Sedera Health is a medical cost sharing organization that facilitates the sharing of healthcare expenses among its members. Unlike insurance, there is no chance of financial catastrophe from large medical bills. Members share in each other's medical costs by paying an Initial Unshared Amount (IUA) per medical need, ranging from $500-$5000, with the remainder shared by the community. After 3 needs for individuals or 5 for families, all further costs are fully shared. Pre-existing conditions are shareable after waiting periods. Sedera also provides access to additional services like counseling, telemedicine, and medical bill negotiation to support members' health needs.
This document summarizes an innovative healthcare strategy that provides affordable, flexible plans through medical cost sharing and preventative wellness services. It offers two major plan categories - Self-Managed plans for healthy individuals who pay out-of-pocket up to an initial amount, after which medical costs are shared, and Physician-Managed plans for those wanting predefined pricing and networks similar to traditional insurance. Both plan types provide medical cost sharing through a community to limit out-of-pocket costs from major medical expenses above the initial unshared amount. The strategy aims to control costs through various wellness, advocacy, and technology services.
The document discusses how Medicaid provides essential health services and supports for high-risk populations, including those experiencing homelessness. Medicaid covers primary care, mental/behavioral health services, long-term supports, and case management for over 36 million Americans. The document argues that Medicaid, in combination with permanent supportive housing, has the potential to effectively and cost-efficiently end homelessness for individuals with multiple health issues. It provides an advocate's agenda for educating partners and decision-makers about how Medicaid and housing supports can work together to improve lives and strengthen the social safety net.
This document summarizes the major public and private health insurance programs in the United States, including Medicare, Medicaid, the Affordable Care Act (ACA), and private insurance. It also discusses healthcare infrastructure such as hospitals and nursing homes. The ACA expanded access to insurance through marketplaces, subsidies, and Medicaid expansion. However, safety net providers serving the uninsured are stressed due to low reimbursements and may be further impacted by ACA funding changes.
Rx AARP Health Care Reform Priorities Lowering Prescription Drug Prices Fact ...Scott Wegenast
AARP advocates for lowering prescription drug prices to help older Americans who are struggling with high costs. An older woman shares that her medication costs over $300 per month and will put a financial strain on her family. AARP reports that brand name drug prices increased by 8.7% in 2008, twice the inflation rate, and specialty drugs increased even more. Lower-priced generics are not always available due to deals between manufacturers to delay generics entering the market. There is also no approval process for affordable generic versions of biologic drugs which often cost much more. AARP calls on Congress to take action to address high drug costs through health reform.
This document discusses issues related to Medicare and actions that can be taken to improve the program. It notes that while Congress has taken some steps to strengthen Medicare, such as adding a prescription drug benefit, many beneficiaries still struggle to afford rising out-of-pocket costs. It advocates for legislative and regulatory actions like promoting care coordination, value-based purchasing, reducing cost-sharing requirements, and negotiating drug prices to improve the sustainability and affordability of Medicare. The document argues that failure to take such actions will undermine the health of beneficiaries and long-term strength of the Medicare program.
The annual report summarizes Lifelong AIDS Alliance's programs and services in 2013. It provides details on the number of meals and grocery bags provided by the Chicken Soup Brigade program. It also outlines the demographics of clients served and programs that helped connect people to treatment, education, housing, and other resources. Financial information is given showing the majority of funding comes from public grants and the majority of expenses go to client health insurance programs.
The document discusses the U.S. Financial Health Pulse, which provides an ongoing snapshot of the financial lives of Americans. It outlines CFSI's Financial Health Framework, which includes behaviors like spending less than income, paying bills on time, and having sufficient savings. Key findings show that 70 million Americans are financially healthy while 138 million are coping and 42 million are vulnerable. It also discusses the links between financial and physical health, noting that financial stress impacts both physical and mental health.
Sedera Health is a medical cost sharing organization that facilitates the sharing of healthcare expenses among its members. Unlike insurance, there is no chance of financial catastrophe from large medical bills. Members share in each other's medical costs by paying an Initial Unshared Amount (IUA) per medical need, ranging from $500-$5000, with the remainder shared by the community. After 3 needs for individuals or 5 for families, all further costs are fully shared. Pre-existing conditions are shareable after waiting periods. Sedera also provides access to additional services like counseling, telemedicine, and medical bill negotiation to support members' health needs.
This document summarizes an innovative healthcare strategy that provides affordable, flexible plans through medical cost sharing and preventative wellness services. It offers two major plan categories - Self-Managed plans for healthy individuals who pay out-of-pocket up to an initial amount, after which medical costs are shared, and Physician-Managed plans for those wanting predefined pricing and networks similar to traditional insurance. Both plan types provide medical cost sharing through a community to limit out-of-pocket costs from major medical expenses above the initial unshared amount. The strategy aims to control costs through various wellness, advocacy, and technology services.
