2007 outlook for US health care provider sector viewed by Ernst & Young. - Pharma Marketletter

In 2007, the convergence of market pressures, public policy developments and cost recovery concerns in the US health care provider sector will drive momentum for wider adoption of electronic records, improved efficiencies, greater transparency and new metrics for quality care, according to professional services company Ernst & Young's health care provider practice.

'Health care is operating under a growing strain to serve more patients, cut costs and maintain - and demonstrate - quality of care,' said Dee Balle, America's provider care sector leader at Ernst & Young. 'We are likely to see more focus on a transformation in business processes and operations in the coming year as hospitals and hospital networks confront these challenges. And the leaders - those who get out front - will raise the bar and create a more competitive environment among health care providers,' she added.

According to Ernst & Young' study, among the key issues that will shape 2007 for the USA's health care provider industry are:

Cost recovery

Since 2000, the percentage of individuals without health insurance has increased from 14.2% to 15.9% of the US population. To compound the problem, states facing budget challenges are pushing back on their contributions to Medicaid and there is explicit concern regarding underfunding for Medicare and Medicaid.

The US Government Accountability Office (GAO) recently issued a report advising the incoming Congress to reform Medicare and Medicaid. 'Absent reform, Medicare's and Medicaid's long-term fiscal sustainability for supporting health care for elderly, disabled, and low-income Americans is in jeopardy,' reports the GAO. While resolution may be unlikely due to political posturing, the dialog around the problems and possible remedies will escalate.

Technology 'catch up'

The health care sector lags behind other industries in its use of technology for business processes; especially notable is that only a small percentage of medical records are computerized. To spur progress in this area, there is growing support for the federal government to play a leadership role in establishing standards and funding.

Before the 2006 US mid-term elections, two competing health information technology (health IT) bills were passed, one in the House and one in the Senate, but no further action was taken in the 109th Congress, which ended with 2006. There is a good possibility that health IT proposals will once again emerge during the 110th Congress. Incoming Senate Health Committee Chairman Edward Kennedy (Democrat, Massachusetts) has stated that one of his top priorities will be to pass health IT legislation.

Transparency

Congressional interest in health IT stems, in part, from patients (voters) who are demanding more information and services from their health care providers - on their terms. In August last year, President George W Bush signed an executive order requiring more transparency in pricing and quality reporting. Communities increasingly want to understand all hospitals' pricing and quality of treatment and outcomes.

There is an argument that greater transparency and communication will change attitudes about health care, give consumers the ability to make more intelligent choices about hospitals and physicians and enable hospitals to better track quality and efficiency and use that information to incentivize physicians.

Professional staffing challenges

Labor costs are rising at a faster rate than inflation at hospitals and skilled nursing facilities. With the aging baby boomer population expected to place unprecedented demands on the health care system, the US Department of Labor predicts an additional 5.3 million health care workers will be needed by 2010 (2.2 million replacements, 3.1 million new positions). Issues of cost and how to efficiently increase staff according to demand will receive much attention from health care administrators in 2007.

Pay for performance & gainsharing

In the interest of improving quality and reducing costs, health care payors, including Medicare, are looking to incentivize doctors and hospitals based on quality and safety performance. The US Centers for Medicare and Medicaid Systems (CMS) will implement a 'pay for performance' program in 2007, under which doctors serving Medicare patients can qualify for a 1.5% bonus if they report data on the quality of care, using measures specified by the government.

Gainsharing, says Ernst & Young, is another incentive program that is being discussed at many levels. Gainsharing occurs when hospitals provide physicians with a percentage of any reduction in hospital costs resulting from the physician re-engineering of patient care without sacrificing quality. The ultimate goal of gainsharing is to reduce overall costs.

Community benefit and tax exempt status

Not-for-profit hospitals are facing a growing burden to demonstrate their value to the community. As pressure increases on the federal deficit, discussion in Washington DC questions the benefits that tax-exempt hospitals provide that taxable hospitals do not, which gets to the very heart of whether they should, in fact, be granted tax-exempt status.

Private equity investment in health care

Private equity funds typically target companies with lagging performance, potential for profit growth and strong cash flow that can be leveraged to pay off incurred debt from the deal, all of which are characteristic of many health care organizations.

Despite the current array of challenges facing health care today, PE funds have observed the combination of growth potential (note previously mentioned demographic trend) and opportunity for business operations improvement to increase efficiency and turn a healthier profit, says Ernst & Young. On the heels of the 2006 private equity deal for a large multi-hospital system, we can expect to see additional PE activity in the sector and will be watching how PE infusions of talent and cash may raise the bar for the competition.

Women and health in America: Historical readings - Medical History

Judith Walzer Leavitt (ed.), Women and health in America: historical readings, second edition, Madison, University of Wisconsin Press, 1999, pp. ix, 692, L22.50 (paperback 0-299-15694-7).

Until recently, traditional accounts of the history of medicine have largely ignored women's role as either givers or receivers of health care. Over the last few decades, more scholarship has focused on women's experiences, and it has become increasingly sophisticated and nuanced, moving away from a view in the 1970s of women as victims to women as agents who act in ways that both enable and challenge established medical practice. Women and health in America adds more detail to this increasingly complex picture. In this thoroughly revised second edition, Judith Walzer Leavitt has assembled another outstanding group of essays about women's experiences in the health care arena. This book is especially valuable since it collects in one volume existing scholarship that had been previously available only in a variety of disparate sources.

The volume is organized chronologically into three parts: the first covers subjects from the seventeenth and eighteenth centuries, while the second focuses on the nineteenth century. The third, which addresses health concerns from the late nineteenth to the twentieth century, is the largest unit, containing twenty-eight out of the thirty-five selections that comprise the volume. This final section is further subdivided into specific topics: body image and physical fitness; sexuality; fertility, abortion, and birth control; childbirth and motherhood; mental illness; health care providers (midwives, nurses, physicians); health reform and public health; and the medicalization of health practices.

Twelve brief, but helpful introductions precede every section, providing a concise overview of the subject and a pr&is of each article. Only six essays from the 1984 edition remain. The remaining twenty-nine were initially published over the last fifteen years, from as early as 1986 to as recently as 1996. Topics bearing on issues of race, ethnicity, class, and sexual orientation have a much more prominent place in this volume than in the first edition. Some contributors provide broad over-views of a particular subject, such as Nancy Dye and Daniel Smith's chapter on `Mother love and infant death, 1750-1920', which tracks maternal feelings and perceptions about children during this period through an examination of women's personal writings. Others narrow the focus considerably. In `From robust appetites to calorie counting: the emergence of dieting among Smith College students in the 1920s', Margaret Lowe probes the change in attitudes of Smith College students toward food and their bodies. Prior to the First World War, weight gain was perceived as a sign of health, but by the 1920s, dieting and weight loss became central concerns which, Lowe argues, 'signal a pivotal shift in the way white middle-class college women understood and shaped their bodies' (p. 173).

The range and depth of this book is impressive, and several themes emerge from even cursory browsing. First, medicine both shapes and reflects social attitudes of the time in ways that profoundly constrain and limit our knowledge of health and disease. Second, but related to the first point, medical and social understanding of health and illness have material consequences in people's lives. Conceptions about the body influence what a society considers appropriate or inappropriate behaviour based on age, gender, race, or condition of health, as Elizabeth Lunbeck's article, ''A new generation of women': progressive psychiatrists and the hypersexual female', vividly demonstrates. While it is important to recognize how these societal beliefs affected past medical practices, it is equally, if not more, important to be cognizant of how they continue to operate. Leavitt's book is a compelling testimony to how an appreciation for the contingencies of history and cultural values, particularly with regard to gender, can guide the current direction of health care in America. And this is Leavitt's express intent: 'It is my hope that the historical articles in this book can further that understanding by helping to inform current health policy debates.... By looking back while we plan ahead, the issues at the turn of the millennium ... can be put in a perspective and context that can maximize future development' (p. 7). Women and health in America thus provides a fascinating glimpse into the past, while furthering an understanding of the complex social factors that continue to shape health care in America today.

[Author Affiliation]

American health provider's IT hub to create 50 jobs - Belfast Telegraph

A COMPANY which is a household name in the US is to base an IToffice in Belfast and create 50 jobs over the next two years.

CVS Caremark, a Fortune 50 firm with approximately 200,000employees and 7,300 outlets across America, is the largest pharmacyhealthcare provider in the US and its planned information systemsdevelopment centre will be the company's first foray intointernational territory.

Invest Northern Ireland has offered Pounds 300,000 of support,while a further Pounds 200,000 of support has been offered under theDepartment for Employment and Learning's Assured Skills Programme.

The new jobs will contribute Pounds 1.5m to the economy annuallyand hiring is due to start within weeks.

Stephen Wrenn, senior vice- president of IT services of CVSCaremark Corporation, said that he has worked in Northern Irelandwith several different companies in his career and said that he has'always been amazed' at the quality of the workforce here and saidthat in terms of future expansion, 'the sky's the limit'.

'The IT talent in Northern Ireland has always been phenomenal. Icannot say enough about the university system here, and how theuniversities have always been so willing to tailor their curriculumsto what international investors are looking for,' he said.

'I have always been amazed at the quality, the discipline andlevel of commitment of the workforce and the friendliness of thebusiness community.

'We looked at lots of different regions but chose NorthernIreland for those reasons and also the security of the data systemsand legal system here which will allow us to protect the data andapplications that we are hoping to develop here in Northern Ireland.

'People do want to put numbers on everything but in terms ofexpansion I will say that if this works out there could be nolimitations to what we could do here.'

