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SIIA TRADE SHOW
It is time for the annual SIIA National Conference and Expo. As in years past, Complete Health Systems will be exhibiting at the show, which will be held on October 1 - 3, 2012 in Indianapolis, IN. The conference's theme is "Raising the Game".
Be sure to stop by booth #500, so we can show you how CHS can help improve how you manage self-insured programs.
RBS (REGULATORY BUDGET
HEALTHCARE DEBATE HEATING UP IN PRESIDENTIAL ELECTIONS
By: Nicola Crean, CHS Marketing Coordinator
It is widely known that there are very few topics that Republicans and Democrats agree on. When it comes to healthcare, both sides seem to publicly acknowledge that it is essential for there to be a decrease in medical expenses nationwide. However, since both parties have varying ideologies, the solution for how to reduce costs differs.
Rising medical expenses are attributed to numerous factors that have all contributed to the underlying problem. A lack of efficiency among every entity within the health industry has led to wasteful spending, which eventually becomes a financial burden to insurers, providers and patients.
An article published in Fox Business reports that a study performed by the Institute of Medicine (IOM) determined that 30% of medical costs in 2009, approximately $750 billion, was spent on covering rising administrative costs and administering unnecessary medical services. The IOM’s findings demonstrate that there is a widespread problem to be addressed.
As the U.S. Presidential Elections near, the topic of healthcare is undoubtedly a major issue that both President Obama and his Republican opponent, Mitt Romney, have had to address in recent weeks. With Obama coming off the victory of the Supreme Court ruling on the Affordable Care Act, Romney has had to develop his own plan of action for the healthcare industry.
Traditionally, both parties have reviewed regulation very differently. The Affordable Care Act is Obama’s attempt to add more regulation in an effort to control the marketplace and eliminate the risk for potentially huge increases in medical costs.
Separately, the Republican supports a free marketplace in order to promote competition between all entities. While Romney has vocalized this support of this idea, his healthcare strategy appears to include some of the newly approved Obamacare provisions.
“I’m not getting rid of all of health care reform,” said Romney in an interview during ‘Meet on the Press’. “Of course, there are a number of things that I like in health care reform that I’m going to put in place.”
While many conservatives expect that a newly elected Romney would revoke Obamacare in its entirety, there are two specifics parts of the new law that Romney intends to uphold. Similar to a health plan he imposed in Massachusetts, providing insurance for those with pre-existing conditions, in addition to young adults are important aspects to Romney’s healthcare strategies.
On ‘Meet the Press’, the Republican presidential candidate attempted to clarify that including those components did not mean he would keep Obamacare. However, an article published in Politico anticipated that pursuing similar objectives as the current administration may not appeal to the conservative Republican base.
“The grass roots have dog ears that are trained to certain whistle tones,” said Tom Miller, a member of the American Enterprise Institute, in the Politico article. “Running against Obama has only gotten them so far. They’ve got to say what they are actually running for.”
As the debates approach, it will provide both parties with an opportunity to convince the general population why there outlook on healthcare serves to be the most beneficial for the majority of individuals. Romney has to separate himself from the aspects of Obamacare he appeared to be in favor for, while demonstrating what his healthcare strategy is. Obama has an opportunity to define his position on the newly enacted Affordable Care Act.
While both sides appear to take different approaches, each has a similar goal at the heart of each proposed strategy. The attempt at regulating healthcare costs and providing medical coverage to the majority of individuals is the ultimate objective. However, based on each political parties’ core values, the principles behind the solution have the potential to widely vary.
GOVERNMENT SEEKS REGULATION TO LIMIT OVERCONSUMPTION
By: Nicola Crean, CHS Marketing Coordinator
Individuals and various other entities look for ways to cap healthcare expenses to eliminate the financial burden as costs continue to rise. Creating a healthier atmosphere within the workplace and the country, as a whole, is a significant step to take towards reducing medical spending.
While there are multiple factors that contribute to the general health status of the US, obesity is one that is a major health concern affecting approximately 68 percent of the American population, according to the Food Research and Action Center’s website. The site defines obesity as individuals that have a body-mass index of 30 and up.
