Health Insurance RI: 6 Questions During Open Enrollment

Every year during open enrollment, you have the opportunity to review and alter your health insurance. Here are 6 questions that can help you make the right decision for the coming year.

http://www.spine-health.com/blog/6-questions-ask-during-open-enrollment

How a Chiropractic Treatment Plan is Developed

A chiropractic treatment plan will try to reduce pain and restore normal joint function and muscle balance in the short term and restore functional independence and normal activity in the long term.

http://www.spine-health.com/treatment/chiropractic/chiropractic-treatment-plan

Integrating Care in Chiropractic

What's the best way to incorporate chiropractic care in with care from other doctors?

http://www.spine-health.com/treatment/chiropractic/integrating-chiropractic-care-other-doctors

Chiro Post-Operative Care

Even though there is usually some temporarily added muscle soreness (similar to the feeling of having completed an aggressive exercise session) after the manipulation, the patient should experience an immediate increase in range of motion post-anesthesia care.

http://www.spine-health.com/treatment/chiropractic/post-operative-care

How to Select the Best Chiropractor

If you decide to explore chiropractic to address your back pain, it may take some time to find the right practitioner for you. Learn what questions to ask when interviewing potential chiropractors, and what you can expect during chiropractic care. Learn more...

Specialists Who Treat Back Pain

When it comes to physicians who treat spinal conditions and back pain, there is no one option that works for everyone. Many types of health practitioners care for patients with spinal conditions, and each has a slightly different role. Learn more...

Study links high benzodiazepine usage to mental health issues

Study links high benzodiazepine usage to mental health issues

A study in the journal Pain Medicine found patients taking benzodiazepines every day for chronic noncancer pain were more likely to have comorbid mental health issues and to use emergency health care. The study authors said the high benzodiazepine usage rates are "inconsistent with guidelines for the management of CNCP or chronic mental health conditions." PhysiciansBriefing.com

NEW RESEARCH: Chiropractic Proves More Effective than Standard Medical Care in the Military

NEW RESEARCH
Chiropractic Proves More Effective than Standard Medical Care in the Military

This study compares standards medical care and the addition of chiropractic to low back pain patients. The results conclude that adding chiropractic renders statistically and clinically significant benefit to receiving chiropractic care and adds to the body of evidence in diverse forums that chiropractic for mechanical back pain is more effective and cost-effective than standard medical care.

To access the article: CLICK HERE

 

This research is offered as a community service from our office.

Follow ACA's YouTube Channel for Chiropractic Patients

Make Your Voice Heard: Help Veterans Receive the Care They Need Senators Jerry Moran (R-Kan.) and Richard Blumenthal (D-Conn.) have introduced the Chiropractic Care to All Veterans Act. The bill would require the Department of Veterans Affairs (VA) to phase-in the chiropractic benefit at all major VA medical facilities over several years. You, too, can help ensure the essential services provided by doctors of chiropractic are available to the brave men and women who have served our country by simply clicking the link below to urge your senators to cosponsor this bill! To contact your senators, clickhttp://cqrcengage.com/aca/app/write-a-letter?10&engagementId=78697.

Make Your Voice Heard: Help Veterans Receive the Care They Need

Senators Jerry Moran (R-Kan.) and Richard Blumenthal (D-Conn.) have introduced the Chiropractic Care Available to All Veterans Act. The bill would require the Department of Veterans Affairs (VA) to phase-in the chiropractic benefit at all major VA medical facilities over several years. You, too, can help ensure the essential services provided by doctors of chiropractic are available to the brave men and women who have served our country by simply clicking the link below to urge your senators to cosponsor this bill!

To contact your senators, click http://cqrcengage.com/aca/app/write-a-letter?10&engagementId=78697

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Chiropractic News - House budget plan to include repeal of Affordable Care Act

House budget plan to include repeal of Affordable Care Act
A House Republican budget proposal will include language to allow a repeal of the Affordable Care Act by a simple majority vote in the Senate. Future Medicare beneficiaries would receive support to buy private insurance, and Medicaid spending would be reduced and delivered as block grants to the states. The New York Times (tiered subscription model) (3/16)

Join Current Care Today!