Enterprise Minister Arlene Foster said that the new office, thelocation of which has not been confirmed, will play a 'small butstrategic role' in the overall corporation.

She added that more and more investors are recognising thatNorthern Ireland is 'big enough to do business, but small enough tocare' adding that 80% of investors here end up re-investing.

'It's been said that companies come here for the cost and stayhere for the people,' she said.

'A lot of people here do not realise how central CVS is toeveryday life right across the US -- they are everywhere.

'Invest NI has been negotiating with the firm since October andStephen has remarked upon how quickly and easily everything has goneand the flexibility we can offer to international investors.'

Pounds 300,000

Rebounding Home-Health Provider CareSouth Builds for Future in Augusta, Ga. - Knight Ridder/Tribune Business News

By Damon Cline, The Augusta Chronicle, Ga. Knight Ridder/Tribune Business News

Feb. 15--CareSouth Homecare Professionals was created from the ashes of a scandal-ridden company's bankrupt assets, then nearly went bankrupt itself when the government changed how it paid home-health companies a few years ago.

Today, standing in CareSouth's new 30,000-square-foot headquarters on Walton Way Extension, where 200 workers last year processed more than $200 million in revenue, a visitor would consider that as ancient history.

Turnaround. Rebound. Rebirth. Whatever you call it, CareSouth has done it.

The 8-year-old company, which had $31 million in debt in 1998 and posted a $5 million loss in 2000, is on track to beat the $5 million profit it made in 2003.

CareSouth employs 650 at six home-health agencies in five states, where its registered nurses and aides provide doctor-prescribed, in-home care to elderly, debilitated and recovering patients.

The company also manages nearly 2 dozen more home-health operations for organizations such as University Hospital in Augusta and St. Joseph's/Candler in Savannah, Ga.

The company wants is hoping to get a bigger piece of the $40 billion home-health market through acquisitions and, possibly, by becoming a public company like home-health giant Gentiva Health Services, a $750 million, Nasdaq-traded corporation.

'Wall Street is looking at home health in a very positive light,' said CEO Rick W. Griffin. 'The future looks really, really bright where we're going.'

And why not? The Census Bureau estimates that more than one-fifth of the U.S. population will be 65 or older by 2030.

'That's a huge number,' Mr. Griffin said. 'Those are the people likely to utilize our service.'

Mr. Griffin was general counsel for the Central Georgia Health System, the Macon-based hospital network that created CareSouth in September 1995 when it paid $54.7 million for the assets of Augusta's Healthmaster Home Health Care, which was bankrupted by a Medicare fraud scandal that sent its owner and top two executives to prison.

CareSouth is now majority-owned by Alexandria, Va.-based venture capital firm Capitol Partners LLC, with Mr. Griffin and other key managers holding small equity stakes.

The management buy-out deal was consummated March 9, 1998. Twenty-one days later, when the Medicare home-health payment system was overhauled, CareSouth nearly went under, like more than 3,000 of its competitors.

'It was a nightmare,' Mr. Griffin said.

CareSouth, like most of its peers, gets 90 percent of its payments from Medicare, the federal health insurance program for people over 65.

Medicare's home-health payment system has changed many times since it was created in 1965, but no change was more dramatic than the 1997 Balanced Budget Act, which converted the government's payment method from 'cost-based' to 'prospective-based.'

Under the cost structure, Medicare simply reimbursed home care companies dollar-for-dollar for their services. With no incentives to prompt efficiency, fraud and abuse became rampant, as in the Healthmaster case.

The prospective system aimed to change that by reimbursing companies in 60-day intervals based on the patient's condition and geographic location. That brought efficiency because companies would incur a loss if their treatment costs exceeded the government's reimbursement.

'It's a good system,' Mr. Griffin said. 'The companies that deliver the best care in the most efficient manner are the ones that are the most successful financially.'

The problem for CareSouth and the rest of the industry was that the system took two years to implement, instead of months as the government had forecast.

The interim system designed to be a transition was simply the old cost system with reduced reimbursements. Not only that, but the reductions were made retroactive for a year, meaning companies such as CareSouth had to give back what the government said were overpayments.

'When that happened, we were absolutely guaranteed a huge loss,' Mr. Griffin said. 'They basically said that when we were reimbursed $100, we should have only been paid $75.'

So, on April 1, 1998, when the intermediate system went into effect, CareSouth suddenly owed the Medicare program $14 million. That violated the company's loan covenants with Bank of America, which called due the company's $17 million debt.

Had it not been for the cash infusion from Capitol Partners, CareSouth would have perished like 3,000 other home health companies between 1998 and 2000, based on figures from the National Association for Home Care in Washington, D.C.

'They kept it alive,' Mr. Griffin said.

With the dark days behind it, CareSouth hopes to bring more business to its Augusta office, which opened in January 2003. The renovated facility in the Walton's Corner office-retail park was formerly occupied by an Eckerd drugstore and a Winn-Dixie supermarket.

'We have a large infrastructure in Augusta that will allow us to take in additional business without incurring extra cost,' said Mr. Griffin, whose office was the frozen-meat section in its past life.

There probably will be more Medicare twists and turns ahead. Mr. Griffin said the fundamentals of CareSouth and home health care won't change.

'We believe in the long term, this is an industry the country needs,' he said.

To see more of The Augusta Chronicle, or to subscribe to the newspaper, go to http://augustachronicle.com/

(c) 2004, The Augusta Chronicle, Ga. Distributed by Knight Ridder/Tribune Business News.

Access to care and factors that impact access, patients as partners in care and changing roles of health providers.(Brief article)(Book review) - Reference & Research Book News

9780857247155

Access to care and factors that impact access, patients as partners in care and changing roles of health providers.

Ed. by Jennie Jacobs Kronefeld.

Emerald Group Publishing

2011

297 pages

$134.95

Hardcover

Research in the sociology of health care; v.29

RA394

Sociologists and other social scientists, and medical and other health-care researchers explore sociological dimensions of relations between health care and people. The overall themes are providers of care, patients as consumers of health-care services, and modifications and reforms in health-care systems. Among the topics are insider knowledge and male nurses, medical interpreting by bilingual staff whose primary role is not interpreting, emergency situations when older homebound women had fortuitous help and a typology of helpers who were involved, feminist centers negotiating medical authority in the 21st century and implications for feminist care and the US women's health movement, and privatization in Malaysia and its effects on the health-care system. There is no index. Distributed in North America by Turpin Distribution.

Day to honor women and health providers - Chicago Sun-Times

The month of March is one in which women and families arecelebrated. Today is International Women's Day, focusing on the keyrole of women in all aspects of life - at home, at work, ingovernment and politics and more. And March 10 is ProviderAppreciation Day, a day to honor those committed and brave workerswho staff the family planning clinics of this nation and providewomen with much-needed reproductive health care and services.

We believe that today is a time for the United States to honorthe commitment made at the 1994 International Conference onPopulation and Development in Cairo. This conference called foraccess to quality and affordable reproductive health care; reductionsin infant, child and maternal mortality, and gender equality,including girls' access to education. Many of these goals can be metby ensuring access to family planning. Family planning addresses allof these issues.

PRESIDENT OBAMA BACKS NATIONAL COUNCIL POSITION ON NEW FEDERAL DEFINITION FOR COMMUNITY MENTAL HEALTH PROVIDERS. - States News Service

ROCKVILLE, MD -- The following information was released by the National Council for Community Behavioral Healthcare:

In the compromise health care reform proposal released by the White House yesterday, President Obama calls for a new federal definition for Community Mental Health Centers (CMHCs) and other community-based mental health and addiction providers. The details of the Administration proposal are strikingly similar to the Federally Qualified Behavioral Health Center (FQBHC) definition that the National Council has been actively pursuing throughout the health reform care debate.

In July 2009, the House Energy and Commerce Committee adopted an amendment co-sponsored by Rep. Doris Matsui (D-CA) and Rep. Elliot Engel (D-NY) to the House health care reform bill that authorizes the new FQBHCs. This legislation takes a critical first step toward achieving parity between community behavioral health providers and other parts of America's safety net including public hospitals and Community Health Centers. In addition, the House measure more accurately reflects the evidenced-based and recovery-focused services that National Council members provide while establishing nationwide accountability and reporting requirements.

These new standards should help to avert instances in which unscrupulous entities have exploited the 1981 CMHC definition to engage in fraudulent Medicare billing practices. After nearly three decades of minimal federal leadership, the Matsui/Engel FQBHC proposal will achieve the goals that President Obama announced today while, at the time, improving health outcomes for millions of low-income Americans living with mental illnesses and addiction disorders.

REPRODUCTIVE HEALTH PROVIDERS AND ADVOCATES CELEBRATE LIFE AND ACCOMPLISHMENTS OF ARHP MEDICAL DIRECTOR EMERITUS, LOUISE TYRER, MD. - States News Service

WASHINGTON, DC -- The following information was released by the Association of Reproductive Health Professionals:

The Association of Reproductive Health Professionals (ARHP), representing more than 12,000 reproductive health care providers, researchers, and educators, is mourning the loss of Louise Tyrer, MD, who passed away on May 20 at the age of 89.

Dr. Tyrer was a legend in the international community of family planners and reproductive rights advocates. She broke barriers as a pioneering woman in medicine and make major contributions as a reproductive rights leader.

In 1971, Dr. Tyrer was the first female physician hired by American College of Obstetricians and Gynecologists (ACOG), where she served as director of family planning. She was the vice president of medical affairs at Planned Parenthood Federation of America (PPFA) for 15 years where she developed national medical standards and guidelines for contraception use and established two medical review committees to improve patient care.

