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Friday, February 28, 2020
TDI encourages proactive planning for COVID-19
How to prepare for coronavirus in the U.S. (Spoiler: Not sick? No need to wear a mask.)
Reis Thebault, Alex
Horton February 28, 2020
There are the exam
gloves, the surgical masks, the dubious supplements and the deceptive
disinfectants. If unchecked Internet information is any guide, there’s an
inexhaustible list of products you should buy to prepare for the spread of coronavirus in
the United States — which, according to U.S. health officials, now appears inevitable.
But here’s the thing: The virus may be novel,
but you really don’t need to buy anything new or special to brace for it. The
Washington Post spoke to epidemiology experts, and they said the most important
aspect of preparedness costs nothing at all — calm.
As of Wednesday afternoon, 59
people had the virus in the United States, all but 17 of them evacuees from the
Diamond Princess cruise ship. But officials with the Centers for Disease
Control and Prevention said they expect to see the number of cases increase as
the disease spreads, while also stressing that the immediate risk remains low.
So here’s what doctors, researchers and the
CDC say you can do now — and in the event of a future outbreak — to prepare and
protect yourself.
‘Don’t
panic’
Timothy Brewer is a professor of epidemiology
and medicine at UCLA’s Fielding School of Public Health and its David Geffen
School of Medicine, yet his central piece of advice is not exactly medical.
“Don’t panic,” he said. “There’s no value in
panicking or telling people to be afraid. Don’t let fear and emotion drive the
response to this virus. That can be extremely difficult because it is new, and
we’re still learning about it, but don’t allow fear of what we don’t know about
the virus to overwhelm what we do know.”
Brewer said it’s important to remember that
covid-19, the disease caused by the novel coronavirus, is a respiratory
disease, as is influenza, and while there’s not a vaccine for it, there are
tried-and-true ways to deal with this type of illness — which we will cover
here.
Saskia V. Popescu is a senior
infection-prevention epidemiologist for a Phoenix-based hospital system. “The
most important thing right now is to remain calm,” she said. “Remember, we
don’t have that many cases in the U.S., and prevention strategies for this
coronavirus are not new. We’ve been doing them for years.”
The
basics
A few minutes into a phone call with this
reporter, Brewer paused, coughed and then explained himself. “I’m currently
recovering from a non-covid respiratory virus,” he said.
But the precautions he took when fighting his
influenza-like illness are no different from what people should be doing every
day to stave off coronavirus and other respiratory diseases, Brewer said.
You’ve seen the guidance before: Wash your
hands regularly. Cover your nose and mouth when you sneeze. And when you’re
sick, stay home from work or school and drink lots of fluids.
The CDC recommends washing
with soap and water for at least 20 seconds after using the bathroom, before
eating and after blowing your nose or sneezing. It also advises not to touch
your eyes, nose and mouth and to clean objects and surfaces you touch often.
“These are all things you can do to prevent
the spread of pretty much any respiratory virus,” Brewer said.
And for the record, he added, he stayed home
sick last week.
“I practiced what I preached,” Brewer said.
Keep
the shopping cart light
You probably don’t need to buy anything new,
but if you’re already on your way to CVS, Brewer has some advice.
“Don’t go crazy,” he said. “You don’t need to
go out and stock up on lots of things.”
And those surgical masks? If you’re not sick,
you don’t need to wear them — and you certainly don’t need to buy every box
your local pharmacy has in stock.
“The main point of the mask is to keep someone
who is infected with the virus from spreading it to others,” Brewer said.
The CDC agrees, writing on its website: “CDC does not
recommend that people who are well wear a facemask to protect themselves from respiratory
diseases.”
Common surgical masks block the droplets
coming out of a sick person from getting into the air, but they are not tight
enough to prevent what’s already in the air from getting in.
There are specialized masks — known as N95
masks because they filter out 95 percent of airborne particles — that are more
effective, and some online retailers are sold out of them. But there’s a
problem: The masks are difficult to use without training. They must be fitted
and tested to work properly.
“If you just buy them at CVS, you’re not going
to do all that,” Brewer said. “You’re not going to get it fit-tested, and
you’re not going to be wearing it properly, so all you’ve done is spend a lot
of money on a very fancy face mask.”
