Medicare Agent News: December 2020

Wednesday, December 30, 2020

Princesses (even Carrie Fisher) get sick, too: Women with heart disease are often ignored

The tragic death of actress and author Carrie Fisher this week, best known for her portrayal of Princess Leia in “Star Wars”, has shocked the world. According to the latest reports, Fisher suffered a cardiac arrest while flying from London to Los Angeles last week. Witnesses reported that she began to have chest pain and became unresponsive while in flight. CPR was performed and an AED was used to restart her heart.

She arrived at LAX and was transported urgently to the hospital. There have been no reports that Fisher had any prior heart disease or risk factors for heart disease outside of cigarette smoking and occasional issues with weight.

Carrie Fisher had a long history of substance abuse and, according to some reports, she had recently relapsed. Some believe that this may have been a contributing factor in her untimely death.

According to the American Heart Association, two thirds of women who die suddenly of heart disease have no previous symptoms—making prevention even more difficult. Unfortunately, only 54 percent of women recognize that heart disease poses their greatest risk of death.

Women and Heart Disease

Heart disease, while long thought to be a disease of men, actually affects both genders equally. In fact, more women than men die from heart disease in the United States every single year.

In 2013 nearly 289, 000 women died of heart disease—that is one in four American women.

Heart disease can be more difficult to recognize in women than in men and many women do not even know that they are at risk.

While men tend to present with “classic” heart attack symptoms such as chest pain and shortness of breath, women often have very atypical symptoms including nausea, back pain, flu like illness and feelings of dread. Many times, women who are having heart attack symptoms do not even realize that they are having a heart attack.

What are the Risk Factors for Heart Attack in Women?

The risk factors for heart disease are similar in both men and women. There are two types—those that we can modify and those that we cannot.

Modifiable risk factors include: Smoking, high cholesterol, diabetes, high blood pressure and obesity.

Those that we cannot change are our genetic makeup—having a family history of heart disease.

One of the most important things that women can do is to take stock in their own cardiovascular health. If a woman has multiple risk factors, then screening tests are appropriate. It is vital that women engage with their health care provider and determine exactly what their risk is—once risk is known, steps can be taken to reduce risk and screening tests can be performed.

How can Women Prevent Heart Disease?

Prevention is all about knowledge — every woman must know her numbers. Here are five numbers to keep track of:

1. Have your blood pressure checked annually. Hypertension is known as the silent killer. While you may not have symptoms from high blood pressure, long-standing hypertension can damage your heart and blood vessels and put you at higher risk for heart attack and stroke. If you and your physician are able to identify high blood pressure early, you can limit the negative effects of hypertension by treating with lifestyle modifications and drug therapy if needed.

2. Have cholesterol checked annually. Most heart attacks are caused by a build up of fatty plaques inside the heart arteries. When these plaques rupture and occlude a coronary artery, a heart attack occurs. Cholesterol contributes to the development of these plaques. By checking your cholesterol annually you can assess your risk and your physician can put you on drugs to lower your cholesterol if necessary.

3. Maintain an optimal body weight—Assess your body mass index (BMI) and make changes to diet and exercise regimen in order to attain a more healthy weight. Make healthy food choices. Obesity leads to generalized inflammation and inflammation has been directly associated with the development of heart disease. In addition, obesity puts you at risk for Type 2 Diabetes as well as high blood pressure, high cholesterol, and ultimately heart disease.

4. Lower your stress levels. Studies have shown that stress can increase the incidence of heart attack in susceptible individuals. Emotional stress evokes a hormonal response in our bodies. When under stress, we release increased amounts of stress hormones including epinephrine and cortisol. These hormone raise blood pressure and heart rate. Chronically elevated levels of these hormones can lead to heart attack and stroke in susceptible individuals. Daily stress lowering strategies such as meditation, exercise and relaxation breathing can make a huge difference in limiting your levels of these hormones.

