Current Events and Blog

13Nov 2018

Geriatric Psychiatry: Challenges and Rewards – Healio


Older adults are increasing in number in the United States. The US Census Bureau estimates that 15% of the US population, or 49.2 million people, were age 65 years and older in 2016, and this number is expected to double by 2060.1 The rate of growth of the population age 85 years and older in the US is expected to be even higher. Estimates predict this population will double by the year 2035 and triple by 2060.1 The population of centenarians will be more than 5 times greater in 2060 compared to what it is today, and about one-half will be part of minority groups, in contrast to the predominantly white population of centenarians today.2 Although the overall number of older women is predicted to remain higher than that of older men, the overall ratio of men to women is expected to decrease. This change in ratio is related to an increased life expectancy for men, with more growth in the number of men age 85 years and older.1

Although patients with mental health issues have a shorter lifespan than the general population, these patients’ lifespan has been expanding with improving treatments. In 2010, 5.6 to 8 million (or 14% to 20% of the older population) had mental health or substance use disorders.3 The Institute of Medicine (now the National Academies of Medicine) estimated that by the year 2030, from 10.1 to 14.4 million Americans age 65 years and older will have mental health or substance use disorders. These numbers are likely to be underestimates of the population, as they did not include populations from all mental health disorders.3

Despite these data demonstrating a significant increase in the geriatric population, and particularly those with mental health disorders, the ratio of geriatric psychiatrists to the geriatric population is declining.3 With the 2008 report by the Institute of Medicine4 demonstrating an overall shortage of geriatric specialty care and mental health providers, this decline is concerning. The purpose of this article is to describe the current state of the subspecialty of geriatric psychiatry, including current challenges and methods of improvement for these challenges, as well as the rewards of practicing in this field.

Current State of Geriatric Psychiatry

The American Board of Psychiatry and Neurology (ABPN) applied to the American Board of Medical Specialties and received approval of a certificate for added qualifications in geriatric psychiatry in 1989.5 The only other psychiatry fellowship program previously approved was child psychiatry in 1959.5 The ABPN administered the first subspecialty examination and began certification in geriatric psychiatry in 1991, and in 1993 the Accreditation Council for Graduate Medical Education (ACGME) approved the fellowship training requirements.5,6 Initial certification examinations are offered every other year and 3,465 initial certificates have been issued through December 2017.5 The ABPN began offering maintenance of certification examinations in the year 2000, and since then has administered 2,255 examinations.5 This certification lasts for 10 years, at which time recertification is required.5

For ACGME-accredited general psychiatry residency programs, only 1 month of geriatric psychiatry experience is required.7 When certifications began for geriatric psychiatry in 1989, there were 29 programs in existence. There was an initial increase in the number of programs, but the number has remained fairly stable since the 2000s.8 The number of filled positions, however, has declined by about one-half.3 There were 60 actively accredited geriatric psychiatry programs in the 2017–2018 academic year and 57 in the 2016–2017 academic year.9 Approximately one-half of these programs had two positions, with a range of 1 to 7 positions per program.8 In the 2016–2017 academic year, there were 153 positions available, and 56 active fellows in geriatric psychiatry;10 42% of these fellows were graduates of international medical schools. Overall, the fill rate was about 40% in 2016–2017, and there has been a 16% decline in the number of fellows during the past 5 years.8

Opportunities in the subspecialty of geriatrics are available in both psychiatry and medicine. Geriatric medicine can be pursued through either internal medicine or family medicine, and like geriatric psychiatry programs, the number of available positions consistently exceeds the number of positions filled.3 Mental health education is required in geriatric medicine programs via didactic and clinical experience; however, there is no consensus on curriculum requirements, which leads to great variability in education among different programs. As geriatric medicine physicians must balance complex medical issues with limited time due to high demand and concerns for reimbursement rates, mental health issues may not be adequately addressed without consultation with a geriatric psychiatrist. A multidisciplinary approach provides patients with the best care as providers navigate the interactions between medical and mental illness and how treatments may affect both.

Current Challenges of Geriatric Psychiatry

Geriatric psychiatry involves the diagnosis and treatment of mental health disorders in older adults. These disorders include the anxiety, mood, psychotic, and substance use disorders that a general psychiatrist will treat, along with significantly more neurocognitive disorders. The geriatric population has more physical, emotional, and social challenges compared with the general population, and the problems older patients face often overlap between these areas.2 This complicates the diagnosis and, subsequently, the treatment of geriatric patients. Comprehensive assessments often require a multidisciplinary approach and family involvement. Psychiatric care for older adults involves both the management of chronic mental illness and new-onset symptoms. Shifts in normal physiology change the manifestations and treatment of mental illness. Given the growing number of older adults with mental illness and the insufficient number of providers to care for them, the importance of prevention is comparable to that of treatment.

These issues are inherent in the field of geriatrics, which in and of itself may contribute to one of its greatest challenges–the decreased numbers of physicians pursuing advanced training in the area.

The need for improved education is likely a major factor in recruitment, as 21% of US medical schools lacked specific teaching on geriatric psychiatry during the psychiatry clerkship.11 It is difficult to integrate specific education on this topic when it may not be prioritized in the constantly expanding medical curriculum, and the number of faculty available with expertise in the area may also limit the quality and availability of geriatric education.