Current Care is the RI health community's central bank of patient's records. By joining it, you allow your doctors to access x-rays, blood work, medication lists...etc using their computers rather than waiting for faxes, mail or patients to pick up their information for them.

Everyone (not just my patients but friends, relatives co-workers...) should sign up! Stop by the office anytime and fill out the simple enrollment form that takes just two minutes and we will take care of it from there. Pick up more and have all of your family and friends fill them out and return to us. You can also enroll on the internet at CurrentCareRI.org or call 888-858-4815

Back Care for Lower Back Pain

Since most episodes of lower back pain are self-limited, it is often advisable for patients to employ back care on their own early in the course of low back pain.

Back Care First Aid

In most cases, do-it-yourself back care for low back pain should center on a combination of:

• A short course of rest, limited to one to two days
• Pain medication, such as NSAIDs (e.g. ibuprofen) and/or acetaminophen
• Application of ice and/or heat on the lower back to decrease inflammation.

Slow mobilization and gentle stretching is then an advisable form of lower back pain care, and the sooner a patient can return to his or her normal functional activities, the sooner the episode of lower back pain will usually get better.

• See Lower Back Pain Treatment

Other Forms of Lower Back Care

Walking is often an excellent exercise for low back pain since it is gentle on the back and helps oxygenate the soft tissues in the back to stimulate a healing response. If walking is too painful, exercising in the water (water therapy or pool therapy) is usually tolerable. Such back care is typically beneficial for lower back pain because the water counteracts gravity and helps to support the patient’s weight in a controlled fashion.

Sitting upright (e.g. in an office chair, driving) will often aggravate low back pain, since this position loads the back three times more than standing. Sitting in a reclining position, however, relieves pressure on the lower back and is often the most comfortable position for patients experiencing an episode of back pain in the lower back (lumbar spine).

When to Seek Lower Back Care from a Medical Professional

Chiropractic on the Lumbar Spine Video

If the lower back pain symptoms do not start to abate within one to two weeks, medical attention should be sought from either the patient’s primary care doctor or chiropractor. The assessment of the patient begins with a history of the patient’s low back pain and includes questions such as:

• Where is the back pain?
• Is there more low back pain or more leg pain?
• How long has the pain been present?
• Does anything make the lower back pain better?
• Does anything make the low back pain worse?
• What back pain care has been tried?
• Have there been other episodes of lower back pain?

A physical exam will also be done to assess the patient’s nerve function and motion in the lower back. Sometimes diagnostic studies (such as an x-ray) will be recommended to better assess the anatomy of the patient’s spine and determine the specific type of back care.

• See Introduction To Diagnostic Studies For Back Pain

Initial Back Care and Lower Back Pain Help

Combining the information from the patient’s history, physical exam, and diagnostic studies, the health provider will then recommend a course of back care for the lower back pain. Generally, conservative (non-surgical) treatments for the low back pain will be recommended first.

If conservative back care fails, back surgery may be a reasonable option to try to cure the lower back pain.

Further Reading: Lower Back Pain Treatment

Current Care

Current Care is the RI health community's central bank of patient's records. By joining it, you allow your doctors to access x-rays, blood work, medication lists...etc using their computers rather than waiting for faxes, mail or patients to pick up their information for them.

Everyone (not just my patients but friends, relatives co-workers...) should sign up so that we can move into the 21st century!! Stop by the office anytime and fill out the simple enrollment form that literally takes 2 minutes and we will take care of it from there.

Pick up more and have all of your family and friends fill them out and return to us. You can also enroll on the internet at CurrentCareRI.org or call 888-858-4815.