While obesity itself is a health risk, it often escalates and develops into other diseases, such as diabetes or cardiovascular disease. The complications caused by obesity inevitably continue to cost companies, employees and the government in the long run. An article published in The Atlantic states that approximately $190 billion is spent annually on health care and lost productivity because of obesity and other related problems.
Many of the diseases attributed to obesity can often lead to high medical expenses caring for the individual, in addition to the threat of early mortality. Both employers and the government have created various initiatives and programs to motivate the public about the importance of creating a more health-conscious country.
Recently, both the federal and local governments have developed numerous plans to control the level of unhealthy food choices that are readily accessible to the public. Eliminating the use of artificial trans-fat in New York restaurants to enacting a soda pop tax have all been considered by cities to make it more difficult for people to consume potentially damaging food.
"Food companies understand how customers respond to their products and marketing better than anyone and could make many changes that would promote health,” said Dr. Thomas Farley, M.D., M.P.H, Commissioner of New York City Department of Health and Mental Hygiene in an article published in JAMA.
With calorie consumption almost-triple what it was in 1970s, Dr. Farley suggests that individuals have grown accustom to the increase in serving size. Instead of consuming a food or beverage till they are satisfied, they unknowingly finish larger portions simply because that’s how they received it.
Limiting large serving sizes, as New York recently did with the sale of sugary drinks, has allowed the government to regulate how food is being served to the public. With various reports being released indicating that there will be a dramatic increase in obesity in the next twenty years, it is evident that this is a growing concern for the U.S. that needs to be addressed.
The government’s ability to regulate food intake is a political issue that is faced with many opinions. However, the trends prove that obesity among the American population is quickly becoming a public health issue. Reducing super size portions have the ability to reduce calorie consumption and in turn, create awareness that there may not be a need to over consume. This is one step in the direction of halting the spread of obesity among Americans.
THERE ARE SOME BEHAVIORS
YOU JUST CAN'T REGULATE.
By: Chacko Kurian
Regulations depend on carrots and sticks. If you don’t
pay your taxes, there will be serious consequences – the
stick. If you buy a home with a home loan, we’ll let you
take the interest payment deduction on your taxes – the
carrot. The HITECH Act has a number of sticks associated
with the security of Protected Health Information (PHI). We
at CHS will be addressing the issue of security of PHI in
forthcoming articles. There is, under some circumstances,
one link in the security chain that no regulation can affect
-the uninformed behavior of the user. This article addresses
one method where cyber criminals make unwitting users
partners in a security breach.
Prior to founding
Apple Computers, the Steves (Wozniak and Jobs) could be
found ripping off Ma Bell using a blue box to make long
distance phone calls (domestic and international) for free.
The subculture that reveled in this activity called
“phreaking” was probably the progenitor of the subculture of
hackers who, today, like to hack computer systems just
because they’re there. There is the story of Steve Woz(niak)
actually making a “phreak” phone call to the Vatican and
asking to speak to the Pope while pretending to be Henry
Kissinger with a think German accent. These are the guys who
later found legal ways to take your money.
Before the age of digital telephone switching systems,
telephone switches reset trunk (long distance) lines with a
tone at a specific frequency – 2600Hz. This meant that the
trunk line was disconnected at one end and available for
dialing at the other end. The dialing was also accomplished
by tones at preset multiple frequencies. How did one get
those frequencies? Legend has it that the 2600Hz frequency
was discovered by accident by Joe Engressia, known among
phreakers as ‘Joybubbles’, at the age of 7! He was
apparently able to whistle at that frequency and so attach
himself to the dialing end of an available long distance
But how does one progress from knowing that you could get
a trunk line to using it to make free long distance calls.
In 1954, the then undivided Bell System published an article
in the Bell System Technical Journal about the basics of
signaling using multi-frequency tones. This piece of
information by itself was of little use. The second and
final piece of the puzzle was published, again courtesy of
Ma Bell, in the November 1960. Bell System Technical Journal
in an article called “Signaling systems for control of
telephone switching”. This article published the actual
multi-frequency tones used to control the switches. From
that information to the creation of the reputed “Blue Box”
that became a clandestine product was a short step. With one
of these boxes, anybody was able pick up a phone and make
free long distance calls.