The National Academies of Medicine identified stigma against both older people and mental illness as another barrier to recruitment.3 In a study of psychiatry residents, perceived poor patient outcomes and financial reimbursement were also identified as factors that could keep providers from specializing in geriatric psychiatry.12 Dissatisfaction with bureaucracy may be difficult to avoid, with much of the reimbursement for geriatric psychiatry coming from US government agencies such as Veterans Affairs or Medicare. Although there is variability in discussions about remuneration, one study showed similar reimbursement rates for general psychiatrists compared with trained geriatric psychiatrists in treating older adults.13 Many providers who do not have specialty training in geriatric psychiatry feel uncomfortable treating older patients, but additional training improves this level of comfort and does not preclude providers from continuing to see general adult patients.

Addressing Challenges of Geriatric Psychiatry

During the past few years there have been increasing efforts to address the many barriers a geriatrician may face. Rej et al.14 showed that early exposure to clinical experiences with older patients and positive experiences prior to medical school were important factors for psychiatry resident interest in geriatric psychiatry. The National Academies of Medicine report also identified the importance of experiences with older people to combat stigma.3 Another factor in engaging resident interest is the availability of conferences, and the American Association for Geriatric Psychiatry offers reduced membership and meeting fees, as well as scholarships, to attend the annual meeting.15 There has been an increase in the funding for the scholarship that is available to medical students and residents with interest in geriatric psychiatry. At the annual meeting, there is a special 1-day program with networking and mentorship opportunities.15 Although the idea remains controversial, there have been proposals for integrating specialty training in the fourth year of general psychiatry residency with the hope that this may provide incentive for trainees to pursue subspecialty training.16,17 Although there are disadvantages to this model, it could ameliorate some of the financial burden of an additional year of training.

The Rewards of Geriatric Psychiatry

Despite the challenges and complexities of working with older adults, multiple studies have shown high levels of satisfaction for providers in the field.18 Geriatric specialists had the second highest level of satisfaction compared with other physicians in 2009 study in the United States.19 A study in Australia and New Zealand from 2010 cited high career satisfaction among 88% of geriatric psychiatrists, and they identified working with older people, working as part of a multidisciplinary team, and intellectual challenge as the main benefits of the specialty.20 The medical complexity of geriatric patients may present a challenge to some providers, but this survey showed providers view this as a reward.20 This is not surprising, as intellectual stimulation is a major reason why many people initially enter the medical field. These complexities also promote more frequent use of multidisciplinary teams. These teams often include a geriatric psychiatrist, pharmacist, nurse, occupational therapist, physical therapist, dietician, social worker, psychologist, and a primary care provider. This team-based approach helps both the patients and family navigate the complicated process of aging with mental illness. Working with families is another rewarding aspect of the field, as the impact of a geriatric psychiatrist improves the lives of many people per patient treated.

In addition to the high career satisfaction, there have been increasing efforts to improve financial incentives for geriatric providers. South Carolina created the first Geriatric Loan Forgiveness Program to help mitigate the rising costs of medical education and offset the compensation difference for additional years of training.21 The Geriatrics Loan Forgiveness Act was introduced in the US Congress in 2009 as an amendment to the Public Health Service Act to aid in loan forgiveness for geriatric specialists, including mental health providers.22 According to a 2003 survey by the American Association of Geriatric Psychiatry, psychiatrists who passed the subspecialty examination by the National Board of Medical Examiners earned higher salaries.15 In an academic setting, completion of an ACGME-accredited fellowship also provides leverage for higher salary and quicker academic promotion.

There is also a significant degree of flexibility in the practice of geriatric psychiatry, especially given the current high demand. This demand means opportunities in both urban and rural areas throughout the US, in both the private and public sectors. Providers can work in a variety of settings, including inpatient, outpatient, and long-term care units. With technological advancements and the increasing use of telehealth, access to care for elderly patients has improved, especially in rural areas. Telehealth also allows for flexibility in provider schedule, especially when seeing long-term care residents.

Telehealth is just one of the advances in geriatric psychiatry that is developing at a rapid pace and creating an exciting environment for practitioners. New imaging techniques and genetic testing are improving diagnoses.2 Prevention and cure have been the targets of investigational studies, including vaccines and gene therapy for Alzheimer’s disease and other dementias.2 Grants are available for those interested in research at a variety of different training or career levels.

