As you probably know, under the Affordable Care Act (ACA), preventive care is covered without being subject to deductibles or coinsurance. The idea was to remove financial barriers that might discourage people from getting preventive services. But a gap in the program left out consideration of preventive services required by people with a chronic condition.

For example, if a person who did not have diabetes went to the doctor and had a screening blood test done to see if they had diabetes, the visit and the test would be fully covered without a deductible or coinsurance. However, if a person with known diabetes went to their physician and had the same test done as part of the regular follow-up care for their condition, the visit would be subject to their deductible and coinsurance.

Interestingly, responsibility for many of the regulations that apply to the ACA falls under the IRS (since they are related to the taxability of health benefits). A July 2019 IRS update expands coverage for preventive care for those with chronic conditions so that these preventive services will now no longer be subject to deductibles or coinsurance.

It is well known that many people with chronic illnesses do not receive needed preventive care for their conditions because of the cost they have to bear for these services. This new regulation should help reduce this barrier to care and help those with chronic needs better care for themselves.

While this change applies to fully insured plans, what does it mean to self-insured employers? With many companies defining their 2020 benefit programs at this time of year, we think employers would be wise to examine their coverage for preventive care and adopt this coverage approach within their plan design. Evidence-based preventive care is always cost-effective and contributes to better health and well-being for employees and their family members.

To learn more about this update, read the IRS notice here. If you have questions about these changes or would like guidance defining the parameters for preventive care coverage, contact Health Advocate. Our clinical team will be happy to help.

Research demonstrates positive impact on quality and cost for employers that screen for hyperlipidemia in the workplace

PLYMOUTH MEETING, Pa. — Intrado’s Health Advocate, a leading provider of health advocacy, navigation and integrated benefits programs, announced today that its recent peer-reviewed manuscript published in the American Journal of Health Promotion has been selected as one of five Editors’ Picks Papers of the Year for 2018. The award-winning research demonstrates that workplace health screening programs can identify undiagnosed hyperlipidemia in employees and motivate significant numbers of those employees to seek treatment.

Health Advocate analyzed medical and pharmacy claims data from nearly 19,000 individuals from 39 self-insured employer groups* participating in Health Advocate’s workplace biometric screening program. During the screening, 1,872 (9.9 percent) individuals who did not have a prior claims history of hyperlipidemia were found to have a cholesterol level of at least 240 mg/dL, or an LDL level of at least 160 mg/dL, both highly suggestive of hyperlipidemia. Further, in the month immediately following screening, the number of doctors’ visits with new diagnoses of hyperlipidemia doubled compared to the three months prior, and prescriptions for treatment also increased among individuals who were identified as having hyperlipidemia at the screening.

“Our analysis shows the value and the need for these onsite health screenings for both employers and their employees,” said Abbie Leibowitz, M.D., F.A.A.P., Chief Medical Officer, Founder and President Emeritus of Health Advocate. “By identifying issues like hyperlipidemia sooner, employees can access appropriate treatment earlier, leading to improved health outcomes and reduced costs.”

Importantly, approximately one year following the initial screening, more than half of those individuals identified as having hyperlipidemia were tested again and showed significant improvements in both total cholesterol (8.5 percent decrease) and LDL levels (10.2 percent decrease), demonstrating the effectiveness of the intervention.

American Journal of Health Promotion editors selected the award-winning papers based on wide-ranging criteria including the timeliness and importance of the topic, the quality of the research, and the findings’ unique contribution to the medical literature.

Health Advocate’s workplace screening program provides convenient, professional health screenings onsite to help identify employees’ risk for a number of common conditions. Because hyperlipidemia is often asymptomatic and can be effectively treated, screenings may be critical in identifying issues among employees who may not otherwise see a physician regularly. 

By encouraging employee participation in these programs, employers can take steps to improve outcomes among their workforce while reducing healthcare costs by identifying and addressing conditions like hyperlipidemia earlier.

The article, “Identification of Undiagnosed Hyperlipidemia: Do Work Site Screening Programs Work?” was published in the May 2018 issue of the American Journal of Health Promotion and is available hereAll four authors are part of Health Advocate’s data analytics team.

*Data were fully de-identified prior to analysis and were received and managed in compliance with HIPAA regulations

About Health Advocate’s Biometric Screening Program

Health Advocate’s Biometric Screening Program is a turnkey solution that provides convenient, professional health screenings and related services at the workplace. Available nationwide to organizations of all sizes, this customizable program offers a wide selection of screening options to identify employees’ risk for hypertension, diabetes, hyperlipidemia, obesity and other serious health issues.

About Intrado’s Health Advocate

Intrado’s Health Advocate makes healthcare easier for over 12,000 organizations and their employees and members nationwide.

Our solutions leverage a unique combination of personalized, compassionate support from healthcare experts using powerful predictive data analytics and a proprietary technology platform including mobile solutions to provide clinical support and engage members in their health and well-being.

Our members enjoy a best-in-class, personalized concierge service that addresses nearly every clinical, administrative, wellness or behavioral health need. Our clients benefit from high levels of engagement, improved employee productivity and health, and reduced medical costs, while simultaneously simplifying and upgrading their health benefits offerings.

For more information, visit us at www.HealthAdvocate.com.

About Intrado

Intrado, formerly West, is an innovative, cloud-based, global technology partner to clients around the world. Our solutions connect people and organizations at the right time and in the right ways, making those mission-critical connections more relevant, engaging and actionable – turning Information to Insight.

Intrado has sales and/or operations in the United States, Canada, Europe, the Middle East, Asia Pacific, Latin America and South America. Intrado is controlled by affiliates of certain funds managed by Apollo Global Management, Inc. (NYSE: APO). For more information, please call 1-800-841-9000 or visit www.intrado.com.