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The Catch: The Mouths of Former Smokers

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The ghosts of cigarettes past continue to damage the oral health of former smokers.

Researchers at the U.S. Centers for Disease Control and Prevention (CDC) look at the relationship between oral health and smoking in a study based on data from the CDC’s 2008 National Health Interview Survey.

The researchers found that 16% of current smokers with teeth had poor oral health status, compared with just 4% of the survey participants with teeth who had never smoked.

About 8% of the former smokers with teeth were in poor oral health. They were only half as likely as the smokers to have problems with their teeth and mouth, but twice as likely to have problems as participants who had never smoked.

About 55% of never smokers ages 18 to 64 reported having no oral health problems within the previous 6 months, compared with just 36% of the current smokers and 45% of the former smokers.


Executives at Coventry Health Care Inc., Bethesda, Md. (NYSE:CVH), talked some about the effects of the Patient Protection and Affordable Care Act (PPACA) minimum medical loss ratio (MLR) rules during their earnings call.

Coventry is reporting $86 million net income for the fourth quarter of 2011 on $3.1 billion in revenue, compared with $150 million in net income on $3 billion in revenue for the comparable quarter in 2010.

The drop in earnings was due largely to a legal settlement with health care providers in Louisiana, the company says.

Company executives emphasized during the call that the company has diversified its revenue base and now gets about half of its business from Medicare and Medicaid plans.

Executives noted that PPACA could increase opportunities to increase individual commercial business through the new health insurance distribution exchanges starting in 2014.

Individual commercial enrollment already has increased to 200,000 today, from 123,000 in 2008, executives said.

The company’s commercial MLR was 83.7% in the fourth quarter, which was slightly higher than it had predicted, in part because the company began to learn more about the relationship between the federal MLR rules and payments to outside vendors, executives said.

Most individual customers, half of the small group customers and one-quarter of the large group customers be getting rebates, executives said.

Coventry has been using some capital that could be going into rebates to improve the quality of care and possibly lower future care costs, executives said.

PPACA provisions of all kinds probably have added about 1.5 percentage points to 2 percentage points to health care cost increases but should not add much to the rate of increase this year, executives said.

Executives at Coventry have noticed a decrease in health care costs, especially in the use of inpatient hospitalization, and they said they are setting prices to reflect the likelihood that utilization will return to normal.


Centene Corp., St. Louis (NYSE:CNC), a company that focuses on the government plan market, is reporting $30 million in net income for the latest quarter on $1.5 billion in revenue, up from $25 million on $1.2 billion in revenue.

Enrollment increased to 1.8 million at the end of 2011, from 1.5 million a year earlier.