References

  1. Vespa J, Armstrong DM, Medina L. Demographic turning points for the United States: population projections for 2020 to 2060. https://www.census.gov/content/dam/Census/library/publications/2018/demo/P25_1144.pdf. Accessed October 3, 2018.
  2. Jeste D. Geriatric psychiatry. In: Sadock BJ, Sadock VA, Ruiz P, eds. Kaplan & Sadock’s Comprehensive Textbook of Psychiatry. 10th ed. Philadelphia, PA: Wolters Kluwer; 2017:3948–4286.
  3. Eden J, Maslow K, Le M, Blazer D, eds. The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands? Washington, DC: National Academies Press; 2012.
  4. Institute of Medicine (US) Committee on the Future Health Care Workforce for Older Americans. Retooling for an Aging America: Building the Health Care Workforce. Washington, DC: National Academies Press; 2008.
  5. American Board of Psychiatry and Neurology. Facts and statistics. https://www.abpn.com/about/facts-and-statistics/. Accessed October 3, 2018.
  6. Faulkner L, Juul D, Andrade N, et al. Recent trends in American Board of Psychiatry and Neurology psychiatric subspecialties. Acad Psychiatry. 2011;35(1):35–39. doi:. doi:10.1176/appi.ap.35.1.35 [CrossRef]
  7. Accreditation Council for Graduate Medical Education. Psychiatry: program requirements and FAQs. http://www.acgme.org/Specialties/Program-Requirements-and-FAQs-and-Applications/pfcatid/21/Psychiatry. Accessed October 3, 2018.
  8. Juul D, Colenda C, Lyness J, Dunn L, Hargrave R, Faulkner L. Subspecialty training and certification in geriatric psychiatry: a 25-year overview. Am J Geriatr Psychiatry. 2017;25(5):445–453. doi:. doi:10.1016/j.jagp.2016.12.018 [CrossRef]
  9. Accreditation Council for Graduate Medical Education. Geriatric psychiatry programs. https://apps.acgme.org/ads/public/reports/report/1. Accessed October 3, 2018.
  10. Accreditation Council for Graduate Medical Education. ACGME resource book. Academic year 2016–2017. http://www.acgme.org/About-Us/Publications-and-Resources/Graduate-Medical-Education-Data-Resource-Book. Accessed October 3, 2018.
  11. Lehmann S, Blazek M, Popeo D. Geriatric psychiatry in the psychiatry clerkship: a survey of current education practices. Acad Psychiatry. 2015;39(3):312–315. doi:. doi:10.1007/s40596-015-0316-y [CrossRef]
  12. Lilly M, Lapid M, Richardson J. Perspectives on geriatric psychiatry: results of a single site survey of psychiatry residents. Acad Psychiatry. 2012;36(1):69–70. doi:. doi:10.1176/appi.ap.11080145 [CrossRef]
  13. Colenda CC, Wilk JE, West JC. The geriatric psychiatry workforce in 2002: analysis from the 2002 national survey of psychiatric practice. Am J Geriatr Psychiatry. 2005;13(9):756–765. doi:. doi:10.1097/00019442-200509000-00003 [CrossRef]
  14. Rej S, Laliberte V, Rapoport MJ, Seitz D, Andrew M, Davidson M. What makes residents interested in geriatric psychiatry? A pan-Canadian online survey of psychiatry residents. Am J Geriatr Psychiatry. 2015;23(7):735–743. doi:. doi:10.1016/j.jagp.2014.08.015 [CrossRef]
  15. American Association for Geriatric Psychiatry. AAGP scholars program, an opportunity for psychiatry residents and medical students. https://www.aagponline.org/index.php?submenu=education_submenu&src=gendocs&ref=AAGPScholarProgram&category=Main. Accessed October 18, 2018.
  16. Kirwin P, Conroy M, Lyketsos C, et al. A call to restructure psychiatry general subspecialty training. Acad Psychiatry. 2016;40(1):145–148. doi:. doi:10.1007/s40596-014-0144-5 [CrossRef]
  17. Ray-Griffith SL, Krain L, Messias E, Wilkins KM. Fostering medical student interest in geriatrics and geriatric psychiatry. Acad Psychiatry. 2016;40(6):960–961. doi:. doi:10.1007/s40596-015-0431-9 [CrossRef]
  18. Siu AL, Beck JC. Physician satisfaction with career choices in geriatrics. Gerontologist.1990;30(4):529–534. doi:10.1093/geront/30.4.529 [CrossRef]
  19. Leigh JP, Tancredi DJ, Kravitz RL. Physician career satisfaction within specialties. BMC Health Serv Res. 2009;9:166. doi:. doi:10.1186/1472-6963-9-166 [CrossRef]
  20. Draper B, Reutens S, Subau D. Workforce and advanced training survey of the RANZCP faculty of psychiatry of old age: issues and challenges for the field. Australas Psychiatry. 2010;18(2):142–145. doi:. doi:10.3109/10398560903314138 [CrossRef]
  21. South Carolina Lieutenant Governor’s Office on Aging. Geriatric physician loan forgiveness. https://aging.sc.gov/programs-initiatives/geriatric-physician-loan-forgiveness. Accessed October 3, 2018.
  22. Geriatrics Loan Forgiveness Act of 2009, HR 1457, 111th Cong., 1st Sess (2009). https://www.govtrack.us/congress/bills/111/hr1457.

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13Nov 2018

Lyft rewards program will offer perks to frequent riders – Engadget



Lyft

Lyft thinks it has a simple way to reel people into its service: shower frequent riders with perks. It’s launching a Rewards program in December for “select” passengers. The more you travel, the more points you’ll get toward bonuses like ride upgrades and more experienced drivers. There will also be double-points days to encourage you to head out.

More people will have access in 2019, Lyft said. It also vowed to listen to rider input and tweak the program.

This isn’t Lyft’s first rewards effor,t strictly speaking. You can already earn Delta SkyMiles, and workers can use Business Rewards to earn credit for personal trips. This could have a more tangible impact for many people, however. If you’re the sort who frequently uses Lyft but can’t justify an All-Access plan, this could keep you loyal when you’d otherwise be tempted to try Uber or another competing service.

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13Nov 2018

MoneyFix Podcast: Travel-Hack the Holidays – NerdWallet (blog)


Welcome to this episode of the “MoneyFix” podcast! Your hosts, Dayana Yochim and Sean Pyles, answer your real-world money questions with the help of NerdWallet’s in-house financial experts, so you can make smart money moves.

