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Tuesday, 10 May 2016

Princess Health and May 10th, 2016 A Focused Offensive. Princessiccia

Princess Health and May 10th, 2016 A Focused Offensive. Princessiccia

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May 10th, 2016 A Focused Offensive

Yesterday's defense against a chaotic schedule was replaced with a focused offensive today. I had a long list of things to accomplish, many I needed to accomplish yesterday, but couldn't. I had a very productive day. Part of my morning "me time" includes envisioning how I want the day to unfold. Granted, I don't always get my way, and that's okay. 

Yesterday was a perfect example of how a day can turn into unforeseen circumstances in fast need of adjustments. And these adjustments aren't exclusive to practical-real, physical modifications to the plan, they're coupled with adjustments in perspective. When my life-stream changes course, my fundamental elements stream moves in harmony...it's the equal and opposite reaction theory in practice.

When I'm in a defensive stance, I'm asking how can I maneuver this circumstance while maintaining the integrity of my maintenance plan? This defensive response is very different from old reactions where immediately dropping my defenses and declaring defeat was the go-to. 

This automatic go-to response was very popular within me because the accepted/volunteered defeat released me from the responsibility of taking exceptional care. In this mode, I was constantly the victim of life's difficult circumstances and I liked it that way, because in that, releasing my plan--clearly, wasn't my fault. And if it wasn't my fault, ever, I could live with myself while immersed in constant struggle.

With a focused offensive and cooperating circumstances, goals get set and accomplished without much need for modifications. Not every day is like today. Some days are like yesterday, or worse--and those are the days where I must ask myself a powerful question:

Will I focus on reasons why this can't work or will I ask how it can?

If I ask how it can, and I'm being completely honest with myself, most usually the best options become obvious--and they do, because they're supported by willingness.

I made it home at a decent time, prepared and enjoyed an amazing lunch--worked on a personal project for a little while before grabbing a nicely measured nap. I had a support call scheduled at 6:15 and the regular Tuesday night conference call support group at 7pm. I met Kristin at my favorite Mexican place for a fast, convenient and on-plan dinner. The food and conversation was wonderful. This later dinner, out, worked perfectly with today's schedule. I knew it would be a later dinner, that's why I tilted my meal schedule slightly--eating something late morning as a holdover, then the later lunch.

I maintained the integrity of my maintenance calorie budget. I remained abstinent from refined sugar. And I exceeded my water goal by 32 ounces.

Today was a focused offensive. I'll have another one ready for tomorrow. And if tomorrow turns full of unforeseen circumstances, I'll have a solid defensive ready to meet the challenges, with willingness to ask that game changing question: How can I make this work?

Today's Live-Tweet Stream:


































Thank you for reading and your continued support,
Strength,
Sean

Princess Health and Many Americans, including those on Obamacare plans, can't afford their health-insurance deductibles, studies show. Princessiccia

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The United States has entered the era of high out-of-pocket medical cost as a way to keep insurance premiums low, but recent studies have found that many Americans are having trouble paying them, and the presidential candidates are hardly talking about this issue, Harris Meyer reports for Modern Healthcare.

Graph: Urban Institue's Health Reform Monitoring Survey
Nearly 25 percent of Americans surveyed last September who had coverage through employer plans, the Affordable Care Act, or individual plans outside health-insurance exchanges reported problems paying family medical bills in the previous 12 months, according to the Urban Institute's Health Reform Monitoring Survey. That compared with 16 percent of people on Medicaid and 27.8 percent of the uninsured.

The Kaiser Family Foundation also found that people on Medicaid or policies bought through the federal or state exchanges, also called marketplaces, couldn't afford their deductibles. This 2016 focus group study of 91 low-income Medicaid and exchange-plan enrollees in six cities found that "all reported that they had trouble affording some aspect of their current coverage, including premiums, deductibles, and/or co-payments." It also found that "nearly all marketplace participants" said they had received unexpected bills for services they thought were covered, and fear of this often led them to forgo care.

The latest Kentucky Health Issues Poll found that affordability is also a problem in Kentucky, with 28 percent of Kentucky households having at least one person who reported struggling to pay their medical bills in the previous 12 months. This rate was about the same as in 2014 and didn't vary much between those with insurance or without insurance.  In addition, the poll found that 20 percent of Kentucky households did not get the medical care they needed, or delayed care because of cost in the past 12 months.

This lack of affordability also affects health-care providers. Meyer reports that the chief financial officer for Community Health System told analysts at the first-quarter earnings report meeting that the fourth quarter of 2016 will be his company's best quarter, because patients will have hit their insurance deductibles and only then be able to afford needed care at their facilities.