The document discusses how Medicaid provides essential health services and supports for high-risk populations, including those experiencing homelessness. Medicaid covers primary care, mental/behavioral health services, long-term supports, and case management for over 36 million Americans. The document argues that Medicaid, in combination with permanent supportive housing, has the potential to effectively and cost-efficiently end homelessness for individuals with multiple health issues. It provides an advocate's agenda for educating partners and decision-makers about how Medicaid and housing supports can work together to improve lives and strengthen the social safety net.
This document summarizes the major public and private health insurance programs in the United States, including Medicare, Medicaid, the Affordable Care Act (ACA), and private insurance. It also discusses healthcare infrastructure such as hospitals and nursing homes. The ACA expanded access to insurance through marketplaces, subsidies, and Medicaid expansion. However, safety net providers serving the uninsured are stressed due to low reimbursements and may be further impacted by ACA funding changes.
Rx AARP Health Care Reform Priorities Lowering Prescription Drug Prices Fact ...Scott Wegenast
AARP advocates for lowering prescription drug prices to help older Americans who are struggling with high costs. An older woman shares that her medication costs over $300 per month and will put a financial strain on her family. AARP reports that brand name drug prices increased by 8.7% in 2008, twice the inflation rate, and specialty drugs increased even more. Lower-priced generics are not always available due to deals between manufacturers to delay generics entering the market. There is also no approval process for affordable generic versions of biologic drugs which often cost much more. AARP calls on Congress to take action to address high drug costs through health reform.
This document discusses issues related to Medicare and actions that can be taken to improve the program. It notes that while Congress has taken some steps to strengthen Medicare, such as adding a prescription drug benefit, many beneficiaries still struggle to afford rising out-of-pocket costs. It advocates for legislative and regulatory actions like promoting care coordination, value-based purchasing, reducing cost-sharing requirements, and negotiating drug prices to improve the sustainability and affordability of Medicare. The document argues that failure to take such actions will undermine the health of beneficiaries and long-term strength of the Medicare program.
The annual report summarizes Lifelong AIDS Alliance's programs and services in 2013. It provides details on the number of meals and grocery bags provided by the Chicken Soup Brigade program. It also outlines the demographics of clients served and programs that helped connect people to treatment, education, housing, and other resources. Financial information is given showing the majority of funding comes from public grants and the majority of expenses go to client health insurance programs.
The document discusses the U.S. Financial Health Pulse, which provides an ongoing snapshot of the financial lives of Americans. It outlines CFSI's Financial Health Framework, which includes behaviors like spending less than income, paying bills on time, and having sufficient savings. Key findings show that 70 million Americans are financially healthy while 138 million are coping and 42 million are vulnerable. It also discusses the links between financial and physical health, noting that financial stress impacts both physical and mental health.
Understanding the Health Care Law, by Dr. James RohackWayne Caswell
The document discusses the history and current state of healthcare and health insurance in the United States. It notes that average lifespans have increased from 68 to 78 years old but costs have risen due to new medical technologies. The document outlines challenges facing the healthcare system like the growing retiree population, rising Medicare costs, and high numbers of uninsured individuals. It examines factors influencing health and healthcare disparities.
The document discusses the high costs of employee healthcare and links chronic disease to lifestyle behaviors. It then introduces the WellSteps solution, which provides a turnkey wellness program for employers. The program includes communication strategies, behavior change campaigns, a wellness guide, coordinator training, and an online program center. Data from Salt Lake County's wellness program shows it achieved 51% participation and significantly reduced healthcare costs, with a cost benefit ratio of 3.32 to 1. WellSteps guarantees engagement of at least 50% of employees and significant changes to behaviors, risks, and healthcare cost trends.
The document discusses recent changes and expected trends in Rhode Island's nursing home industry. It outlines a two-phase rollout of an Integrated Care Initiative to better coordinate Medicare and Medicaid benefits for dual eligible individuals. It also notes that Medicaid reimbursement rates have fallen short of the actual costs of providing care. The rest of the document outlines several expected trends in areas like staffing, aging in place, person-centered care, technology, occupancy challenges, regulatory environment, consolidation strategies, environmental factors, and services provided.
The Challenges and Opportunities of Integrated Health HomesMary Tolan
Fragmented care has long been a frustrating thorn in the sides of those living with multiple or chronic illnesses. Despite the complexity of their conditions, these patients often receive little to no support when coordinating their medical treatment and struggle to shoulder the administrative burden themselves.
Richard W. Bank, MD is a 67-year-old medical consultant who feels that proposed cuts to Medicare and Medicaid would negatively impact elderly and poor communities. In 2014, the Centers for Medicare and Medicaid Services initially proposed cuts to the popular Medicare Advantage program, but faced resistance from insurers and politicians. While the CMS later suggested a smaller 1.9% reduction, health industry lobbyists challenged this and the CMS ultimately agreed to a 0.4% payment increase after reconsidering factors like risk assessment methods.
