Jan 3, 2017 | Articles Of Interest
What to Know
Drug Allergy Definition: the abnormal reaction of a body’s immune system to a medication; it can be mild (skin rash/itching) to severe (anaphylaxis).
Drug Intolerance Definition: predictable adverse effects or side effects to a drug that occur at a dose normally tolerated by non-hypersensitive persons.
What to Do
–Properly identify drug allergies vs. intolerances on admission (ask what happened to the patient when the reaction occurred -example: diarrhea is not an allergic reaction)
-Be sure to include all allergies on face sheet, MAR, POS, electronic health record and outside of the chart
-Prior to the first dose of any drug given, reconcile the drug vs. the allergy profile
-Be sure to notify the pharmacy of any changes in the allergy profile of a patient
-Contact the doctor for any potential allergy flags, document the outcome, and communicate it to the health care team
Dec 9, 2016 | Articles Of Interest
Example Medicare Drug Plan for 2017*
Your plan may vary depending on your deductible and copays
| COVERAGE STATUS
You/Medicare |
Your Actual Drug Cost |
Your Out-of-Pocket Cost |
| Deductible Period
You pay all/Medicare pays none |
$0-$400 |
$0-$400 |
| Coinsurance/Copayment Period
You pay 25%/Medicare pays 75% |
$400-$3,700 |
$400-$1,225 |
| Coverage Gap Period
You pay all/Medicare pays none |
$3,700-$7,425 |
$1,225-$4,950 |
| Catastrophic Period
You pay 5%/Medicare pays 95% |
over $7,425 |
over $4,950 |
*The example above shows 2017 calendar year costs for covered drugs in a plan that meets Medicare’s standards in 2017. Your costs may vary since each Medicare drug plan is structured differently.
YOUR YEARLY JOURNEY THROUGH THE DONUT HOLE:
Deductible Period-
You pay the first $400 of your actual drug cost before your Medicare coverage begins to pay.
Coinsurance/Copayment Period-
You pay your coinsurance or copayment amount until the actual cost of your drugs reaches $3,700. Notice: This does not mean your out-of-pocket will be $3,700. The actual drug cost of $3,700 is based on your out-of-pocket plus what Medicare pays.
Coverage Gap Period (Donut Hole)-
You pay the cost of your drugs until your total out-of-pocket reaches $4,950. This includes amounts you paid earlier during your deductible and coinsurance/copayment period. Based on the example above, the most you would pay during the coverage gap period would be $3,725. In 2017, you will receive a 60% discount on covered brand drugs and 49% discount on generics during the coverage gap. Check with your plan to see if your drugs are eligible for the discount.
Catastrophic Coverage Period-
You pay the reduced coinsurance or copayment amount set by your Medicare drug plan for the remainder of the year.
Note: People who have limited income and resources and qualify for full Extra Help or have additional coverage aren’t affected by the gap in coverage. They would continue to pay the same copayment amount for each prescription they get.
© Copyright 2017, Guardian Pharmacy, LLC Atlanta, GA
Oct 3, 2016 | Articles Of Interest
By Jonathan Blum, Deputy Administrator and Director for the Center of Medicare at the Centers for Medicare and Medicaid Services
A number of visitors to www.HealthCare.gov have told us they’d like to know more about the Medicare “donut hole” in the Part D program.
If you aren’t familiar with Medicare, it is a health insurance program for people 65 or older, people under 65 with certain disabilities, and people with End-Stage Renal Disease (permanent kidney failure). People with Medicare have the option of paying a monthly premium for outpatient prescription drug coverage. This prescription drug coverage is called Medicare Part D.
In 2010, basic Medicare Part D coverage works like this:
You pay out-of-pocket for monthly Part D premiums all year.
You pay 100% of your drug costs until you reach the $310 deductible amount.
After reaching the deductible, you pay 25% of the cost of your drugs, while the Part D plan pays the rest, until the total you and your plan spend on your drugs reaches $2,800.
Once you reach this limit, you have hit the coverage gap referred to as the “donut hole,” and you are now responsible for the full cost of your drugs until the total you have spent for your drugs reaches the yearly out-of-pocket spending limit of $4,550.
After this yearly spending limit, you are only responsible for a small amount of the cost, usually 5% of the cost of your drugs.
You may have read in the 2010 Medicare & You Handbook that there are some Medicare Part D plans that offer coverage in the donut hole—but these plans may charge a higher monthly premium. (There are also some Part D plans that are “enhanced” and offer fixed co-pays (for example $5, $10, and $20) for prescription drugs instead of the deductible and 25% cost-sharing that was described above. These plans also may charge a higher monthly premium.)
For those that qualify, there is also a program called Medicare Extra Help that helps you pay your premiums and have reduced or no out-of-pocket costs for your drugs.
Needless to say, for most people with Medicare Part D, the donut hole presents serious financial challenges. Some people have had to choose between their rent or groceries and their prescription drugs.
But, the recent health reform law – the Affordable Care Act – has some important changes that will help to relieve this burden for the people with Medicare that hit the donut hole each year (and are not already on a program called Medicare Extra Help,):
This year, if you enter the Part D donut hole, you will receive a one-time, $250 rebate check. The mailing of these checks began in June. If you are eligible and do not receive your check, call your Part D plan first and then 1-800-Medicare.