Dayana and Sean talk with NerdWallet’s travel-hacking expert, Joe Cortez. Read (and listen) on to learn how you can use your credit card points to cut lines, avoid crowds and make holiday travel a little less miserable.

Takeaway tips

Use your travel insurance. If you paid for your flights with a travel credit card, you might be covered if a flight is delayed or canceled altogether.

Make the most of your Priority Pass. If you carry a credit card with Priority Pass membership, make the airport a little less stressful by ducking into one of those fancy lounges while you wait.

Get rewarded for using your card. By taking advantage of select travel loyalty programs, you can earn rewards by making purchases you’ll have to make anyway, like flights and hotel rooms.

More about travel on NerdWallet

Your Money-Saving Guide to Holiday Travel

Find the Best Travel Credit Card

9 Easy Ways to Earn Travel Rewards You’ll Actually Use

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12Nov 2018

American Airlines Joins Rivals In Making It Harder To Reach Top Frequent Flyer Status – GET.com (blog)


American Airlines has notified members of its frequent flyer program that effective January 1, 2019, their top-tier elite level will cost more to attain. Starting on that date, flyers will have to spend $15,000 annually on qualifying tickets to become Aadvantage Executive Platinum members.

This latest change to the airline’s frequent flyer program is similar to the changes that United Airlines and Delta Air Lines have also made to their loyalty programs. While Delta already requires members to spend at least $15,000 a year with the carrier to attain their top-tier elite status in its SkyMiles frequent flyer program, United recently raised its spend threshold to $15,000 if members of its Mileage Plus frequent flyer program want to attain top-tier status with the airline.

American Airlines has stated that the carrier has improved the way that these miles can be earned. The airline is now allowing miles earned on partner flights with Iberia, Japan Airlines, British Airways and Finnair to be applied toward their status at the full rate. This is a significant improvement for travelers who often do not receive this benefit for their overseas travel.

The airline industry has seen a very high demand for seating over the last few years. As demand increases, the cost of giving away free seats to passengers who cash in their miles also increases. To ensure that the airline is able to meet the demand of paying customers while also meeting the demand stemming from loyalty program redemptions, most airlines have made changes to their frequent flyer programs to adjust their costs accordingly.

The airline is encouraging all of their frequent flyer program participants to familiarize themselves with the updated terms of the program.

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12Nov 2018

Employers modernizing total rewards programs – Employee Benefit News


In a tight labor market, employees are demanding more out of their employers and out of their benefits packages. And apparently, employers are listening.

Employers are increasingly looking for ways to upgrade their total rewards programs to keep up with the changing workplace, a recent Willis Tower Watson survey finds. That includes career coaching, flexible work schedules and personalized benefits.

Nearly two-thirds of employers (66%) surveyed have made at least one change to their total rewards program. Out of the remaining third, two out of the three plan to implement changes this year, while the other third looks to make changes over the next three years.

In droves, employers this year have announced changes highlighting those benefits. For instance, Amazon said it was looking to fill more than 250 virtual jobs that allow workers to work from home. And Chipotle and Lowe’s expanded education benefits and career training programs for their employees.

“With a highly sought-after talent pool, more employers are looking at their benefit packages to make their job offer more appealing,” says Julie Stich, associate vice president of content at the International Foundation of Employee Benefit Plans. “Savvy employers are taking a closer look at the needs of their current and potential employees, and carving out unique benefits that meet their needs.”

But while employers are recognizing the need to offer more, nearly half the companies polled by the consulting firm admit they don’t know which benefits their employees’ value. Even less understand which benefits potential candidates want. The survey, which polled 275 U.S. companies, found that employees care about flexibility, transparency and personalization.

In the past, total rewards programs relied mostly on compensation and benefits, but today’s workforce is interested in a more holistic and personal approach, says Adrienne Altman, North American rewards leader at Willis Tower Watson.

“One-size-fits-all was pretty sufficient,” she says. “But now, you’ve got different expectations from different employees based on generations and based on different functions.”

“What we’re seeing is employees are saying: I want information that I get to be relevant to me,” Altman says. “I also want to have some choice and flexibility because my needs are different to yours.”

This explains why two-thirds of the companies polled are working to improve their personalized communication with their employees over the next three years.

Through her research, Altman says the way companies get work done is changing. She says the traditional workplace is being replaced with a more agile one because of the technology firms are incorporating.

“Traditionally, people have been rewarded based on a set of goals and a set of performance measures for doing their role,” she says. “But if roles are constantly in flux, then the current construct of how you reward your people will have to change.”

As millennials make up more of the workforce, companies should also focus on pay transparency when they upgrade their total rewards programs. And just like personalized communication, Willis Towers Watson found that nearly two-thirds of employers plan to improve pay transparency within three years. Following legislative changes that aim to address wage inequality, today’s employees are very comfortable talking about pay in the open, Altman says.

Part of Altman’s research was to look at the total rewards programs of leading companies versus lagging ones.

“Leading companies didn’t just think of comp and benefits,” she says. “Rewards include things like career opportunities, well-being, learning and development and they are more likely right to have a well-articulated strategy that includes all of those elements.”

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12Nov 2018

Travel startups are taking off – TechCrunch


The second wave of Internet-era travel companies has captured the attention of venture capitalists.