How many people in this room expect to need long-term care one day? It’s not surprising that few of us do, because it’s hard to face the fact that our health might decline. But statistics suggest that the risk is greater than we think. Approximately 70% of us--that’s 7 out of every 10 people here today--will need some type of long-term care services during our lifetimes at some point after we reach age 65. And though it's good news that people are living longer, a long life span increases the chance of developing serious health problems. In fact, according to the Alzheimer’s Association, one in nine people age 65 and older has Alzheimer’s disease, which often leads to the need for nursing home care. And while older people are more likely to need long-term care, younger people may need care too, as a result of a disabling accident or illness such as multiple sclerosis or Parkinson’s disease.
This isn’t meant to scare you, but rather to remind you that the need for long-term care can happen to anyone at any time. The need to be prepared is real, and something that you shouldn’t ignore.
This document provides an overview of Medicare and insurance options from Boone Insurance Associates. It defines key terms like deductible and coinsurance. It describes the main parts of Medicare including Part A for hospital coverage, Part B for medical coverage, Part C for Medicare Advantage plans, and Part D for prescription drug coverage. It also outlines some options for supplemental coverage through Medigap plans. The document discusses factors to consider when analyzing and choosing a health insurance plan, and lists the different enrollment periods for making changes.
Health Care Reform: Primary Care and Behavioral Health IntegrationNASHP HealthPolicy
This document summarizes key aspects of health care reform related to integrating primary care and behavioral health. The Affordable Care Act aims to increase insurance coverage and focus on coordination of care and chronic disease prevention. Grants are available to help community behavioral health agencies improve physical health screening and referrals for those with serious mental illnesses. The goals are to improve health outcomes by better coordinating primary and behavioral care.
The cost of healthcare continues to rise without corresponding increase in patient outcomes. Find out how to change that with community care coordination.
Panelist PPT. Presented at the Safety Net Summit, June 23, 2009, hosted by Health & Medicine Policy Research Group (HMPRG) and the U.S. Health Resources and Services Administration (HRSA)
Mental Health is more prevalent than what we think. Current care models and technology solutions are targeting medical conditions but the fact is most of the mental health patients are also chronic condition patients. It is important to provide holistic care for mental and medical conditions. vCareConnect technology helps organizations deliver holistic care to their patients with mental illness and chronic conditions.
The document discusses different types of health insurance in the United States. It explains that health care costs are very high, so most people have health insurance through their employers or private insurance companies. It then defines common health insurance terms like premiums, co-payments, and deductibles. Finally, it outlines several public health insurance programs in the US like Medicaid, Medicare, TRICARE, and Workers' Compensation that provide coverage for specific groups.
The document discusses the Affordable Care Act and its potential impact on health disparities in communities of color. It outlines the law's goals of reforming health insurance, reducing costs, and expanding access. Key provisions that have already taken effect include dependent coverage until age 26 and prohibiting denial of coverage for pre-existing conditions. Starting in 2014, most individuals will be required to have health insurance and employers with 50+ employees must offer coverage. The law also aims to improve data collection, prevention efforts, workforce diversity, and Medicaid coverage. Next steps include advocating, educating, and ensuring representation in policy discussions going forward.
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The document discusses rising healthcare costs in the US, especially for the aging population, and potential solutions. It notes that Medicare and Medicaid costs are unsustainable and many doctors do not accept those patients due to low reimbursement rates. Several solutions are proposed: 1) Reconsidering elder care options like home care instead of nursing homes could reduce costs while improving quality. 2) Using technology to deliver home-based care may improve financial outcomes. 3) Educating elders on healthy behaviors could reduce expensive chronic diseases. Overall, changes are needed to make elder care more efficient and reduce healthcare spending.
Recovery from substance use issues is a personal journey that depends on the individual's perspective. It is not a destination that is achieved but rather a process of gaining improvement. Recovery involves voluntarily controlling substance use and maximizing health and well-being while participating fully in society. Services can help facilitate recovery through treatment, support, and connecting individuals to recovery communities and mutual aid groups. Recovery principles emphasize hope, empowerment, social support networks, and focusing on individuals' strengths rather than deficits.
Medicare 101 Presentation from Erin Hart, American HealthCare GroupMary Hagan
Erin Hart is an independent licensed Medicare Broker who helps retirees and seniors decide which Medicare benefit is the best choice for them. She meets with individuals or employer and community groups.
The document summarizes Washington State's Healthier Washington initiative, which aims to transform Medicaid (Apple Health) delivery over five years through three main strategies:
1) Integrating physical and behavioral healthcare and moving to value-based payments through Accountable Communities of Health.
2) Providing long-term services and supports to delay need for intensive care.
3) Supporting housing and employment through Medicaid benefits.