Dr. Tyrer was a founding member of ARHP in 1963 and served as the organization's medical director from 1991 until 2002. According to Wayne Shields, ARHP's president and CEO, 'She was an amazing obstetrician/gynecologist provider prior to Roe v. Wade, when abortion was illegal. She was one of the 'first voices' for the pro-choice movement.'

A special tribute to the incredible life and contributions of Dr. Tyrer is being planned for Reproductive Health 2010, the annual meeting hosted jointly by ARHP, PPFA, and the Society of Family Planning. Reproductive Health 2010 will take place September 22-25 in Atlanta.

Fuel's surge a headache for home health providers - AP Online

Stethoscope? Check. Bandages and medications? Check. Money for fuel? Uh-oh.

U.S. home health care workers, particularly those in rural areas, are suffering from financial headaches caused by the escalating cost of transportation, forcing some to borrow cash from co-workers in between paychecks and others to consider leaving the industry altogether.

Providers of home care in New York, California and other states are doling out prepaid gas cards, rental cars and other perks in an effort to retain their workers, who care for roughly 12 million elderly and disabled patients nationwide and drive an estimated 5 billion miles a year, according to a recent study by the National Association for Home Care and Hospice.

The industry is also contemplating abandoning uneconomical home visits in far-flung locations, and increasingly checking patients' blood pressures, heart rates, blood-sugar levels and other vital signs via remote monitoring systems, which many companies previously deemed too expensive.

Industry officials said they had not heard of any instances where a patient's care was compromised by the high cost of getting a health care professional to their home, though they are worried it could happen. After some home health providers threatened earlier this year to cease operations in rural parts of South Dakota, Democratic Sen. Tim Johnson said he would push Congress to revamp the Medicare payment system to account for the industry's rising fuel bill.

While lots of industries are suffering as a result of gasoline prices that have risen more than 80 percent in the past 18 months, experts said it's a particularly knotty problem for nurses, aides and other employees of home health care agencies _ many of whom are responsible for their own travel expenses and depend on government reimbursements that haven't yet caught up with the rising prices at the pump.

A recent survey by the National Association of Area Agencies on Aging underscores the impact: half of the respondents said they had already cut back on home visits because of surging fuel costs _ and 90 percent said they expected to make cuts in 2009.

The Northern Montana Home Health Care and Bear Paw Hospice, a not-for-profit company based in Havre, Mont., that covers two counties made up of 24,000 people across 7,136 square miles, is looking at discontinuing service in the state's back country.

The company's director, Lisa Genereux, said the formula underpinning Medicare reimbursements simply doesn't account for $4.09-a-gallon gasoline, the average price at the pumps in the Rocky Mountain states these days.

Donald Wagoner, a nurse who travels up to 100 miles a day traversing New York's Adirondack region, said his newest professional challenge these days is simply not running out of fuel. "I've come close a couple of times," said Wagoner, who drives a Saturn Vue SUV that gets around 25 miles to the gallon.

For the most part, providers are taking steps to make sure their staffs can afford to travel from home to home and, when they cannot, that patients continue to get the care they need.

_ AristoCare Home Health Services, which operates in Arizona and California, recently began paying a $10-$15 travel stipend for trips outside downtown Tucson, and uses computer mapping software to reduce the number of miles home care workers drive between assignments.

"With as much driving as they do, we had to do something," said Cyndy Michaud, the Tucson, Ariz.-based company's branch relations manager.

_ Bons Secours Home Care in Newport News, Va., has arranged with a rental-car company to provide 15 fuel-sipping Toyota Corollas for its registered nurses. The nurses pay $150 a month for the car, they can drive it for personal use, and the agency picks up the cost of gas for the first 20,000 miles driven each year.

"As soon as we were able to start offering these cars, I had people knocking down my doors," said Sharon Riddick, the agency's director. "Now I'm fully staffed for the first time in seven years."

For its part, the Home Care Technology Association of America is lobbying Congress for changes in Medicare to allow companies that use remote monitoring systems to get reimbursed for it _ a major reason more companies haven't embraced the technology.

Even if remote monitoring technology becomes more widely embraced, patients requiring wound care, physical therapy and other hands-on attention will always receive it, the trade group's executive director, Bob Walters, said.

Many home health agencies reimburse workers for fuel on a per-mile basis. But with paychecks often two weeks or more apart, employees must cover rising gas costs out-of-pocket _ an extra burden for those working in rural areas, where pay tends to be lower but the distances between patients is higher.

Kathy Liddell, assistant director of patient services of North Country Home Services in New York's Adirondack Mountains said some home health aides _ who start at $9 an hour _ have had to borrow gas money from office staff to make it from one paycheck to the next. The Saranac Lake company's 250 employees collectively travel about 7,000 miles a day serving patients in a 5,000-square-mile patch in northern New York.

Part of the problem is that the agency can't afford to keep raising its reimbursement rate to keep pace with the price of gas.

"When gas was around $2 a gallon, we were paying 30.5 cents a mile. Now we're up to 42.5 cents," she said.

The Internal Revenue Service as of July 1 raised the automobile mileage rate that businesses and others can claim from 50.5 cents per mile to 58.5 cents per mile.

Most home care is funded through Medicaid and Medicare programs using fixed payment rates _ some of which are only adjusted annually _ based on estimates of the cost of providing care. But those costs _ like gasoline _ can rise sharply between adjustments. That makes it difficult for some to raise the fuel reimbursement for employees without busting its own budget, said North Country's Liddell.

The Association for Home Care and Hospice _ a trade group representing publicly traded companies such as Amedisys Inc. and Gentiva Health Services as well as smaller agencies _ also is pushing for changes in Congress.

Guardian Links with Mental Health America to Educate Public on Depression and Disability. - Health & Beauty Close-Up

In the face of historically high unemployment, record home foreclosures and a volatile economy, The Guardian Life Insurance Company of America, a provider of group and individual disability insurance, is collaborating with Mental Health America (MHA) in a effort to raise awareness about depression as a common cause of disability.

The month of May happens to be both Disability Insurance Awareness Month--coordinated by the Life & Health Insurance Foundation for Education (LIFE) since 2007--and Mental Health Month, a tradition that MHA began in 1949.

In a release, the group noted that the month-long educational campaign is centered on a brief online quiz designed to dispel myths about mental illness and disability, as well as reinforce the importance of protecting one's ability to earn an income. Every time an individual completes the quiz during the month of May, Guardian has pledged to donate $1 to support MHA's work nationwide to improve mental health and wellbeing, up to $10,000.

'The continued uncertain economic climate, high unemployment rate and increases in personal bankruptcies and home foreclosures have created additional stress for many Americans--and stress can be linked to depression,' said Barry Petruzzi, Guardian's 2nd Vice President, Group Life and Disability.

'The word 'disability' often makes people think about wheelchairs and catastrophic injuries,' added Larry Hazzard, Vice President of Product Strategy for Berkshire Life Insurance Company of America, the Guardian company that issues individual disability income insurance. 'But disability often means having back problems, being temporarily sidelined as you recover from a heart attack or cancer--or battling depression or other mental illnesses.'

'In this economy, protecting your ability to earn an income with disability insurance--obtained through your employer's group plan or on your own as an individual policy--is more important than ever,' Hazzard said. 'Knowing that your family's well-being can be protected even if a serious illness like depression forces you to leave the work force temporarily is critical.'

'We are pleased to be working with Guardian to bring attention to issues related to mental health and depression,' said MHA's Shern. 'This fundraising challenge is interactive and educational. We hope that people will come away with information that will help them and their loved ones lead healthier and more balanced lives. We encourage everyone to complete the quiz and e-mail the link to their friends so that we can raise the maximum amount for this important cause.'

Fuel's surge a headache for home health providers.(Business) - Daily Herald (Arlington Heights, IL)

Byline: Richard Richtmyer Associated Press

ALBANY, N.Y. Stethoscope? Check. Bandages and medications? Check. Money for fuel? Uh-oh.

U.S. home health care workers, particularly those in rural areas, are suffering from financial headaches caused by the escalating cost of transportation, forcing some to borrow cash from co-workers in between paychecks and others to consider leaving the industry altogether.

Providers of home care in New York, California and other states are doling out prepaid gas cards, rental cars and other perks in an effort to retain their workers, who care for roughly 12 million elderly and disabled patients nationwide and drive an estimated 5 billion miles a year, according to a recent study by the National Association for Home Care and Hospice.

The industry is also contemplating abandoning uneconomical home visits in far-flung locations, and increasingly checking patients blood pressures, heart rates, blood-sugar levels and other vital signs via remote monitoring systems, which many companies previously deemed too expensive.

Industry officials said they had not heard of any instances where a patients care was compromised by the high cost of getting a health care professional to their home, though they are worried it could happen. After some home health providers threatened earlier this year to cease operations in rural parts of South Dakota, Democratic Sen. Tim Johnson said he would push Congress to revamp the Medicare payment system to account for the industrys rising fuel bill.

While lots of industries are suffering as a result of gasoline prices that have risen more than 80 percent in the past 18 months, experts said its a particularly knotty problem for nurses, aides and other employees of home health care agencies many of whom are responsible for their own travel expenses and depend on government reimbursements that havent yet caught up with the rising prices at the pump.

A recent survey by the National Association of Area Agencies on Aging underscores the impact: half of the respondents said they had already cut back on home visits because of surging fuel costs and 90 percent said they expected to make cuts in 2009.

The Northern Montana Home Health Care and Bear Paw Hospice, a not-for-profit company based in Havre, Mont., that covers two counties made up of 24,000 people across 7,136 square miles, is looking at discontinuing service in the states back country.