In the last five years, travel companies have raised more than $1 billion in venture capital funding. That includes short-term rental startups, travel and tourism apps, marketplaces for “experiences” and other travel or hospitality tech platforms. Airbnb, a $38 billion company and an anomaly in the category, has raised $3 billion in that same time frame, according to PitchBook.

In the last few months alone, aspiring Concur-competitor TripActions and travel activities platform Klook entered the “unicorn” club with large venture rounds that valued both of the businesses at more than $1 billion. Meanwhile, luggage maker Away raised $50 million at a $400 million valuation and smaller startups in the space like Freebirds, IfOnly, KKDay, Duffel and RedDoorz all closed modest funding rounds.

“Something is really happening in the industry; something bigger than us,” TripActions co-founder Ariel Cohen said in a recent conversation with TechCrunch about his company’s $154 million Series C financing. “Different startups are identifying the opportunity here and the fact that companies want to make sure their employees are happy while they are on the go. That’s why you see investments in companies like Brex and like TripActions.”

Brex, though not classified as a travel startup, lets startup employees earn extra points on business travel with its corporate credit card for startups. It recently raised a $125 million Series C at a $1.1 billion valuation.

Global travel and tourism is one of the most valuable industries worth some $7 trillion. The online travel market, in particular, is expected to grow to $817 billion by 2020. VCs are hunting for tech-enabled startups poised to dominate that slice.

“You have a new wave of businesses where all of that digital infrastructure is set up, so the focus can be on things like efficiency, improved customer service, scale and growth — you have a ton of companies popping up catering to those needs,” Defy Partners co-founder Neil Sequeira told TechCrunch. Sequeira was a managing director at General Catalyst when the firm made its first investment in Airbnb.

On the other hand, you have a whole cohort of travel business founded amid the dot-com boom that are looking to technology startups for a much-needed infusion of innovation. Many of those larger companies have become active acquirers, fueling VC interest in the space. SAP Concur, for example, acquired the formerly VC-backed travel-booking startup Hipmunk in 2016. Before that, it bought travel planning company TripIt for $120 million, among others.

Expedia has gobbled up a number of travel brands too, like travel photography community Trover; Airbnb-competitor HomeAway, which it paid a whopping $3.9 billion for in 2015; and most recently, both Pillow and ApartmentJet.

Many of these acquisitions are for peanuts, which is far from ideal for a venture-funded company. And building a travel business is cash intensive, hence the $4.4 billion Airbnb has raised to date or even TripActions’ $236 million in total VC funding. To keep momentum in the space, companies need to be striking larger M&A deals.

It doesn’t help that many in and around the venture capital industry are predicting an imminent turn in the market. Travel companies, which are reliant upon a consumer’s tendency to spend excess cash, will be among the first sectors to be impacted by hostile economic conditions.

“If the market turns, people aren’t going to spend $10,000 on a trip to Zimbabwe,” Sequeira said, referencing companies like IfOnly, which sells curated experiences.

Travel startups should raise now while the market is hot. The conditions may not remain favorable for long.

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12Nov 2018

Credit card defaults are down, but debt levels are on the rise – MarketWatch


Usually, a charge-off occurs when an individual doesn’t make payments – usually for six months. This is more than just a credit card status though. It affects your relationship with your credit card issuer, your general credit standing, your ability to get a credit card or loan approved and other credit-related services.

How charge-offs happen:

Once you’re approved for a credit card, you agree to the terms dictated by the card issuer. For example, you could agree to a minimum payment by a certain date each month. Missing this minimum credit card payment continuously for six months will put your card in default. Subsequently, the card issuer reports the default as a charge-off to the credit bureaus after closing your account.

Within the six months building up to the default, the late payment status will also be reported to the credit bureaus, but your credit score will begin suffering earlier as a result of those late payments. New credit card and loan applications will likely be denied since creditors will probably think that you are at risk of defaulting on new credit responsibilities. Some creditors even go as far as rejecting applications who haven’t cleared up the charged off balance.

Consumer debt in America

These days, it seems like Americans just keep slipping further into debt. This is according to one of the key indicators used by analysts which is the Q2 2018 Household Debt, and Credit Report was done by the New York Federal Reserve. This report indicates that the grand sum of household debt in America has continued to increase for the 16th quarter in a row.

Currently, the consumer debt is a little below the $14 trillion ceiling with a whopping $9.43 trillion of that being categorized as housing debt.

And if there were any upside to this, it would be the single economic index that seems to indicate that Americans are currently handling a part of the debt load well considering the fact that credit card default rates are currently reducing.

Don’t miss: How do I cancel 10 credit cards without damaging my credit score?

The S&P/Experian Consumer Credit Default Composite Index which is a metric of the complete default rates across credit cards, auto loans and first, second and third mortgages with each indicator assigned to a unique index. The composite index indicates that while overall default rates have remained constantly flat over the last three years, the credit card default index has experienced dips in May, June, and July.

An advantage to good credit

The Composite Index has been constantly fluctuating between 0-8 and 1 since April 2015. To provide a bit of context, it is important to note that the index peaked at 5.51 in May 2009 during the lowest points of the housing crisis and the recession that followed. As a result of the slow economic recovery, the index plunged below 2.0 in March 2009 and went further down below 1.0 over the next three years. Many believe this caused the mortgage and auto loan indexes to follow a similar track over the same time period.

