Monday, March 28, 2011
The EDC sees this lack of coverage as a great injustice and is working hard via the HICA Campaign to ensure other treatment centers do not face the same situation as Remuda East.
If you or your treatment center have faced lack of reimbursement for residential coverage, please contact: EDCHoldsInsuranceAccountable@yahoo.com for more information on how you can address this injustice.
Remuda Ranch Press Release below:
Remuda East Eating Disorder Treatment Facility to Close
Residential behavioral facility closes due to reductions in insurance reimbursement
Milford, VA. (March 15, 2011) – Officials with Remuda East today announced plans for the closure of the residential eating disorder behavioral facility located in Milford, Virginia.
The decision follows the reduction of insurance coverage for residential treatment program patients in Virginia. Remuda East is a 48-bed residential behavioral facility focused on the treatment of eating disorders in women and young females.
The closure is expected at the end of March with the discharge of the last patient.
A number of factors are impacting the sustainability of residential behavioral programs like Remuda East. Most significantly, starting in January 2011, fewer patients have residential benefits as part of their insurance coverage, including those with Federal Blue Cross Blue Shield, a major payor in the state of Virginia, which eliminated coverage.
“This was not an easy decision for the leadership of Remuda East to make,” said Mark Bowers, executive director of Remuda East. “Insurance companies are playing a more active role in determining the levels of care we are able to provide to eating disorder patients, including eliminating, denying and severely limiting coverage for treatment in a residential setting.”
Additionally, because of economic conditions, fewer individuals have the financial resources to seek care as private pay patients.
Despite Remuda’s efforts, the combination of reduced reimbursement rates from insurance companies, fewer patients with residential treatment benefits, and fewer patients with the ability to seek care on their own has resulted in an inadequate number of patients and financial resources to sustain the facility’s operations.
“We have spent the past year exploring a variety of ways we can continue to serve our Remuda East patients at the highest level, but ultimately, no matter how efficiently and effectively we treat our patients, reimbursement is being eliminated,” added Bowers.
The last patients have been admitted to the Remuda East for treatment which is typically a 30-day program. Any new patients are being referred to the Remuda Ranch facility in Wickenburg, Arizona to explore treatment options there. Remuda Ranch will continue its 20-year tradition of providing treatment for patients and families suffering from eating disorders. Remuda Ranch is licensed in Arizona as an inpatient behavioral health facility and is covered by most insurance programs.
“While a decision like this is not easy, it is necessary, and we are committed to working with each and every patient at Remuda, and their families, to continue to provide them with the highest quality care, attention, assistance and support during their treatment process and follow up,” said Bowers.
Remuda East’s 73 employees will remain on the payroll with full benefits through May 14, 2011, and leadership will work with each employee to assist them through the transition process and with their search for new employment.
More information can be found at www.remudaranch.com.
Thursday, March 24, 2011
Though there has been confusion and hot debate we do have reason to celebrate as the first provisions of the ACA went into effect this past year. Positive acts from which millions are benefiting include: the elimination of insurance exclusions due to pre-existing conditions for children up to age 19; young adults up to age 26 can now remain on their family insurance policy; and annual and lifetime health insurance limits are gone!
To help with the continued confusion about what the ACA and explain a bit about what the law will do I decided to borrow from a Washington Post blogger. Hope this helps for those of you wanting more clarification.
This is the second part of Ezra Klein's blog in the Washington Post today
"the Affordable Care Act, once it kicks in fully in 2014, is expected to do four things: provide coverage; remake a small slice of the private insurance market; pay for itself; and try to control costs. Let’s take them in order.
The law has two main mechanisms for covering people: Medicaid — which is a government insurance program that focuses on the poor — and subsidies to help people afford private insurance. The split is expected to be almost even: Of the 32 million people the law is expected to cover by 2019, 16 million will be on Medicaid and the rest covered by private insurance.
