Paying for Health Care Reform with Medicare/Medicaid Savings

Here in Asheville North Carolina, health insurance reform is a huge issue as our local population consists largely of retirees, many of whom are becoming increasingly concerned about the cost sustainability of their Medicare and their North Carolina health plans. As health care costs continue to rise, reform is something the Obama Administration earnestly hopes to include in the 2010 Fiscal Budget. President Obama has identified savings which could constitute a reserve fund for the proposed health care reform plan. Approximately half of the funding would come from proposals to generate revenue, while the rest would come from Medicare and Medicaid savings.

Based on White House projections, the Medicare savings proposals would reduce beneficiary premiums for physician and outpatient services by about $33 billion over the next decade. As a result of these proposals, beneficiaries would also see an improvement in the quality of their Medicare services. The reserve fund includes a host of Medicare/Medicaid savings proposals, some of which include:

- Improving the accuracy of Medicare and Medicaid payments. The Centers for Medicare and Medicaid Services (CMS) would have to strengthen their integrity efforts in order to address flaws that have led to billions in overpayments and fraud each year.

- Reducing Medicare overpayments to private insurers would save taxpayers roughly $177 billion over 10 years, as well as reduce Part B premiums. This would be accomplished through the establishment of a competitive system in which payments are based on an average of plans' bids submitted to Medicare.

- Reducing hospital readmission rates and improving post-hospital care. The idea here is that a combination of incentive payments and penalties would lead to better care and fewer readmissions, which would save approximately $25 billion over 10 years.

- Expanding the Hospital Quality Improvement Program to improve quality of care for beneficiaries. This would be done by tying a portion of Medicare payments for acute in-patient hospital services to hospital performance on certain measures of quality. As a result of this effort, Medicare would save around $12 billion over 10 years.

- Cutting waste, abuse and fraud. When it comes to care, patients need quality, not quantity. Unnecessary treatments are not only expensive, but can also pose risks to patient health. To prevent physicians from ordering unnecessary treatment, the Administration proposes increasing scrutiny (through a pre-payment review process) in high-risk areas or for those physicians who order an excessive amount of high-risk services.

For residents of North Carolina, health insurance, Medicare and health care reform are no doubt important topics. As citizens directly affected by these potential changes in policy, it's important that you stay abreast of the facts, beware of misinformation surrounding health care reform, and show your support for legislation that speaks to your needs (which are probably not unlike those of many other Americans). If you are satisfied with your Asheville North Carolina health plans, rest assured in knowing that under Obama's plan, you would be able to keep your private insurance and continue seeing the doctors you trust.

BCBSNC Encourages Awareness, Prevention on Swine Flu

Chapel Hill, N.C. (April 29, 2009) - Blue Cross and Blue Shield of North Carolina (BCBSNC) is monitoring swine influenza (swine flu) concerns and assures customers it has plans in place to meet customer needs in the event of a public health emergency.

In 2006, BCBSNC created a pandemic subcommittee and prepared detailed plans for responding to the varying levels of intensity of a pandemic.

“Our primary concern is helping our customers stay informed and healthy, and our preparations will ensure that in the event of a pandemic, we will be able to provide the customer service our members want and need,” said BCBSNC Chief Medical Officer Don Bradley, M.D. “A key part of our preparations include making sure our business remains financially solvent and that we are able to cover customers’ medical expenses over an extended period of time during a pandemic. BCBSNC’s financial reserves are there for just such an emergency.”

While no cases of swine flu have been confirmed in North Carolina residents are urged to take the same preventive measures they take during any flu season, including:

·Cover your nose and mouth when you cough or sneeze.

· Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol- based hand cleaners are also effective.

·Avoid touching your eyes, nose or mouth since bacteria can live on surfaces you handle.

·Avoid close contact with sick people.

·If you become ill with flu symptoms, call your doctor for advice, and stay home from work, school or other public events.

· Try not to touch surfaces that may be contaminated.

· Get plenty of sleep.

· Manage your stress through exercise and plenty of rest.

· Drink plenty of fluids.

· Eat healthy, nutritious food.


According to the Centers for Disease Control and Prevention, swine flu has not been shown to be transmitted to people through eating properly handled and prepared pork (pig meat) or other products derived from pigs. The virus is killed by cooking temperatures of 160°F/70°C, corresponding to the general guidance for the preparation of pork and other meat.

A variety of reliable resources are available to help answer questions about the Swine Flu:

Centers for Disease Control and Prevention (CDC)
World Health Organization U.S. Department of Health and Human Services www.pandemicflu.gov
North Carolina Department of Health and Human Services

BCBSNC customers with the Health Line Blue benefit can talk to a nurse about possible symptoms. Customers should check their benefit book or online account to determine if they have this benefit and for the Health Line Blue telephone number.
“In previous emergencies, such as hurricanes and ice storms, BCBSNC demonstrated flexibility in order to assist our customers and our employees. We would bring that same kind of flexibility and customer focus to a pandemic,” said Bradley.

