AIDS in African-American Women Reminds Us Why We Need World AIDS Day

As we approach World AIDS Day on Dec. 1, the troubling incidence of AIDS among African-American women serves as a potent reminder about how far we must travel on the long journey to eradicating this disease.

Health care professionals like to highlight the tremendous progress we’ve made in treating people with HIV and AIDS. The prescription drugs, long-term care plans and innovative treatments we’re providing to patients are all getting better. In general, Americans with HIV and AIDS are living longer and stronger lives. We’ve come a long way in the 25 years since the AIDS epidemic began. The World AIDS Day website, worldAIDSday.org has a lot of information about the history of our battle against this dreaded disease.

But we’ve so much more work to do to battle the spread of HIV among African-Americans, and particularly among women. The Centers for Disease Control and Prevention (CDC) reports that nearly half of the more than 1 million Americans living with HIV/AIDS are African-American and that 40 percent of the nearly 563,000 Americans with AIDS who died in 2007 were black.

Among all women in the U.S. living with HIV/AIDS, 64 percent are African-American. In fact, the rate of AIDS diagnosis for African-American women nationwide is 22 times the rate for white women.

The situation in Pennsylvania reflects the national trend: 67 percent of all women with AIDS or HIV in the Keystone State are African-Americans. This problem is even more pronounced in places like Washington, D.C., where the prevalence of HIV and AIDS among African-American women rivals that of Nigeria.

What’s most frustrating to health care professionals is that AIDS is generally preventable through simple changes in behavior, including increased use of safer-sex practices and testing.

Sadly, too many people – especially African-American women and young people – are not getting the message. According to the CDC, the U.S. has the highest rate of teenage infection in the developed world. Every hour, two Americans between the ages of 13 and 24 contract HIV.

We know that regularly testing those most at risk for HIV – and then providing antiretroviral drugs for HIV/AIDS patients – dramatically reduces the number of people who become infected. Without treatment or education, people will continue to transmit the virus to their partners.

Preventing HIV is not complicated. It takes the individual decision by every person who is sexually active to use safe sex techniques and to get tested. It takes people avoiding IV drugs and drug users vowing never to share needles. Treating AIDS is equally simple: it takes going to health care providers and following their instructions on how to manage the disease and slow its spread.

Many people avoid discussions of diseases that can be spread through sexual contact. But it’s better to talk about sensitive subjects than to let a lack of information threaten lives. Let’s hope that people everywhere, especially African-American women, hear the message of World AIDS day and find out how to protect themselves from HIV and AIDS.

A Checklist of Vaccinations to Keep You Healthy

Earlier this week, I was talking about the fact that many adults forget to get booster shots for the immunizations that they had years ago. I came across a complete list of recommended vaccinations that I thought I would share with you. It’s at www.cdc.gov/vaccines.

Here’s some of the vaccines every adult should have, with a schedule of when they should get them and how often:

• Tetanus, diphtheria, pertussis - Booster of Td every 10 years from age 19-65+
• Human papillomavirus (HPV) for women - 3 doses between ages 19-26
• Varicella (chicken pox) - 2 doses between ages19-65+
• Zoster (shingles) - 1 dose for ages 60+
• Measles - 1 or 2 doses between ages 19-50 yr, 1 dose after age 50
• Influenza - 1 dose annually
• Pneumococcal - 1 dose ages 65+
• Hepatitis A, Hepatitis B, Meningococcal - based on medical and occupational risk factors

Don’t forget to follow the advice of your physician when it comes to both vaccinations and boosters.

Don’t Forget Your Other Vaccinations

There has been lots of media attention on flu vaccines this year, and especially the vaccine for the N1H1 (or swine) flu, which has reached pandemic proportions throughout the world. People most susceptible to the swine flu should get the H1N1 vaccine, and that includes children, adults under 65 years of age, healthcare workers, pregnant women and people with asthma, other lung disease or heart, liver, kidney, blood or immune system problems.

But, even as people are clamoring for their flu shots, many adults are forgetting another important part of preventive medicine, booster shots for those immunizations most of us got as children years ago. Childhood immunizations can fade over time, and some vaccinations require boosters in order to stay effective. Depending on age and medical history, it may be time to update your own vaccination record.