The companys director, Lisa Genereux, said the formula underpinning Medicare reimbursements simply doesnt account for $4.09-a-gallon gasoline, the average price at the pumps in the Rocky Mountain states these days.

Donald Wagoner, a nurse who travels up to 100 miles a day traversing New Yorks Adirondack region, said his newest professional challenge these days is simply not running out of fuel. 'Ive come close a couple of times,' said Wagoner, who drives a Saturn Vue SUV that gets around 25 miles to the gallon.

For the most part, providers are taking steps to make sure their staffs can afford to travel from home to home and, when they cannot, that patients continue to get the care they need.

AristoCare Home Health Services, which operates in Arizona and California, recently began paying a $10-$15 travel stipend for trips outside downtown Tucson, and uses computer mapping software to reduce the number of miles home care workers drive between assignments.

'With as much driving as they do, we had to do something,' said Cyndy Michaud, the Tucson, Ariz.-based companys branch relations manager.

Bons Secours Home Care in Newport News, Va., has arranged with a rental-car company to provide 15 fuel-sipping Toyota Corollas for its registered nurses. The nurses pay $150 a month for the car, they can drive it for personal use, and the agency picks up the cost of gas for the first 20,000 miles driven each year.

'As soon as we were able to start offering these cars, I had people knocking down my doors,' said Sharon Riddick, the agencys director. 'Now Im fully staffed for the first time in seven years.'

For its part, the Home Care Technology Association of America is lobbying Congress for changes in Medicare to allow companies that use remote monitoring systems to get reimbursed for it a major reason more companies havent embraced the technology.

Even if remote monitoring technology becomes more widely embraced, patients requiring wound care, physical therapy and other hands-on attention will always receive it, the trade groups executive director, Bob Walters, said.

Many home health agencies reimburse workers for fuel on a per-mile basis. But with paychecks often two weeks or more apart, employees must cover rising gas costs out-of-pocket an extra burden for those working in rural areas, where pay tends to be lower but the distances between patients is higher.

Kathy Liddell, assistant director of patient services of North Country Home Services in New Yorks Adirondack Mountains said some home health aides who start at $9 an hour have had to borrow gas money from office staff to make it from one paycheck to the next. The Saranac Lake companys 250 employees collectively travel about 7,000 miles a day serving patients in a 5,000-square-mile patch in northern New York.

Part of the problem is that the agency cant afford to keep raising its reimbursement rate to keep pace with the price of gas.

'When gas was around $2 a gallon, we were paying 30.5 cents a mile. Now were up to 42.5 cents,' she said.

The Internal Revenue Service as of July 1 raised the automobile mileage rate that businesses and others can claim from 50.5 cents per mile to 58.5 cents per mile.

Most home care is funded through Medicaid and Medicare programs using fixed payment rates some of which are only adjusted annually based on estimates of the cost of providing care. But those costs like gasoline can rise sharply between adjustments. That makes it difficult for some to raise the fuel reimbursement for employees without busting its own budget, said North Countrys Liddell.

The Association for Home Care and Hospice a trade group representing publicly traded companies such as Amedisys Inc. and Gentiva Health Services as well as smaller agencies also is pushing for changes in Congress.

Telemedicine bill could aid home health providers, Jeffords says. - Home Health Business Report

Telemedicine bill could aid home health providers, Jeffords says

By MATTHEW HAY

HHBR Washington Correspondent

WASHINGTON Sen. Jim Jeffords (R-VT) has introduced bipartisan legislation that would simplify federal regulations for and enhance the delivery of telemedicine services targeted at senior citizens living in rural areas. The legislation would amend Medicare rules to increase coverage of the costs of telemedicine. Last year, Medicare only covered 6% of all telemedicine doctor-patient visits with senior citizens and disabled persons.

Jeffords, the chairman of the Senate Health, Education, Labor and Pensions Committee, introduced the Telehealth Improvement and Modernization Act with Sen. John Rockefeller (D-WV) and eleven other cosponsors on May 4.

The National Association for Home Care (NAHC; Washington) quickly endorsed the bill and said it would give home health providers the flexibility to provide cost- effective and quality home care visits within the prospective payment system.

By better utilizing high technology, we should not only be able to increase the quality of healthcare, but also increase efficiency and see cost savings, Jeffords said. He noted that more than 25% of the nations senior citizens live in rural America and said his legislation streamlines federal regulations to help better utilize telemedicine programs.

Jeffords bill also eliminates several current provider requirements and clarifies current law to permit telehomecare visits under the home health PPS. He said telehomecare should not be prohibited. Where home health providers are paid on a prospective basis, nothing prevents them from incorporating telehomecare where appropriate into their care plans, said Jeffords.

He said that part of the problem in getting greater coverage for beneficiaries is that the Health Care Financing Administration (HCFA; Baltimore) has misinterpreted federal laws and imposed cumbersome rules.

According to the NAHC, Jeffords bill also mandates that a telehomecare visit for a low utilization payment adjustment, outlier payment, or therapy service cannot be used as a substitute for in-person visits for purposes of establishing coverage and payment under PPS.

Help sought on bills: ; Health providers want legislation for prompt payment - Charleston Daily Mail

DAILY MAIL CAPITOL REPORTER

Many doctors and hospitals are sick of health insurers andmanaged care providers in West Virginia taking months to paypatients' medical bills and now want legislation to force thecompanies to pay on time. The worsening financial burden of latepayment threatens the state's health care providers, said WilliamMacLean, executive director of Health Partners Network, anorganization that includes 12 hospitals and 760 physicians in thestate.

The pattern of late payment is creating 'a chilling effect' withmore physicians reluctant to join managed care outfits, MacLean toldan legislative interim committee Monday.

And if the doctors he represents are suffering, he said 'I hateto think what private physicians are facing in their environment.'

He asked legislators to pass a 'prompt pay' bill that would set atime limit for insurers to pay patient bills.

Similar legislation exists in 39 states.

Regionally, prompt pay laws range from a restrictive policy foundin Pennsylvania to a less stringent arrangement in Maryland.

Both insurance companies and the state's Insurance Commissionhave agreed to try to work something out. The bill is expected tocome up at the Legislature's regular session early next year.

MacLean said he's 'not advocating onerous regulations' like inPennsylvania, but doctors and hospitals 'just need a little bit ofhelp.'

He would like to see West Virginia pass legislation similar to abill in Maryland, which enforces a 45-day pay period. He saidPennsylvania's law is 'too heavy-handed' and might scare off healthinsurers from entering the market.

Rather than fight legislation, health insurance companies arewilling to work out a bill 'that is acceptable to everyone,' saidRandy Cox, a lobbyist for the HMO Association of West Virginia andthe Health Insurance Association of America.

'If it's a balanced bill, my clients can live with some sort oftime limit,' Cox said.

Managed care companies, including HMOs, are among the worst atpaying on time, according to statistics of payments at UnitedHospital Center, a West Virginia University Hospital.

So far this year, bills of patients using managed care companiesremained unpaid for an average of 74 days, MacLean said. Blue Crosstook an average of 43 days to pay up.

Other commercial providers took 72 days.

But with large numbers of patients using managed care companies,the delays are especially troublesome.

Unpaid bills from managed care companies alone stack up to totalabout 20 percent of the $35.1 million in current assets at UnitedHospital Center.

MacLean also asked for so-called 'clean claim' legislation, whichwould require insurers to pay claims that include all the necessarypatient information.

MacLean said it's 'relatively common for there to be a protractedprocess of determining if a claim is clean.'

Some insurers are merely being 'tough editors' of claims, MacLeansaid, but other outfits are just trying to keep their money longer.

He estimated that about one-third of questioned claims arejustified, while two-thirds are just 'red herrings.'

MacLean pointed to the state's Medicaid program as the paradigmof prompt payment of bills.

Medicaid, the state's largest health insurer, processes 15million invoices a year, but pays 90 percent of its bills within 30days and 99 percent in 90 days, said Phillip Lynch, Medicaid'sbudget director.

'Quite frankly,' MacLean said, 'if everyone paid on thatschedule, I wouldn't be here.'

The Doctor Won't See You Now.(Health)(America's doctor shortage) - Newsweek

Byline: Mary Carmichael

A critical shortage of primary-care physicians is yet another symptom of our ailing health-care system.

After taking a month to regroup, the White House has put health care back at the top of its agenda, asking Republicans for new ideas and trying to regain momentum for old ones. But last week's summit came down mostly to the same old talking points. And even if the president does manage to get some version of health-insurance reform passed in the next few months, he and the country are still going to be dealing with the related crisis of America's doctor shortage. Primary-care physicians, family docs, general practitioners--whatever you call them, they're the country's first line of defense, the ones responsible for promoting preventive care, finding ways to keep people from getting sick in the first place, and thus bringing down costs throughout the system. If every American went to one of these doctors regularly, health-care costs might come down as much as 5.6 percent a year, saving $67 billion, according to one estimate. Yet we don't have nearly enough doctors to make that happen, and fewer are being produced every year.

The annual number of American medical students who go into primary care has dropped by more than half since 1997. It's hard to get an appointment with the doctors who remain. In some surveys, as many as half of primary-care providers have stopped taking new patients. The other half are increasingly overworked and harried. Clearly we need to find a way to increase their ranks, and both the congressional health-care bills and President Obama's reform proposal make moves in that direction. But those efforts are somewhat limited, and a more comprehensive solution could be thwarted by the same thing that's stalled the rest of health-care reform so far: politics.

The reason behind America's doctor gap is a matter of money. The average income in primary care is somewhere in the mid-$100,000s, which sounds like a lot but is less than half what specialists such as radiologists and dermatologists make. Given that doctors may graduate with as much as $200,000 in med-school debt, it's easy to see why primary care started hemorrhaging recruits more than a decade ago and why radiology and other well-paid, high-tech specialties took off in popularity.