The problem with subsidizing insurance is that the sick rush to sign up and the insurers refuse to cover them. The law escapes this conundrum by telling people who can afford insurance that they have to buy it or face a small fine (the dreaded individual mandate) and by telling insurers that they can’t discriminate based on preexisting conditions. That is to say, healthy people can no longer say no until they get sick and insurers can no longer say yes only when applicants are healthy.
These transactions will happen on the new “exchanges” — a place that will, in effect, be a Web site where people can compare plans and choose the one that will serve them best. But behind the pleasing exterior (you can see it at HealthCare.gov), the exchanges offer another layer of consumer protection: Just as Amazon.com would stop carrying a toaster that routinely exploded when customers plugged it in, if an insurer repeatedly misbehaves, regulators can kick it out of the exchange.
All this will cost money — and in a system that’s already overpriced. Which brings us to offsets and cost controls. It’s important to know the difference: Offsets are the policies that cover the law’s costs. They’re concrete, simple reforms — cutting this much, taxing that much — and as long as we are willing to implement them, they are likely to work. Controls are the policies that try to rein in health-care spending. They’re ambitious attempts to change the way doctors are paid, insurance is bought and Medicare is reformed. If they work, they will, in the long run, save an enormous amount of money — much more than the offsets.
The big offsets in the health-care law slow payment increases to providers who participate in Medicare ($240 billion), cut payments to private insurers that participate in Medicare but cost more than the basic Medicare program does ($140 billion), increase the Medicare tax on high earners ($210 billion) and add a tax on very expensive health-care plans ($20 billion, although much more than that between 2020 and 2029), and so on. All in all, the legislation is expected to save or raise about $100 billion more than it spends in the first 10 years.
The cost controls will occur over a longer period and are more speculative. Medicare, for instance, is going to experiment with paying hospitals a flat sum for all successful care associated with a particular condition. This will mean that doctors make more money when they do less and are successful at it, rather than making more for doing more, as is the case now. The tax on expensive health insurance plans is meant to drive people — and employers — to seek plans that better control costs.
The Independent Payment Advisory Board is a group of stakeholders and experts charged with helping Medicare control costs and empowered to make changes to the system even if Congress is too paralyzed or distracted to act. It will be fed ideas by the new Center for Medicare and Medicaid Innovation, which will test ways to improve care and cut expenses. The exchanges will make it easier to comparison-shop, and the subsidies are linked to the lowest-priced plans in the exchanges to reward cost-efficient insurers. New information about what drugs and treatments work best and for whom will come from trials, and if combined with electronic-medical records, could help doctors make more cost-effective decisions.
Is it a perfect piece of legislation? Not even close. Will everything work as expected? Almost certainly not. But for all its flaws, it’s a good law, which is why Republicans have had so much trouble coming up with state plans that could cover more people at a lower cost. And it’s worth trying.
So happy birthday, Affordable Care Act. Here’s to many more."
Wednesday, March 16, 2011
The Eating Disorders Coalition is currently looking forward for leaders that will be part of the Junior Board and will use their voices to raise awareness and funds for the EDC. The Eating Disorders Junior Board supports the organization, raises money, advocates for important legislation, and brings awareness to the work we are doing. We are looking for individuals from diverse backgrounds, and geographic locations to fill seats on the Junior Board, and who will work independently and as a team with fellow members in order to meet goals our organization has set for the year.
The Junior Board application process is competitive: the commitment we make to each member requires us to limit the opportunity.
Members of the Junior Board will be expected to:
• Spread the word about FREED, the EDC, and Lobby Days
• Raise $1500 Give/Get by End of Year
• Participate in Junior Board Calls
• Strongly encouraged to attend at least one Lobby Day a year
We believe the opportunity to work together on this board will be meaningful and rewarding to each member, and lead to future collaboration and advancement in eating disorder advocacy. The Junior Board, under the approval of the Board of Directors, will also have the opportunity to think about other ways they can be spreading the word about the EDC and have their voices heard.