5. Stop smoking. Smoking is the number one cause of preventable death in the United States today. While smoking rates have declined over the last several decades, far too many Americans still continue to smoke. Smoking can cause damage to the heart and blood vessels and can significantly raise your risk for heart attack. Smoking raises blood pressure, decreases exercise capacity and increases the tendency for blood to clot. Smoking may be the most important risk factor for heart disease in young women. If you are a smoker, quit today. Your doctor can help if you need medications—set a quit date, circle it on the calendar and make your goal public. Ask friends and family for support.

The Legacy of Princess Leia

Carrie Fisher has done much good in her short life and has brought joy into many lives through her work on film. Now that she has passed away from a heart attack at a young age, let’s continue to allow Carrie to impact our lives. Let’s raise awareness for women and heart disease. Let’s help spread the word that a woman’s greatest health risk today is from heart attack and stroke. While breast and uterine cancers remain a significant concern, heart disease takes the lives of one in four women annually. In “Star Wars,” Princess Leia fought for a cause that was greater than any one person—let’s let Carrie Fisher’s legacy be one of hope. Hope that women can now recognize their risk for heart disease and make the changes needed to take control of their own heart health.

https://www.foxnews.com/opinion/princesses-even-carrie-fisher-get-sick-too-women-with-heart-disease-are-often-ignored

5 hidden health risks related to hearing loss

Hearing loss is linked with some serious health problems.

By Stephanie Thurrott • August 26, 2020

Hearing loss might seem like an inconvenience. You turn the TV louder, or choose quieter restaurants, or ask people to repeat themselves.

But it’s actually not just an annoyance — hearing loss is also linked with some serious health problems.

“We used to feel that hearing loss was a loss of communication opportunity and that was about it, but what has become clearer in the last several years is that there are much deeper cognitive and physical health implications,” says Donald Schum, vice president of audiology at Oticon, a hearing aid manufacturer.

Paul Farrell, associate director of audiology for the American Speech-Language-Hearing Association, outlines the types of health problems we’re talking about:

1. Social isolation, loneliness and depression

“Most adults develop hearing loss gradually over many years,” Schum says. Over time, you might gravitate away from experiences you no longer enjoy, like restaurants and parties, and toward less-social activities that don’t put as much demand on your hearing.

“As older adults get more and more isolated, that can lead to stress and depression,” Schum says. It’s a downward spiral.

Communication difficulties isolate people, and then people become more depressed and stressed.

Communication difficulties isolate people, and then people become more depressed and stressed.

“Their physical health starts to deteriorate as a result of these factors, and as their physical health deteriorates they become more isolated because they can’t participate. These factors are building on each other,” he says.

“Our big concern in audiology is that we believe we can stop some of that [downward spiral] earlier on if people are willing to do something about their hearing loss,” Shrum says. “We want to get more people to recognize that linkage and act.”

2. Cognitive impairment and dementia

There are a few different hypotheses about the link between hearing loss and decreased brain function, Farrell says. One says neither causes the other, but that neurodegeneration as you age causes both.

Another thinks the energy the brain uses as you struggle to hear might deplete the energy the brain needs in other areas, Farrell says.

And a third suggests that the social isolation that can stem from hearing loss can lead to decreased sensory input, which can then lead to dementia.

“One of the best stimulations for the cognitive system is to be around other people, having a good conversation,” Shrum says. “When you start to lose that because of isolation you’re at greater risk of cognitive decline.”

He points to a British study that found that untreated hearing loss tops the list of factors leading to dementia that are under your control.

“We are in no way saying that getting hearing aids prevents dementia or Alzheimer’s — we’re not anywhere near that — but we do recognize how important social interaction is in the later years, and it’s tricky to create those environments for yourself if you allow yourself to become more isolated because of hearing loss,” Schum says.

3. Falls

Farrell says a study of 2,000 people found that those with a higher degree of hearing loss had a greater risk of falling. It’s not yet clear what the connection is between falling and hearing loss.

