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inside this issue: Weaving workplace flexibility into the fabric of business Future Alzheimer's epidemic puts spotlight on caregivers High-tech dentistry embraces nonembryonic stem cell research |
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July 21, 2008 Weaving workplace flexibility into the fabric of business [top] Future Alzheimer's epidemic puts spotlight on caregivers
Testifying
recently
at a
hearing
by the
Senate
Special
Committee
on
Aging,
former
Supreme
Court
Justice
Sandra
Day
O'Connor
gave the
nation a
glimpse
into
what the
future
may hold
for
employees
with
aging
parents
or
spouses.
In 1990,
O'Connor's
husband,
John,
was
diagnosed
with
Alzheimer's
disease.
"In the
early
days of
my
husband's
illness,
I often
took him
to court
with me
because
he could
not be
left
alone,"
O'Connor
related.
"I
retired
from the
U.S.
Supreme
Court in
2006 to
find a
care
center
for John
in
Phoenix,
where
two of
our
children
live.
Many
caregivers
make
similarly
difficult
decisions
each and
every
day.
Sadly,
these
life-changing
decisions
are
simply
part of
caring
for
someone
with
Alzheimer's."
Today, 9.8 million Americans provide unpaid care for a person with Alzheimer's disease or another type of dementia, according to the Alzheimer's Association. The Alzheimer's Association estimates that 5.2 million Americans now have Alzheimer's. By 2030, it is estimated that 8 million Americans will be stricken, and by 2050, as many as 16 million Americans will have it. Increasingly, part of your workforce will have to care for them as a family member. Caregiving strains Today, about 60% of unpaid caregivers are wives, daughters, daughters-in-law, granddaughters and other female relatives, friends and neighbors. Forty percent are husbands, sons, sons-in-law, grandsons and other male relatives, friends and neighbors. Caregivers range in age from very young to very old. The average age in 2003 was 48. The challenges facing those who care for people with Alzheimer's and other forms of dementia are significant and often overwhelming. "Many family and other unpaid caregivers experience high levels of emotional stress and depression," states the Alzheimer's Association. "Caregiving also has a negative impact on the health, employment, income and financial security of many caregivers." "Caregivers face difficult and heartbreaking decisions every day," Suzanne Carbone, a working caregiver in Maryland whose husband has Alzheimer's, said at the Senate hearing. "You constantly face changing levels of ability and behavior." Just obtaining a diagnosis for Alzheimer's sufferers can be a tremendous drain on a family emotionally, physically and financially. One Alzheimer's patient related that her family went bankrupt trying to find the reason for her behavior. The problems are compounded when employees are in a long-distance caregiver relationship. It's estimated that 10% of the 9.8 million unpaid caregivers of people with dementia live more than two hours from the person for whom they provide care, and another 4% percent live one to two hours away. Specialized help available Employers are increasingly aware of the need to help baby boomers who have eldercare responsibilities. Thirty-nine percent now provide access to information about services for elderly family members, compared with 23% in 1998, according to the Families and Work Institute 2008 National Study of Employers. Also, 65% of employers provide employee assistance programs, up from 56% in 1998. However, EAP and eldercare resources aren't geared toward supporting caregivers of people in advanced stages of cognitive decline. That takes specialized services that haven't been widely available through the workplace. One company that has begun offering advanced caregiver support as a voluntary employee benefit is My Health Care Manager, a three-year-old company based in Indianapolis. MHCM's Personalized Eldercare Program provides employees with access to nurses and social workers who can help them navigate through the medical and eldercare systems and find the resources they need. "One-quarter to one-half of the people who engage us care for someone with cognitive decline, which ranges from forgetfulness to Alzheimer's," says Alan Stanford, CEO of MHCM. "We help caregivers come up with a plan for their loved one that encompasses geography and finances. It's an opportunity to have a skilled, independent person assisting you as you work through some pretty big issues." MHCM differs from local, independent care providers in that it is "heavily informatics based," enabling staff to quickly identify resources around the country, including gerontologists, insurance providers, housing facilities, educational resources and caregiver support groups, says Stanford. MHCM will negotiate discounted rates for covered employees. The company typically charges $195 for the initial fact-finding consultation, $775 for a situational assessment, and $125 an hour for assistance services. Employers can choose to cover some or all of the cost for any type of service. MHCM has several clients that cover all or most of the negotiated cost of the fact-finding consultation. The typical MHCM client is a professional firm whose most productive employees are in their 40s and 50s, Stanford says. However, younger firms, such as Katz, Sapper & Miller, LLP, a CPA firm in Indianapolis, also