Intelli-series is making health insurance more competitive in Western Pennsylvania

I think many people know that Pennsylvania, and in particular western Pennsylvania, is one of the most uncompetitive health insurance markets in the country. It’s a problem that the Pennsylvania Insurance Commission has recognized and is trying to address under Commissioner Joel Ario.

Competition always leads to lower costs and higher quality. Having more meaningful choices for health insurance gives individuals, employers and providers more negotiating power. This forces insurers to compete for customers by adding services, enhancing choices and reducing costs.

Pittsburgh’s healthcare insurance market became more competitive about 18 months ago when UnitedHealthcare and West Penn Allegheny Health System began offering Intelli-series health insurance plans.

Intelli-Series offers a wide variety of health care plans that encompass every recent innovation in health insurance, including health savings accounts (HSA), health reimbursement accounts (HRA), out-of-network options, disease management, preventive care and wellness programs.

Intelli-series enables employers and their employees to select traditional or more innovative plans that combine high deductible, open access insurance with either an HSA or HRA. A high deductible plan is typically the least expensive healthcare insurance option for a business, while the HSA or HRA enables employees to pay for their share of health care with pretax dollars.

Participants in any of the Intelli-series health insurance plans have access to a core network of providers that includes West Penn Allegheny Health System facilities such as Western Pennsylvania Hospital, Allegheny General Hospital and Forbes Regional, and other hospitals including those in the Excela Health System and Heritage Valley Health System. They can also access healthcare services at other regional hospitals and facilities for higher deductibles and copays.

In addition to this extensive local network, participants in any Intelli-series plan can also use UnitedHealthcare’s national network of more than 560,000 healthcare professionals and 4,800 hospitals.

The Intelli-Series is available to employers in nine western Pennsylvania counties: Allegheny, Armstrong, Beaver, Butler, Fayette, Greene, Lawrence, Washington and Westmoreland.

I keep getting asked about wellness programs and I keep saying the same thing: we have them and they’re effective… when people use them

Sometimes I think we at UnitedHealthcare take it for granted that everyone knows about wellness programs. But maybe not so much, judging from some of the questions I get from clients, prospects and news reporters.

Wellness programs have become a really important part of health care. The theory behind wellness programs is that they lead to a healthier workforce and a healthier workforce leads to lower overall health care costs for employees and employers. In addition, healthier employees are more productive because they miss work less.

Like many large national health insurance companies, UnitedHealthcare offers a full range of wellness programs, including many online and some conducted by third-party vendors who are experts in their field. Our most popular programs are those that reflect the most pressing health challenges we face as a nation:

• Weight reduction and nutrition
• Diabetes management
• Smoking cessation
• Heart disease management
• Women’s health issues

Wellness programs are part of many of the health care plans we offer both large and small employers. We have had wellness programs for decades, but over the last 10 years our wellness offerings have expanded significantly due to research that’s proven that preventive care and active involvement in one’s health care decisions are key drivers of better health outcomes and lower overall health care costs.

We can cure it, so why can’t we prevent it?

One thing struck me as I perused through the 2009 America’s Health Rankings survey, which ranks the states on how healthy their citizens are: As a nation, we have become adept at treating many illnesses and diseases, but Americans are not modifying risk factors that contribute to chronic diseases.

Two risk factors, tobacco use and obesity, have emerged as the two leading preventable causes of chronic illnesses that threaten the health of the nation.

While tobacco use dropped from 19.8% of the population last year to 18.3% this year, approximately 440,000 deaths annually are still attributable to this preventable behavior. Over the past year, more than 3 million people have quit smoking, suggesting that smoke-free laws, smoking bans, increased cigarette taxes, access to smoking cessation programs and other interventions can make an impact.

Obesity is growing faster than any previous chronic health issue our nation has ever faced. Today, more than one in four Americans are considered obese. Obesity has increased nearly 130% since the first edition of America’s Health Rankings was issued 20 years ago. Currently, 27% of the population is obese. If current trends continue, 103 million American adults — or 43% of the population — will be considered obese in 2018, making obesity the nation’s next health battle.

The United States currently spends more per capita than any other nation on health care, including $1.8 trillion in medical costs associated with chronic diseases, such as diabetes, heart disease and cancer, which can be linked to tobacco use and obesity.