Schum says, “It’s a little premature to suggest that hearing loss causes falls. There’s some speculation about the mechanisms behind that, but it’s early days.”

4-5. Diabetes and heart disease

Diabetes might affect the blood flow to the cochlea and lead to hearing loss, Farrell says. And while it could be that diabetes is causing hearing loss, not the reverse, hearing loss could still be an important indicator.

That’s because 8.1 million people in the United States with diabetes are undiagnosed.

And hearing loss in the low frequencies could indicate heart disease, though the connection is still unclear. “We’re seeing more and more evidence and continuing to discover the links between these serious conditions and hearing loss,” Schum says.

A wide-ranging concern

Hearing loss is a common problem as you age. According to the National Institute on Deafness and other Communication Disorders, disabling hearing loss affects about 2% of adults aged 45 to 54, 8.5% of adults aged 55 to 64 and nearly 25% of those aged 65 to 74.

Schum says there are two reactions that adults often have that interfere with treatment for hearing loss. One is denial: “They say, ‘It’s not my hearing, people mumble.’”

The other is normalization. “It’s more subtle, but equally dangerous,” Schum says. That’s the assumption that your hearing is going to deteriorate as you get older, so you just accept the effects. “They think, ‘None of my friends can hear well,’ or ‘You should see my spouse.’”

“It’s really important for any individual who has hearing loss to ensure they have a good conversation with their physician and audiologist,” Farrell says. “Be open and honest about all the health conditions you’re being faced with.”

https://www.considerable.com/health/healthy-living/hidden-health-risks-hearing-loss/?utm_source=postup&utm_medium=email&utm_campaign=DNL-123020&recip_id=14218

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On the Record 12 20 2020

"Like access to safe, affordable housing and food security, having a steady job leads to better health outcomes. Providing job training resources helps plans fulfill their primary goal of keeping their members healthy. That in turn lowers costs and yields a positive ROI for the plan."

— Jerry Vitti, founder and CEO of Healthcare Financial Inc., talked with AIS's Health Plan Weekly about why insurers' job training programs offer a broader benefit than just meeting the needs of Medicaid work requirement waivers or filling job vacancies.

Subscribers may read the Health Plan Weekly article in which this quote appeared online. Learn more about subscribing to AIS Health's publications.

The FDA on Dec. 14 approved a...

...two-hour infusion time for Roche's blockbuster multiple sclerosis drug Ocrevus. The news comes as Novartis launches its MS challenger, Kesimpta, which is self-administered. For the treatment of multiple sclerosis, Ocrevus is covered under the pharmacy benefit for 39% of covered lives, the medical benefit for 26% of covered lives, and both the medical and pharmacy benefit for 24% of covered lives. In the pharmacy benefit, Ocrevus holds preferred status for 6% of covered lives, growing to 17% with utilization management restrictions applied.

SOURCE: MMIT Analytics, as of 12/17/20

Surprise Medical Billing Comes to An End, Insurers Oppose Arbitration Mechanism

by Peter Johnson

After years of failed attempts, Congress has finally come to an agreement on a measure to end the practice of surprise medical billing.

Surprise billing, also known as balance billing, is the practice of charging patients for out-of-network procedures that insurers refuse to pay for in whole or in part. Often, patients incur these balance bills without their knowledge. The new legislation would ban providers from sending such a bill to patients, and would instead require providers to negotiate reimbursement with the patient’s insurer or submit the dispute to a binding arbitration process.

Providers will have 30 days from the day of the procedure to negotiate a compromise reimbursement amount with payers. If the parties can't agree, they must submit their preferred reimbursement amounts to an HHS-approved arbitrator, who will pick one of the two amounts.

Loren Adler, associate director of the USC-Brookings Schaeffer Initiative for Health Policy, praised the legislation as "closer to the ideal, consumer-friendly solution" than previous attempts to address the issue.