�As individuals take on high deductibles and higher co-pays, they are essentially taking on insurance risk they can't necessarily afford,� Trevor Fetter, CEO of Tenet Healthcare Corp., told Meyer. Fetter told Meyer that his company now focuses on helping patients understand how to pay their bills, "including pressing for cash payments at the point of service."

What are the presidential candidates saying?

Meyers writes that Democratic front-runner Hillary Clinton offers the most help for those who can't afford their high deductible. She says she "would require health plans to: cover three annual visits to a doctor for illness without applying the deductible; give insured people a $5,000-per-family refundable tax credit for out-of-pocket costs exceeding 5 percent of their income; cap out-of-pocket costs for prescription drugs; bar providers and insurers from charging patients out-of-network bills for services received at an in-network hospital; and strengthen states' authority to block excessive insurance premium increases."

"Vermont Sen. Bernie Sanders, Clinton's Democratic opponent, wants to eliminate premiums and cost-sharing entirely by establishing a tax-funded, government single-payer insurance program covering the full range of healthcare services, including long-term care," Meyer writes.

"Donald Trump, the presumptive Republican nominee, has released a seven-point health policy agenda that doesn't directly address out-of-pocket costs. It would offer households a tax deduction for buying coverage, expand health savings accounts, and let insurers sell plans across state lines," Meyers writes.

Meyers calls the issues surrounding high deductible plans and high prescription drug costs "the domestic policy elephant in the room," and says these issues are not getting enough attention.
Princess Health and Why some dogs (and humans) are born hungry. Princessiccia

Princess Health and Why some dogs (and humans) are born hungry. Princessiccia

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The brain is the central regulator of appetite and body fatness, and genetic variation that affects body fatness tends to act in the brain. One important site of variation is the POMC gene, which codes for a signaling molecule that suppresses food intake. A new study shows that Labrador retrievers often carry an inactive version of the POMC gene, causing them to be highly food motivated, obesity-prone-- and perhaps more easily trainable.

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Monday, 9 May 2016

Princess Health and May 9th, 2016 The Exception. Princessiccia

Princess Health and May 9th, 2016 The Exception. Princessiccia

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May 9th, 2016 The Exception

Today was one of those that just wouldn't stop coming. I have a long list of things I didn't get done because other things required my attention. Long, long day. 6am-2pm & 4:30 to 10pm for intense weather coverage is a long day for me. Luckily, it's the exception, not the rule. I'm not complaining, I'm fortunate to have a job, one I enjoy and know how to do well. I'm just exhausted.

When it comes to maintaining the integrity of my maintenance calorie budget and remaining abstinent from refined sugar, there's no exceptions. It IS the rule, come what may--busy day--high stress--doesn't matter, those non-negotiable elements reside at the top of my priority list. I'm proud to write, I kept those promises to myself in the face of high stress--long hours and even while not being completely prepared food-wise.

I seriously didn't anticipate this long night. My plan was to finish up coverage, participate in the weekly Monday night exclusive support group I co-facilitate with Life Coach Gerri and Kathleen Miles, then prepare a nice dinner at home. In fact, until about 5:40pm, I was convinced I'd be on the group support conference call. I had to miss it tonight. I don't like missing the group call. Thanks to Gerri and Kathleen for covering.

Hitting the pillow.

Tweets, take me away!!

Today's Live-Tweet Stream:




































Thank you for reading and your continued support,
Strength,
Sean
Princess Health and Beshear calls for transparency as Bevin and feds work on Medicaid changes and stakeholders prepare to meet Thursday. Princessiccia

Princess Health and Beshear calls for transparency as Bevin and feds work on Medicaid changes and stakeholders prepare to meet Thursday. Princessiccia

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By Melissa Patrick
Kentucky Health News

Former Gov. Steve Beshear sent an open letter to Gov. Matt Bevin and Health and Human Services Secretary Sylvia Burwell May 9, accusing his Republican successor and President Obama's appointee of working "in secret" and with "no public input of any kind" to change the Medicaid program that Beshear expanded under Obama's reforms.

"On behalf of all who care about the health of Kentuckians, we demand the Bevin and Obama administrations pull back the curtain, stop the back-room deals, and allow for full disclosure and transparency throughout the development of this Medicaid waiver proposal that will impact the lives of hundreds of thousands of Kentuckians, and the future of the entire commonwealth," Beshear wrote.

Beshear asked Bevin to release the details of his plan before Thursday, May 12, when the Foundation for a Health Kentucky is scheduled to host a stakeholders' meeting to discuss what they would like to see in the plan. He also asked Burwell to "demand" that Bevin provide details of the plan before any "formal or informal" decisions are made.

"This meeting of stakeholders should mark the beginning of the the process to solicit input from as many Kentuckians as possible, and the Bevin administration must create future opportunities for other interested stakeholders to weigh in before taking any next steps in the process," he wrote.