Every year, United Health Foundation teams up with the American Public Health Association and Partnership for Prevention to conduct the America’s Health Rankings survey. This year, United Health Foundation commissioned a supplemental report to help understand the financial impact of obesity. This supplemental “Future Costs of Obesity” report, written by Kenneth E. Thorpe, Ph.D., Emory University professor and Partnership to Fight Chronic Disease executive director, is the first to provide projections around future health care costs directly attributable to obesity that have been individually calculated for each state, as well as the nation. Left unchecked, obesity will add nearly $344 billion to the nation’s annual health care costs by 2018 and account for more than 21% of health care spending.

So how does Pennsylvania rank when compared to other states when it comes to our two biggest health challenges since 1990, smoking and obesity?

Here are the results.
2009 Pennsylvania State Ranking: 28th
2009 Smoking and Obesity Rankings: (based on a comparison of the incidence rates among all 50 states)
Prevalence of Smoking: 38th
Prevalence of Obesity: 36th

20-Year Ranking in Smoking and Obesity: (based on a comparison of the incidence rates in 1990 among all 50 states to today’s rates)
Prevalence of Smoking: 8% decrease in smoking from 29.3% in 1990 to 21.3% in 2009
Prevalence of Obesity: 15.8% increase in obesity from 12.5% in 1990 to 28.3% in 2009

It looks as if we in Pennsylvania have a long way to go in reducing the preventable causes of chronic illnesses.

New study shows that Pennsylvanians need to improve our health

Every year, UnitedHealthcare’s foundation teams up with the American Public Health Association and Partnership for Prevention to conduct the America’s Health Rankings survey. The 20th edition was just released and the news for Pennsylvania is mixed. Pennsylvania ranks 28th among all states in terms of the health of its citizens (the lower the number, the better the ranking in all cases), which is in the lower half of all states.

One thing I noted in the survey is that in the past ten years, the incidence of obesity among Pennsylvanians has increased by an alarming 46%. And there has been a mind-boggling 59.5% increase in obesity among our African-American population. If obesity rates in Pennsylvania continue to rise at their current levels, obesity is projected to soon cost $13.5 billion or $1,455+ per adult, for state health care spending.

Here are some other areas in which Pennsylvania lags behind other states:
· High incidence of infectious disease – 40th/19.6 cases per 100,000 pop.
· High levels of air pollution – 47th/13.9 micrograms per cubic meter
· Low per capita public health funding – 41st/$49 per person

The study shows that Pennsylvania does have some strengths compared to other states when it comes to the health and wellness of our citizens:
· Low rate of uninsured population – 7th/9.7%
· High rate of high school graduation – 7th/83.5%
· Low geographic disparity within state – 8th/7.9 relative standard deviation

America’s Health Ranking” is the longest running report of its kind. For 20 years, the Rankings has provided an analysis of national health on a state-by-state basis by evaluating a historical and comprehensive set of health, environmental and socio-economic data to determine national health benchmarks and state rankings. The Rankings employs a unique methodology, developed and annually reviewed by a Scientific Advisory Committee of leading public health scholars.

Younger Employees Want Health Care on the Job

Not that there is a lot of hiring going on, but I recently read another study, this one about what college seniors want in a first or second job.

Believe it or not, despite that old myth that young people think they’re invincible, more graduating students want health care benefits than want a retirement plan.

In the study, 19,000 graduating students from all 50 states ranked having a good insurance package a strong third behind opportunities for advancement and job security.

And when the same group listed which benefits were most important to them, medical insurance finished in first place, ahead of even annual salary increases and having access to a 401(k) plan. Moreover, only medical insurance, salary increases and 401(k) plans were mentioned by more than 50% of those surveyed. Women tended to think having a good insurance package was more important than men did.

These findings counter the long-time conventional wisdom that younger people prefer benefits that give them either more opportunity to develop their careers, like tuition reimbursement and bonuses, or more lifestyle flexibility, like vacations and flex-time.

The study was conducted by the National Association of Colleges and Employers, a national resource center for information about the employment of college graduates for more than 50 years.

