18. December 2011 · Comments Off · Categories: Health Trends

I’m fortunate to have a family with a passion for music.  Kiff Gallagher, my brother-in-law, runs an amazing non-profit out of San Franciso devoted to transforming lives and communities through music.  The Center for Music National Service puts music into schools, hospitals, and other community-based organizations where music can improve academic outcomes and lives.  I was happy to learn recently that Music National Service is now partnering with the San Francisco VA community center.  As our veterans, young and old, avail themselves of the great services of this VA hospital, music can now be a component of their healing.

09. December 2011 · Comments Off · Categories: Cycling

I have yet to set up my ‘cross bike on the device in the photograph.  I am waiting for the weather outside to be truly frightful, and the calendar to read “January.”  But the hardest aspect of actually using the trainer is its current “barrier to entry.”  That is, it needs to be fully accessible and easy to hop on.  As it now sits, it’s simply a pain to set the bike on it and make all the adjustments, and then get down to the real act of “riding” and training.  In the coming month, I’ll make room for it in the basement amidst all the other stuff.  I think for many people exercise is like that – it is not in and of itself hard to commence – it’s just the “getting to it” in order to start that makes it hard.  I don’t think our work environments (or our health plans, for that matter) make it any easier, either.  The message?  Make it easy to start the workout and the workouts will be easier to start, if not do.

06. December 2011 · Comments Off · Categories: Health Law · Tags: ,

 

 

Buried deep in the Affordable Care Act of 2010 is a section of the law that creates a lending mechanism for the establishment of new, non-profit, “consumer driven” health plans.  The idea is to have these plans supplement the other options that will be offered through each state’s insurance exchange.  CMS envisions that these plans will be run by consumers, for consumers of health care, and could be composed entirely of a new group of “members” or composed of a previously existing group, say a cooperative that already has a critical mass of people, among other models.  In theory, these plans could provide coverage for independent contractors (composed of all professions) or similar groups of potential insureds.   The goal is to have at least one CO-OP per state, although CMS will allow others.  Congress has allocated over $3 billion (that’s billion with a “b”!) to the program, so the funds are there for the right applicant at the right time.  The state insurance exchanges are set to roll out in 2014 and CMS’s goal is to have each state’s CO-OP start at the same time.

 

CMS issued earlier this year a proposed rule governing the manner in which each CO-OP is established, functions, and is governed.  In short, each CO-OP acts as a non-profit entity under that CO-OP’s state law, and must have a board of directors, professional management, and demonstate financial stability, including reserve loss ratios that meet each state’s particular insurance requirements.  Start-up loans are available with five year terms, and operational loans are availble for fifteen year terms.

 

There are other details, of course, but CMS has stated that in granting the loans it will be flexible, and recognizes that not all CO-OPs necessarily will fit into a single form.  Consumers may welcome new competition in the market for health plans.  Think about it!