The same goes for exam gloves, Brewer said,
which can get contaminated just like our hands. There’s no need for them if
you’re washing your hands properly and often, he said.
If you’re itching to buy something, you can
stick to the typical respiratory-virus medicine: decongestants,
anti-inflammatory drugs and acetaminophen for fevers.
'Practice
makes permanent’
Popescu has had a bag packed since she was in
graduate school — if she didn’t have one, she said, she would feel like a bad
public-health-emergency advocate. She explained one of the best things you can
do to prepare for any emergency, including a coronavirus outbreak, is put
together an emergency kit.
Hers contains a first-aid kit, flashlights, a
space blanket, an external battery for her cellphone, a change of clothes and
extra food for her dog. The CDC has a useful checklist for
families.
It’s also important to have plans in place in
case the outbreak disrupts your daily routines, Popescu said. You should be
asking yourself: What if schools close for a week or two? What if there are
issues with public transportation? What if I have to work from home or stay at
work late?
You should have a plan for child care, for
getting to work and for feeding pets, she said.
“A lot of preparedness is planning ahead of
time,” Popescu said. “Practice makes permanent. If I have a plan, that means I
don’t have to panic.”
And it’s good advice in general, she added,
not just in the age of coronavirus.
“This is a good reminder to go through your
resources and your plans so that, should it get more serious, you are not taken
off guard,” she said. “People think they need to go out and buy stuff, but so
much of it is just having a plan.”
Be
mindful of where you are
Health officials have stressed keeping your distance from people who are
sick, especially when it comes to respiratory viruses.
And because there is no medical solution for
coronavirus, preventive steps and awareness are really the best tools at your
disposal, said Stanley Perlman, an infectious-disease expert at the University
of Iowa.
It is worth considering limiting exposure to
large groups, especially during flu season. “Any congregation of people is a
setup for spreading an infectious agent,” he said.
Most of us like to look at our smartphones and
wear headphones, but in confined spaces, such as mass transit, it’s important
to look around and see what’s going on, see where everyone’s hands are going
and make a mental note to wash up later.
“We remember hand-washing at home but not when
we get off a subway or leave the grocery store,” Popescu said. She also
recommends avoiding the middle of a packed train car and doing your best to
turn away if someone is coughing nearby.
But awareness cuts both ways. While the United
States is likely to have more coronavirus cases, she said, it is important not
to panic. “Just because someone has the sniffles or has a cough, it doesn’t
mean they have the coronavirus,” she said. “There are a lot of respiratory
viruses.”
Watch
what you read
While coronavirus is spreading rapidly, so
is misinformation about it.
Popescu and other experts call this an “infodemic,” and it can be as harmful as
any disease.
Hoaxes, lies and junk science about
coronavirus have swirled online since the earliest cases were reported, mostly
through social media.
“People are more click-susceptible during
these events because there’s more info and people aren’t sure who to trust,” University
of Washington researcher Jevin West told The Post this
month.
Look to trustworthy sources, such as the CDC,
the World Health Organization and local health departments, to stay informed,
Popescu said — not the anonymous user doling out advice in
Twitter mentions.
“It can be really easy to go online, buy
supplies and freak out and then just stay on Facebook,” she said. “But stay up
to date.”
Be
kind
On college campuses,
at a music conservatory,
in Chinese restaurants,
among the ranks of a famous dance troupe and
on streets every day, Asians have reported a rise in aggressions micro and
macro.
As coronavirus has spread, so, too, has anti-Asian prejudice.
The WHO has urged government agencies to do what they
can to prevent discrimination against specific populations, since
stigmatization can fuel the spread of the outbreak by driving marginalized
individuals to hide infection and avoid seeking treatment.
“Remember to not let fear override your common
humanity about how you treat other people,” Brewer said. “Just remember we’re
all in this together. This is a virus. It does not think. It is not planning.
We shouldn’t be blaming our neighbors or our fellow colleagues or people in the
community because a virus happens to exist and is spreading.”
Kim Bellware contributed to this report.