A major focus is applying an equity lens to reduce disparities and address social determinants of health like housing, by engaging communities and considering equity in project selection. The goals are better health outcomes while saving costs through a smarter, transformed system.
This document discusses three healthcare options - Self Directed, VPC (Virtual Primary Care), and DPC (Direct Primary Care) - that aim to control costs through self-care, physician care, and community care. The Self Directed option focuses only on self-care and community care. VPC adds virtual primary care physician services. DPC provides the most services, including unlimited in-office primary care visits. All options aim to avoid costs through prevention and wellness programs, and contain costs by negotiating bills and providing low monthly or initial unshareable amounts. Community members share remaining costs after an IUA (Initial Unshareable Amount) is met. The document promotes these options as lower-cost alternatives to traditional health insurance.
Corporate Wellness Pogramming To Maximize Return on Investment (ROI)Health Fairs Direct
This document discusses how to maximize return on investment from corporate wellness programming while complying with relevant laws. It recommends establishing a year-round program with online wellness tracking, health fairs for screening and education, targeted programs to address health risks, and incentives to encourage participation and lifestyle changes. Legal requirements under laws like the ADA, GINA, HIPAA, and ERISA are also outlined to maintain employee privacy and prevent discrimination.
Sedera - Select Employee Health Care Sharing Guide C. Rod Maxson
This document provides information about health care sharing through Sedera Health as an alternative to traditional health insurance. It summarizes that Sedera offers lower monthly costs than group health insurance through health care sharing. It provides preventative care coverage through a Minimum Essential Coverage plan and shares larger medical needs exceeding $500 or $1000 through member contributions. It offers services like 24/7 telemedicine to help members with their health care needs at low costs.
Understanding the Health Care Law, by Dr. James RohackWayne Caswell
The document discusses the history and current state of healthcare and health insurance in the United States. It notes that average lifespans have increased from 68 to 78 years old but costs have risen due to new medical technologies. The document outlines challenges facing the healthcare system like the growing retiree population, rising Medicare costs, and high numbers of uninsured individuals. It examines factors influencing health and healthcare disparities.
The document discusses the high costs of employee healthcare and links chronic disease to lifestyle behaviors. It then introduces the WellSteps solution, which provides a turnkey wellness program for employers. The program includes communication strategies, behavior change campaigns, a wellness guide, coordinator training, and an online program center. Data from Salt Lake County's wellness program shows it achieved 51% participation and significantly reduced healthcare costs, with a cost benefit ratio of 3.32 to 1. WellSteps guarantees engagement of at least 50% of employees and significant changes to behaviors, risks, and healthcare cost trends.
The document discusses recent changes and expected trends in Rhode Island's nursing home industry. It outlines a two-phase rollout of an Integrated Care Initiative to better coordinate Medicare and Medicaid benefits for dual eligible individuals. It also notes that Medicaid reimbursement rates have fallen short of the actual costs of providing care. The rest of the document outlines several expected trends in areas like staffing, aging in place, person-centered care, technology, occupancy challenges, regulatory environment, consolidation strategies, environmental factors, and services provided.
The Challenges and Opportunities of Integrated Health HomesMary Tolan
Fragmented care has long been a frustrating thorn in the sides of those living with multiple or chronic illnesses. Despite the complexity of their conditions, these patients often receive little to no support when coordinating their medical treatment and struggle to shoulder the administrative burden themselves.
Richard W. Bank, MD is a 67-year-old medical consultant who feels that proposed cuts to Medicare and Medicaid would negatively impact elderly and poor communities. In 2014, the Centers for Medicare and Medicaid Services initially proposed cuts to the popular Medicare Advantage program, but faced resistance from insurers and politicians. While the CMS later suggested a smaller 1.9% reduction, health industry lobbyists challenged this and the CMS ultimately agreed to a 0.4% payment increase after reconsidering factors like risk assessment methods.
How many people in this room expect to need long-term care one day? It’s not surprising that few of us do, because it’s hard to face the fact that our health might decline. But statistics suggest that the risk is greater than we think. Approximately 70% of us--that’s 7 out of every 10 people here today--will need some type of long-term care services during our lifetimes at some point after we reach age 65. And though it's good news that people are living longer, a long life span increases the chance of developing serious health problems. In fact, according to the Alzheimer’s Association, one in nine people age 65 and older has Alzheimer’s disease, which often leads to the need for nursing home care. And while older people are more likely to need long-term care, younger people may need care too, as a result of a disabling accident or illness such as multiple sclerosis or Parkinson’s disease.
This isn’t meant to scare you, but rather to remind you that the need for long-term care can happen to anyone at any time. The need to be prepared is real, and something that you shouldn’t ignore.