Chiropractors as Primary Spine Specialists

By Dr. Brandon Manson
For Columbia-Greene Media 

Spine related disorders (SRDs) are one of the most common and costly health problems in society, affecting almost every person at some point in life. These disorders encompass a group of conditions directly related to the spine: back pain, neck pain, many types of headache, radiculopathy or referred pain, and a variety of other symptoms.
Recent statistics indicate the cost to the United States health system is huge, and growing. Well over $100 billion is spent annually on SRDs. Yet despite the fact that between 1997 and 2005 expenditures for back and neck pain alone rose by 65 percent (inflation adjusted), patients with SRDs are now worse off than ever. In fact, measures of physical functioning, work productivity, school and social activity, and mental health among patients with SRDs all declined during the same period. Clearly, the dramatic increase in health care costs for diagnosis and medical treatment of SRDs has failed to improve the health of patients. Instead, chronicity and disability related to these disorders continues to steadily rise.

So, you might be saying, “This is just another example of the health system not working… what’s new?” Because spine related disorders account for a significant drain to our health system, it would make sense for policy makers to look at ways that these disorders can be better managed.

In the late 1990s this is exactly what a group of health economists from the University of Ottawa did. They were commissioned by the Ontario government to examine ways to reduce the financial costs of SRDs to the province’s health system. The researchers reviewed every study, every trial, every government inquiry and every scrap of evidence done to date related to treatment of back and neck associated disorders.

What these researchers found was profound: by transferring the care of back pain alone from medical doctors to chiropractors, the government health system would be able to save an estimated 12 percent of its annual health budget annually. The savings could be significantly higher if care of other spine related conditions, such as neck pain and various forms of headache, were also transferred to chiropractic doctors. The researchers showed that the benefit would be not only financial. They concluded that chiropractic care for these conditions was not only significantly more cost effective than medical care, it was more effective (better outcomes) and safer. Numerous studies on patient satisfaction have underlined this conclusion: patients are about three times more satisfied with chiropractic care for back pain than medical care.

Clearly, the time has come for a major change in our management of spine related disorders. It is time for policy makers to get serious about this crippling problem and begin to do what is best for patients and the health system: take steps to establish chiropractic doctors as “primary spine care specialists”.

6.4 million total enrolled for HealthCare.gov in 2015

http://www.cnbc.com/id/102290183

There's going to be a lot of new Obamacare plans underneath Christmas trees on Thursday.
As of last Friday, about 6.4 million people had signed up for 2015 health insurance plans sold on HealthCare.gov, the federal Obamacare exchange that serves 37 states, officials announced Tuesday.

That big number included about 1.9 million new customers, existing Obamacare customers who actively re-enrolled since sign-ups began Nov. 15, and people who were automatically re-enrolled in their current health coverage in the past week, according to the Health and Human Services Department.

The tally reflects a surge in sign-ups that occurred in advance of HealthCare.gov's Dec. 15 deadline for enrolling in plans that take effect Jan. 1. It also reflects the policy of automatic re-enrollment for most current customers, which began Dec. 16 and was completed by last Thursday.

When the 6.4 million HealthCare.gov total is added to confirmed sign-ups from the 13 Obamacare exchanges run by states and the District of Columbia, total enrollment for 2015 plans in this open-enrollment season is about 7.44 million, according to data compiled by the Obamacare tracking site ACASignups.net.

"I expected a surge in enrollment as the year wound down, but this was a bigger surge than I expected," said Larry Levitt, a Kaiser Family Foundation expert on Obamacare.

Levitt also said "it seems pretty clear at this point that the Obama administration will exceed their target" of having 9.1 million people enrolled in Affordable Care Act insurance plans sold through government-run exchanges by the end of 2015. To be considered officially enrolled, a customer must make a premium payment.

He said he expects another big surge in sign-ups in advance of the Feb. 15 close of open enrollment. "If you don't sign up by February 15, you can't get insurance for the rest of 2015," Levitt noted.
He said it will be tougher this year to sign up new, currently uninsured customers for Obamacare plans than it was during the first open-enrollment season, which ended in mid-April.