The field has since entered a vicious cycle. As fewer people have entered primary care, the doctors who are left have been forced by tight schedules to shortchange some patients, forgoing the long, meandering chats that used to be a big part of checkups in favor of 15-minute, checklist-style appointments. The close relationships that general practitioners once had with patients drew many idealistic students into the field. Now recruiters face an extra-tough sell: they have to convince bright young would-be docs to pursue a career that won't pay very well and won't be as emotionally fulfilling as it once was.

How can schools entice more aspiring doctors into primary care? The Tufts University School of Medicine, to take one example, offers a $25,000-per-year scholarship for med students who agree to work in primary-care practices in rural Maine for much of their training period. Students on this Maine Track start shadowing doctors on the third day of orientation. This year's program drew 257 applicants for just 36 slots.

The problem with the Maine Track is that it doesn't actually require med students to enter primary care after they graduate. It can't, says Peter Bates, chief medical officer at Maine Medical Center, which jointly administers the program with Tufts. 'If you're a bright kid with a great future, being told you have to be a family physician in rural Maine--even if that's what you want to do [now]--might strike you as confining,' Bates says. 'Why would you close down your opportunities?'

There are dozens of training programs like Tufts's around the country, as well as the National Health Service Corps, which pays back loans and hands out scholarships and stipends in exchange for a few years of service in rural areas, where the shortage of primary-care providers is most acute. Obama and the Senate have both called for an expansion of the program in their proposals for reform, which has already received $200 million in stimulus funds. Several new medical schools, including some that focus on primary care, have also recently opened. But all those changes may not be enough to fill the gap. 'We need more than half of doctors in this country doing primary care,' says Harris Berman, interim dean of the medical school at Tufts. 'It's a bigger problem than we can solve with programs like ours.'

So what else can be done? Lately, some policymakers have argued that instead of having a primary-care doctor, more people--especially young, healthy patients with simple medical needs--should see a nurse or physician assistant who administers routine care and kicks more complex problems up to a doctor when they arise. 'If you're just coming in to have your blood pressure checked and your pulse taken, you really don't need to see a doctor, and you might not need to see a nurse, either,' says David Barrett, president and CEO of the Lahey Clinic in Burlington, Mass. 'There are three-stripe military sergeants with two-year degrees who can provide excellent primary care. There's absolutely no reason to force all primary-care providers to have an M.D.'

The Lahey Clinic is an 'integrated group practice'--one of the teamwork-oriented organizations, like the Mayo Clinic and the Cleveland Clinic, that have been lauded for cutting costs and eliminating waste in the health system. In its primary-care service, a 'team captain' physician supervises nurses, PAs, and other health-care professionals who perform tasks like checking blood pressure but don't necessarily make formal diagnoses on their own. The problem with taking this approach nationwide is that nurses and PAs are subject to the same economic forces that drive medical students. Almost half of current nurse practitioners and physician assistants work in specialty practices, where the money is. Then there's the fact that the country already has a nursing shortage. How are nurses going to replace doctors if there aren't enough nurses to begin with?

There's one more group of people, foreign medical graduates, who could theoretically fill in for the missing primary-care providers. The trouble is, they're already doing that. More than a quarter of primary-care doctors currently practicing in the United States have gotten their diplomas abroad. Increasing their numbers would be problematic for both the left (which might object to poaching doctors from developing countries that need them) and the right (which would surely object to recruiting non-Americans to do a job that reliably pulls in six figures, especially when unemployment is high).

Inevitably, then, the solution to the primary-care crisis is going to have to involve something simpler: paying primary-care providers more, so as to draw more bright young physicians into the field. At least it sounds simpler. But even this turns out to be maddeningly complex.

Most primary-care doctors, like all other physicians, are paid bit by bit for each medical task they perform (unless they work somewhere like the Lahey or the Mayo, which pay set annual salaries). Private insurers decide how much they'll reimburse docs for each task partly by looking to Medicare's policies for guidance. Medicare, in turn, makes its decisions by committee. Here is the bad news for primary-care docs: most of the physicians on the committee that sets the reimbursement rates are specialists. Medicare--and, consequently, private insurance--doesn't reimburse primary-care doctors as lavishly as it does their more specialized counterparts. That's why primary-care incomes are relatively low in the first place.

Changing anything about the way primary-care providers are paid will be immensely complicated. For one thing, rural doctors sometimes perform specialized procedures because no one else is available--would they still qualify for a raise? And then, what exactly constitutes a task that should be reimbursed? For a high-tech specialist, this is often clear-cut: each scan or chemical test counts. But what about all the things primary-care doctors do that don't involve technology? 'You don't get paid to talk to people and tell them to stop smoking. Nobody values my time to do that,' says Joe Gravel, a family physician and chief medical officer at the Greater Lawrence Family Health Center in Massachusetts. 'They'll pay for the lung transplants, but they won't pay to prevent 50 people from needing them.'

In January, Medicare raised reimbursement rates for some primary-care services by about 4 percent, and its payment committee will call for another small increase this week. That's a good start, says Lori Heim, president of the American Academy of Family Physicians, but 'if you're talking about changing the way students view primary care, it needs to be more like 25 percent, and that's on the low side.' Both the House and Senate reform bills also include a slight increase in primary-care payments--5 and 10 percent, respectively.

To fund such a pay raise, Congress would either have to spend more money on health care or pinch some from the specialists by lowering their pay rates. The first strategy is clearly controversial--no one wants to increase health-care costs further. The second, budget-neutral strategy is bound to tick off the specialists. Peter Mandell, a spokesman for the American Academy of Orthopaedic Surgeons, sent a clear message last year when the Medicare reimbursement committee suggested a 10 percent shift in payments toward primary-care docs and away from specialists. Telling The New York Times that his group had 'a problem' with the idea, Mandell added, 'If there's less money for hip and knee replacements, fewer of them will be done for people who need them.' It's a short step from his polite, reasonable statement to rallies over the specter of rationing.

Panel to health providers: talk more, test less. - National Underwriter Life & Health-Financial Services Edition

Doctors should spend more time talking to their patients about how to take better care of themselves and less time conducting routine tests without any proven value, according to a new report released by a group of prominent preventive health specialists.

The report, released by the United States Preventive Task Force, an independent panel of preventive health specialists first convened in 1984, reflects new evidence about important health benefits of selected preventive services.

In addition, the report, a complete update of guidelines first issued by the taskforce in 1989, reflects a more critical look at what sponsors say does and does not work with regard to preventive health practices.

The task force issued new recommendations for and against 200 different interventions for more than 70 common diseases and conditions ranging from cancer to chickenpox.

Some of the selected recommendations the group has endorsed include:

* Annual fecal occult blood testing to screen for colorectal cancer.

* Routine cholesterol tests for men aged 3 5 to 65 and women aged 45 to 65, and others at increased risk for heart disease.

* Routine vaccinating for all newborns, children, adolescents and young adults against hepatitis B.

The task force came out against the following:

* Routine screening for prostate cancer with prostate-specific antigen (PSA) or digital rectal examination.

* Urine tests for early detection of bladder cancer or asymptomatic urinary tract infection.

Authors of the study said it should help medical providers throughout the health care system determine what route to best take when providing preventive care.

The task force 'follows the philosophy that when you're offering [Preventive treatment] to somebody who is healthy, the provider has to weigh the costs and [potential] harms to the patient,' said Dr. Harold Sox, a professor of medicine at Dartmouth Medical School and chair of the task force.

'Doctors should spend more time talking to their patients' about how to take better care of themselves through behavioral changes 'and less time doing routine tests that don't have any proven value, ' said Dr. Sox, referring to urine tests to detect the presence of cancer.

Indeed, one of the principal findings of the latest report is that counseling patients about personal health practices--smoking, diet, physical activity, drinking, injury prevention and sexual practices--remains one of the most 'underused, but important' parts of the health visit.

'Most leverage on health status comes from people working on behavioral changes,' said Dr. Donald Berwick, vice chair of the task force and president of the Institute for Healthcare Improvement, Boston.

The American Medical Association, for its part, supports the development of these criteria of preventive services but is not in agreement with all of the panel's recommendations, according to Nancie Steinberg, a spokeswoman for the AMA. She would not elaborate.

Members of the managed care community, meanwhile, applauded the recommendations.

In a letter to the task force, Carmell Bocchino, director of medical affairs for the Group Health Association of America/American Managed Care and Review Association, which represents 800 managed care organizations, said the guide offers a 'practical approach to assessing the validity of preventive services and the potential impact of clinical preventive services on improving health status.'

ALL ACCESS HEALTH INSURANCE PROVIDER GIVES CLIENTS A GO-TO ONLINE.(DAYBREAK) - The Wisconsin State Journal (Madison, WI)

Byline: Patricia Simms Wisconsin State Journal

Welcome to the brave new world of health insurance.

On this new frontier, customers can:

* View pharmacy claims and the actual costs of prescriptions.

* Find out how much of their deductible they've used.

* Find out which procedures were done and what the charges were.

* Update personal information online.

* Print out medical and pharmaceutical charges for tax purposes.

* Choose a new primary doctor online.

And that's just GO-TO, a Web-based self-service health insurance program that Physicians Plus Insurance Corporation rolled out this spring.

'This will allow a much simpler and more direct way for members to manage their business with us,' said Bill Jollie, chief operating officer of the managed care organization. 'We have a 7 a.m. to 7 p.m. office, but people don't live a 7-to-7 life.'

GO-TO is available at any time -- in real time -- and eliminates some paperwork and waiting times for as many of the 95,000 PPIC members that choose to enroll, Jollie said.

