Timing: Make Wellness a Business Priority By Implementing Wellness Programs to Improve Employee Health

Over the past year, employers across the state have become more committed to implementing easily adaptable, incentive-based, employee-driven wellness programs to improve employee health and office morale, and increase health insurance savings, among other things.

As an employer, have you considered offering incentives for employees who get or stay healthy? Monetary or other types of incentives are big motivators for employees who exercise regularly, eat healthfully or participate in stop smoking programs, for example. Wellness programs are also great ways to build teamwork within your organization. Further, having healthy employees can make a real impact on your bottom line.

Wellness research indicates that employer health promotion programs can be directly linked to improved productivity, less absenteeism, greater health knowledge, better health behaviors and a reduction in chronic health conditions. In fact, research shows that for every dollar invested in worksite health promotion, there is a medical cost savings of $3.48 and an absenteeism cost savings of as much as $5.82. Healthy employees offer companies a competitive advantage, with increased retention and lower medical costs.

Incorporating these efforts into your business and taking advantage of the benefits starts at the top. Senior executives must set an example, attend wellness functions and demonstrate involvement in other ways. The support of leadership demonstrates to employees that wellness is a high priority for your organization. It also helps to add a little incentive: consider giveaways for those that attend wellness functions and achieve stated goals, as even moderate incentives have been shown to greatly improve participation.

Encouraging employees to take part in a health assessment will help identify the most significant health issues for your organization, and enable you to develop long-range plans to address those issues. And, by setting attainable and measurable goals, it becomes enjoyable for employees to measure their success.

By using all available resources, your employees and your business may have a healthier 2011.

Timing: Make Wellness a Personal Priority By Taking Full Advantage of Health Insurance Benefits

In the next few weeks, you should be receiving information about your 2011 health insurance benefits. Many people are unaware that their health plans offer value-added benefits and other resources at no additional cost.

While enjoying the holiday season, take time to familiarize yourself with all of your benefits so come the New Year, you can begin getting the greatest value out of your health insurance policy.

• Lower your prescription costs. Use generic or preferred brands. Or split tablets, if approved by your physicians, cutting your medication co-pay in half.
• Use case manager assistance, if needed. Utilize your health plans specially trained nurses to guide you through troubling conditions, such as lower back pain, or more serious illnesses, such as cancer.
• Activate check-up reminders. Make sure to schedule your check-ups and procedures such as mammograms, pap smears, vaccinations and annual physicals, utilizing your health plan’s Web site calendar feature such as the one on myuhc.com.
• Request electronic prescriptions. Ask for prescriptions to be delivered to pharmacies electronically and use electronic health records – both avoid errors and lead to safer outcomes.
• Conduct a self-assessment of your health. Take your health plan’s online health self-assessments. These often provide interactive advice and coaching about how you can change your lifestyle to improve your health.

Maximizing your health benefits may help you improve the health of you and your family… and ensure you get the most for your healthcare dollar.

Get the facts about your health insurance options this open enrollment season.

Health insurance isn’t one-size-fits-all. That’s why most employers offer employees a choice in health insurance plans and a chance to re-evaluate their options once a year during an “open enrollment period.”

For many people, this might be their first time participating in open enrollment. Others might be trying to figure out how health care reform legislation will affect their options this year. Whatever your situation, the most important thing you can do during open enrollment is get the facts.

When it’s time to evaluate your health insurance options, gather as much information as you can and go through it carefully. If you ask questions, attend informational seminars, and make sure you understand the details of the insurance plans your employer is offering, you will be well equipped to choose the right option for yourself and your family.

To help you through the process, here are some tips for navigating the upcoming open enrollment season:
1. Decide what you need. Take the time to think carefully about your family’s specific health needs in the coming year. Are you and your family members generally in good health? Do you have any medical conditions like diabetes that require special care or rely on ongoing prescription drugs? Be sure the plan you choose offers the best options for all of your needs.

2. Do your research. Especially now that we’re in the midst of implementing the federal health reform legislation, it is important to attend employers’ information sessions to learn about different health plan options. Ask questions, talk to human resource managers and learn about changes that might impact you and your family.

3. Know how much your plan costs. Rising health care costs across the country could effect how much comes out of your paycheck, your copays or other out-of-pocket health care expenses. Make sure you understand in advance all costs associated with each of the health plans offered, in addition to the monthly premium.