The credit card index reached a high of 9.15 in April 2015 and experienced a dip at a steady pace to 2.49 in December of the same year. Since then, there have been repeated waves of increases and lesser waves of decreases. At the moment, experts believe we are in a decreasing wave, and as of July 2018, the index dipped to 3.56 from Aprils 3.86

So, what does this mean? Well, it means that the index has changed logically to reflect the tightening of credit going on. This could be expected after the post-recession surge in defaults; credit tightened to a point where only borrowers with rock-solid scores could get loans leading to a reduction in risky loans and defaults. Now, credit cards are more common and represent a wide category of risk levels making the credit card index more prone to fluctuations.

Debt levels are on the rise

Although credit card defaults may be experiencing a decline at the moment, it is clear that credit card debt is not. According to the Household Debt and Credit report, credit card debt increased by $14 billion in the second quarter.

Currently, credit card debt growth is hitting households hard because of the relatively high interest rates. The current average APR (annual percentage rate) is almost 17% – making it extremely higher than most mortgage rates and slightly higher than the interest rates of most of the other types of debt. Also, the penalty APRs levied after a payment is missed can go as high as 30%.

See: How to rebuild your credit—fast

If you tend to carry balances often, it is a good idea to ensure your credit score is as high as possible to get the best interest rates. Check your credit report regularly for errors or signs of fraud that could cause your score to drop without your knowledge. Also, make sure that all payments are made on time as they are the most significant impact on credit scores.

What you can do to keep your debt from rising

One of the best ways to avoid interest charges and unnecessary credit card debt is to make sure you never charge more to your card than you can pay at the end of each month. Although that may not be practical in your case, it is necessary to formulate a plan that will help manage and pay off all balances to keep your debt in control.

Read: Half of Americans with this credit card regretted getting one

Finally, when dealing with multiple debts, it is usually a good idea to strategize over which debts to pay off first – whether it be the debt with the lowest balance or the debt with the highest interest rate. If you can afford to pay extra against the principal on mortgages and other installment loans, you can do this to save on interest, but remember, it is also a good idea to create an emergency fund to help deal with any financial crises so that you can avoid putting them on credit cards.

This article originally appeared on Credit.com.

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11Nov 2018

How to come out ahead with rewards cards – CNBC


For credit card companies, millennials are the Holy Grail.

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In sheer size, they outnumber any other demographic. They’re also spending more than other generations on everyday purchases such as groceries and gas, as well as on experiences such as dining out, according to a report by Bankrate.com. And, because they are just starting out, they have the potential to be very long-term – and lucrative – customers.

“Credit cards that appeal to millennials with good credit and high incomes are a big push in the industry lately,” said Ashley Dull, the editor in chief at CardRates.com.

To attract these consumers, card issuers have upped the ante with better rewards and sign-up bonuses.

Banks are also specifically partnering up with the brands millennials know and love. New reward card contenders include the Uber Visa, Ikea Visa, Amazon Rewards Visa and a soon-to-be-released Apple-Goldman Sachs card.

And it’s working. Credit card originations from consumers ages 18 to 34 rose 10 percent from the same period last year, according to TransUnion’s latest quarterly report.

However, rewards cards, which dole out points when you make purchases at airlines, gas stations and restaurants, aren’t always as good as they seem.

For starters, these credit cards generally have higher-than-average interest rates to compensate issuers for the additional perks.

The national average APR is already over 17 percent — a record high — according to CreditCards.com, but the annual interest rate on the Ikea card, for example, is even higher at 21.99 percent.

So the benefits of using a fancy card are quickly negated if you carry a monthly balance.

Further, depending on how much you spend each month, signup bonuses and other rewards don’t always offset the cost of an annual fee, which can be as much as $450 depending on the card, according to WalletHub’s 2017 Credit Card Rewards Report.

On the other hand, don’t rule out a card entirely because of the fee. Often these cards have better initial bonuses and higher earning rates than cards without a fee. For big spenders, it is easier to rack up enough charges to reap the benefits of a rewards card and offset the fee.

But overall, only a select few are even taking advantages of all the perks that reeled them in in the first place, according to Ted Rossman, an industry analyst at CreditCards.com.

A little more than half of rewards cardholders have redeemed for cash back within the past year and another 29 percent have redeemed for gift cards, Bankrate found. Only 13 percent of cardholders exchanged their points for merchandise and less than 10 percent traded in for a free hotel stay or airfare.

Nearly a quarter, or 22 percent, of cardholders haven’t redeemed any rewards, according to Bankrate.

That’s why cash back is often a better bet, Rossman said, even though travel rewards are still considered the best deal because they have more redemption value.

If you’re in the market for a new credit card, be honest with yourself about how you plan to use the card and what you want to get from it, advised Matt Schulz, the chief industry analyst at CompareCards. For example, do you spend more money at restaurants or at grocery stores?

“The best way to make sure that you get the most out of a rewards card is to make sure that it fits your lifestyle,” he said.

However, if you have any credit card debt, forget about cash back, travel perks or any other rewards, Rossman added. You need to focus on getting out of the red as quickly and cost-effectively as possible.

To that end, Rossman recommends snagging a zero-interest balance transfer offer, such as the Chase Slate, BankAmericard or American Express Everyday, which offer 15 months at 0 percent if you make the transfer within the first 60 days of opening the account.

Then, aggressively pay down your balance.

“On the Money” airs on CNBC Saturdays at 5:30 a.m. ET, or check listings for air times in local markets.