This document provides an overview of Medicare and insurance options from Boone Insurance Associates. It defines key terms like deductible and coinsurance. It describes the main parts of Medicare including Part A for hospital coverage, Part B for medical coverage, Part C for Medicare Advantage plans, and Part D for prescription drug coverage. It also outlines some options for supplemental coverage through Medigap plans. The document discusses factors to consider when analyzing and choosing a health insurance plan, and lists the different enrollment periods for making changes.
Health Care Reform: Primary Care and Behavioral Health IntegrationNASHP HealthPolicy
This document summarizes key aspects of health care reform related to integrating primary care and behavioral health. The Affordable Care Act aims to increase insurance coverage and focus on coordination of care and chronic disease prevention. Grants are available to help community behavioral health agencies improve physical health screening and referrals for those with serious mental illnesses. The goals are to improve health outcomes by better coordinating primary and behavioral care.
The cost of healthcare continues to rise without corresponding increase in patient outcomes. Find out how to change that with community care coordination.
Panelist PPT. Presented at the Safety Net Summit, June 23, 2009, hosted by Health & Medicine Policy Research Group (HMPRG) and the U.S. Health Resources and Services Administration (HRSA)
Mental Health is more prevalent than what we think. Current care models and technology solutions are targeting medical conditions but the fact is most of the mental health patients are also chronic condition patients. It is important to provide holistic care for mental and medical conditions. vCareConnect technology helps organizations deliver holistic care to their patients with mental illness and chronic conditions.
The document discusses different types of health insurance in the United States. It explains that health care costs are very high, so most people have health insurance through their employers or private insurance companies. It then defines common health insurance terms like premiums, co-payments, and deductibles. Finally, it outlines several public health insurance programs in the US like Medicaid, Medicare, TRICARE, and Workers' Compensation that provide coverage for specific groups.
The document discusses the Affordable Care Act and its potential impact on health disparities in communities of color. It outlines the law's goals of reforming health insurance, reducing costs, and expanding access. Key provisions that have already taken effect include dependent coverage until age 26 and prohibiting denial of coverage for pre-existing conditions. Starting in 2014, most individuals will be required to have health insurance and employers with 50+ employees must offer coverage. The law also aims to improve data collection, prevention efforts, workforce diversity, and Medicaid coverage. Next steps include advocating, educating, and ensuring representation in policy discussions going forward.
Health%252 b care%252breform%252bproject%252bpart%252bii-1-1 (3)lifeontwofeet
The document discusses rising healthcare costs in the US, especially for the aging population, and potential solutions. It notes that Medicare and Medicaid costs are unsustainable and many doctors do not accept those patients due to low reimbursement rates. Several solutions are proposed: 1) Reconsidering elder care options like home care instead of nursing homes could reduce costs while improving quality. 2) Using technology to deliver home-based care may improve financial outcomes. 3) Educating elders on healthy behaviors could reduce expensive chronic diseases. Overall, changes are needed to make elder care more efficient and reduce healthcare spending.
Recovery from substance use issues is a personal journey that depends on the individual's perspective. It is not a destination that is achieved but rather a process of gaining improvement. Recovery involves voluntarily controlling substance use and maximizing health and well-being while participating fully in society. Services can help facilitate recovery through treatment, support, and connecting individuals to recovery communities and mutual aid groups. Recovery principles emphasize hope, empowerment, social support networks, and focusing on individuals' strengths rather than deficits.
Medicare 101 Presentation from Erin Hart, American HealthCare GroupMary Hagan
Erin Hart is an independent licensed Medicare Broker who helps retirees and seniors decide which Medicare benefit is the best choice for them. She meets with individuals or employer and community groups.
The document summarizes Washington State's Healthier Washington initiative, which aims to transform Medicaid (Apple Health) delivery over five years through three main strategies:
1) Integrating physical and behavioral healthcare and moving to value-based payments through Accountable Communities of Health.
2) Providing long-term services and supports to delay need for intensive care.
3) Supporting housing and employment through Medicaid benefits.
A major focus is applying an equity lens to reduce disparities and address social determinants of health like housing, by engaging communities and considering equity in project selection. The goals are better health outcomes while saving costs through a smarter, transformed system.
This document discusses three healthcare options - Self Directed, VPC (Virtual Primary Care), and DPC (Direct Primary Care) - that aim to control costs through self-care, physician care, and community care. The Self Directed option focuses only on self-care and community care. VPC adds virtual primary care physician services. DPC provides the most services, including unlimited in-office primary care visits. All options aim to avoid costs through prevention and wellness programs, and contain costs by negotiating bills and providing low monthly or initial unshareable amounts. Community members share remaining costs after an IUA (Initial Unshareable Amount) is met. The document promotes these options as lower-cost alternatives to traditional health insurance.