Getty Images

U.S. Secretary of Health and Human Services Sylvia Burwell.

 

HHS Secretary Sylvia Burwell said, "We still have a lot of work to do before the February 15 enrollment deadline, but this is an encouraging start. People shopped for coverage and signed up—finding more choices and greater competition."

"Thanks to the Affordable Care Act, so far nearly 6.4 million consumers, including about 1.9 million new consumers, have access to quality, affordable health coverage for 2015 through the federal Health Insurance Marketplace.This law is working, and families are better off as a result."

Tuesday's enrollment report comes as most states' deadline for enrolling in coverage that takes effect Jan. 1 has passed.

Tuesday is the deadline for Massachusetts and Washington state residents to choose plans effective by the New Year. Exchanges in four other states—Vermont, Minnesota, Hawaii and Rhode Island—have given residents until Dec. 31 to select plans that take effect the next day.

However, the open-enrollment season in Obamacare plans ends Feb. 15. People will have until then to choose a plan effective in 2015 and can change a plan they had already selected.

4 ways to detoxify Obamacare: Bossidy</p> <p>Larry Bossidy, former Honeywell CEO, discusses the outlook on the U.S. economy and explains why changes need to be made to the Affordable Care Act in order to help small business.

 

Under the ACA, nearly all Americans must have some form of health insurance—such as Obamacare plans, employer-provided coverage, Medicare or Medicaid—or pay a tax penalty.

People who lacked health coverage in 2014 are subject to a potential fine of up to 1 percent of their taxable income. In 2015, that rises to up to 2 percent.

Before open enrollment began Nov. 15, about 6.7 million people nationally were enrolled as paying customers in Obamacare health plans sold on the government-run exchanges.

About 85 percent of those people received federal government subsidies to help pay for their monthly premiums. Such tax credits are available to people who earn between one and four times the federal poverty level, or $11,670 to $46,680 for a single adult, or $23,850 to $95,400 for a family of four.
In a report issued in early December, HHS said an analysis of plans available for 2015 shows that almost 8 in 10 customers on HealthCare.gov would be able to buy coverage for $100 or less per month after the application of those tax credits.

U.S. Military Health Care Reform

 Michael E. O'Hanlon | December 22, 2014 2:30pm 

On December 19, the Center on 21st Century Security and Intelligence (21CSI) at the Brookings Institution held a wide-ranging event on military health care reform. The conversation included a diverse group of speakers from the Department of Defense (DoD) to the think tank and management consultancy worlds to the Congressional Budget Office.

Michael O’Hanlon of 21CSI hosted the event and was pleased to welcome Assistant Secretary of Defense for Health Affairs Jonathan Woodson as keynote speaker. Woodson described the value of the DoD health care system—which cares for nearly 10 million beneficiaries, costs more than $50 billion a year and has treated more than 50,000 war wounded in the conflicts of the 21st century to date. It employs roughly 140,000 full-time personnel at more than 50 hospitals and some 600 medical or dental clinics. It also involves a network of private providers who treat DoD patients as well; that network includes some 400,000 providers in round numbers.

Among Woodson’s most important points were that the value of military medicine has to be determined across the broad missions that the military health system is responsible for— readiness, health and hospital care, public health, research and development and education and training; and that global security and global health crises have increased the demand for DoD's health expertise even as combat operations are diminishing. Woodson pointed out that the DoD has made important strides in military health care in recent years, including in technologies such as advanced prosthetics, in battlefield survival rates for casualties and also in responsibly holding down cost growth through reforms in areas such as pharmaceutical prescriptions, payment reform and the stand-up of a Defense Health Agency to better integrate care across the military departments. He also spoke of progress in linking the DoD health care system to the Veterans Affairs (VA) system (a separate organization with a separate and even larger health care budget), while acknowledging that a great deal of integration and further improvement remains. He also noted, in response to a question, that it is important to facilitate the access to health care services for activated reservists, and DoD is working hard to make the associated procedures simpler for reservists and families.

