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Reframing Healthcare in the Minds of Younger Americans

August 27, 2013 in fitness, health care costs, health care quality, Health Insurance, lifestyle, mental health, nutrition

The clock is ticking towards October 1, 2013 when public insurance exchanges are set to go live and begin offering health plan benefits to an estimated 30 million previously uninsured Americans. And as that day draws closer, all parties involved—plans, providers, employers, and patients—are scrambling to figure out just what it will mean to them from a cost and quality of care perspective. Yet, perhaps one of the biggest conundrums associated with the health insurance marketplace is how to deal with the potential sticker shock facing younger Americans and the ripple effect it could have on everyone. Specifically, with an age band as narrow as 3:1, there is a possibility that premiums for younger people (who tend to be lighter users of service) will be considerably higher in order to compensate for older Americans, who typically utilize more health care services. When combined with a relatively low penalty for not getting coverage, there is a very real fear that many of these ‘young invincibles’ will forgo coverage and simply choose to pay the penalty.

So, the question becomes, ‘how do we articulate the value of health coverage to this younger generation?’ or, in other words, convince them that coverage is relevant (and worth it) to them?

We need to help this younger population understand and believe that healthcare is not solely about supporting the sick – support is also critical for the well. For example: a recent college grad that is just starting out in his/her career and may have issues dealing with the stress of that new job; the twenty-something who runs marathons but wants to improve their nutrition; the new mother who wants to start a workout program to shed some of the baby weight; or the avid skier who suffers a knee injury on the slopes and wants to understand what treatment options are available to them.

These scenarios play out each day across the U.S. and could happen to just about anyone between the ages of 18-35, not solely older people or those with chronic conditions. And there are programs, resources and tools focused on shared decision making and wellness that are critical components of modern healthcare that young people can take advantage of. So at the core, the solution for this current dilemma needs to be about making the younger population aware of these resources because they support behaviors that contribute to better health and wellbeing. Specifically, we need to create a  culture that encourages all people—including the younger population—to think differently about their health, make more informed choices, and understand not only the resources at their disposal but also the value they provide.  If we can do that, we will go a long way in positively impacting the health and wellness of these younger generations and controlling spiraling healthcare costs.

Robert Mandel, MD, MBA, is the CEO of Health Dialog and has more than 15 years’ experience in senior leadership positions in health systems and health plan management. 

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Is caffeine withdrawal a mental health issue?

August 11, 2013 in lifestyle, mental health

Brietta’s graphic begs the question, are the effects of too much caffeine and the withdrawal messing with our mental health?

The American Psychiatric Association says it’s time for some rigorous research and has included caffeine withdrawal in its latest Bible, the DSM-5.  Here’s why:

Picture 10 Click here to play the video

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An anxious month for social workers, psychologists and psychiatrists

January 28, 2013 in Insurance Bills, Member Stories, mental health

If you visit your therapist this month or next and he or she seems stressed out, it could be about money. Here’s why.

Therapists who accept health insurance submit a bill that includes a code for your visit.  90862 was, for example, a very common code for a medication adjustment visit to a psychiatrist.  As of this month, almost all the mental health codes are changing and this is causing a lot of anxiety.

Therapists aren’t sure which code to use and, they aren’t sure how much they’ll be paid.  Insurers say the new codes, which are reviewed and set by the American Medical Association, will likely mean lower reimbursement rates for therapists who don’t prescribe drugs.  Insurers say they won’t cover some of the codes at all. Many therapists are angry and discouraged.

“The Governor and the President are asking for more emphasis on mental health, but then the coding requirements increase and the reimbursements go down,” says Jonas Goldenberg with the Massachusetts chapter of the National Association of Social Workers.

Psychiatrists may see an improvement in payments for some visits because they’ll be able, for the first time, to bill for medical care they provide while monitoring the effects of medications.  But the new codes do not resolve ongoing concerns about whether mental health providers are paid at the same rate as are doctors who deal with physical health.  Under the new codes, it does not appear that psychiatrists who evaluate a patient’s physical response to medication will be paid what an internist would to make a similar evaluation.

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Let’s Talk Mental Health

December 20, 2012 in Member Stories, mental health

I’ve written here about migraines that sent me shopping for an MRI, my search for a “good” colonoscopy, my kids’ dental bills and a bunch of other stuff.  But I realized this week, in all the conversations after Sandy Hook, that I haven’t written anything about mental health.

My dad, Jim Bebinger, on his way to or from the Korean War, 1951

And you know what, I don’t think anyone else has either.

So let’s talk.  If a line about our anxiety or depression or phobia or addiction is as easy to throw into a conversation as a reference to our asthma, then maybe we can unravel the embarrassment or shame of living with these conditions.

Here’s a little about my experience with mental illness.  My dad killed himself when I was 17.  I lost most of my 20s to depression.  I wouldn’t be where I am without lots of therapy.  In August I started seeing a counselor again about some issues with my kids.  It’s helping a lot.

And you?  Gotta story?  Most of us do.

I look forward to reading yours.