recognize the value of this benefit. "As time goes on, [care-giving] will become more of a reality for our employees," says Kimberly Canada, Katz's benefits coordinator. "It's great that there are companies like MHCM that can help employees navigate what can be a very complicated system at a time that's very stressful for them and their aging loved one." Clarian Health, another Indianapolis firm, added the Personalized Eldercare Program to its benefits offering in January. "We were anecdotally aware that the baby boom generation is [coping] with more parent-care issues, and we knew there was a mathematical certainty we'd be dealing with this in the next few years," says Brian O'Connor, director of employee benefits for the hospital system. "We thought that even though it might be a low-utilized benefit, it would be greatly valued." For Clarian, the service will reduce absenteeism and presenteeism. "An employee will perform better at work if he's comfortable with the decisions made regarding a parent," O'Connor says. "They'll be less stressed and more at peace with themselves. "This is a benefit whose time is coming," he maintains. Organizations considering such a service should look at the provider's geographic network, he advises, because "while your employee is with you, you don't know where the parents are." Canada believes educating employees about eldercare support options is the most important thing an employer can do - a view echoed by Alzheimer's caregivers. "Guidance in all aspects of care is important, from where to go for the initial consultation with medical experts to more in-depth services," she says. "It's important to show employees that they have resources and that they are not alone." [top] High-tech dentistry embraces nonembryonic stem cell research
When Americans desire new teeth, they primarily turn to dental implants, thus slowly bringing an end to the days when dentures and bridges were the dominant options. Now, some dental experts and consultants are hoping that new science merging nonembryonic stem cells and dentistry will actually grow new teeth.
The scientists believe that adult stem cells can help grow dentin - calcified tissue of the body - along with enamel, cementum and pulp. With those four ingredients, new teeth growth becomes a possibility. The question remains whether dental insurers and employers will cover stem-cell-based dentistry when it hits the market. Breaking new ground"In today's world, the standard of care for losing a tooth is to put in an implant, rather than a denture, a false tooth or a bridge," says Doyle Williams, chief dental officer at DentaQuest, a Massachusetts-based third-party dental benefit administrator. Dentistry has already changed the paradigm of thinking among Americans, who now expect implants. "The expectation today is I will simply get an implant.' So naturally, in five or 10 years, consumers are going to want their natural teeth, which stem cells are able to do," states Williams. In the next five or 10 years, when an adult loses a tooth, rather than having a bridge, wearing a denture or having an implant, the patient may ask the dentist to inject stem cells in the tooth area to grow a real tooth. Songtao Shi, a researcher and professor at the University of Southern California School of Dentistry, says that dentistry has been experimenting with stem cells since 2000. "Great progress has been made, but mainly in the animal model stage and not so much in human trials yet. But it's on its way," asserts Shi, whose research team has used mesenchymal stem cells to design and fabricate roots of teeth upon which prosthetic crowns are made. In the United States, embryonic stem cells are used primarily for spinal cord injuries. Besides embryonic stem cells, there are adult stem cells, which are from living humans. Medical research involving adult stem cells is less controversial than stem cells taken from embryos. Banking on baby teethThe Forsyth Institute, a Massachusetts-based research organization, is using adult human stem cells to grow complete mature teeth in rats. The reasons researchers test rats is because their DNA structure is close to humans' DNA structure. The logic goes, if it works with rats, it will typically be transferable to humans. The fact that the institute was able to take adult stem cells and grow a mature rat tooth is a breakthrough, says Williams, adding that the Texas-based company BioEden is also conducting groundbreaking work with stem cell research and dentistry. According to Williams, the company will harvest and freeze stem cells inside the pulp of baby teeth when a child loses them. Children mainly have their baby teeth up until they are 12 years old. Scientists claim that the stem cells in the teeth, which are considered adult stem cells, can help grow dentin, smooth muscle tissue and cartilage. The biotech outfit sends consumers a kit. "When your child loses a baby tooth, you mail it back to the company, which then cryogenically freezes the stem cells from the teeth. Customers pay nearly $600 for the process," Williams notes. Medical researchers hope that the cells will generate new teeth for the child if he or she needs them in the future. "All of these things are possible with stem cells," Williams contends. Covering innovation"Automatically, you would assume that employers and insurers would never cover such procedures because they