With all of the controversy coming out of Washington and Sacramento, it is easy to miss the latest news going on in our industry. Therefore, being a member of NCEBC has many benefits. We offer great networking and social events to relax with colleagues, educational sessions with industry leaders, our annual golf tournament and a monthly newsletter. If you are a member, let co-workers and clients know why you find membership valuable and point them to our website. As always, we want to thank our members for their participation in our chapter!
An Afternoon of Wine and Lavender
June 23, 2017
1:30 PM to 4:30 PM
Matanzas Creek Winery
6097 Bennett Valley Rd
Santa Rosa, CA 95405
Join your colleagues for a TGIF gathering at Matanzas Creek Winery
July 19, 2017
2:30 PM to 5:30 PM
Sir Francis Drake Hotel, Mezzanine Level
450 Powell Street @ Bush Street
San Francisco, CA 94104
How will the changes in Healthcare Policy affect you?
23rd NCEBC Golf Tourney - Harding Park
August 14, 2017
10:00 AM to 5:00 PM
Returning to the Gorgeous Harding Park Course - Sponsorships Still Available
NCEBC Holiday Party
November 16, 2017
4:00 PM to 7:00 PM
Embarcadero Center, 4 Embarcadero Center, Lobby Level
San Francisco, CA 94111
Always an Industry Favorite
New CMS rules could discourage 'young invincibles' from exchange
The Trump administration is requiring people who sign up for insurance on the federal marketplace during special enrollment periods to submit proof they are eligible, potentially making it less attractive to young, healthy consumers.
Starting June 23, people who lose coverage because they lose or switch jobs or move will need to have proof of their circumstances verified by the CMS before coverage can begin.
In August, those who are newly married, gaining a dependent or who have been denied for Medicaid or CHIP coverage also must provide documentation.
The goal is to prevent fraud on the exchanges and improve the individual market risk pool, according to the administration. The multiphased pilot was first referenced in a market stabilization rule released earlier this year, but the CMS just now released details to marketplace navigators and brokers.
Insurers have bemoaned the additional risk that special enrollment periods can introduce, as consumers often wait to gain coverage until they have serious and costly medical issues. Some consumers run up expensive medical bills and then drop their coverage.
Last year, the Blue Cross and Blue Shield Association released an analysis that revealed consumers who join during special enrollment periods use 55% more in medical services than those who gain coverage during the standard open enrollment period.
Stan Dorn, senior fellow at the Urban Institute Health Policy Center, believes the new CMS practice will result in fewer special period enrollments, which can potentially mean fewer losses for plans and maybe even convince some to continue to sell on the marketplace.
Others worry tightening eligibility will further harm the federal marketplace. Studies show that young and healthy people are less willing to go through the hoops of providing documentation for coverage than older individuals dealing with an illness, according to Sandy Ahn, a research professor at Georgetown's Health Policy Institute.
"Young people are likely not going to finish going through the process," Ahn said. That could be detrimental to the exchanges because it would leave mostly older, less healthy people in the risk pool.
Another concern is that the pilot gives consumers specific deadlines to submit documentation, but does not impose the requirements on the employers or insurance companies that would provide the documents needed, according to Elizabeth Hagan, senior policy analyst with advocacy organization Families USA. The CMS also has given a timeline for certifying documents.
Others say it's unclear what problem the administration is trying to solve. Despite insurers reporting losses incurred by consumers who sign up during special enrollment periods, there isn't wide evidence of fraud, according to Matthew Fiedler, a fellow with the Brookings Institution's Center for Health Policy.
Check out our Healthcare Reform Update Event July 19th if you would like to know more about the future of Exchanges Nationally and in CA.
HHS targeting outdated regs in wake of damning cybersecurity report, WannaCry
Leveraging the Department of Health and Human Services Cybersecurity Task Force report released June 2, HHS, Centers for Medicare and Medicaid Services and the Office of the Assistant Secretary for Preparedness and Response are assessing what it can do to improve cybersecurity.
At the forefront of the agencies’ radar are regulations, as the changing threat landscape no longer matches current guidelines.
“The threat has changed, the problem has changed,” HHS Deputy Chief Information Security Officer Leo Scanlon said at Thursday’s House Energy and Commerce Committee. “There are matters that need to be brought to light… Organizations are now being attacked on a level they aren’t capable of handling on their own.”
“The regulations in place weren’t designed for current threats… Regulatory mechanisms are fundamentally challenged by threat actors who work at machine speed,” said Scanlon. “But it’s hard to avoid the place where we’re victimizing the victim.”