About 350 members have been enrolling each week, he said, and a similar module for health-care providers is near.

Because the detail of actual claims is available online, members are able to see clearly what services were delivered. 'It's going to make people much more conscious of what physicians are doing ... what services physicians are actually billing for,' Jollie said.

GO-TO, developed on software sold by Perot Systems, is the latest local evidence of a sharp shift toward consumer education and choice -- the trendy term is 'consumer-driven health care.'

'This is, in fact, the direction that health-care consumerism is going,' said Susan Pisano, vice president for communications for America's Health Insurance Plans, a Washington, D.C.-based trade organization.

'That means access to more information about cost and quality, more transparency, more choices and customization.'

The technology that's fueling the shift didn't exist 10 years ago, she said.

Last fall, for example, Group Health Cooperative of South Central Wisconsin, another Madison managed care organization, launched a system called GHC MyChart that gives patients access to their medical records.

Employers benefit as well: WPS recently announced it is making data on health-care cost and utilization available to employers via the Internet. Jollie said Physicians Plus debuted a product directed to employers last year, and Christopher Queram, chief executive officer of the Employer Health Care Alliance Cooperative, said the Alliance has offered employers a similar service -- again via the Internet -- since last fall.

'The capabilities and design of these systems vary slightly, but they are all part of the mega-trend of increased access to information,' Queram said.

As the cost of pharmaceuticals and technology soars, health-care companies want patients to know what their pills and products cost.

Pisano said this should be good for consumers. 'I don't think American consumers embrace the idea that one size fits all,' she said. 'Choice is one of the paramount principles for the American consumer. That hasn't necessarily played out in the health-care arena, but it certainly is beginning to.'

In the past, the American health-care system paid the same for bad quality as it did for good, she said. 'The system has not particularly provided the information that allows consumers to drive businesses to the better-quality and lower-cost providers,' she said.

For patients in managed care, which is about 65 percent of the Madison market, GO-TO may be the first time members will get a look at the real cost of the drugs they take, said March Schweitzer, director of product development at Physicians Plus.

'There is a subtle educational component,' Schweitzer said.

Experts think savvy health-care consumers will drive down costs, Pisano said.

'There is a distinct body of opinion that says if you have information on cost and quality, you are going to make good choices based on cost and quality,' she said.

'Ultimately ... good quality costs less than poor quality.'

But it's too early in the evolution to know what impact these systems will have on costs and on individual behavior, Queram said.

'Certainly the hope and the expectation is that information will drive better decision-making and that will impact both cost and quality,' Queram said. '... we have a long journey ahead to create an informed and empowered' consumer. Yet, we are creating the tools and that is, in itself, a positive sign.'

Fore more information, visit www.pplusicdigital.com

Health America Adds Medicare HMO Plans in Southwest Pennsylvania.(Originated from Pittsburgh Post-Gazette) - Knight Ridder/Tribune Business News

Feb. 8--Health America yesterday became the third contender in a race to enroll the region's senior citizens in health maintenance organizations.

The region's second-largest managed-care insurer unveiled two HMO plans -- one with no monthly premium, the other with a monthly fee of $13 -- that are similar to plans introduced here last year by U.S. Healthcare and Blue Cross of Western Pennsylvania.

For the insurers, the HMO plans could open the door to a lucrative market: Some 400,000 Medicare beneficiaries in a region where benefits spent on each are richer than they are in most other parts of the country.

For retirees, the introduction of more HMO options as alternatives to traditional fee-for-service Medicare coverage and Medigap supplements may cause confusion and concern, but also a chance to save money. HMOs and other managed-care plans are far less expensive than Medigap supplements, but they limit choices of physicians and, some consumers worry, also may put limits on medical treatment.

The extent to which the region's elderly switch to managed care also will have a huge impact on hospitals. The relatively large Medicare population here, which accounts for more than 50 percent of hospital revenues, has buffered health-care institutions from the admissions declines they've seen in the private sector, where health-care plans have been shifting to managed care at a rapid rate.

Local analysts expect a rapid conversion of the Medicare population to managed care, because many employers are expressing interest in adding HMOs to the list of choices they offer former employees under their retiree health benefits programs. Pending legislative changes also could make Medicare more expensive for seniors, forcing those without corporate retiree benefits also to join HMOs.

Clearly the plans can save retirees money. Medigap plans, which many seniors buy to augment Medicare coverage, typically cost upwards of $100 a month and in many cases don't provide as many benefits. By comparison, all of this region's Medicare HMOs offer a zero premium plan. All of the plans also offer limited dental and eye-care benefits that are not provided under traditional Medicare or via Medigap supplemental coverage. Co-payments for doctor's visits and prescriptions vary among the plans.

Among its other terms, Health America's new zero-premium plan requires subscribers to pay a $6 co-payment for each doctor's visit and an $8 co-payment for each prescription. Prescription benefits are capped at $900 annually.

By comparison, the Health America plan that carries a $13 monthly premium requires no co-payments for doctors' visits and a $5 co-payment for each prescription. The annual ceiling on prescriptions under that plan is set at $1,200.

While Medicare HMOs are relatively new here, they have become competitive. Blue Cross began its Medicare program without a zero premium plan, but has since introduced one to compete with U.S. Healthcare, which has lowered prices and expanded benefits several times here.

Compared with what is offered in most regions of the country, all of the plans are relative bargains, health benefits consultants said.

'I've been very hard-pressed in other areas of the country to find Medicare-risk plans (the government's term for the HMOs) with premiums and benefits as attractive as (those offered) in Western Pennsylvania,' said Ed Pudlowski, a benefits consultant with William Mercer & Co.

That's because Medicare HMOs here are operating in one of the richest Medicare markets. Allegheny County not only has the second-largest elderly population in the nation, but the region also has the 13th-highest per-beneficiary Medicare costs in the country. Health care for a Medicare beneficiary here costs the government $5,096 annually vs. less than $3,000 in some of the lowest-cost regions.

HMOs, which try to reduce costs by weeding out unnecessary hospital admissions and other costly medical practices, hope to profit by bringing this region's costs closer to those where managed care has been more prevalent. The more successful they are, the more revenues hospitals are likely to lose, possibly increasing the kinds of staff cuts, mergers and other cost-cutting measures that they've turned to in the past two years.

'Behind the scenes, the specter of Medicare-risk plans (HMOs) coming to town, more than anything...got the providers to respond' with cost-cutting campaigns and other survival strategies, said David Lagnese, a benefits consultant with Towers Perrin's Downtown office.

Thus far, Blue Cross and U.S. Healthcare are running ahead of their own enrollment projections for their Medicare HMO plans. Blue Cross, which launched its plans last March, has signed up 23,259 members and expects its tally to grow to 60,000 by year end. U.S. Healthcare has signed up 21,000.

Flu shots urged for health providers.(NEWS) - Family Practice News

All health care workers should be vaccinated annually against influenza, and doing so should be a condition of new or continued employment, according to a position paper from the Society for Healthcare Epidemiology of America.

This is the first time the organization has recommended mandatory vaccination of all health care workers; and its position was also endorsed by the Infectious Diseases Society of America.

'I am very hopeful that this guideline will encourage the adoption of more mandatory policies at all health care institutions,' said Dr. Neil Fishman, president of SHEA and director of health care epidemiology and infection control for the University of Pennsylvania Health System, Philadelphia.

Various vaccinations already are required at health care facilities, including measles, mumps and rubella, and some facilities also require vaccination against chickenpox, pertussis, and hepatitis B.

'So there are precedents for having vaccines as a condition of employment,' Dr. Fishman said.

The hope is that SHEA's new recommendation--published Aug. 31 in the journal Infection Control and Healthcare Epidemiology--will improve the current influenza vaccination rates for health care workers, which now hover in the 30%-40% range, Dr. Fishman said. (See related story, p. 26.) The recommendation applies to all workers, students, and volunteers in all health care facilities, regardless of whether they have direct patient contact.

Under the SHEA position paper, the only exceptions to the mandatory vaccination policy would be for medical reasons, such as a severe allergy to eggs, Dr. Fishman said.

The Centers for Disease Control and Prevention currently recommends that all health care professionals get an annual influenza vaccine and that health care facilities provide the vaccine to its workers with a goal of vaccinating 100% of staff.

Some health facilities and systems already require influenza vaccination as a condition of employment. The University of Pennsylvania Health System, where Dr. Fishman works, has required flu vaccination for its workers since 2009.

Researchers at the Virginia Mason Medical Center, Seattle--believed to be the first in the country to institute mandatory influenza vaccination for its health care workers in 2005--recently studied their institution's efforts to improve influenza vaccination rates.

They found that in the first year after the mandatory influenza requirement was put in place, 97.6% of the facility's 4,703 health care workers were vaccinated, followed by adherence rates of more than 98% in the following 4 years. Less than 0.7% of the center's workers were exempted from vaccination for medical or religious reasons, and less than 0.2% refused vaccinated or left employment at the center rates (Infect. Control Hosp. Epidemiol. 2010;31:881-8).

'Influenza vaccination of health care providers is a professional and ethical obligation ... to prevent the spread of influenza, an infection that can spread rapidly through an institution,' Dr. Fishman said.

MENTAL HEALTH AMERICA ADOPTS POLICY OPPOSING LIFE SENTENCES WITHOUT PAROLE FOR JUVENILES. - States News Service

ALEXANDRIA, VA -- The following information was released by the Mental Health America:

Mental Health America has adopted a strong policy opposing sentences of life without parole for juvenile offenders, calling such punishment 'inconsistent with any of the purposes which ordinarily guide sentencing.'

