Helping make the health care system work for you

BMI: An unreliable scale that could alter your insurance premium

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Your doctor has probably checked your body mass index – or BMI – at one time or another. But according to a new report from UCLA and UC Santa Barbara, there's a good chance your health was misclassified based on your BMI. 

The researchers analyzed the link between BMI and several health markers, like blood pressure and glucose, cholesterol and triglyceride levels, using data from the most recent National Health and Nutrition Examination Survey.

They found that nearly half of people considered overweight on the BMI scale and 29 percent of those considered obese were metabolically healthy. On the flip side, more than 30 percent of people considered to be normal weight on the BMI scale were metabolically unhealthy.

Overall, the study found some 74 million Americans' health has been misclassified based on their BMI.


Doctors and patients are discussing ways to cut costs

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Many people might find it awkward to bring up money with their doctor, but a new study finds that physicians and patients are talking about health care costs in about one-third of office visits, and that nearly half of those conversations focus on ways patients could save money. 

"With surprising frequency, doctors and patients are talking about health care costs during clinical encounters," says Dr. Peter Ubel, a Duke University professor and one of the authors of the study, published last month in the journal Medical Decision Making.

Though doctors were not traditionally taught to consider the cost of care, the study finds that they initiated about 58 percent of the cost conversations.

"I think the doctors are bringing it up because they see a lot of patients suffering," Ubel says. "They've had enough patients complain about costs. They're more aware of it; their antennas are up for the problem."


Bill would force health insurers to tell you about 'unreasonable' rates

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A bill introduced in the California legislature this week seeks to force health insurers to notify consumers about coverage premiums that state regulators have deemed "unreasonable." The legislation would also require insurance companies to give those consumers time to shop for a new plan.

Under existing law, the California Department of Managed Health Care and the California Department of Insurance review rate hikes proposed by the insurers and health plans each regulates.  

But when the agencies conclude that an increase is unjustified, there's not much they can do. The regulators can ask the insurer to rescind the increase, but the company is not legally obligated to comply. The two departments' only recourse is to post the information on their websites. 

"Frankly most consumers aren’t looking over a Department of Managed Health Care or Department of Insurance website," says Anthony Wright, executive director of Health Access California, which sponsored the bill.  "And even if they did, it would be hard for them to figure out whether the plan they're in has the unreasonable rate."


Impatient asks: Have you experienced postpartum depression?

Elliot 6days photoshoot

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This week, the U.S. Preventive Services Task Force for the first time specifically included pregnant women and new mothers in its  recommendation that all adults get screened for depression. The guidelines, published Tuesday in JAMA, say screening should be accompanied with effective treatment or referral to someone who can provide care.

Dr. Emily Dossett, an associate clinical professor in the psychiatry and obstetrics and gynecology departments at Los Angeles County-USC Medical Center, described the move as "wonderful."

"We're hoping [the recommendation] will encourage primary care doctors, pediatricians working with postpartum moms, and OB-GYN's working with pregnant women, to really take these recommendations to heart and start implementing them in their practices," says Dossett, who also runs a program at County-USC that offers prenatal care and psychiatric treatment to low-income women.


High deductibles don't make people shop for health care

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The concept behind high-deductible health plans is that if people are on the hook for a larger share of their medical bills, they'll be more likely to consider cost when making health care choices. But a new report finds that people enrolled in high-deductible plans are no more likely than those in traditional plans to shop for affordable care.

Researchers at Harvard and USC conducted a national survey of about 2,000 people; about 1,100 of them had deductibles greater than $1,250 for individuals or above $2,500 for a family. Despite being concerned about costs and aware of cost differences, just 4 percent of people in these high-deductible plans said they compared costs the last time they used medical care. Three percent of those in plans with low deductibles said they had done any cost shopping.