Medicare Advantage Plans Report AEP Growth
by Taylor McDonald | Feb 28, 2020
Medicare Advantage Plans Report
AEP Growth
Medicare Advantage
enrollments as of February 2020 reflected higher year-end growth on a count
basis, but lower on a percentage basis than the previous year. The table
below shows that Medicare Advantage enrollments increased over 1.3 million from
December 2019 to February 2020, 8,000 higher than the year-end 2018
growth. On a percentage growth basis, the 5.9% increase from December
2019 to February 2020 was 0.6% lower than the growth percentage for the
previous year end.
Based on these February
2020 enrollment numbers, CSG Actuarial is projecting that Medicare Advantage
enrollment as of December 2020 will be 24.7 million (or 25.4 million if other
Medicare “capitation” contracts are included).
'Really astonishing': Average cost of hospital ER visit surges 176% in a decade, report says
Hospital
emergency rooms are more likely to charge pricier levels of care than
a decade ago, generating bigger bills that consumers increasingly must pay with
their own money, according to a new report.
The
nonprofit Health Care Cost Institute (HCCI) examined insurance claims for a
decade’s worth of hospital emergency room bills,
analyzing millions of insurance claims for people under the age of 65
who get health insurance through an employer.
HCCI
found that hospital emergency rooms not only substantially increased
prices for care from 2008 through 2017. The hospitals and doctors also billed
for more complex care, which allows them to collect more lucrative fees from
consumers, employers and private insurers.
The
average emergency room visit cost $1,389 in 2017, up 176% over the decade.
That is the cost of entry for emergency care; it does not include extra charges
such as blood tests, IVs, drugs or other treatments.
“When
you look at the last 10 years, it’s really astonishing how this average cost of
admission to the ER has gone up,” says HCCI senior researcher John Hargraves,
who presented his report this week at the AcademyHealth meeting in
Washington, D.C.
Last
month, President Trump called on Congress to curb surprise medical billing,
which describes when a consumer gets an often-expensive bill from a
hospital or doctor that is not part of their insurance network. Many states
already have passed legislation to address these unexpected bills.
It comes down to the codes
But
less attention has been paid on how ERs bill patients.
Every
hospital emergency room visit is assessed on a scale of 1 to 5 – a figure intended
to gauge medical complexity and the amount a consumer will be billed.
An
insect bite might be assigned the lowest billing code, 99281. A heart attack,
the highest code, 99285.
The
difference in how an emergency room visit is coded might cost a consumer
hundreds more for simply stepping in the building.
In
2008, 17% of hospital visits were charged the most expensive code. That
surged to 27% of visits in 2017, the report said. The average price for the
most expensive code more than doubled from $754 in 2008 to $1,895 in 2017.
Hospitals
also increased billings for the second most expensive code, but they
billed the three least expensive codes less often compared to a decade
ago.
Are we sicker? Or just being billed like it?
Does
that mean Americans became sicker over the past decade, requiring more
intense and complex care at hospital emergency rooms? The report does not
address that question.
Americans
don't go to the hospital ER more often than they did a decade ago, the report
said. However, those visits cost more and are more likely billed with more
expensive codes.
"We
don't see a big rise in overall ER rates," Hargraves says. "Which is
what you'd expect if there's a large increase of people having heart attacks or
other (more severe) things. I think that's telling."
The
report combines the amount charged by hospitals and doctors, who often
bill patients separately.
Hospital
industry officials point to their own studies to explain the increased use
of more expensive codes at emergency rooms.
An
American Hospital Association report found the average number of emergency
room visits per 1,000 patients increased nearly 12% between 2006 and 2010. The
report also found those adults had a rising level of illness. The report
examined hospital use by older adults eligible for Medicare; HCCI reported on
hospital claims of people under the age of 65.
“Hospital
emergency departments treat many of our nation’s sickest and most complex
patients,” says Ashley Thompson, senior vice president of policy at the
American Hospital Association. “As hospitals serve as the front-door for
dealing with issues ranging from violence, mental health conditions and
the opioid epidemic, the
number and complexity of ED visits overall continues to increase.”
The
decade-long change in billing practices comes as hospitals have shifted to
electronic health records systems. These computerized systems might prompt
hospital staff to better document care, which might support the use of more
expensive codes, Hargraves said.