The policy was adopted by Mental Health America's Board of Directors at its September meeting. The U.S. Supreme Court will consider whether such sentences are cruel and unusual punishment this term.

The United States is one of the few countries in the world that sentences juveniles to life without parole. In 42 states and under federal law, children who are too young to legally buy cigarettes are being tried for crimes as adults and if convicted can be sentenced to life without the possibility of parole.

There are currently at least 2,500 youthful offenders serving life without parole in U.S. prisons. Nationally, 59 percent of these individuals received their sentences for their first ever criminal conviction. Sixteen percent were between the ages of 13 and 15 when they committed their crimes, and 26% were sentenced under a felony murder charge where their offense did not involved carrying a weapon or pulling a trigger.

'Sentencing, including sentencing to imprisonment, has long been guided by four considerations: deterrence, retribution, incapacitation and rehabilitation. None of these purposes are served by sentencing juveniles to life without parole,' the policy position states.

'Victims of child abuse and neglect are over-represented among incarcerated juveniles, including those serving life without parole. Studies of this population also consistently demonstrate a high incidence of mental health and substance use disorders, serious brain injuries, and learning disabilities. In many instances, these juveniles have not received adequate diagnostic assessments or interventions.'

The policy also notes that such sentences violate international law and the Convention of the Rights of the Child, which has been ratified by every country in the world, except Somalia and the United States.

Mental Health America is also encouraging its more than 300 affiliates to work to repeal laws in those states which permit a sentence of life without parole. And it urges mental health advocates, professionals and other service providers work to ensure that juveniles are provided with appropriate services while incarcerated whose goal is to identify and ameliorate those problems which may have led to the crime and which need to be addressed before release will be safe and appropriate.

U.S. Plans To Rate Health Providers; Campaign Aimed At Improving Care - The Washington Post

The federal government is planning for the first time to issuedetailed ratings of the quality of care provided by nursing homes,Medicare health plans, dialysis centers and eventually hospitals anddoctors, a senior Bush administration official announced yesterday.

The Health Care Financing Administration (HCFA), using newspaperadvertisements, the Internet and toll-free telephone numbers, plansto release numerical scores for every Medicare provider four times ayear based on a half-dozen criteria, ranging from medical credentialsto staffing levels.

Relying on both government inspection reports and customersurveys, the plan would provide the most comprehensive, objective wayto evaluate health care providers, going far beyond the limitedinformation currently available to consumers.

'Collecting data and publishing it changes behavior faster thananything else,' Thomas Scully said yesterday in his first speech ashead of the agency that oversees Medicaid and Medicare.

Similar to the publishing of automobile crash test data, the planhas far-reaching -- and controversial -- implications for millions ofAmericans, and for an industry that has been slow to adoptstandardized quality measurements.

Proponents say scorecards will help give consumers the power toaggressively shop for health care. Even more significantly, consumer-friendly, numerical ratings appear to be the best way to force thehealth care industry to raise its standards.

'There is a lot of evidence that the people who use this type ofinformation the most are providers,' said Nancy-Ann DeParle, formerhead of HCFA. 'They look to see how they are doing versus otherproviders.'

Representatives of health care groups, however, questioned theplan, saying the government's data could be misleading because itfails to take into consideration factors such as whether facilitiestreat a sicker patient population. For such reasons, groupsrepresenting doctors, hospitals and other health care providers havelong opposed the release of such ratings.

The federal government now spends about $300 million a yearcollecting information on the thousands of health providers thatserve the 70 million people in Medicare and Medicaid. But the datahas never been presented in an easy-to-understand way.

Scully said the new approach should also help governmentinspectors focus on poor-performing facilities. 'Bad actors should beinspected a lot more frequently,' he said during a luncheon addressat the U.S. Chamber of Commerce. It is illogical, he argued, toinspect safe, high-quality, nursing homes as often as the decrepit,dangerous ones. If a facility scores poorly, he warned, 'we'll be inthere every day.'

Details of the proposal are still being worked out, but HCFA staffmembers said they are confident the agency has the data, money andauthority to move quickly.

Scully hopes the effort will enable Americans to scan a list ofscores for every nursing home or dialysis clinic in the community,comparing cost, client profiles, staff credentials, medicaltreatments and customer satisfaction.

'HCFA already collects a fairly substantial amount of data,' hesaid, predicting the agency will settle on a list of criteria 'fairlyquickly and start using it.' He hopes to add ratings for hospitalswithin a year and for physicians after that.

Spokesmen for the nursing home industry said they have nocomplaint with objective, quality scoring. But they said the data nowavailable is at best insufficient and perhaps misleading.

The information HCFA collects is essentially a collection oflists, said Larry Minnix, chief executive officer of the AmericanAssociation of Homes and Services for the Aging, which represents5,600 not-for-profit health centers for the elderly.

For instance, government reports indicate how many patients at aparticular facility had bedsores on a particular day, 'but it doesnot tell you if they take more of those patients or if the home has aparticular program for treating those wounds,' Minnix said,suggesting it would take two to four years to develop a workablerating system.

Carmela Coyle, senior vice president for policy at the AmericanHospital Association, warned that any quality data must be given inthe proper context. She noted that several years ago, the governmentpublished hospital mortality rates. But the rates did not factor inwhether a hospital served a high-risk population such as those inpoor neighborhoods or performed experimental treatments -- both ofwhich could elevate the rates.

Scully said the ratings plan is part of a broader effort tooverhaul his agency. By the end of the month, he and Health and HumanServices Secretary Tommy G. Thompson plan to revamp virtually everyaspect of the agency, from its name to how it markets programs.

REP. PETERSON-BACKED BILL WOULD EXTEND MEDICARE PAYMENTS TO RURAL HEALTH PROVIDERS - US Fed News Service, Including US State News

Rep. John E. Peterson, R-Pa. (5th CD), issued the following press release:

Rep. John E. Peterson, R-Pleasantville, joined several of his rural colleagues on Capitol Hill this morning in announcing his support for legislation to extend provisions in the Medicare Modernization Act of 2003 designed to ensure that rural Americans have access to quality, affordable health care.

'The extension of these critical reimbursement provisions for rural health care providers should be a top priority of this Congress,' said Peterson. 'Folks in rural areas already face tough challenges when it comes to receiving timely, quality health care. It's the federal government's job to recognize the scope and severity of those challenges, and work to create the most equitable repayment plan it can. This bill accomplishes that important mandate.'

Peterson, who co-chairs the 145-member Congressional Rural Caucus, worked with other rural lawmakers during the Medicare deliberations in 2003 to include important reforms in the final version of the bill to improve reimbursement plans for rural hospitals and health care providers, which have historically been underfunded compared to their larger, urban counterparts. Led by Peterson and more than 80 House lawmakers representing rural districts across the country, the group was successful in getting their colleagues to agree to the inclusion of more than $25 billion in the Medicare bill for rural hospitals, physicians, home health agencies, ambulance services, and other health care providers.

'When the Medicare bill was being considered in 2003, my rural colleagues stood shoulder-to-shoulder with me to ensure that our rural hospitals and health care providers got a fair shake in the final version of the bill,' said Peterson. 'Three years later, we stand ready to go to work once again, and I'm hopeful this time we'll be able to extend that important rural payment relief into the future.'

This legislation, H.R. 5118, would extend Medicare reimbursement methods for services provided in isolated or underserved areas in America to help ensure that such reimbursements are equitable and fair for costs incurred by rural health providers. H.R. 5118 was introduced in early April and now enjoys the bi-partisan support of more than 50 co-sponsors.

Among some of the other important provisions included in H.R. 5118:

* Extend the 5% payment adjustment for home health services provided in rural areas to help offset higher home health delivery costs, which can be as much as 12- to 15-percent higher than in urban areas;

* Extend the Medicare incentive payment program for physicians practicing in designated physician scarcity areas, communities and counties throughout the nation recognized as having low number of physicians serving populations in rural areas;

* Extend the 2% bonus payment for ambulance trips in rural areas to help offset the higher costs of ambulance services in rural areas, which contain farther distances between patients and care facilities;

* Extend the 1.0 floor on Medicare physician reimbursements to rural areas, who would be penalized for geographic location without extension of the MMA provision, to ensure fair and reasonable repayment to facilities and care providers in rural areas;

* Extend the hold harmless treatment for the nation's 535 sole community hospitals, which provide inpatient health services for residents in rural, isolated communities, to ensure equitable reimbursements for services provided; and,

* Extend reasonable cost reimbursement for clinical lab tests performed by rural hospitals as part of their outpatient services (i.e. for area patients receiving care at home or in nursing homes).

Oral Health America: Hispanic Parents Expect Schools to Play a Role in Keeping Kids' Mouths Healthy. - Health & Beauty Close-Up

Almost three out of four Hispanic parents (72 percent) are looking to schools to reinforce messages about the importance of oral health, saying it is extremely or very important for schools to teach children about taking care of their teeth, according to a new public opinion survey commissioned by Oral Health America.

'If we want our children to be in school, ready to learn, both parents and schools have a vested interest in working together with dental care providers to teach good habits that will last a lifetime and keep mouths healthy,' said Beth Truett, President and CEO, Oral Health America. Tooth decay is the number one chronic childhood disease in the U.S., and children lose over 51 million school hours each year due to dental related illness.

According to the survey, Hispanic parents remain committed to oral health, and a majority (82 percent) believe that taking children to the dentist is an important part of getting ready to go back to school. But are children getting the message? Seven in ten parents say they give a brushing reminder on a daily basis, but less than half of children (34 percent) remember hearing their parents give these daily reminders. At school, just four in ten (39 percent) children report learning about oral or dental health in the past year.