Employers Still Paying Most of Healthcare Premiums

I saw a recent survey that told me what I knew already: that even as employers seek to reduce costs, they still continue to pay most of the premium cost of their employees’ health care insurance.

That’s what the Kaiser Family Foundation and the Health Education and Research Trust (HRET) say in the 2009 version of their annual snapshot of employee health benefits, which just came out.

The study found that premiums on average rose about 5% across the country over the past year, and now stand at $13,375 per year for family coverage. Individual coverage now averages $4,824 per year across the country. Since 1999, the cost for family coverage nationally has soared by 131%.

Even as premiums continue to outpace overall inflation, employers are standing by their traditional commitment to help employees pay for health care insurance. Employers now pay about 73% of the cost of the premium for family coverage, the same percentage as in 1999. Employers currently pay about 83% of the premium for individual coverage, according to Kaiser and HRET.

And it looks as if employers on the whole are committed to holding the line on employee costs as much as possible. When asked for their plans for the coming year, only 21% of employers offering health care insurance said they were very likely to raise their employees’ contribution and only 16% were very likely to raise the deductible.

The survey reports that offering health care insurance remains a challenge to the very smallest businesses. Only 47% of businesses with 3-9 employees offer health care benefits, compared to 72% of firms with 10-24 employees, 87% of firms with 25-49 employees and 95% of firms with more than 50 employees. These numbers demonstrate that a lot of people in the work force remain uninsured. Health care reform similar to what the insurance industry is proposing would do a lot to address that challenge.

Another amazing online tool that helps people manage their healthcare

The computer jockeys at UnitedHealthcare just came up with another online tool to help people manage their health care and their health care expenses…and it’s completely amazing!!!

It’s called the treatment cost estimator, and it can estimate the potential cost of many medical treatments.

The treatment cost estimator analyzes the cost data related to hundreds of medical services, including the treatment of 116 diseases and also 3,000 prescriptions. It can tell the user the fees for treatments and procedures specific to individual network physicians and to geographic areas, showing calculations and real-time adjustments for insurance coverage.

The treatment cost estimator can be especially helpful when considering alternative treatments. Patients now can know what it will cost before they see the doctor, which should help them get the best value for the care they need. Sweet!!

Planning to travel this winter? Take along more than a bathing suit and party clothes

Whether it’s a week of relaxation on a quiet beach in the Bahamas or a weekend getaway to the Big Apple for a concert at Lincoln Center and some shopping—or at least window-shopping—, nothing can turn a dream vacation into a nightmare faster than a medical emergency. And with the swine flu epidemic raising concerns about the potential health risks of traveling, it’s important for winter vacationers to be prepared.

Travelers with a medical condition for which they take prescription medication or might need special attention in the event of an emergency should:

• Carry prescription medications in their original containers in a carry-on bag and label them clearly.
• Have their physician write a letter explaining the condition, its limitations, and prescriptions to carry with them in case of an emergency.
• Obtain a copy of their personal health record and carry it with travel documents.
• Always carry their health insurance card and understand the insurance company’s process for seeking medical care when traveling.

Understanding your health care insurance is especially important when traveling abroad on a winter vacation. To be fully prepared for a medical emergency when away from home, travelers should:

• Carry an insurance identification card and a claim form with other important travel documents.
• Understand how their health insurance coverage works outside of the United States. For example, some insurers like UnitedHealthcare offer extended coverage for international medical expenses.
• Find out how the health care system and emergency treatment works in the country they plan to visit.

Anyone planning a trip out of the country should consult with his or her physician about additional vaccinations that may be recommended or required prior to traveling. Also check with your health insurer because not all travel-related vaccinations are covered. Physician visits should be scheduled four to six weeks prior to departure because most vaccines take time to become effective, and some must be given in a series, over a period of days or sometimes weeks.

When traveling abroad, keep in mind that in many foreign destinations there will be obstacles to communication that could make finding help in an emergency difficult. To ensure a language barrier doesn’t stand in the way of getting help, travelers should:

• Contact the International Association for Medical Assistance to Travelers at the nearest U.S. embassy to find medical facilities and English-speaking doctors in the area where they plan to travel.
• Learn the words for doctor, emergency, and hospital in the native language.

Now, “Bon Voyage” and don’t think about your job while you’re having fun!