According to 2008 data from The Center for Disease Control and Prevention’s National Health Interview Survey, only 63% of adults under age 50 have received a tetanus shot (Td) in the last 10 years, while only 52% have had a recent vaccination for tetanus, diphtheria and pertussis (Tdap). Only 25% of adults under age 65 with a high-risk status report having ever received a pneumococcal vaccination and just 17% of those between 19-49 received an influenza vaccine this past flu season, according to the NHIS (http://www.cdc.gov/nchs/nhis.htm).

A new kind of tetanus booster now offers added protection against pertussis, also known as whooping cough, and can help prevent the spread of pertussis among children who are too young to be fully vaccinated. Other recommendations include vaccines that protect against shingles, meningitis, hepatitis and human papillomavirus (HPV), which causes cervical cancer in women.

And the winner is…

In my last blog, I bragged about UnitedHealthcare’s “All Star of the Game” program that honored Penn State football fans who have done something to improve their own health or someone else’s…but I didn’t mention the winner! Ooops!!

And the winner is…

Susan Day of Gardners, Pa., for leading her team in tackles against a devastating disease. And for her tireless work, UnitedHealthcare and Penn State Sports Properties awarded her the Penn State football “All Star of the Game” grand prize.

Day received the grand prize for working with family and friends to start the Angels for Alyssa foundation to raise research funding for Methylmalonic Acidemia (MMA), a rare genetic disease that causes developmental delays, seizure, hypoglycemia, stroke, coma and even death. Day had lost her nephew Blake to MMA and later became a champion for a cure when her niece Alyssa was diagnosed with the disease.

In addition to naming her All Star of the Game, UnitedHealthcare donated $2,000 to the Angels for Alyssa foundation to help it continue its commitment to finding a cure for Methylmalonic Acidemia.

All of us at UnitedHealthcare are inspired by Susan’s work with Angels for Alyssa. Her dedication gives other children and families suffering from this debilitating disease hope that someday there will be a cure. She is a true All Star in the fight against MMA.

The real all-stars who help other people

UnitedHealthcare of Pennsylvania just completed what’s called a promotional program that allowed me to get to know a little bit about some very special people, this season’s nine Nittany Lion Fan “All Stars of the Game.”

UnitedHealthcare partnered with Penn State Sports Properties at the beginning of the 2009 college football season to honor Nittany Lions fans who are working to improve their own health or the health of others in their family, community or workplace.

Each “All Star of the Game” received a $100 gift certificate for Penn State merchandise and a chance to win the grand prize, a $200 gift certificate plus tickets and tailgate passes to the Nov. 14 game against Indiana University.

We recognized a total of nine All Stars this Penn State football season: Susan Day of Gardners, Pa, John Page of Downers Grove, Ill., Katrina Domkowski of Dallas, Pa., L. Ramon Beiler of New Berlin, Pa., Greg Underkoffler of Myerstown, Pa., Dan Mosel of Harrisburg, Pa., Peter Augulis of Wayne, N.J., Cynthia Wolf of State College, Pa., and Yvonne Dunn of Lewistown, Pa.

All nine of these All-Stars did something great in their community. John Tull of Penn State Sports said “it was one of the most meaningful community promotions I have ever been involved with in my 20-year sports marketing career.”

More Neat Stuff: Medical Swipe Cards

There is a simple way to reduce health care costs and improve coordination of care and patient satisfaction: widespread adoption among doctors, hospitals and health insurance companies of magnetic stripe health care ID cards.

Everyone with health insurance has a card that they give to the receptionist at the doctor’s office. The receptionist usually makes a photocopy of the card and then fills out all the forms by hand or through repetitive data entry to file a claim with the insurance company.

With a health care ID card that uses magnetic stripe technology, the patient simply swipes the card through a device similar to a credit card terminal, and the physician’s office has access to all appropriate patient-eligibility information and personal health records. Some of the information will even automatically populate into the claim form for the physician’s office staff with the swipe of the card, enabling them to submit claims online and receive approvals from the insurance company in a matter of seconds.

The new cards have a number of built-in protections for consumers – information is never stored directly on the card, and access through the card can only be made with the patient’s permission.