Starting in 2011, you will receive a 50% discount on brand-name drugs in the donut hole, and you will start to pay less and less for your generic Part D drugs in the donut hole.
Starting in 2013, you will pay less and less for your brand-name Part D prescription drugs in the donut hole.
By 2020, the coverage gap will be closed, meaning there will be no more “donut hole,” and you will only pay 25% of the costs of your drugs until you reach the yearly out-of-pocket spending limit.
Throughout this time, you will get continuous Medicare Part D coverage for your prescription drugs as long as you are on a prescription drug plan.
Oct 2, 2016 | Articles Of Interest
by Peter Barron Stark
What attitude did you bring to work with you today? Unfortunately, very few leaders are aware of their attitude at any given moment.
We talk about attitude a lot, but what, exactly, is it? Psychologists define attitude as a learned tendency to evaluate things a certain way. Most people are aware if they don’t feel well or if they are hungry, but few have taken their emotional intelligence to a level where they can acknowledge their attitude at a given moment and how it’s impacting them and others. One of the greatest gifts a leader can bring to a team is self-awareness and an understanding of their attitude and the impact it plays on relationships, the performance of their team, and everyone around them.
Some leaders who are described as having a bad attitude exhibit pessimism, laziness, rudeness, gossip, procrastination, or negativity. Other bad attitudes are developed by events such as an unhappy customer, boss or a team member who undermines your expectations.
The problem with a leader having a bad attitude is that it’s like a virus… it spreads quickly. A bad manager can ruin the work environment and lower morale for everyone. Managers with bad attitudes are also expensive to keep. When their attitude impacts employees, it’s usually felt by customers who know that they can find another business with more positive people to service their business needs.
The greatest thing about attitude is that it is the one thing we all have the ability to control. It’s a choice. According to Viktor E. Frankl, “Our greatest freedom is the freedom to choose our attitude.” Emotional intelligence is the ability to understand that it’s not what happens to you that determines your attitude, but how you decide to respond.
So what happens if you or a leader who you work with has a bad attitude? Telling someone that they have a bad attitude doesn’t work. Why? Because people will defend their attitude to their death and they have a goal of outliving you. The only chance you have of changing another person’s attitude is to change their behaviors and actions.
Attitude is a hidden ingredient in a company’s culture and is impossible to measure. Luckily, a positive attitude and culture make it very difficult for others in your industry to compete. Some may even say attitude is everything. It may not be everything but a positive attitude will have a positive impact on productivity, quality, service, innovation, and the emotional bond customers feel with your organization.
The following ten tips will help you as a leader exhibit a positive attitude and build a culture where your team members love coming to work and sharing their positive attitude:
Develop a positive vision: A vision is the description of your clear mental picture of the future. Leaders with the right attitude have a positive vision of the future and a deep belief they can turn the vision into a reality. What’s important to note about vision is that whatever your vision is—negative, status quo or positive—you’re right.
Set goals and take actions daily to turn the vision into a reality: Leaders with a positive vision set goals and then take the daily actions needed to turn the vision and goals into a reality.
Choose positive self-talk: It’s impossible to think without using words. And, it’s the words we say to ourselves that create our emotions and attitude. It’s difficult to have a bad attitude when you’re thinking about how blessed you are to be alive and to have wonderful family, friends, co-workers and clients as part of your life. Choose your words carefully!
Hang out with other positive people: It is hard to be negative about life when you only hang out with positive people. On the other hand, it’s a lot more difficult to be positive when the five people you spend the most time with are all negative. Choose your associates carefully.
Focus on job responsibilities, not job functions: In a recent study identifying the most common career-limiting habits, “It’s Not My Job” came in second place. If you want to offer absolutely no help to improving your team or company, this line says it all. Is the task your responsibility? If no one else does the task and it will negatively impact a customer or another team member if it’s not done, it may not be your job, but it’s your responsibility.
Think funny: Having the ability to think funny, laugh and not to take yourself too seriously when things go wrong helps in maintaining a positive attitude. Learn to laugh often.
Do what you love: When you do what you love each day, you’ll never have to get a job and work. It’s easy to have a positive attitude when you have passion and love for what you do.
Stay physically fit: When you do what you know you should do and don’t do what you know you shouldn’t do, you feel better about yourself. When you feel good about yourself, positive thoughts lead to a positive attitude.
Stay focused on results: Every leader has been challenged with some type of personal or family problem that has a significant impact on their attitude. It’s easy to let negative feelings caused by these things impact your attitude and drag you down. Don’t let them. Stay focused on achieving positive results at work. The only thing worse than feeling bad about your home life is combining it with poor results at work.
Listen to others: As a leader, if you listen and observe, you can see the morale of your team. If the team is flat or down, it may be related to your attitude. Conversely, when the team is up and highly motivated, there is also a good chance it’s related to the attitude of the leader. Listen, observe and determine what attitude you want to project to your team.
A bad attitude is contagious . . . fortunately, so is a positive attitude. The choice is yours.