Others
aren't so sure.
Whistleblowers
Jeffrey
Newman is a Boston attorney who has represented whistleblowers under the
federal False Claims Act. The federal law allows individuals to bring
lawsuits on behalf of the government and collect a portion of any settlement.
The law is often used by ex-employees of hospitals, medical practices, drug
companies or medical-device makers when they suspect a former employer is
improperly billing federal health programs such as Medicare or Medicaid.
In
March, a nurse practitioner represented by Newman settled a False Claims Act
case for $2.1 million against CareWell Urgent Care Centers.
The
settlement said that CareWell managers directed doctors and other medical
providers ask patients about 13 body parts or systems and examine at
least 9 areas, even if the patient's symptoms that did not require such extra
attention.
If the
doctors did not ask the questions, the urgent care center's medical records
system registered a "no" answer. The robust queries were meant
to ensure the urgent care center could bill at a higher
level reimbursement code, the settlement said.
Newman
said he believes there are not enough checks and balances to guarantee medical
services are properly coded.
"They
can find reasons to say they were doing more complex things," Newman says.
"They often see this as an easy mark to pump the services and say, 'We're
being better doctors,' when it contravenes the rules."
Long-Term Care Insurance v. a Hybrid: AALTCI Gets the Numbers
AALTCI has also
digested Connecticut LTCI claim data.
The American
Association for Long-Term Care Insurance (AALTCI) has come out with a new
long-term care (LTC) benefits product cost comparison analysis.
AALTCI looked at
how much a consumer might pay to get long-term care benefits through a
stand-alone long-term care insurance (LTCI) policy, versus how much the same
consumer might pay to get the same amount of benefits through a life insurance
policy that offers LTC benefits.
Resources
AALTCI considered
several different coverage purchasing scenarios.
In one scenario,
for example, AALTCI assumes that the consumer is a single, 55-year-old female.
She is shopping for coverage that would provide a $505,000 pool of
benefits at age 90, with 3% annual coverage growth.
That woman
would pay $2,750 per year for a stand-alone LTCI policy providing that amount of
coverage, according to AALTCI.
One life insurer
would charge the woman $5,500 per year for a life-LTC hybrid providing a
$505,000 pool of benefits at age 90.
A second life
insurer would charge the woman $7,010 per year for that kind of pool of
life-LTC hybrid LTC benefits, according to AALTCI.
If the woman goes
with the life-LTC hybrid policies, she will get a maximum death benefit of
$130,000 along with the LTC benefits, according to AALTCI.
In related news,
AALTCI has also released new LTCI claim data, based on an analysis of data from
the Connecticut Partnership for Long-Term Care.
The Westlake
Village, California-based organization found that:
·
The average time between the purchase of LTCI coverage and
the time the first claim arrives is 162 months, or about 13.5 years. That’s up
from an average of 12.8 years in 2017.
·
The total amount paid to Connecticut partnership program
claimants has ranged from $19 to $1.5 million. That compares with a range of
$19 to $1.6 million in 2017.
·
The average amount paid to Connecticut claimants is $127,628, up
from an average of $122,436 in 2017.
Allison Bell, ThinkAdvisor's insurance editor,
previously was LifeHealthPro's health insurance editor. She has a bachelor's
degree in economics from Washington University in St. Louis and a master's
degree in journalism from the Medill School of Journalism at Northwestern
University. She can be reached at abell@alm.com or on Twitter at
@Think_Allison.
Seven Steps Toward A Long-Lasting Retirement – Step Six: Have A Strategy For Long-Term Care
Some of the big risks we want to protect
against in retirement are major market downturns, higher taxes, inflation,
longevity risk, and sequence risk. What many overlook when planning for
retirement are health care costs. A long-term care event in retirement has the
potential to erode your wealth.
The statistics don’t lie. We're living longer.
Nearly 70% of people age 65 and older will need
long-term care assistance for in-home care, adult day care, or nursing home
care, and one in every three 65-year-olds today
will live past age 90. One in seven will live past 95. Because of these longer
life expectancies, your chances of needing care will be higher as well, with
the average length of care at around 3 years.