Unlike many other industries facing revolutionary new technologies, the medical industry has been slow to adapt swipe card technology. In fact, according to a recent survey published in the New England Journal of Medicine, just 17 percent of all physicians’ offices use any kind of advanced card technology.

Imagine the savings in administrative costs to both health care providers and insurance companies if most or all health care facilities used swipe cards. Millions of administrative transactions per day would become faster and easier. In fact, the Medical Group Management Association (MGMA) estimates that machine-readable patient ID cards could save physician offices and hospitals as much as $1 billion a year by eliminating unnecessary administrative efforts and denied claims. MGMA recently launched a campaign to promote machine-readable cards.

The cost to install card readers is relatively minor, and once installed, the swipe card soon pays for itself in lower administrative costs.

I encourage all health care providers and insurance carriers to adopt swipe card technology using the new universal standards. Other industries have seen rapid adoption of information technologies that lead to cost savings and quality improvements. The health care industry has an opportunity to follow suit, and thereby make a tremendous impact in reducing costs, enhancing quality and playing a critical role in positive health care reform.

More Neat Stuff: Tracking Medical Expenses

Employers have long asked insurance companies to make it easier for employees to keep track of medical expenses.

With the growing trend toward employees taking more ownership over health care decisions, employers have been concerned about getting their employees the information they need to navigate the complexities of health care. For example, research that Intuit Inc. conducted found that many people are overwhelmed by the paperwork associated with receiving medical care.

A number of health insurance companies have begun offering software that helps employees track their health care expenses online. This software works in real time to pull information from an employee’s health care claim making it easier to track doctor visits, prescriptions filled and account balances. The software complies with privacy laws and keeps the information confidential. At UnitedHealthcare, we use Intuit’s Quicken Expense Tracker.

Expense Tracker helps employees better navigate the health care system in several ways by:

• Showing the calculations behind the amount billed and what is owed for each medical bill.
• Giving the current status of the user’s deductibles and out-of-pocket spending and tracking medical expenses for tax reporting.
• Sending email alerts if a claim has an outstanding balance after insurance payments.
• Defining health care terms and codes in easy-to-understand language, which increases the user’s knowledge of health care.

Use of expense tracking software is voluntary on the part of employees. While larger employers have been the early adopters, more and more small business owners are making it available to their employees, too.

Women Have Arrived…

We’re all the rage. Just pick up any business journal or life style publication and you’ll see why; as managers, executives and entrepreneurs, women are taking over as leaders in the corporate world. But what these articles don’t say is that it isn’t any different at home. In many households today, women are acting as the Chief Health Officer (CHO) and taking on the difficult job of managing their family’s health care.

I was recently appointed CEO of UnitedHealthcare’s Pennsylvania region, and nothing could have better prepared me for this role than my experience as the CHO of my own family’s health care. One of my three children was born with a serious health problem that has required seven delicate surgeries, so I have spent more than twenty years managing difficult decisions on both sides of the health care system.

As both a CEO and CHO, I know that keeping up with a family’s health care is a challenging job for any woman. Thankfully, UnitedHealthcare has launched an innovative new online community called Source4Women that has the tools a busy woman needs to simplify and personalize health care decisions.

The website has comprehensive information on health, wellness and disease management along with tips, checklists and support groups tailored for women at different stages of their lives. Interactive resources make everyday tasks like finding a doctor, keeping track of expenses and making healthier lifestyle choices easier with everything from physician ratings to recipes to open forums with health care experts.

Most importantly, Source4Women is a place where we, as CHOs and CEOs, can go to share our stories and show support. It’s an incredible challenge to make the right health care decisions for yourself and your family and we can learn a lot from each other’s experiences. That’s why I want to hear how other women are tackling the issues of health care today while also managing to move ahead in the business world. Feel free to share your thoughts and comments as fellow family health care gurus, and join the community at www.source4women.com.

Stop Elective C-sections, Reduce Infant Mortality

A report I read about yesterday in the New York Times and heard on NPR reminded me of an earlier topic I blogged about a few weeks back: the alarming number of babies delivered through premature elective Caesarian sections (C-sections). According to the report by the National Center for Health Statistics, the United States has a disturbingly high infant mortality rate – a strain on the entire health care system – and it’s mainly because of premature births.