"It's very likely that this bill reduces premiums," says Adler, who has contributed to research that found surprise billing increases health care costs.

Insurance stakeholders are displeased that surprise bills will be resolved through arbitration. Instead of arbitration, America's Health Insurance Plans had lobbied for out-of-network reimbursement to be tied to a benchmark rate.

Adler thinks that insurers' objections to arbitration are overblown, and he argues carriers will gain leverage in balance billing negotiations because of the legislation.

"It seems pretty easy for an insurer or a [plan sponsor] company to call a provider’s bluff," Adler says, citing rules in the bill that he thinks will prevent providers from abusing the arbitration system.

Dan Mendelson, founder of Avalere Health, is more skeptical about the bill's potential to reduce costs and slow premium inflation, since it will require new administrative costs.

"There is no question that whenever you force more cost into the system, it's going to be reflected in consumer cost," Mendelson explains. "So there will be a premium effect. Will people actually be able to differentiate it from the typical rise in costs? No….I do expect that it will have an effect, just from an economics standpoint."

From Health Plan Weekly

Nearly Over

By Alex Eule | Wednesday, December 30

Penultimate Trade. The days of stimulus disappointment appear to be over for investors. Even with hope for $2,000 checks fading in a gridlocked Congress, stocks still marched higher. The Dow Jones Industrial Average was up 74 points, or 0.2%, to an all-time high, while the S&P 500 and Nasdaq Composite edged up, good enough for their second-highest closes ever.

While $2,000 checks may not be happening, Americans have begun to receive the $600 checks from the Covid relief bill that became law over the weekend. In a twist on their usual tax collecting, the Treasury Department and Internal Revenue Service confirmed those payments in a press release yesterday:

The initial direct deposit payments may begin arriving as early as tonight for some and will continue into next week. Paper checks will begin to be mailed tomorrow, Wednesday, Dec. 30. ... This second round of payments will be distributed automatically, with no action required for eligible individuals.

There's not much good data on the Covid-19 case front -- hospitalizations hit another all-time high -- but the vaccine news continues to be positive. The U.K. approved the low-cost vaccine from AstraZeneca, which has said it could deliver 3 billion doses in 2021. While that could prevent the virus in nearly half the world's population, the vaccine has yet to be widely accepted in other parts of the world. Questions about the company's vaccine trial has delayed its acceptance in the U.S.

AstraZeneca has said it doesn't plan to profit off the vaccine initially. Its stock is flat on the year. (See also: Regeneron’s Antibodies Appear to Help Hospitalized Patients—and Could Help 2021 Revenue)

It was a rare bad day for big tech. The market's five-largest stocks (Apple, Microsoft, Amazon.com, Google-parent Alphabet, and Facebook) all slipped on the day. Facebook and Alphabet led the losses, down 1.8% and 1.2%, respectively. It has been a tough month for the two internet-advertising giants, which are in the crosshairs of regulators. Facebook is down almost 2% over the last month while Google is down 1%, even as the Nasdaq is up nearly 6%. Apple has been the big-tech standout in December; its stock is up 12% this month.

We'll wait until New Year's Eve to give you all the year-end stats, but here's a quick preview: With one day to go, the S&P 500 is up 15.5% on the year. The Nasdaq, meanwhile, has soared 43%. Even more impressive, the tech-heavy index is up 94% over the last two years. That’s still not good enough for a record, though. From 1998 to 1999, the Nasdaq was up 159%.

DJIA: +0.24% to 30,409.56
S&P 500: +0.13% to 3,732.04
Nasdaq: +0.15% to 12,870.00

The Hot Stock: Freeport-McMoRan +7.2%
The Biggest Loser: AES -2.3%

Best Sector: Energy +1.6%
Worst Sector: Communication Services -0.7%

A one-day chart of the Dow Jones Industrial Average.

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