the link to the article referred to in this segment:

https://www.healthcaredive.com/news/healthcare-labor-trends-2023/641352/

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In general, the Inflation Reduction Act of 2022 alters how the healthcare industry handles drug costs and Medicare.

Other provisions expand the Affordable Care Act and prescription availability, including diabetic medicines and vaccines.

Along with direct assistance, the Act attempts to improve everyone’s health and well-being by reducing environmental hazards.

Like all things in healthcare, your benefits from the Inflation Reduction Act can vary wildly. Luckily, you can fare better if you understand how the provisions affect you personally.

While only your lawyer can give you those specifics, by listening in to this segment, you can learn the basics of each provision so you will be better equipped when asking the experts.

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Actions You Can Take When Mistakes Are Made With Your Medication

Eating the wrong thing, taking a wrong turn, and making a mistake in your medication are all unfortunate events that can happen to anyone. But what happens when you accidentally take a double dose of your medication? Or take it at the wrong time? Or get the dosage wrong entirely?

Mistakes like these are more common than you might think—and they can have serious consequences. That's why it's so important to understand how to avoid mistakes in your medication and what to do if you make one.

Here are ways to prevent these mistakes and what to do if they occur:

1)Don't take medication too often.
Taking too many medications at once can lead to side effects, confusion, and in some cases, a life-threatening reaction. If you're on more than one medication, make sure you know how they interact with each other and that your doctor is aware of everything you're taking.

2) Take your medications at the correct times.
It's important to take all of your medications at their scheduled times, even if some of them are meant to be taken together with other medications or supplements on an empty stomach first thing in the morning or right before bedtime (for example).

3) Use due diligence when picking up a new prescription drug.

When you pick up a new prescription, it's easy to rush through the process of getting it filled and head home. But if you're not careful, that haste could cost you. It's important to use due diligence when picking up a new prescription drug.

4) Make sure you receive the right dose of your medication.

If you have been prescribed medication by a doctor, it's important that you take it exactly as directed—and not more than is recommended or less than is needed. This can be especially tricky if you have multiple prescriptions or if someone else has given them to you. Make sure that the pharmacist has given you all the correct doses for each medicine and double check.

5) Check with your doctor to ensure that you are taking the drug correctly.

In order to avoid mistakes in medication, it's important to check with your doctor before taking any medication. This is especially true if you have been prescribed a new medication or if you are taking multiple medications at once.

6) Don't skip doses or miss doses on purpose for any reason.

When you're taking medication, it's important to take it as prescribed. If you miss a dose or forget to take it, there's a chance that your body's not getting the amount of medication that it needs; this can lead to some serious problems in terms of your health.

To avoid this, make sure you always have your medications on hand so that you can take them when the time comes. If you're having trouble remembering when and how much of your meds to take each day, consider writing down reminders in a planner or on sticky notes around the house.

7) Know what to do when you think you’ve made a mistake.

If you think you've made a mistake with one of your medications—for example, if you took too much—it's important that you do something about it right away! If possible, call your doctor or pharmacist immediately; they will likely be able to tell if there is any danger from what happened and what steps need to be taken next. In addition, if there are any serious side effects from using too much of the wrong medication, they will be able to advise accordingly.

KEY TAKEAWAY:
Overall, everyone makes mistakes with medicine. It's a fact of life. The important thing is to be educated about your medications, to know what you are taking, and to make sure that you take them as directed. If you have questions or concerns, speak to your doctor as soon as possible to avoid any long term negative effects from a medication error.

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