If you are ready to pursue this opportunity to be part of EDC’s work and mission, please complete the survey here: http://www.surveymonkey.com/s/73FSWK5
Friday, March 11, 2011
Spread Your Passion for
EDC National Lobby Day by
Urging Eating Disorder Advocates to Attend:
EDC National Lobby Day,
April 12, 2011
Dear FAC Members,
We know that YOU understand the importance of the FREED Act and EDC National Lobby Day…but there are many ED Advocates who do not yet know about the FREED Act and EDC National Lobby Day! With your help, time and passion, we can increase attendance at EDC National Lobby Day and increase the likelihood of passing the FREED Act into law!
Of course we want advocates from all 50 states to come to the Hill to advocate for the FREED Act (–the first ever comprehensive bill in the 200+ years of Congress to address eating disorders!) But this year we are targeting our attention on a few specific states (listed below).
If you are interested in putting up flyers on your campus, starting a letter-writing campaign, spreading the message on Facebook and/or other social networks email firstname.lastname@example.org
Here are our “Target States” for April, 2011 –but again, ideally we need to represent ALL 50 States in order to pass the FREED Act!
Thursday, March 3, 2011
U.S. Senators Harkin, Klobuchar, and Franken introduce bill to confront eating disorders in the U.S.
FOR IMMEDIATE RELEASE
David Jaffe, Eating Disorders Coalition,
WASHINGTON, D.C. – The United States took an important step toward addressing the national emergency of eating disorders when Senators Tom Harkin, Amy Klobuchar, and Al Franken introduced the Federal Response to Eliminate Eating Disorders (FREED) Act today.
“The FREED Act is the first legislative effort in the history of the Senate to comprehensively confront the seriousness and deadly threat of eating disorders in the
A coordinated national response like the FREED Act can help the millions of Americans suffering (and, too often, dying) from eating disorders.
“It has been ten years since anorexia killed my daughter Anna,” said EDC Board Member Kitty Westin. “And eating disorders have killed thousands of Americans since then. It’s time for Congress to pass the FREED Act as a critical first step in addressing this national emergency.”
Eating disorders do not discriminate: men and women, all economic classes, old and young are affected. Sadly, eating disorders even touch young children. According to a recent report in the December issue of PEDIATRICS, Official Journal of the
The FREED Act would fund much needed research to better understand eating disorders and provides solutions for prevention, education, screening, diagnosis and treatment. Among other things, the legislation would fund grants to conduct research on treatment efficacy, train health professionals and school personnel to identify and respond to eating disorders, and build on existing reform efforts to ensure that treatment is available to those who need it.
Ten months ago, two days before she was to join the Eating Disorders Coalition citizen lobbying effort on Capitol Hill, a young woman from Pennsylvania named Nicole died in her sleep from her eating disorder. Nicole’s mother sadly states, “If the FREED Act was in place, I might still have my daughter with me today.” Nicole’s aunt, Wendy Bloom, added, “The FREED Act will stop the endless pain for millions of people. It will allow treatment for a disease without the fear of not completing their treatment because their insurance doesn't cover it. It will end the torment and pain of another mother burying her child because she couldn't afford treatment.”
For more information about the FREED Act and/or The Eating Disorders Coalition, please contact:
202-543-9570 or visit www.eatingdisorderscoalition.org.
...from the introduction of the article:
"Increases in the incidence and prevalence of anorexia nervosa (AN), bulimia nervosa (BN), and other eating disorders in children and adolescents make it critically important that pediatricians be familiar with early detection and appropriate management of these disorders. Results of epidemiologic studies have indicated that the numbers of children and adolescents with eating disorders increased steadily from the 1950s onward. During the past decade, the prevalence of obesity in children and adolescents has also increased dramatically, accompanied by further emphasis on dieting and weight loss among children and adolescents."