HHS is attempting to shift from compliance into risk identification while hoping the report will provide insight on where regulations are impeding organizations from improving cybersecurity.
CMS CISO, Senior Privacy Official and Task Force Co-Chair Emery Csulak said that the harmonization of regulation is both a key piece and a challenge of that. HHS is looking at the potential negative impact of current regulations -- like its Office of Civil Rights ‘Wall of Shame’ -- that “punish people for doing the right thing.”
HHS also plans to instate a senior advisor for cybersecurity who will collaborate with the private sector, NIST and the Department of Homeland Security to develop voluntary guidelines, chair the cybersecurity research group and act as a one-stop, point of access for HHS cybersecurity.
Although the U.S. wasn’t a major victim of the WannaCry ransomware campaign, Congress and HHS are analyzing the data from the attack to determine the necessary improvements the government and HHS can make to its best practices to prevent a similar impact in the U.S. in the future.
“Frankly, we were largely spared from the infection that crippled the U.K’s health system: But this incident was an important test,” said Rep. Tim Murphy, R-Pennsylvania.
Murphy said HHS was vital in the U.S.’ response in the wake of WannaCry, disseminating information to the applicable organizations to help prevent the spread.
“HHS must remain vigilant: WannaCry may have been the first major attack, but it won’t be the last,” Murphy said. “HHS has the opportunity to set the tone. This is no longer about protecting patient data, but about patient safety… I shudder to think what would happen if the attack happened here.”
Even worse, Scanlon thinks the U.S. was just plain lucky that it wasn't affected as much as other countries.
“There’s a great deal of analysis to determine what happened and why,” explained Scanlon. “I don’t believe we were spared the spread: We were spared the impact.”
From unpatched IoT devices to medical devices not developed to be put online, these flaws put the U.S. health system at risk. But the WannaCry attacks highlighted the need for better communication, as Scanlon explained it’s difficult to reach all of the disparate systems without one communication channel.
Further, while other sectors can modify and patch systems without a great deal of difficulty, Scanlon said that can’t be done in a health system where the risks are unknown to patient safety.
“Over the years, nothing has challenged healthcare more than cybersecurity,” said Director of Division of Resilience for the Office of Emergency Management at HHS Office of the Assistant Secretary for Preparedness and Response Steve Curren.
These attacks lock down access to life-saving information and communication between staff. The wave of healthcare breaches have compromised the personal data of millions of individuals, said Curren. “The risk of the attacks to healthcare is confidence in the healthcare sector in general… We need to rely on these technologies, but they need to be safe.”
For the latest on Healthcare Reform be sure to register for our Healthcare Reform Event July 19th in San Francisco.
The Best Foods for Good Gut Bacteria
There are 1,000 kinds of good bacteria living in your digestive tract. Here's what to feed them.
Your digestive tract contains a metropolis of bacteria that helps digest and absorb nutrients from the food you eat. Recent research finds, however, that maintaining a proper mixture of gut microbes has a plethora of health benefits that goes beyond the body’s ability to properly digest food.
“Your health is directly tied in to gut microbiome and the diversity of the bacteria in your gut,” says Steven Fox, MD, Medical Director of Gastroenterology at Mercy Health Muskegon in Muskegon, Michigan. Here's the lowdown on how.
The perks of good gut bacteria
Having a healthy population of gut bacteria can prime the immune system to react more aggressively to a pathogen, so that your body can take immediate action when something goes wrong.
A diverse array of microbes also reinforces the inner lining of your digestive tract. There is evidence linking changes to the gut microbiome or a lack of diverse bacteria to painful digestive tract conditions such as hernias, colon cancer, and other inflammatory conditions like inflammatory bowel disease and Crohn’s disease.
“Overall, individuals who do not have a diverse gut bacteria tend to have poorer health,” says digestive expert Dr. Fox. "It's directly related to obesity, type 2 diabetes and multiple autoimmune processes such as arthritis, diabetes and thyroid disorders."
Foods that promote gut-friendly bacteria
While these conditions may sound scary, some experts believe there's one big thing you can do to promote a diverse bacterial environment in your digestive tract: indulge in gut-friendly foods like prebiotics, which provide nutrients that help good bacteria grow and function. Dr. Fox recommends foods high in fiber, including fresh fruit and green vegetables like spinach, lettuce, kale, broccoli, asparagus, green beans, peas, arugula and Brussels sprouts.
Some foods explicitly contain good bacteria, which also help promote healthy gut microbacteria. “Probiotic foods such as yogurt contain healthy bacteria such as lactobacillus, which help with the digestion of dairy products,” adds Dr. Fox. Avoid processed foods that are high in refined sugar and in saturated fat, because they have been found to disrupt and alter the gut microbiome.