Swine flu is a respiratory disease of pigs caused by type A influenza that regularly causes outbreaks of influenza among pigs. It can be transmitted from pigs to humans through contact with live pigs, and cases of human-to-human spread of swine flu viruses have been documented.

About BCBSNC:

Blue Cross and Blue Shield of North Carolina is a leader in delivering innovative health care products, services and information to more than 3.7 million members, including approximately 900,000 served on behalf of other Blue Plans. For 76 years, the company has served its customers by offering health insurance at a competitive price and has served the people of North Carolina through support of community organizations, programs and events that promote good health. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Access BCBSNC online at www.bcbsnc.com.

Buying Generic Drugs Safely Online

Many consumers are shopping online for generic drugs to fill their prescriptions economically. This guide will help you shop safely to avoid online fraud and save time in choosing a legitimate online source for your generic drugs. Also make sure to visit the Federal Drug Administration’s (FDA) website for warnings against buying certain drugs online.

Generic drugs tend to be cheaper and have the same dosage, intended use, effects, side effects, risks, safety, and pharmacological effect as name brand drugs.
Make sure to check your insurance policy to see if your insurance pays only for generics or covers more expensive name brand drugs. Also check with your doctor for the generic counterpart if they prescribe only name brand drugs. Also check online to find out if there's a generic version of a drug to save money.

Statistics show that almost half of all US prescriptions filled are generic drugs which saves consumers an estimated $8 to $10 billion a year because of the price differences.
Check first with your local pharmacy when comparison shopping for generic drugs. Many local stores now have competitive prices because of the online competition. They also may be faster and don’t charge for delivery.

The top points to consider when shopping online are the quality, reliability and service record of the online merchant. There is a lot of fraud online so beware to consider this before purchasing generic drugs on the internet. Make sure to check the following details of each online merchant: The physical address and contact information, whether they are a licensed pharmacy, their privacy policy for security, their website security certificate for secure online purchases, their prescription policy for filling and verifying prescriptions.

The legitimate online US pharmacies usually require a prescription from your doctor before you can purchase medications. That means you will have to fax a copy of the prescription and they will verify it before any online transactions. Beware of online merchants who have lax requirements for prescriptions. They could be selling fake medications that may hurt you.

According to current price comparisons, many of the large pharmacy chains now offer very competitive prices for generic drugs. This can save you time and money to just shop locally for your prescription drugs. For those who do purchase online, be careful and always double check the online merchant for your safety and health.

Get personal attention and expert advice concerning your NC medical insurance coverage plans. Contact NC insurance agent Judi Goloff with BCBSNC ® for experienced help with NC health plan options and rates. Call 800-438-5834 for reliable NC health insurance quotes.

BCBSNC adopts policies to improve hospital patient safety, reduce medical errors

Chapel Hill, N.C. – Blue Cross and Blue Shield of North Carolina (BCBSNC) today announces the adoption of a formalized policy to improve hospital patient safety and quality as well as reduce costly medical errors.

Under this policy, hospitals will not be reimbursed for adverse patient events identified by the National Quality Forum if the error was preventable by the hospital. Such events include procedures that are performed on the wrong side of the body, at the wrong site, or on the wrong person.

The policy on medical error billing was developed after consultation with the North Carolina Hospital Association (NCHA) and the North Carolina Quality Center and incorporates principles promoted by those organizations for hospitals. “These new guidelines will effectively move us forward to improve the quality and safety of medical services for patients throughout North Carolina,” said Don Bradley, M.D., Chief Medical Officer, BCBSNC.

BCBSNC, the State’s largest health insurer, provides a portion of the financial support for the North Carolina Quality Center, helping fund a number of patient safety initiatives. These initiatives include efforts among more than 100 North Carolina hospitals to implement quality improvement measures and improve patient safety. The Center is also working on an initiative for hospitals to confidentially report adverse patient events under the new federal Patient Safety Organization regulations. The Center will analyze these events to assist hospitals in developing best practices to improve systems of care and patient safety.

About BCBSNC:
Blue Cross and Blue Shield of North Carolina is a leader in delivering innovative health care products, services and information to more than 3.7 million members, including approximately 900,000 served on behalf of other Blue Plans. For 76 years, the company has served its customers by offering health insurance at a competitive price and has served the people of North Carolina through support of community organizations, programs and events that promote good health. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Access BCBSNC online at www.bcbsnc.com.

Health Insurance and the Stimulus Package

The American Recovery and Reinvestment Act voted in on Friday 2/13/2009 has all of us watching to see how this will affect the healthcare and insurance industries.
There are many changes in the works for the nation. Helping Americans gain access to healthcare and preventing others from losing it is at the forefront of President
Obama's stimulus package. The Senate approved $21 billion to provide a 60% federal subsidy for up to nine months for the cost of continuing an employer’s health
care coverage after a layoff under COBRA program; $87 billion to help states with Medicaid; $19 billion to modernize health information technology systems; $10
billion for health research and construction of National Institutes of Health facilities.
All of this is exciting for BCBSNC, healthcare providers and the nation as a whole
See the full bill at : http://www.rules.house.gov/111/LegText/111_hr1_text.pdf - stimulus act