DEA extends pandemic rules for telehealth prescribing through 2024 as agency irons out new policies

By Heather Landi - The Drug Enforcement Administration (DEA) said Friday it will extend telehealth flexibilities that enable clinicians to virtually prescribe controlled medications to their patients through 2024 as it mulls permanent policy changes. Read Full Article…

VBA Article Summary

1. Extension of Telehealth Flexibilities: The Drug Enforcement Administration (DEA) has extended telehealth flexibilities regarding the prescription of controlled medications until December 31, 2024. During this period, all DEA-registered practitioners can prescribe Schedule II-V controlled medications via telemedicine. This extension aims to support patients and medical practitioners, providing them with sufficient time to adapt to upcoming telemedicine regulations expected to be finalized by fall of 2024. This move has been welcomed by telehealth leaders, including the American Telemedicine Association (ATA), as it provides an opportunity to expand access to crucial healthcare services for underserved patient populations.

2. Concerns Over Proposed Rules: In February, the DEA proposed rules that reinstated limitations on virtual prescribing of controlled substances, requiring in-person visits for prescription refills and Schedule 2 medications. The proposals aimed at safeguarding against online over-prescribing. However, these proposed rules were met with significant backlash from the medical and telehealth communities, with many expressing concern over patients’ ability to secure in-person appointments within the required timeframe. The DEA received a record 38,000 comments on its proposed telemedicine rules, reflecting the deep concern and engagement from the healthcare sector.

3. Call for Permanent Tele-prescribing Rules: Despite the extension of telehealth flexibilities, some organizations, including the Health Innovation Alliance, have expressed disappointment that the DEA has not enacted permanent rules regarding tele-prescribing of controlled substances. Critics argue that the DEA should recognize the success of tele-prescribing and trust medical professionals in delivering patient care, urging the agency to establish permanent regulations without further delay. The lack of a "special registration" pathway for practitioners to prescribe controlled substances via telemedicine without prior in-person evaluation—something mandated 15 years ago—is also highlighted as a concern by stakeholders.

Who profits most from America’s baffling health-care system? Not Big Pharma.

By The Economist - On October 4, more than 75,000 employees of Kaiser Permanente, a large health-care chain, began a three-day strike. The walkout was the biggest in the history of America’s health sector, and called attention to the staffing shortages plaguing the country’s hospitals and clinics. Read Full Article…

VBA Article Summary

1. The Rise of 'Big Health': Over the past decade, there has been a significant increase in the presence of intermediary companies, often referred to as "Big Health," in the American healthcare industry. These companies do not manufacture drugs nor provide direct treatment to patients. Instead, they act as middlemen—insurers, pharmacies, drug distributors, and pharmacy-benefit managers (PBMs)—playing a crucial role in the healthcare supply chain. These intermediaries have expanded their influence, with their combined revenue making up approximately 45% of America's healthcare expenditure, up from 25% in 2013.

2. Impact of Vertical Integration: As profit opportunities within their core operations narrow, Big Health companies have sought growth through vertical integration, acquiring various entities along the healthcare supply chain, from clinics to pharmacies. While these acquisitions may improve efficiency and revenue streams for the integrated firms, concerns have emerged about the potential negative side-effects, including increased prices, lower quality of care, and anti-competitive practices. For example, prices often rise after hospitals acquire physician practices without any concurrent improvement in the quality of care provided.

3. Challenges and Potential Disruptions: With the enormous profits generated by Big Health companies, new entrants are seeking to disrupt the industry, positioning themselves as consumer-friendly alternatives. Companies like Bright Health Group, Oscar Health, and Mark Cuban Cost Plus Drug Company are looking to bring transparency and lower costs to consumers. Amazon has also shown interest in healthcare, expanding its services even after the failure of its joint venture, Haven Healthcare. However, these newcomers face significant challenges due to the complexity of the healthcare business and the entrenched position of existing firms, making disruption a slow and difficult process.