To be able to win this questionable prize, the phreaker
required two pieces of information and they were found in
two locations, but once they were combined, the information
became quite powerful. Today – cybercriminals put two pieces
of information discovered from different locations together
to achieve their nefarious goals..
Spear Phishing is the technique by which pieces of
information stolen from different locations are put
together, by cybercriminals, to steal your identity, your
money and anything of value. How does this work? Unlike the
shot gun approach taken by those Nigerian scam artists who
send out millions of emails, the Spear Phisher is looking
for prey with a small email blast to very targeted
prospects. All they need to start the process is one piece
of information – your email address and sometimes your name.
They don’t need anything like a credit card number, the
password to your on-line bank account or your social
security number– well, not yet. The attack is quick and over
in less than a day, before security and software companies
have an opportunity to react.
A typical Spear Phishing attack starts with an email that
comes to you and looks something like this, courtesy of the
Microsoft Safety and Security center
Remember they already have your email address and
sometimes your name so the “Hello” salutation is not so
innocuous. It looks very familiar but the highlighted items
should make you suspicious. If you examine the links you
will find that they link to unsecured and unfamiliar sites
as shown below:
Once you click on the link and enter the information
they’re asking for, they’ve got you.
Another variation of this technique is to send you an
email making you an offer that sounds reasonable on the
surface, but requires you to open an attachment with the
details of the offer. Again, once you open that attachment,
they’ve got you. What happens behind the scenes is that the
attachment has a robot program that can do almost anything
that they want it to do. It can install a keystroke logger
and send your internet banking or credit card passwords to
the cybercriminal. It can give control of your computer over
to the cybercriminal and so enable more of these schemes to
be run from your computer. The possibilities are endless.
Sometimes the Spear Phisher makes the email look like its
coming from your boss – again remember he has email
addresses and names. The email may require you to give up
password and other authentication information in order to
perform a “security audit” or an “account verification”.
Key to making this criminal endeavor work is that it
requires your participation to either provide the missing
information or open the attachment. So the best defense it
to verify the email by contacting the sender by phone or
alternate method if the email looks suspicious. A good
antivirus program installed on your computer can help
too.Remember for the scheme to work it requires your
We might as well brace for a number of these email
attacks. Recently Epsilon, a division of Alliance Data
suffered an illegal entry on its client’s email databases.
This is the company that processes marketing communications
for loyalty programs like Marriott Rewards, Citibank
Advantage and many other large organizations. Imagine the
rich information for cybercriminals that email addresses,
names and loyalty program associations can provide. If you
belong to the Marriott Rewards program like I do, expect an
incredibly valuable offer to come to you via email. Do not
open the attachment even though the logo looks almost right
and the text has only one or two spelling mistakes.
There’s lots of regulations coming from Washington DC
these days, but I don’t think they can think one up for
CHS SOFTWARE UPDATE
CHS Software you may want to use
Often, we at CHS, are
guilty of not informing you of products or features that we
have implemented over the past year that you may want to
use. This year we have rounded out our individual
enrollment, billing and administration offering with a full
cycle product. If you sell individual policies or sell
voluntary products in addition to your regular employer
sponsored group health offerings, this may interest you.
"Full Cycle" in this context means the following:
i) taking the application for enrollment of the
individual/family on the web, after getting their responses
to qualifying/underwriting questions,
ii) enrolling them in the plan of choice,,
iii) billing their credit card or bank account at the
appropriate frequency, i.e. monthly, quarterly,
semi-annually or annually,
iv) applying the payments received against the appropriate
v) disbursing premium/commission and other payments to
carriers, brokers/agents and other suppliers
vi) updates to Accounts Receivable, Accounts Payable and
General Ledger without manual intervention after set-up.
We would like to say that all of the above happens
"automatically" (a grossly over-used word) but it doesn't.
It happens with minimal, but appropriate, human
intervention. For example, there are checks and balances in
place to make sure that premium billing adjustments owing to
changes in family composition or product choices are made
accurately. The web enrollment product, CHS iCoverNow, has
to be customized with your logo, color palette, questions
and response logic. Users of our product like it. It has
allowed them to grow into areas where they couldn't before.
We believe that this will interest administrators of
individual health plans who sell to the public at large and
may become a valuable tool in the context of health care