After his remarks, a panel made up of former DoD Comptroller Robert Hale, Carla Tighe-Murray of the Congressional Budget Office, Alice Rivlin of the Engelberg Center on Health Care Reform at Brookings, Henry Aaron of the Economic Studies Program at Brookings and Jack Mayer, Executive Vice President at Booz-Allen-Hamilton, convened to continue and broaden the discussion, with O’Hanlon moderating. Among the key points raised were the following:

• Secretary Hale noted the success DoD has had in recent years in reducing provider costs and having beneficiaries share a modestly greater fraction of the military cost burden. Further efforts are underway, motivated in part by the assessment of the Joint Chiefs of Staff that in a budget-constrained environment, resources for training and equipment could be compromised if compensation costs were allowed to grow excessively. Hale made this argument while defending the premise that military compensation should be adequate to meet recruiting and retention needs, that those personnel less able to afford any premium increases should be assisted, and that in general the goal of compensation reform should be to limit future cost growth rather than to make significant cuts. Secretary Hale also advocated closing or streamlining some military treatment facilities that have inadequate caseloads to justify their expense. He suggested a new way of budgeting – return of health care funds to the military services along with centralized execution financed with a working capital fund – that might increase the incentives for the military services to streamline facilities.
  
• Tighe-Murray explained that much of the growth in military health care costs in recent times has been due, not to the wars in Iraq and Afghanistan, but to expanded benefits, as well as a failure of DoD premiums and co-payments to keep up with the general growth in health care costs in the United States. This set of factors has translated into more enrollees, more use of services and higher costs per doctor or hospital visit than would have otherwise been the case. While Secretary Hale had talked about options for DoD health care reform that would save the Pentagon, and taxpayer, perhaps a couple billion dollars a year, Tighe-Murray outlined options that might ultimately save nearly $10 billion annually.
  
• Rivlin and Aaron placed DoD health care in broader context. They recognized that the Department of Defense must provide certain kinds of capabilities, including for battlefield expeditionary medical care, that the private sector does not need to offer in similar ways. But nonetheless, they talked of the pros and cons of more fundamental possible DoD health care reform. For example, in less densely populated parts of the country or for population groups such as retirees that had other options, it might seek to encourage migration of more individuals from the military health care system to the private sector and the civilian system. This option may take on new feasibility in light of the Affordable Care Act. Rivlin and Aaron were careful to emphasize, however, that the DoD could still subsidize the health care costs of its personnel, and perhaps particularly its lower-salaried personnel, under such an approach. Acknowledging the complexities of the issue, however, Aaron also pointed out that it was not clear that the DoD (or the VA system) were necessarily any less efficient as health-care providers than the private sector, at least in some areas of the country.
  
• Jack Mayer underscored the need to think comprehensively about military health care as one element of compensation policy. With an all-volunteer force, the goal of compensation policy is to be fair to the men and women of the U.S. military, to be sure, but also to attract and retain a sufficiently large and high-quality pool of talent. In this regard, the country needs to be careful about providing benefits that may have limited relevance to the recruiting and retention mission and cost the country a good deal as well. Generous health care for able-bodied military retirees and their families may be a case in point—though Mayer also underscored the need for a consensual approach that recognized the interests and equities of many stakeholders. As such, his proposals for reforms focused more on rethinking benefits for future recruits than on changing existing "contracts" with current beneficiaries.

A number of the very useful and often spirited questions and comments during the discussion period came from military personnel, their families and some of their various organizations represented at the event. For those wishing more information, CSPAN covered the discussion and will feature it on the cspan.org website, and Brookings will post a transcript as well.

 Michael E. O'Hanlon | December 22, 2014 2:30pm