The Great Resignation may be over, but ‘resenteeism’ is here to stay

By Sara Sabin - The Great Resignation may have slowed, but now companies have to contend with resenteeism instead. In 2021 and 2022, everyone was talking about the Great Resignation. The trend started around April 2021, when a record 4 million people quit their jobs according to the U.S. Labor Department. By the end of 2021, 47 million had quit and the trend continued into 2022, with 50 million more resignations. Read Full Article…

VBA Article Summary

1. Recognition of Resenteeism:

   Overview - Despite the slowing of the Great Resignation in 2023, employers should remain vigilant as the issue of resenteeism takes center stage. Resenteeism refers to employees remaining in jobs they find dissatisfying due to a lack of better options, all while harboring growing resentment towards their employers.

   Symptoms - This phenomenon is marked by consistent tardiness, lack of enthusiasm, active disengagement, and a decline in work quality and performance. Such employees are not invested in their roles, leading to suboptimal outcomes, loss of customers, and a potential threat to the company's reputation.

   Loud Quitting - With approximately 20% of employees “loud quitting,” or being actively disengaged at work, it's imperative for companies to address this issue earnestly to maintain a healthy and productive work environment.

2. Impact of Resenteeism:

   Operational Efficiency - Resentful employees often produce substandard work, resulting in decreased efficiency and requiring additional resources for correction and damage control. The negative attitude and apathy of these employees can permeate the workplace, affecting the overall team dynamic and performance.

   Customer Relations - Employees who are disengaged are less likely to provide quality customer service, potentially leading to customer attrition, revenue loss, and long-term reputational damage.

   Toxic Culture - Resenteeism contributes significantly to a toxic work environment, breaking down trust and collaboration within teams and hindering creativity and innovation.

3. Addressing Resenteeism Proactively:

   Employee Feedback - Actively seeking and valuing employee feedback is a crucial step in understanding and mitigating resenteeism. Employers should use surveys, interviews, and open communication channels to identify and address the root causes of employee resentment and dissatisfaction.

   Development Opportunities - Offering career advancement, training, and mentorship opportunities can enhance employee morale and retention, combatting boredom and disengagement.
   Management Training - Equipping managers with the necessary skills and knowledge to lead effectively and empathetically is vital. Managers should be trained to appreciate and motivate their teams, fostering a positive, engaging, and productive workplace atmosphere.

6 AI Wellbeing Tools For Work You Should Try This Mental Health Day

By Rachel Wells - Eight-four percent of employees admitted that improving their physical, financial, and mental health was a key priority for this year, a recent Deloitte and Workplace Intelligence study uncovered. However, another study revealed that the average workweek has increased by 2.6 percent since November 2021, with 78.7 percent of employees reporting soaring stress levels due to more tasks but not enough time to complete them all. Read Full Article…

VBA Article Summary

1. Addressing Wellbeing Disconnect Through AI-Powered Tools: The growing concern for mental health in the workplace is evident, with a startling 16% of US employees claiming to be in a high state of wellbeing. However, there is a significant gap between acknowledging wellbeing as a priority and incorporating actionable measures into daily work routines. As October, designated as Mental Health Awareness Month, unfolds with various wellbeing initiatives, it’s crucial to ensure that the focus on mental health is not just seasonal. AI-powered wellbeing tools, like Reclaim.ai, Headspace, and Welltory, offer invaluable support in bridging this disconnect. These tools aid in maintaining a work-life balance, optimizing productivity, managing stress, and fostering a consistent focus on mental health, thereby providing a sustainable approach to workplace wellbeing.

2. Exploring Diverse AI Applications for Mental Health Support: The array of AI-powered tools available offer varied and personalized support to address unique mental health and wellbeing needs. Reclaim.ai assists with scheduling and productivity enhancement for better work-life balance. Headspace offers tailored meditation sessions and focus music, while Welltory provides real-time stress level feedback through AI analysis. Other tools like Todoist help in task management, Breathhh acts as a mental health companion during browsing sessions, and MealMind offers personalized meal planning. With the rapid advancement in AI, these tools provide an adaptive and proactive approach to mental health maintenance, aiding in stress reduction, concentration improvement, and overall wellbeing enhancement.