Corporate Wellness Pogramming To Maximize Return on Investment (ROI)Health Fairs Direct
This document discusses how to maximize return on investment from corporate wellness programming while complying with relevant laws. It recommends establishing a year-round program with online wellness tracking, health fairs for screening and education, targeted programs to address health risks, and incentives to encourage participation and lifestyle changes. Legal requirements under laws like the ADA, GINA, HIPAA, and ERISA are also outlined to maintain employee privacy and prevent discrimination.
Sedera - Select Employee Health Care Sharing Guide C. Rod Maxson
This document provides information about health care sharing through Sedera Health as an alternative to traditional health insurance. It summarizes that Sedera offers lower monthly costs than group health insurance through health care sharing. It provides preventative care coverage through a Minimum Essential Coverage plan and shares larger medical needs exceeding $500 or $1000 through member contributions. It offers services like 24/7 telemedicine to help members with their health care needs at low costs.
(1) Primary care has a public purpose of improving population health outcomes at affordable costs. Investing in primary care services like open access, extended hours, quality improvement activities, and increasing patient enrollment can generate returns through better health and lower healthcare spending.
(2) There are multiple potential sources of investment in primary care, including state departments of health, Medicaid, Medicare, health plans, employers, and foundations. Investment approaches may differ between more conservative "red states" and liberal "blue states".
(3) To stimulate investment in primary care, advocates should build political support among patients, speak with a unified voice, work with state governments and payers, and provide leadership.
The document discusses the U.S. healthcare system and the need for reform. It provides an overview of costs, coverage, delivery of care, and financing. Key points made include that healthcare costs are rising unsustainably and over 16% of GDP is spent on healthcare. Nearly 50 million Americans are uninsured and costs are concentrated in a small portion of the population. Reform efforts face obstacles due to the complexity of the system with multiple payers and political resistance to change. Overall the document analyzes the current system and arguments for why reform is needed to address rising costs and the number of uninsured Americans.
Chandler 2013 open enrollment presentation with voice kg (2)KimberlyAGuevara
The document provides information about Chandler Unified School District's 2013-2014 UnitedHealthcare plan benefits, including updates required by healthcare reform. It outlines the medical plan options (Choice Plus PPO, HDHP1500, HDHP2700), contraceptive coverage changes, breastfeeding support benefits, and HSA contribution amounts. Voluntary benefits like dental, vision, life and disability insurance are also summarized. The open enrollment period is from April 22nd to May 10th.
Chandler 2013 open enrollment presentation with voice 2KimberlyAGuevara
The document provides information about Chandler Unified School District's 2013-2014 UnitedHealthcare plan benefits, including updates to comply with healthcare reform laws, changes to medical plan options and costs, and details about voluntary benefits employees can purchase. Key updates for the upcoming plan year include no-cost coverage of certain women's contraceptives, expanded breastfeeding support benefits, and decreased rates for some medical plans. The HDHP plans will have increased HSA contributions and the dental plan options include a new Total Dental Administrators plan. Voluntary benefits like vision and life insurance also have new carriers.
ACA: A Step Toward Healthcare For All (Dr. John Cavacece, DO)Zach Jarou
Presented to the American Medical Student Association (www.AMSA.org) at Michigan State University's College of Human Medicine (MSU CHM) on Tuesday, March 20, 2012
The document discusses key components and goals of the Affordable Care Act (ACA) and healthcare reform initiatives, and their potential impact on continuing medical education (CME) and medical communication businesses. It describes major provisions of the ACA that aim to increase access to healthcare coverage, improve quality of care, and contain healthcare costs. These include the individual mandate, health insurance exchanges, Medicaid expansion, essential health benefits, and various programs to promote higher-quality, more coordinated, and cost-effective care through value-based purchasing and alternative payment models.
This document discusses concerns around the use of financial incentives in wellness programs and health plans. It notes that while wellness programs can improve health and lower costs, regulations do not adequately define reasonable programs or alternatives for those unable to meet health metrics. There are also concerns that higher premiums may penalize those with pre-existing conditions and create barriers to preventive care. Overall the document examines debates around using financial incentives to influence health behaviors and control rising healthcare costs.
Presentation from INTEGRATED's Chuck Gooder, senior advisor, and Blake Sternard, the business analyst. The presentation focuses on the ways to identify the major changes of healthcare, with specific attention to the potential challenges posed to enrollees, physicians, hospitals, and healthcare organizations associated with the implementation of Obamacare.
This document compares the healthcare systems of Australia and the United States. In the US, 49% of coverage comes from employers, while 16% of Americans are uninsured. Australia provides universal healthcare coverage through Medicare. While both countries face rising costs due to aging populations, Australia spends half the percentage of GDP on healthcare as the US and has no uninsured citizens.
This document compares the healthcare systems of Australia and the United States. In the US, 49% of coverage comes from employers, while 16% of Americans are uninsured. Australia provides universal healthcare coverage through Medicare. While both countries face rising costs due to aging populations, Australia spends half the percentage of GDP on healthcare as the US and has no uninsured citizens.