The report nails down the increasing number of C-sections used to deliver babies before the full 39 week term recommended by the American College of Obstetricians and Gynecologists as one of the major factors leading to such shocking mortality statistics. Newborn babies delivered before full term are at risk for serious health complications and in too many cases, don’t survive.

So why such a high number of premature C-section births? Research shows there is a sharp increase in C-sections and the reasons vary, ranging from avoiding holiday hospital stays to scheduling around vacation plans. But whatever the reason mothers and physicians schedule elective C-sections before a pregnancy reaches full term 39 weeks, it’s downright dangerous. A growing body of research reveals that newborns delivered prior to 39 weeks are two-times more likely to end up in the NICU than babies born at 39 to 42 weeks.

That’s why UnitedHealthcare is working with physicians, hospitals and the March of Dimes to reduce the number of elective C-sections. We’ve shared the startling data with all OB/GYN doctors and 4,800 hospitals in our national network and now inform all expectant parents of the risks in our pregnancy pamphlets and online resources. And it’s working. Since we began to spread the word, there has been a 46% decline of NICU admissions!

As anyone can see in the New York Times report, premature births are dangerous, costly, and far too common. If we keep working to eliminate elective C-sections and allow newborn babies to grow to full term, we can not only reduce the cost of health care, but also significantly lower the number of infant mortalities in the United States – a saving grace for the health care system, and a relief to all parents.

More Neat Stuff: Nurses manage chronic diseases over the phone

Once a month like clockwork, thousands of people with UnitedHealthcare insurance get a call from a nurse about their chronic condition, usually heart condition or diabetes. The nurse discusses with them how they’re feeling, answers any questions and reminds the patient of prescription refills and doctor’s visits.

These people are all in UnitedHealthcare’s disease management program designed to help improve the health of members with heart failure, coronary artery disease and diabetes.

People in the program have told us they like the personal attention of the regular phone call because they get to talk to a medical professional about their problems without having to pay a co-pay. Some end up spending more time on the phone with the nurse than they would at a short office visit with a physician. And they have to go to fewer physician appointments, which saves them both time and money.

I know of one patient in our disease management program with heart disease, who developed a frequent cough. When he told the nurse, she thought it could be a side effect from one of his medications and suggested he check with his doctor. He followed her instructions and was prescribed a substitute that worked without the side effect.

UnitedHealthcare’s disease management program attempts to manage the “whole person,” by augmenting the calls from the nurses with referrals to social workers and dieticians. The goal is to assist the patient in integrating their physicians' treatment plans into their lifestyle. Some participants receive phone counseling once a month, others more often.

We're Giving Money Away

Since it’s open enrollment season, I’ve been reviewing all the great new and recent programs we have at UnitedHealthcare that help our members lead healthier lives or cut costs out of delivering health care. I don’t want to break my arm patting UnitedHealthcare on the back, but it really is amazing how much neat stuff we’re doing! I think I’ll spend a couple of blog entries talking about some of it.

One really great program is SimplyEngaged, which offers incentives to people who take an active role in improving their health. Our members who participate in the SimplyEngaged program receive a $75 reward for completing a health assessment online or over the phone. Then, based on personal results they are given recommendations for how to go about improving their health. Those who take advantage of tools like online or telephonic health coaching receive an additional $25 reward.

When Cattron Group International, a Sharpsville, PA-based manufacturer of radio remote controls, began to offer SimplyEngaged as a way to make its new insurance plan more attractive to employees, an older workforce who never saw preventative care as a high priority, the possibility of earning cash in return for better health was a cause for action.

So far, 365 Catron employees have enrolled in SimplyEngaged, 93 have completed the health assessment and received the initial $75 reward and 69 have gone further to participate in health coaching and other programs. Some of the most popular programs among employees at Cattron are the healthy lifestyles and health trackers programs as well as the personal health record.

One of the keys to the program’s popularity is that participation is confidential. Employees initiate the program themselves by completing the assessment and receive the financial rewards directly from UnitedHealthcare. This ensures compliance with HIPPA regulations and creates a boundary between the organization and employees’ personal lives.

Cattron likes Simply Engaged because so far it has helped increase the health literacy of its workers and made them more proactive in managing health concerns like hypertension, high cholesterol, diabetes and arthritis while improving their overall wellness. With the help of Simply Engaged, they’re cashing in on better health.