One of my grandmothers lived to 95 and needed
care from ages 90-95. During those five years, she moved from upstairs to
downstairs, from her own bed to a hospital-style bed, from part-time care to
full-time care, and then from full-time care to in and out of the hospital
until she eventually passed. It was expensive then, but now the average cost of
a private room in a nursing home today is $8,517 a month. Who knows what the cost will
be 20-30 years from now, but you can probably imagine how quickly it can drain
one’s assets in retirement. There is a reason there are so many senior living
facilities being built all around us — the need for care is great.
There are several ways to protect yourself
against a long-term care event in retirement. Here are three common ways
to do so.
1. Purchase
stand-alone long-term care insurance. Monthly premium averages $2,700 a year.. Most
policies do have a cost-of-living adjustment, because you could potentially pay
into a policy for a long time without needing the benefit, only to need it 25
years from now.
A benefit that grows with a cost-of-living
increase would be important to have to make sure your monthly benefit considers
inflation. Although there is a good chance you'll use the policy at some point
in your life, there is also a chance you won't, and if you don't use it, that's
money down the drain all those years.
For this reason, and because many carriers
have increased policy premiums by an average of
45%, most people now (policyholders and financial
professionals) don't care too much for stand-alone long-term
care insurance.
2. Purchase a hybrid
life insurance or annuity policy that includes long-term care benefits. These
hybrid policies can be good alternatives or additions to a long-term care
policy and can complement existing long-term care benefits. Most hybrid
policies allow a policyholder to use the coverage several ways, offering more
flexibility.
Let's say you own a hybrid life insurance
policy with an additional rider for long-term care benefits. With life
insurance, we know we are going to die, just not when. The cost is based on
mortality tables and not future health care costs, which are unpredictable. As
long as the premium is paid and it's the type of policy that lasts us the rest
of our lives, we know it will pay out at some point or another.
Furthermore, if we added this rider and do
have a long-term care event, but need assistance in our homes, adult day care
facility, or nursing home, these policies allow you to spend down the death
benefit (otherwise payable when you die) while you're alive.
Let’s look at a hypothetical example. Say you
own a hybrid life insurance policy with a death benefit of $300,000. With some
policies (be sure to read and understand the coverage you have and/or
purchase), you may be able to accelerate up to $6,000 of monthly benefit (2% of
the death benefit monthly) to be used for long-term care or ANY expense, as
long as you can prove you can't perform two of the six activities of daily
living.
These are known as living benefit policies
that you don't have to die to use. They are a great concept with good
flexibility. Furthermore, with cash value life insurance, these policies
usually build cash values, which we can withdraw or borrow against. You can
even create a return of premium option so that you get back all the premiums
contributed over time in cash value — another living benefit offering
flexibility.
There are also annuities that offer additional
riders for long-term care benefits. Some will double an income benefit if
confined to a nursing home. Some will double an income benefit if care is
needed in-home, at a nursing home, OR at an adult day care facility. If
you own this rider as part of your policy, having a policy that pays
out and can be used multiple ways is best. This will give you the most
flexibility in using the policy down the road.
3. Self-insure. You
can protect against a long-term care event by setting aside money now for a
future event. If you have enough saved for retirement (perhaps $1,000,000 or
more), the chances of you being able to self-insure are probably pretty good.
You have the most flexibility here and will save yourself annual premiums, but
you would have to be disciplined and truly set aside a portion of your nest egg
strictly for a potential long-term care event later in life. This could be part
of a bucket approach in retirement. A bucket of funds for growth, some funds
for income, a bucket for health care and long-term care, and some for legacy if
so desired.
Whatever you do, have a plan in place to help
insulate you from a future long-term care event. Don't sweep this under the
rug. Address it head on and have a plan.
This content is brought to you by Impact
BrandVoice. Annuity guarantees, including optional income for life, are backed
by the financial strength and claims-paying ability of the issuing insurance
company. Insurance and annuities offered through Abraham Abich, VA Insurance
License #557877. DT1056557-0121
https://www.forbes.com/sites/impactpartners/2020/01/28/income-riders-mount-up/#6061116b4c51
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