3. Navigating AI Tool Usage with Caution: While AI tools offer significant support, users should approach them cautiously. It’s crucial to understand that AI chatbots for emotional processing and companionship may have limitations and could potentially offer biased or harmful advice. Users need to experiment with different tools to identify which ones align with their needs and work best for them. Engaging with these tools should be seen as a supplementary practice to other mental health and wellbeing initiatives, rather than a sole reliance. This cautious and informed approach ensures that users can leverage the benefits of AI for mental health support while mitigating potential risks and drawbacks.

What To Know About Stop-Loss Insurance Coverage

By Editor - The insurance landscape is constantly evolving, and new options for business owners are emerging. Stop-loss coverage is one such option with increasing popularity. Insurance professionals are responsible for educating clients about this useful solution and how it can safeguard their finances. We’ll discuss what to know about stop-loss insurance coverage, including the features and benefits that make it an essential consideration for your client’s portfolio. Read Full Article…

VBA Article Summary

1. Key Differences Between Self-funded and Level-funded Plans: The article delineates the distinctions between self-funded and level-funded health plans as a foundational understanding for stop-loss insurance. In a self-funded plan, employers shoulder the financial responsibility for employees’ health claims, whereas level-funded plans offer a balanced approach where employers pay a consistent monthly amount for stop-loss coverage. Recognizing these differences is vital as it influences the need and application of stop-loss insurance for various clients.

2. Significance and Varieties of Stop-Loss Coverage: Stop-loss insurance plays an indispensable role in providing financial safety against high-cost or catastrophic health claims for employers. The coverage comes in two main forms: Specific and Aggregate stop-loss. Specific stop-loss caters to individual claims that surpass a set limit, while Aggregate stop-loss offers protection when the total claims for a group exceed a predetermined threshold. Grasping the nuances of these coverages is crucial for advising clients effectively on choosing plans that align with their business size, industry type, and risk tolerance.

3. Financial Stability Through Stop-Loss Insurance: Implementing stop-loss insurance is highlighted as a strategic move for businesses engaging in self-funding, as it mitigates the financial risks associated with high claim costs. This coverage ensures financial stability, allowing firms to explore alternative health plans confidently without jeopardizing employee welfare. As a consultant, guiding clients through the intricacies of stop-loss insurance not only shields them from unforeseen financial setbacks but also strengthens advisor-client relationships, facilitating the creation of a robust employee benefits program tailored to specific client needs.

How employers are showing support as student loan payments resume

By Maya Goldman - Millions of Americans have student loan payments starting to come due this week, after a three-year pause during the pandemic and the Biden administration’s attempt to forgive the majority of student debt. In response—and in an effort to attract and retain workers—more employers are providing student loan repayment support, a new study shows. Read Full Article…

VBA Article Summary

1. Increasing Employer Support for Student Loan Repayment: A study by the Employee Benefit Research Institute (EBRI) reveals that 34% of employers currently offer some form of student loan repayment assistance, marking an increase from 25% the previous year. Despite not reaching expert Craig Copeland’s early-year forecast of 40%, the growth indicates a rising trend among employers to support their workforce with student debts amid economic uncertainties.

2. Variety of Assistance Programs Garnering Loyalty: Employers who provide student loan assistance gain significant advantages in recruiting and retaining employees. Various support mechanisms are implemented, including debt counseling, loan refinancing, and direct payment support, as seen with Bayhealth in Delaware, which offers new hires a choice between a signing bonus or a substantial student loan repayment. While direct payments are uncommon due to their high costs and potential resentment among other employees, Copeland suggests that alternative offerings like contributions to children’s college funds can mitigate such risks.

3. Future Landscape of Student Loan Benefits Amid Economic Challenges: With the introduction of the Secure Act 2.0 next year, employers may further incentivize employees to pay off student loans by matching their payments with contributions to 401(k) plans. Although the Act simplifies the administrative process for employers, economic uncertainties and a potential recession could limit participation in these programs and hinder the growth of employer-supported student loan repayment initiatives. Copeland suggests that economic downturns might lead employers to retract these benefits as a cost-saving measure, highlighting an uncertain future for these support programs amidst a volatile economic landscape.