Bevin's office declined to comment, but told Kentucky Health News that stakeholder meetings have occurred and more formal ones are in the works. Bevin has said that he wants to announce his plan this summer.

According to the website on the type of waiver Kentucky is seeking, states are required to post their proposed plans for a 30-day comment period before sending them to the federal government. Once the Center for Medicare & Medicaid Services accepts the application, it is required to post the proposal for another 30-day comment period.

Under federal health reform, Beshear expanded Medicaid to Kentuckians with incomes up to 138 percent of the federal poverty level, adding about 400,000 people. The federal government pays for this expanded population through this year, but next year the state will be responsible for 5 percent of the expansion, rising in annual steps to the reform law's limit of 10 percent in 2020.

Bevin told reporters in early May that he had "gone to the mat" with federal officials but remains optimistic they will agree. "If it does not happen it will be because CMS does not want to see expanded Medicaid continue in Kentucky," he said.

Burwell's press secretary, Ben Wakana, "indicated any changes to Kentucky's Medicaid plan should not weaken it," Deborah Yetter reports for The Courier-Journal. Wakana told her, "Kentucky's Medicaid expansion has led to one of the biggest reductions of uninsured people in America, and any changes to the program should maintain or build on the historic improvements Kentucky has seen in access to coverage, access to care and financial security."

Read more here: http://www.kentucky.com/latest-news/article76530622.html#storylink=cpy

Bevin has said many times that the state can't afford its Medicaid population. He appointed Mark Birdwhistell, a University of Kentucky health executive and former state health secretary, in December to help his administration design a new Medicaid program.

Since then, no details have been released, but Bevin has said Kentucky's revised program should require its members to have "skin in the game" and that the state cannot continue to pay for the health insurance of "able-bodied adults."

He has also referred to Indiana's plan, which has monthly fees, co-payments and refers its participants to a work program, as a model for Kentucky. However, spokeswoman Jessica Ditto told Kentucky Health News in March that, "The Indiana model is just one of many models that we are looking at for influence in crafting a plan that is specifically tailored for the needs of Kentucky."

Beshear said evidence suggests a move to a plan like Indiana's will "lead to increased cost for enrollees, and less access to healthcare for the most vulnerable Kentuckians."

He noted that "federal rules prohibit waivers for the sole purpose of saving money or shrinking the size of the program, both of which Gov. Bevin has publicly stated are his goals." He suggested that it is "precisely these types of changes" that are in the proposal, and calls again for "public review and debate." In addition, he calls for CMS to not approve changes that "would leave beneficiaries worse off than they are under a state's existing Medicaid program."

Beshear writes in conclusion, "Transparency, openness and honest conversation with the people of Kentucky is not only the right thing to do on such a critical decision, the people demand it."

Princess Health and Bardstown hospital makes health-analytics company's list of Top 100 Rural and Community Hospitals. Princessiccia

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Flaget Memorial Hospital in Bardstown is the only Kentucky hospital to make the list of Top 100 Rural and Community Hospitals compiled by iVantage Health Analytics. No Kentucky hospitals made the company's list of Top 100 Critical Access Hospitals, which are rural hospitals that agree to limit their operations in return for extra federal reimbursements.
Princess Health and Humana leaving some state health-insurance exchanges to cut its Obamacare losses. Princessiccia

Princess Health and Humana leaving some state health-insurance exchanges to cut its Obamacare losses. Princessiccia

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Humana Inc. said last week that it may leave some state health-insurance exchanges to cut its losses, and then left two, in Alabama and Virginia. "Humana also continues to reel after losing a large Medicare Advantage employer account," Bob Herman reports for Modern Healthcare. "Those factors and others forced the first-quarter profit at the Louisville, Ky.-based insurer to fall 46 percent to $234 million."

Humana said it would probably raise exchange-policy premiums "heavily and ditch some on- and off-exchange policies in 'certain statewide' markets," Herman reported. Later, Zachary Tracer of Bloomberg News reported that the company wouldn't sell Affordable Care Act policies in Alabama and Virginia in 2017.

"Humana is a relatively small player in the ACA, with about 554,300 individual members from the exchanges as of March 31," Tracer noted. "About 12.7 million people picked ACA plans for this year in the government-run markets. The company offers Obamacare plans in 15 states," including Kentucky.

"Humana did not hold an investor call because of its pending merger with Aetna," Herman reported. "If Humana ditches some ACA marketplaces, it would be the second major investor-owned insurer to back away" from them, following United Healthcare. That company "said last month it was losing money and would largely exit the 34 states where it sells plans," report Amrutha Penumudi and Caroline Humer of Reuters.
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