'Parents should commit to spending just two minutes twice a day with younger children to make sure they are not only brushing and flossing their teeth, but doing it right,' says Yolanda Bonta, DMD, MS, MS, Executive Director, Hispanic Dental Association. 'Schools can help by integrating mouth health into health and science classes at all grade levels.'

The public opinion survey was released to kick-off Fall for Smiles, promoting the importance of self care, regular dental visits, healthy food choices, and tobacco avoidance as part of oral and overall health. The survey was sponsored by Oral Healthcare Can't Wait and Plackers, a brand of consumer oral care products, and was conducted on-line within the U.S. by Harris Interactive for Oral Health America in May and June 2010 among 1,144 U.S. parents and 1,346 U.S. children ages 8-18.

Oral Health America is a national, non-profit organization dedicated to changing lives by connecting communities with resources to increase access to care, education and advocacy.

Mental health providers should prescribe exercise more often for depression, anxiety.(Clinical report) - NewsRx Health & Science

Exercise is a magic drug for many people with depression and anxiety disorders, and it should be more widely prescribed by mental health care providers, according to researchers who analyzed the results of numerous published studies.

'Exercise has been shown to have tremendous benefits for mental health,' says Jasper Smits, director of the Anxiety Research and Treatment Program at Southern Methodist University in Dallas. 'The more therapists who are trained in exercise therapy, the better off patients will be.'

Smits and Michael Otto, psychology professor at Boston University, based their finding on an analysis of dozens of population-based studies, clinical studies and meta-analytic reviews related to exercise and mental health, including the authors' meta-analysis of exercise interventions for mental health and studies on reducing anxiety sensitivity with exercise. The researchers' review demonstrated the efficacy of exercise programs in reducing depression and anxiety.

The traditional treatments of cognitive behavioral therapy and pharmacotherapy don't reach everyone who needs them, says Smits, an associate professor of psychology.

'Exercise can fill the gap for people who can't receive traditional therapies because of cost or lack of access, or who don't want to because of the perceived social stigma associated with these treatments,' he says. 'Exercise also can supplement traditional treatments, helping patients become more focused and engaged.'

The researchers presented their findings March 6 in Baltimore at the annual conference of the Anxiety Disorder Association of America. Their workshop was based on their therapist guide 'Exercise for Mood and Anxiety Disorders,' with accompanying patient workbook (Oxford University Press, September 2009). For links to more information see www.smuresearch.com.

'Individuals who exercise report fewer symptoms of anxiety and depression, and lower levels of stress and anger,' Smits says. 'Exercise appears to affect, like an antidepressant, particular neurotransmitter systems in the brain, and it helps patients with depression re-establish positive behaviors. For patients with anxiety disorders, exercise reduces their fears of fear and related bodily sensations such as a racing heart and rapid breathing.'

After patients have passed a health assessment, Smits says, they should work up to the public health dose, which is 150 minutes a week of moderate-intensity activity or 75 minutes a week of vigorous-intensity activity. At a time when 40 percent of Americans are sedentary, he says, mental health care providers can serve as their patients' exercise guides and motivators.

'Rather than emphasize the long-term health benefits of an exercise program - which can be difficult to sustain - we urge providers to focus with their patients on the immediate benefits,' he says. 'After just 25 minutes, your mood improves, you are less stressed, you have more energy - and you'll be motivated to exercise again tomorrow. A bad mood is no longer a barrier to exercise; it is the very reason to exercise.'

Smits says health care providers who prescribe exercise also must give their patients the tools they need to succeed, such as the daily schedules, problem-solving strategies and goal-setting featured in his guide for therapists.

'Therapists can help their patients take specific, achievable steps,' he says. 'This isn't about working out five times a week for the next year. It's about exercising for 20 or 30 minutes and feeling better today.'

Keywords: Anxiety Disorders, Clinical Trial Research, Depression, Mental Health, Pharmaceuticals, Pharmacotherapy, Psychology, Therapy, Treatment, University of Oxford, Southern Methodist University.

Beth Truett Joins Oral Health America as President and CEO. - Biotech Week

Oral Health America's Board of Directors is very pleased to announce the appointment of Beth Truett as President and Chief Executive Officer of the national advocacy organization. Ms. Truett comes to the position with significant corporate and non-profit leadership experience, including over twenty years as a business executive in marketing and sales, and most recently, as the Executive Director of Chicago Lights, a community services organization that annually serves thousands of Chicagoans who face the challenges of aging, poverty, access to education and healthcare (see also Oral Health America).

'We welcome Ms. Truett at an exciting time for oral health and a time of great promise for Oral Health America,' said Kathy Zwieg, CDA, RDA, Chairman, Oral Health America. 'Our hopes for the organization are well matched in her considerable leadership abilities, professional experience, and commitment to the issues.'

At Chicago Lights, Ms. Truett served as the inaugural Executive Director to create the organization, increase revenue, and develop collaborative programs. Her previous successes include restructuring and expanding client solutions as a Vice President and Senior Vice President for two of the nation's largest providers of global event and travel management, marketing communications, and enterprise consulting to corporations in the pharmaceutical, financial services, and technology sectors. She also has developed marketing campaigns for Kraft Foods.

Ms. Truett has a BS in Food & Nutrition from Valparaiso University, a Masters degree in Divinity from McCormick Seminary in Chicago, and holds a Certificate in Fundraising Management from Indiana University School of Philanthropy. She is a member of the Association of Funding Professionals (AFP), serves as an AFP Mentor, is a member of the Corporate Responsibility Group, and one of 100 women inducted in 1997 into Leadership America, an international organization recognizing women for career and volunteer leadership. She is a member of the Board of Directors for Voices for Illinois Children, and has served in multiple volunteer capacities for organizations in Chicago and her hometown of Oak Park, IL.

Oral Health America is the nation's premier, independent advocacy organization, dedicated to improving oral health for all Americans. To find out more about Oral Health America, visit http://www.oralhealthamerica.org/.

Keywords: Oral Health America, Aging.

Guardian Joins Forces with Mental Health America - Wireless News

Wireless News
05-12-2010
Guardian Joins Forces with Mental Health America
Type: News

In the face of historically high unemployment, record home foreclosures and a volatile economy, The Guardian Life Insurance Company of America, a provider of group and individual disability insurance, is collaborating with Mental Health America (MHA) in an effort to raise awareness about depression as a common cause of disability.

The month of May happens to be both Disability Insurance Awareness Month--coordinated by the Life & Health Insurance Foundation for Education (LIFE) since 2007--and Mental Health Month, a tradition that MHA began in 1949.
In a release, the Company noted that the month-long educational campaign is centered on a brief online quiz designed to dispel myths about mental illness and disability, as well as reinforce the importance of protecting one's ability to earn an income. Every time an individual completes the quiz during the month of May, Guardian has pledged to donate $1 to support MHA's work nationwide to improve mental health and wellbeing, up to $10,000.

Consisting of seven quick questions, the quiz is located at guardianlife.com and mentalhealthamerica.net/.

Economy's Vicious Cycle: Workplace absences, lost productivity and long-term disability claims due to depression and other psychiatric disorders can be profound, at both the micro- and macro- economic level. MHA estimates that, in a typical office of 20 people, four will experience a mental health challenge in any given year. Translated across the broader economy, MHA notes that untreated and mistreated mental illness costs the nation $150 billion in lost productivity each year, with U.S. businesses footing up to $44 billion of this bill.

And, just as mental illness has a definite negative impact on the economy, it is likely that the reverse holds true as well.

'The continued uncertain economic climate, high unemployment rate and increases in personal bankruptcies and home foreclosures have created additional stress for many Americans--and stress can be linked to depression,' said Barry Petruzzi, Guardian's 2nd Vice President, Group Life and Disability.

'The word 'disability' often makes people think about wheelchairs and catastrophic injuries,' added Larry Hazzard, Vice President of Product Strategy for Berkshire Life Insurance Company of America, the Guardian company that issues individual disability income insurance. 'But disability often means having back problems, being temporarily sidelined as you recover from a heart attack or cancer-- or battling depression or other mental illnesses.'

Indeed, according to the Council for Disability Awareness (CDA)'s 2008 Long-Term Disability Claims Review, mental illnesses accounted for nearly 6.5 percent of new disability claims, not far behind the 10 percent caused by injuries and accidents.

'In this economy, protecting your ability to earn an income with disability insurance--obtained through your employer's group plan or on your own as an individual policy--is more important than ever,' Hazzard said. 'Knowing that your family's well-being can be protected even if a serious illness like depression forces you to leave the work force temporarily is critical.'

Emphasis on Wellness: In addition to bringing attention to the issue of mental illness as a trigger for disability claims (and the importance of being financially protected should that occur), Guardian and MHA officials hope that this month's educational campaign also puts a spotlight on the need for wellness and prevention.

'Mental health is integral to overall health--and promoting wellness, prevention and treatment of depression and other mental health conditions are central to our mission,' said David Shern, Ph.D., President/CEO, Mental Health America. 'Just as Americans have learned there are things they can do to reduce their risk of heart disease and other illnesses, Mental Health America wants to help people learn what they can do both to protect their mental health in tough times and also to improve their mental well-being throughout their lives.'

'We are pleased to be working with Guardian to bring attention to issues related to mental health and depression,' said MHA's Shern. 'This fundraising challenge is interactive and educational. We hope that people will come away with information that will help them and their loved ones lead healthier and more balanced lives. We encourage everyone to complete the quiz and e-mail the link to their friends so that we can raise the maximum amount for this important cause.'

((Comments on this story may be sent to newsdesk@closeupmedia.com))

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