The relationship between food and gut bacteria needs further research. But by staying conscious of what you eat, you can improve the diversity of good bacteria vital to your health, and treat your body to lifelong health benefits.
California Is Inching Closer to Single Payer Health Care. Is It Already Doomed?
On June 1st, the California state Senate overwhelmingly passed a "single payer" health care bill (the vote was 23-14) that supporters claim would lead to universal coverage and lower medical costs for consumers. But the landmark legislation still has a long way to go–and many of its most crucial details are not yet concrete, raising the specter of a high-profile failure along the lines of another single payer plan passed in Vermont in 2011 which was ultimately scuttled less than three years ago.
States have been testing out various insurance market models amid the chaos which has engulfed the Affordable Care Act (ACA), or Obamacare, as the conservative House-passed American Health Care Act (AHCA) makes its way through Congress.
Single payer has long been a rallying call for liberal health reform activists who argue it's the only way to ensure that everyone has access to medical treatment irrespective of socioeconomic status. However, such a system is easier said than done given the intense complexity and federated nature of U.S. medicine. And the fact that the California bill doesn't lay out a way to pay for its estimated $400 billion tab could foretell major problems down the road. (There's also no assurance the legislation will actually pass the California Assembly or receive Democratic Governor Jerry Brown's signature.)
In the simplest possible terms, "single payer" indicates a health system which has, well, a single government entity responsible for paying for medical care and negotiating costs. That might mean the government pays this money to doctors, hospitals, and other parts of the health sector directly or creates a subsidiary outfit which does so, similar to the National Health Service (NHS) in the U.K.
The idea here is that replacing hugely decentralized, inefficient health care stake holders with a unified payer can eliminate the moral hazard of private firms which may profit at the expense of patients while also making the entire medical sector more transparent, reliable, and ostensibly cheaper.
But while some countries have achieved far more efficient outcomes than the U.S. with single payer systems, nascent attempts to establish them in the U.S. have fallen short. Vermont—the home state of former Democratic presidential contender Sen. Bernie Sanders, a prominent single payer champion—had to abandon its own single payer plan after supporter Gov. Peter Shumlin admitted that the "Medicare for all" approach wasn't sufficiently funded and could potentially hurt the state's economy.
California could brush up against the same problems if its plan ultimately passes the legislature and is ratified by voters in a referendum on how it's funded. And it would certainly face major opposition from private businesses—the largest providers of health care in the country and recipients of massive health care benefit-related tax exclusions—and the various organizations whose taxes would almost certainly be hiked under such a system. That's not even mentioning the private health insurance industry that single payer could theoretically put out of business.
There's also the question of how California single payer would interact with a variety of state and federal health care programs which rely on a mix of private and public actors. For instance, benefits managers, insurance companies which service Medicare, and drug makers could balk at price controls put in place in just one state and tie up the Golden State's medical experiment in court.
Check out our Healthcare Reform Event July 19th to learn more about this.
- 2 Tablespoons coconut oil
- 2 to 3 small green onions, white and light green parts only, cleaned and chopped
- 1 or 2 cloves of garlic, minced
- 1-inch piece of ginger, peeled and grated
- A pinch of red pepper flakes
- 1 ½ pounds young carrots, sliced 1/2 inch thick
- 1 tsp fine sea salt
- ¼ tsp ground cinnamon
- 1-inch piece of turmeric root, peeled and grated (or use ½ tsp ground)
- Freshly ground pepper to taste
- 4 cups (1 quart) filtered water
- ¼ cup plain yogurt or full fat coconut milk for serving
- Chopped flat leaf parsley or carrot fronds for garnish
- Melt coconut oil in a medium saucepan over medium heat. Sweat the green onions, garlic, minced ginger, and pepper flakes for 1 to 2 minutes or just until glossy. Do not brown or develop color.
- Add carrots, salt, cinnamon and turmeric and cook another 1-2 minutes, stirring occasionally. Add water and bring to a boil. Reduce heat, and simmer until carrots are very soft, 20-25 minutes.
- Puree soup in batches in a high speed blender.
- If serving cold, chill soup for at least 3-4 hours or overnight.
- Divide soup between 4 to 6 bowls and place a spoonful of yogurt or drizzle of coconut milk in center of each and finish with chopped parsley or carrot fonds and a pinch of additional salt and freshly ground pepper if desired.
We still have some availability for involvement in our upcoming Golf Tourney at Harding Park! Details Below:
Pricing available HERE.