Kaiser permanente strike: how to prepare for potential domino effect

By Amanda Norris and Jay Asser - UPDATE: The Kaiser Permanente strike—the largest healthcare workers’ strike in history—ended over the weekend without a deal. Nonetheless, the three-day walkout set the stage for future workforce demands. Read Full Article…

VBA Article Summary

1. Anticipate Intensified Labor Negotiations: With the ongoing healthcare workforce crisis, hospital executives should brace for increased and rigorous labor negotiations. As the workforce contends with wage disparities, job security, and benefits, there will be escalating disputes and negotiations, particularly concerning the implementation of across-the-board raises. Hospital leaders must meticulously evaluate the financial impact of wage increases while maintaining a balance between fair compensation for workers and the fiscal sustainability of the organization. The focus should not solely be on reducing labor costs but also on minimizing staff turnover, as the recruitment and training process for new employees can be resource-intensive and financially straining.

2. Address Workforce and Technology Challenges: As the healthcare sector continues to evolve and incorporate more technology, executives should expect workforce challenges related to subcontracting and outsourcing, especially within the revenue cycle. Outsourcing, as exemplified in the Kaiser Permanente strike, is a contentious issue that requires careful financial consideration and planning. Leaders might need to consider investing in technology to improve operational efficiency and workflow, which could alleviate staff workload and expedite payment collection processes. This investment can also minimize the reliance on contract labor during strikes, ensuring smoother revenue cycle management while reducing administrative burdens on staff.

3. Undertake Strategic Workforce Planning: Hospital leaders need to proactively engage in strategic workforce planning to mitigate the impact of potential labor disputes on their budgets and daily operations. This planning involves evaluating the financial viability of meeting various labor demands, including those related to performance bonuses. Executives should align these incentives with the organization's financial objectives while ensuring they effectively motivate employees and uphold fiscal responsibility. With the ongoing economic disparity between staff and executive salaries, leaders should also explore restructuring compensation packages to bridge the pay gap and foster a sense of unity and understanding within the organization. This effort is crucial in demonstrating commitment and support to the workforce, particularly during times of economic instability and inflation.

What health plans can do to improve member experience, satisfaction

By Jay Asser - If you're a health plan and want to not only retain your members, but attract new ones, the status quo may not be enough. A one-size-fits-all approach may not be either, with older beneficiaries preferring one type of experience, and younger members wanting another. That's why health plans have to deliver highly personalized care—something they're seemingly not doing enough of. Read Full Article…

VBA Article Summary

1. Low Member Satisfaction Levels: Recent surveys and studies indicate a significant dissatisfaction among health plan members. HealthEdge, for instance, conducted a survey involving over 2,800 beneficiaries, revealing that merely 45% of the participants are completely satisfied with their current health plans. The remaining 55% of respondents expressed a desire for improved services and benefits from their insurance. This general dissatisfaction is corroborated by a separate study conducted by J.D. Power, which reported a 13-point decline in overall member satisfaction, primarily attributed to drops in customer service (33 points) and in information and communication (16 points).

2. Generational Preferences and Engagement Challenges: The studies also highlight a discernible generational divide in members’ communication preferences and expectations. Younger members, specifically those aged between 18 to 24, demonstrate a four-fold preference for digital communication channels, such as texting and app messaging. In contrast, respondents aged 65 and above lean towards traditional communication forms, like phone calls and emails. Despite these insights, commercial health plans struggle to effectively engage with members across different age groups and meet their varied engagement needs and expectations.

3. Innovative Solutions for Enhanced Member Experience: With member loyalty depending heavily on consistent trust and a demonstrated willingness to evolve, some health plans are actively exploring and implementing innovative solutions to enhance the member experience. Gabriella Gold, the Director of Network Strategy and Innovation at CareFirst BlueCross BlueShield, shared some insights into technology-driven initiatives yielding positive results in improving member experiences in behavioral health. One such innovation is the introduction of an asynchronous chat function for all commercial members. This new feature facilitates engagement, mimicking informal conversations with close acquaintances. Additionally, partnerships aimed at incentivizing technology use among solo practitioners have resulted in streamlined appointment scheduling, significantly reducing the waiting time for members and improving their overall experience with health plans.