Georgians for a Healthy Future advocates for expanding access to healthcare in Georgia. The Affordable Care Act has reduced the uninsured rate, but Georgia did not expand Medicaid so a coverage gap remains for low-income adults. Expanding Medicaid could improve access for over 400,000 Georgians currently ineligible for subsidies.
The document summarizes key provisions of the Affordable Care Act (ACA) and how it aims to improve access to affordable health care. It discusses how the law expands coverage to millions of uninsured Americans through Medicaid expansion and health insurance exchanges. It also outlines important consumer protections now required of health plans, such as prohibiting denial of coverage due to pre-existing conditions. The document also highlights how the ACA strengthens Medicare and aims to reduce health care costs.
This document provides information about long term care planning from Financially Focused, LLC, an insurance brokerage and financial planning firm. It discusses the company's services, common questions about long term care insurance, the history and definitions of long term care, expenses covered by long term care insurance, state partnership plans, statistics on long term care needs, and the tax deductibility of long term care insurance premiums. The overall purpose is to educate clients on long term care planning and insurance options.
This document discusses health care costs, payment models, and insurance in the United States. It explains that health insurance status and type of coverage significantly impact out-of-pocket costs and ability to adhere to treatment recommendations. Various insurance types like private, employer, government, and uninsured are compared. Reimbursement models for providers like fee-for-service, diagnosis-related groups, and accountable care organizations are also overviewed. The document advocates for individualizing care based on insurance coverage to improve quality while decreasing unnecessary costs.
The pending Healthy Ohio 1115 Medicaid waiver would require nearly all non-disabled adults on Ohio Medicaid to pay premiums. If approved by the federal government, the waiver would result in a greater number of uninsured Ohioans as well as increased Medicaid administrative costs and complexity.
Speakers include:
* Tara Britton, Public Policy Fellow, The Center for Community Solutions
* Nita Carter, Project Director, UHCAN Ohio
Are you prepared for the risk of needing long term care for you or your spouse? Even if you think you are prepared, this presentation will provide even the casual observer some important information. Don't wait until it's too late when you cannot do anything about this, start designing your plan now with the help of this presentation.
The document compares the healthcare systems of Australia and the USA. In Australia, Medicare provides coverage for medical services and public hospitals provide free care. The government contributes 44% of healthcare costs. In the USA, private insurance and government programs like Medicaid and Medicare cover most citizens, though 16% remain uninsured. Both countries face rising healthcare costs due to aging populations. While Australia spends less on healthcare as a percentage of GDP, it provides universal coverage, unlike the partially covered US system.
A.I.M. to be Healthy form My Academy of Health ExcellenceC. Rod Maxson
IQYOU is a health assessment tool that combines data from health questions, lab tests, genetics, and lifestyle factors to provide a comprehensive health report and recommendations. It analyzes over 40,000 medical studies to calculate a dynamic health score from 0 to 100 and provides a blueprint to improve wellness based on an individual's unique genetic and physiological profile. The dashboard breaks down contributing health factors and provides personalized nutrition, lifestyle, and wellness recommendations.
A healthy care strategy webinar versionC. Rod Maxson
This document discusses an alternative healthcare strategy called Health Excellence Plus that aims to help individuals take control of their medical costs. It presents several components: avoiding costs through wellness programs; preventing costs with minimum essential coverage; managing costs with HSAs; mitigating costs using telemedicine and tools; and containing remaining costs through medical cost sharing. Members pay for routine care themselves but are supported for larger medical needs. The strategy is presented as a compliant alternative to ACA plans that also allows individuals to become independent contractors and potentially earn income through referrals.
This document presents Health Excellence Plus, a medical cost sharing strategy offered by MPowering Benefits. It consists of several components to help control medical costs, including a wellness program, minimum essential coverage, an HSA, telemedicine, and medical cost sharing. Medical cost sharing involves members sharing each other's medical costs above a chosen amount of $500 or $1000. The strategy uses a group platform and requires becoming an independent contractor by completing a health assessment and referring others. Monthly costs range from $249-799 depending on the plan and number of members. The strategy aims to help members take control of their medical costs through various avoidance, prevention, management and mitigation approaches while containing remaining costs through medical cost sharing.
With Government Programs in Chaos, and Premiums and Out of Pockets sky high, your best solution may be "Health Excellence Plus" - a Health Strategy NOT Health Insurance.
My Academy of Health Excellence - Individual Health Insurance Alternative offerC. Rod Maxson
This document describes a company that assists Americans in reducing healthcare costs through healthcare cost elimination, mitigation, and sharing programs. They utilize wellness coordinators and a multi-touch outreach program, including video, calls, mail, texting, newsletters and a mobile app to engage members. The company provides a wellness portal with health assessments, risk reports, and educational tools. They partner members with health coaches and connect clinicians. Their goal is to help members take control of their healthcare costs by becoming self-pay patients and responsible for costs up to an initial amount, after which costs are shared by community members.