sound too advanced and experimental," says Steven Keller, vice president of business development at DentaQuest. "It may not be covered on day one. But if it's found to be effective, the industry will cover the procedures because, overall, insurers and employers want to improve the oral health of their members and workers," he says. A new procedure or innovation that has dental value can be presented to the American Dental Association's coding committee by obtaining and completing a code submission application from the ADA, explains Glenn R. Melenyk, a senior dental consultant at Michigan-based DenteMax, a dental PPO network. "Anyone can submit a code application," he adds. Any material or technique, however, that has not undergone peer review, been given the ADA seal of approval or received FDA approval could be considered experimental and would not be widely used in the marketplace. "Typically if the procedure does not have an ADA code there is no insurance coverage. One purpose of the code is to have a standard for billing treatment methods that have proven useful and effective," Melenyk points out. Without a code and its precise description, there is no standard for what the procedure is and what it includes. Other times, the innovation is so new that it is not widely accepted as effective treatment and requires the test of time. What's more, "even if a procedure receives a code, the service might still be considered outside the benefit design of a plan," he says. [top] The medical tourism industry continues to mature, sprouting all the attendants of a healthy market: a myriad of professional conferences, trade groups and dedicated media. Despite the buzz, many observers continue look for more concrete evidence validating the movement, namely employers and employees embracing the prospect of traveling to foreign lands in pursuit of quality health care at much lower prices. Confidence in care abroad has increased, and as a result, carriers and employers are starting to offer medical tourism options to workers. Morgan Armstrong, president of South Carolina-based Plan Benefit Services, says representatives from his firm will be traveling to Bangkok and Singapore in March for an onsite review of two hospitals that have recently been included in the Blue Cross network. "Having repriced numerous claims that were incurred locally and compared [them] to the charges for the same procedure at these other facilities, we have found that in most situations the price differentials are truly significant," says Armstrong. He expects the quality of care provided at these facilities to be comparable to care in the United States, and if his visit is as favorable as he expects, he will be recommending that his clients offer these opportunities to their employees. Still, medical tourism is largely being practiced on the individual level, and carriers and advisers continue to question it's feasibility in the group benefits arena. Still, employers appear to be more open to the idea than originally expected. Eleven percent of employers say they pay expenses related to medical tourism for their employees, according to a survey by the International Foundation of Employee Benefit Plans. Employers seem to be less and less fearful of care abroad, and the immense cost savings from medical tourism continues to nibble away at that fear daily. Growing industry"Everybody sees this emerging as a multibillion dollar industry," says Jonathan Edelheit, founder of a new industry group, the Medical Tourism Association. "Everybody wants to figure out how they can get involved, how they can position themselves strongly in the marketplace." Companion Global Healthcare Inc. is continuing to add to its network of overseas hospitals, which includes Anadolu Medical Center near Istanbul, Turkey; Bumrungrad International Hospital in Bangkok, Thailand; and Blackrock Clinic of Dublin, Ireland. Companion Global Healthcare contracts with insurance companies and employer groups that wish to include an overseas option in their health plans. The company provides a single launch point for appointments, information, travel services, case management and follow-up care in the United States. BridgeHealth International, a Denver-based medical tourism company, aims to be one of the first movers in this emerging business space. That company has wrangled yet another hallmark of business buzz: venture capital money. BridgeHealth President Vic Lazarro, the former CEO of UnitedHealthcare for Colorado, says that the provider network for American consumers can't help but go international. The company is still building its infrastructure and plans to tap the broker channel and won't sell directly to employers. The Medical Tourism Association has caught the attention of many employers and insurers and has launched a print magazine and an e-newsletter called "Medical Travel Today." The newsletter aims to serve the growing appetite for information and analysis on the trend of consumers seeking affordable health care options abroad. Edelheit also points to the nearly two dozen annual industry conferences on the subject held throughout the world as further evidence of the market's current and future strength. The MTA hopes to spur the growth of medical tourism internationally, to set credentialing standards for hospitals and medical tourism companies, and to increase access to overseas facilities. |