More from Personal Finance:

The best rewards cards can save you more than $1000

Secrets of credit card super users

To lure millennials, Apple, Ikea and Uber push branded credit cards

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11Nov 2018

This Is Why Travel Agents Want To Be Called Travel Advisors – Forbes


When Peter Schwartz needs to book a trip, he doesn’t contact a travel agent. He calls a travel advisor.

“She’s an expert at identifying great deals on planes and other means of travel plus hotels,” says Schwartz, a marketing consultant from Tucson, Ariz. “She understands how to piece together all the details of an international trip to make sure it is convenient and efficient.”

Like many other travelers, Schwartz is looking for more than someone who will do more than get him from point “A” to point “B.” He wants an expert with professional certifications such as Destination Specialist or Certified Travel Associate, which are offered by the Travel Institute.

“This sort of expert experience is very valuable for me since it saves me a lot of time and money — and frustration,” he adds.

Schwartz is part of a slow-moving trend that started in the 90s when airlines reduced travel agent commissions. Agents soon had competition from online travel agencies such as Expedia and Orbitz, and struggled to survive.

The number of full-time travel agents in the U.S. plummeted from a high of 124,000 in 2000 to roughly 74,000 in 2014, according to the Bureau of Labor Statistics. Although the number bounced back to 81,700 today, the government projects a further 12 percent decline in the number of agents by 2026.

It was obvious to almost everyone in the travel industry that if travel agents continued to see themselves as middlemen between the buyer and seller, their days were numbered. So this summer, the American Society of Travel Agents quietly changed its name to the American Society of Travel Advisors (ASTA). The new name “more accurately describes the value our members provide to consumers and is a distinct declaration of who we work for: the traveling public,” said Zane Kerby, ASTA’s president.

The message was clear: Stop calling us travel agents. Travel agents represent a dying business that no longer serves customers. Travel advisors, which provide a professional service, are the future.

But in a do-it-yourself world dominated by online travel agencies and where artificial intelligence is blurring the distinction between human agents and computers, is that message being received? The answer is complicated. Some customers and former agents are sold on the idea. But barriers, both external and internal, remain. For now, there are ways to tell if you’re working with a real advisor. However, the economics of the business will have to change if the entire industry wants to be recognized as professionals.

Peter Schwartz on a visit to Britain this summer. A travel advisor planned every detail of his trip.Peter Schwartz

Travelers are lukewarm to name change

For travelers like Schwartz, ASTA’s message has gotten through loud and clear. As a busy marketing consultant, he doesn’t have time to make his own travel arrangements.

What’s more, his travel advisor, Donna Wolfe, offers concierge services that old travel agents never used to — anything from dinner reservations to handling travel documents like passports. She’s a certified expert in Mexico, Hawaii, Thailand, Fiji, Grand Cayman, and Alberta, Canada. Wolfe, who works for an agency called Plaza Travel, also belongs to the Signature Travel Network, a consortium of agencies.

Interestingly, travel agency networks such as Signature, Travel Leaders and Virtuoso, have helped travel advisors thrive during a time of cutthroat competition by consolidating their buying power. Those same networks are now helping agents make a transition to becoming advisors. So is ASTA, with its new Verified Travel Advisor program, which trains and certifies agents.

But other travelers are dubious of ASTA’s rebranding.

“The idea of using a travel agent in the traditional sense seems almost comical,” says Cameron Seagle, an engineer from Wilmington, N.C., who co-writes a travel blog called The World Pursuit. “This is the growing sense we get from a lot of our fellow travelers and even our parents’ generation. I think the internet, booking platforms, the sharing economy, and even travel blogs have changed the way we plan travel.”

Seagle says he’s open to using an agent, as long as that person is a subject matter expert — someone highly specialized and trained. If the expertise is easily found online or by asking friends, he’d rather just book it himself.

The author addresses the ASTA annual convention in San Diego in 2017.ASTA

Internal divisions threaten shift from agents to travel advisors

Adding to the problem is the fact that travel advisors are still debating their role in the industry. I was pulled into this discussion when I had an opportunity to address ASTA’s annual convention last year. In my speech, I noted that agents who advocate for their clients, rather than just looking for a commission check, represented the future of the industry.

The speech drew a mixed reaction. While some members supported their agents-are-advisors role, many were deeply offended that I called out the traditional agents and gave examples of some of their anti-consumer behavior from the extensive files of my nonprofit consumer advocacy organization.

At least one member was so upset that she threatened to resign her ASTA membership unless the organization promised never to let me speak again. Talk about shooting the messenger.

Still, the experience was helpful. Seeing this anger up close made me understand that there’s a significant part of the travel agency community that wants to turn the clock back to 1990, to the days when they could earn a comfortable living with a phone call and a few keystrokes. These agents also view any criticism — even constructive criticism — as a hostile act.

Unfortunately, these agents are still in our midst, some pretending to be travel advisors when they just want to sell you a trip with the highest commission. It could take a generation or more before they disappear. So in a sense, making a transition from agents to advisors is as much an internal problem as it is an external one.

How can you tell if your agent is an advisor

How can you tell if you’re dealing with an advisor? Here are a few signs:

They do more than book travel

Travel agents may ticket air, book a hotel, and set up transfers only. “For advisors, that is simply the framework,” Kristin Chambers, a luxury travel advisor with DA Luxury Travel, a Virtuoso agency. “Advisors network and research to build their black book of local connections they spend years building that is beyond hotel and air connections.”