When you combine an experienced and efficient non-profit health cost sharing organization with an expert wellness education and management platform, you get the most comprehensive health sharing program available today – Health Excellence Select!
This document summarizes a health cost sharing program as an alternative to traditional health insurance. It describes how individuals can take control of their healthcare costs by becoming self-pay patients and sharing medical expenses with other health-conscious members. The program provides tools to help members navigate healthcare, find doctors, access telehealth services, and get discounts on additional health needs. However, it notes that the program may not be suitable for those who need financial assistance paying monthly costs or have severe pre-existing conditions.
The document outlines the career experience and accomplishments of an individual in business development, insurance, investments, real estate, and technology innovation spanning over 30 years. It includes positions held as CEO of an insurance agency growing sales to over $5 million, Vice President of a large insurance and investment firm building a 50-person agency, and awards for pioneering the use of computer and internet technologies in marketing real estate and associations.
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2. Our Healthy Care Strategy uses
Medical Cost Sharing to
Eliminates the chance of financial catastrophe from bad health.
Healthcare Expenses
3. Sedera Health (Sedera) is a group healthcare
solutions and benevolence organization. It’s
modeled after a number of proven and highly
successful medical sharing ministries that have
facilitated the sharing of their member’s
healthcare expenses for more than two decades
within the confines of the Christian community.
4. For the benefit of the shareholders that own the
Insurance Company
5. For the benefit of the members that share in the
Community Funds
7. Medical Cost Sharing – a Better Way
Health Care through
Community vs Health
Care through Insurance
Industry Wide Estimate:
1 Billion in Sharing
1 Million Members
Freedom from
Networks
Big Savings Over
Health Insurance
Sharing begins at $500, $1000,
$1500, $2500 or $5000 per
need you decide
Promotes a Healthy
Lifestyle
Medical cost sharing by Sedera Health is not insurance and is specific to the Sedera Health membership community.
“Industry-wide statistic source: www.healthcaresharing.org
8. Medical Cost Sharing is “Need” Based
Defining a “Need” and how it works
A “Need” is one or more medical expenses
caused by a SINGLE accident or illness
Initial Unshared Amount (IUA)
What members pay before Sharing begins for the Need
Needs over the IUA ($500, $1000, $1500,
$2500 or $5000)
Limiting your out-of-pocket costs
Fully Shared with the Community
Three (3) for Individual and five (5) when there are
family members participating. Everything is fully
shareable after that point.
9. Medical Cost Sharing in Real Life
Comparing $5000/Family Member Insurance Deductible vs a $500 Initial Unshareable Amount
For Example, a family’s two year old
daughter had a persistent ear infection.
Their deductible was $5,000/per family
member threshold
Care for the child required:
1. A series of antibiotics and booster
injections
2. Visit with an ENT specialist who
inserted tubes in the child’s ear at
a local hospital
Cost of an average family insurance policy with a primary of 45 and a $5000
deductible is $1450.00 per month, a $500 IUA healthy care strategy is $783.00/mn
10. Medical Cost Sharing in Real Life (continued)
Members pay for visits and treatments up to the IUA, costs are fully shared thereafter.
11. Pre-Existing Conditions
Pre-existing Conditions:
When well controlled, these conditions DO NOT
have sharing restrictions
• High Blood Pressure
• High Cholesterol
• Sleep Apnea
• Non-Insulin Dependent Diabetes
Pre-existing Conditions:
Sharing Restrictions*
A condition is considered pre-existing if a member
had symptoms or treatment in the last 36 months
at the time of joining the community.
• Year 1: No Sharing for the Condition
• Year 2: $15,000 sharing limit
• Year 3: $30,000 sharing limit
• Year 4: Fully Shareable
* Standard sharing restrictions apply when joining the community for genetic defects and/or hereditary disease. There are also restrictions on
existing pregnancies when joining the community. Please see the Sedera Member Access Membership Guidelines for more information..
12. Prescription Drug Coverage
Medications:
Cure
Examples: Antibiotics, pain medications related
to a car accident or post pregnancy, chemotherapy
drugs
+ Same sharing rules apply
Maintenance
Examples: Blood pressure medication, cholesterol
medications
+ Sharing eligible for first 120 days following a new
diagnosis
+ After 120 days on a new diagnosis (or for an existing
diagnosis): Our Pharmacy Consultant has good
resources for securing discounted prices for
maintenance medications (paid from pre-tax HSA or
Health Matching Account HMA)
13. In addition to sharing medical expenses, Sedera provides
access to:
• Counseling – Marital, Emotional and Spiritual
• Medical Bill Negotiation
• Telemedicine
• Expert Second Opinion
• Personal Member Advisor