I remember the time a Cigna health insurance representative gleefully explained their new, “free” disease management programs to our company. It was the early 2000s and insurance companies wanted to make employers feel like they felt bad about the large plan increases they demanded during plan renewal. The hope was that with their new, “free” disease management programs they could reduce high dollar claims that employees with chronic diseases tend to have. And just like today’s workplace wellness programs it made since that a personalized, dedicated program designed to improve an individual’s health status would result in reduced claims costs.

Improved Health Status Delusion

Our company eagerly signed on to adding these five programs to all of our Cigna health plans. They included disease management programs for coronary heart disease, diabetes, hypertension, asthma and chronic obstructive pulmonary disease (COPD)—which at the time we had no idea was a chronic disease. The plan was to keep these programs low-key to protect employees’ privacy. Dedicated nurses working for Cigna would contact employees who incurred claims related to one of the conditions. And, the program was voluntary.

Not surprisingly, all of the targeted employees declined participation in the plan. They didn’t like getting a call out of the blue from a health insurance rep. They thought the health insurer was only interested in saving money for themselves and not with their wellbeing. They also had privacy concerns—they thought we, the employer, would fire them because of their health issues. Sound familiar?

Fast forward 14 years and we are faced with the same employee concerns about workplace wellness (health promotion) programs. Only this time health insurers are claiming that the programs they were peddling more than ten (10) years ago actually do lead to premium savings, when monetary incentives to participate are added. At least that is what Cigna CEO, David Cordani, claimed recently about his organizations health coaches program. Continue Reading...

Tags: disease management programs, health coaches

It’s been a tough 12 months for Theranos and its founder, Elizabeth Holmes. With Theranos, Holmes set out to create a company that, if successful, would significantly lower the cost of lab tests. Holmes claimed that the company had the technology (called, Edison) to perform up to 70 tests with just a few drops of blood and provide results quickly. However, she is having trouble supporting her claims and is in jeopardy of losing her right to own or operate a lab for up to two years, and other sanctions.

This is not just bad news for Holmes and Theranos employees and investors; it’s bad news for all of us who pay high lab and doctor’s fees for routine lab tests. I’m hoping Holmes can meet federal requirements and other information requests before it’s too late and she loses her labs and her company. But if she doesn’t, I hope that some other company quickly comes along and picks up where Theranos left off. I’m thinking 23andme and Alphabet (Google).

Why 23andme And Google?

The company 23andme uses home-based saliva collection kits (eww) to provide over 60 genetic reports about your health, traits and ancestry. Why not add blood collection kits to the mix, 23andme? Also, like Theranos, 23andme has a rocky relationship with federal regulators; however, it hasn’t given up on having its kits approved as a medical device. And, also like Theranos, 23andme has big money support. Google, Genentech and a few billionaires are investing tens of millions of dollars in the company.

But first things first, the Theranos and 23andme technology has to work and meet federal and state health and safety standards. Maybe Alphabet (formerly Google) can help. The co-founder of 23andme, Anne Wojcicki, was married to Google co-founder, Sergey Brin, so he’s already very familiar with 23andme. Also, Alphabet is already engaged in what it calls its health efforts—working on glucose-sensing contact lenses and longevity.

Conclusion

Theranos may never be able to provide low-cost lab tests using its own technology, but maybe with a little help from friends like 23andme and Alphabet, the technology can be perfected. And, of course, there’s always Apple who’s already ankle deep in health tracking technology and is working with 23andme to develop a module for its ResearchKit platform. Continue Reading...

After much compromise, redrafting, haggling, interference, bullying and support, the Department of Labor issued its final version of the fiduciary rule on April 6, 2016. The fiduciary rule requires retirement plan advisors to put investors interests above their own when it comes to the products they recommend. Advisors will have to disclose, in writing, all fees, compensation and potential conflicts of interest associated with their retirement account recommendations.

Finalizing the fiduciary rule was a long and difficult process for the DOL and it did not get everything it wanted due to the intense opposition of those in the financial industry who saw the rule as a threat to their business practices. These in-the-best-interest-of-the-client opponents articulated their reasons for their opposition, including the costs of updating their computer systems and legal procedures. Basically, they are claiming that the disclosure paperwork they have to hire lawyers to draft, the minor changes they have to make to their computer systems and training their workforce to not take advantage of investors will be costly and burdensome to them.

Yet their lukewarm arguments were good enough to get the support of many members of Congress. Even after Wednesday’s announcement, some in Congress are still trying to stop the final rule from taking effect. But even if Congress succeeds in delaying the final rule (advisors already have two-years to get in full compliance with the final rule), Wall Street has heard the message of the Obama Administration and other retirement plan reform supporters.

You may or may not agree with Senator Elizabeth Warren’s statement that retirement plan service providers and fund managers are “bleeding savers dry,” but Wall Street knows she’s not alone in her opinion. Continue Reading...

Tags: retirement plan fees, retirement accounts, Fiduciary rule