They specialize

An advisor develops expertise in one or more areas of travel. “It’s someone who offers specialization and who can offer more in-depth knowledge about a destination,” says Mina Agnos, president of Travelive, a luxury travel agency. “This goes into where to stay and why you should stay there, which tours to take based on your interests, pairing you with the right guides, even booking your dining and spa reservations.”

They customize

Travel advisors create customized itineraries and trips — not boilerplate, one-size-fits-all vacations. “We develop a full client profile to know what the interests and preferences are, in order to customize an itinerary to suit,” says Vivian Temba, the sales director for Amani Afrika, an agency that specializes in safaris. “We’d also make sure to take into account any special requests, like providing gluten-free meals, even for our mountain trekking excursions.”

They offer concierge services

Increasingly, travel advisors offer concierge-type services that you might get from a five-star hotel. “The job of travel advisers may or may not carry over to offering assistance and service while you travel,” says Jacquie Whitt, a travel advisor with Adios Adventure Travel, which specializes in South America. That could mean anything from dinner reservations to theater tickets to really, or whatever else you might need on the road.

They charge a consulting fee

Clients working with a reputable advisor should expect to pay ticket issue fees on air tickets, plan-to-go fees, and itinerary planning fees, says Mollie Fitzgerald, who runs Frontiers International Travel, a travel agency. “Some companies even levy fees for related services like booking dinner reservations, theater tickets, and hair appointments. While commission income is still a meaningful part of our business, this shift to a fee-based industry has definitely helped to professionalize the way in which advisors are viewed, and most clients understand this and know that you often get what you pay for.”

Are agents now travel advisors?

So should you start calling your travel agent an advisor now? Not so fast, say observers.

“Realistically, the new moniker is more appropriate under most — but not all — modern travel booking circumstances,” says Shylar Bredewold, founder of Odyssean Travel, an online travel agency. “Possibly a dash of branding as marketing, sure.”

That’s because most agents already do some, but maybe not all, of the things an advisor does. But the bigger question — are they actual travel advisors? — may be unanswerable for now.

Truth is, the economics of being a travel advisor are complicated. Most advisors still rely on two income streams: fees charged to clients and commissions paid by suppliers. And while advisors say they represent you, the customer, they can’t also ignore the needs of those who pay them. And for better or worse, that’s still the cruise lines, tour operators and hotels, which offer commissions of 10 to 14 percent to the advisors.

Until the economics of travel shifts, advisors will remain, in a very real sense, agents for the suppliers who are paying them.

But changing their names to travel advisors is a necessary first step. It may be a while before they are recognized as full-fledged professionals like financial advisors, but they are on the right path.

Christopher Elliott is the founder of Elliott Advocacy, a 501(c)(3) nonprofit organization that empowers consumers to solve their problems and helps those who can’t. He’s the author of numerous books on consumer advocacy and writes weekly columns for King Features Syndicate, USA Today, and the Washington Post. If you have a consumer problem you can’t solve, contact him directly through his advocacy website. You can also follow him on Twitter, Facebook, and LinkedIn, or sign up for his daily newsletter.

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11Nov 2018

Security chips have not reduced US credit-card fraud – Boing Boing (blog)


The US credit card industry was a very late adopter of security chips, lagging the EU by a decade or so; when they did roll out chips, it was a shambolic affair, with many payment terminals still not using the chips, and almost no terminals requiring a PIN (and some require a PIN and a signature, giving rise to the curiously American security protocol of chip-and-PIN-and-swipe-and-sign).



The adoption of security chips has not slowed credit card fraud, either. 60,000,000 US credit cards were compromised in the past 12 months and 90% of those were chip-enabled. The majority of compromised cards were stolen by infected point-of-sale terminals. The US has the worst credit card security in the world.

The findings come from a Gemini Advisory report, which blames a “lack of chip compliance” in merchants for the rise.


Based on the proprietary Gemini Advisory telemetry data collected from various dark-web sources over several years, we have determined that in the past 12 months at least 60 million US cards were compromised. Of those, 75% or 45.8 million were CP records, likely compromised through card-sniffing and point-of-sale (POS) breaches of businesses such as Saks, Lord & Taylor, Jason’s Deli, Cheddar’s Scratch Kitchen, Forever 21, and Whole Foods. To break it down even further, 90% or 41.6 million of those records were EMV chip-enabled.

Furthermore, the shift in Card-Not-Present (CNP) fraud is becoming more evident with a 14% increase in payment cards compromised through e-commerce breaches in the past 12 months. Payment card data that that was stolen from Orbitz, Ticketmaster, City of Goodyear, and British Airways represented only a small part of the 14.2 million CNP records posted for sale in the past 12 months.


Card Fraud on the Rise, Despite National EMV Adoption
[Gemini Advisory]

Credit Card Chips Fail to Halt Fraud, Survey Says [Jeff John Roberts/Fortune]


(via /.)


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Cory Doctorow

I write books. My latest are: a YA graphic novel called In Real Life (with Jen Wang); a nonfiction book about the arts and the Internet called Information Doesn’t Want to Be Free: Laws for the Internet Age (with introductions by Neil Gaiman and Amanda Palmer) and a YA science fiction novel called Homeland (it’s the sequel to Little Brother). I speak all over the place and I tweet and tumble, too.

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