4. Find out how you can save. Are there options that will help you save more on your health care costs? Many employers offer health savings accounts, in which employees contribute a pre-tax portion of their pay to cover medical expenses and prescriptions. Find out if there are tools available through your insurer to help you better manage costs. For example, UnitedHealthcare’s web portal myuhc.com offers online tools to help plan participants find quality, in-network doctors, compare treatment costs and track health care expenses.

5. Jump on the wellness bandwagon. If your employer offers wellness programs, take advantage of them. A recent study by UnitedHealthcare’s Optum Health division found that employer-sponsored wellness programs are the key to helping people make healthier choices, take advantage of preventative care and catch health conditions before they become bigger, more expensive problems. Smoking cessation classes, online health coaching, disease management, weight loss programs and discounted or subsidized gym memberships are just some of the programs that may be available to you through your health plan. Remember, better overall health means lower health care costs, for you and your family.

Calling all HEROES: New grants available for youth ready to fight obesity

According to the Center for Disease Control and Prevention, one in three children is obese or overweight, putting them on the road to lifelong chronic conditions like diabetes and heart disease. If left unchecked or untreated, UnitedHealthcare’s 2009 America’s Health Rankings™ study projects obesity will affect 43 percent of adults by 2018 and will add nearly $344 billion in that year alone to the nation’s annual direct health care costs – more than 21 percent of total health care spending!

That’s why it’s so important for young people to understand the risks of obesity and learn about good health early in life, and it’s why we launched the HEROES program two years ago.

Our UnitedHealth HEROES program awards micro grants to schools and youth organizations that come up with creative plans for how to educate their communities about the importance of healthy lifestyles. We gave out 265 grants across the country this year, including 24 in Pennsylvania, and we’re now accepting applications for 2011 grants.

We’re calling on even more youth in Pennsylvania to join the fight against childhood obesity and become health HEROES! Teachers and community leaders can submit 2011 grant applications online at www.ysa.org/HEROES until midnight on October 22, 2010.

In 2010, we gave grants to organizations all across Pennsylvania, including one to high school students from the Agatston Urban Nutrition Initiative Youthworks Program in Philadelphia who transformed an abandoned plot of land into a community orchard and amphitheater; to students at Abraham Lincoln Elementary School in Levittown, who photographed “unhealthy signals” in their community such as the placement of junk food in grocery store aisles for a presentation to parents, school boards and legislators; and to students at Claysville Elementary School, who created a “Healthy Living” informational DVD and distributed it to classmates, community members and local media outlets.

I can’t wait to see what creative projects our health HEROES come up with to encourage their friends, families and community members to live healthier lives!

Companies can and do make wellness work on the job

It’s difficult to find a work/life balance today, when work consumes so much of our lives. If we don’t have the time or the resources, it’s a struggle to stick to a healthy lifestyle. But as I’ve learned working for UnitedHealthcare, success on the job doesn’t have to come at the expense of personal health.

That’s because more and more employers are providing the tools employees need to make smarter, healthier decisions, and the tools really help. According to a recent MetLife study of employee benefits, 85% of employees who participate in wellness programs successfully lose weight, while 84% improve their diet and exercise, 81% better manage health problems like high blood pressure, cholesterol and stress and 63% are able to stop smoking.

Why, then, are there still many workers out there not taking advantage of wellness programs? The same MetLife study found that even though more employers are including wellness initiatives in health benefits, just 57% of employees are participating.

Those statistics got me thinking about what different companies can do to get their employees to take a more active role in improving their health. To start, they should take a look at the many employer-sponsored wellness programs in the area that are already taking off.

Companies throughout the Philadelphia region, of all sizes and from many different industries, have found creative ways to engage their employees in wellness initiatives. Some of them are doing such a great job, UnitedHealthcare, in partnership with the Philadelphia Business Journal, decided to give them an award.

At American Heritage Federal Credit Union, for example, employees compete against each other in the “Maintain Don’t Gain” holiday weight-watching challenge. At Compas, Inc., staff members get to spend their lunch hour with a personal trainer. And teachers in the Downingtown area school district can actually win prizes for improving their health. That’s why they’re all winners of the 2010 UnitedHealthcare Healthy Workplace Award.

Here is a complete list of Healthy Workplace Award winners.

Healthier food products mean healthier choices, and that means healthier Americans.

An event I recently attended got me thinking about the fight against obesity. We work hard at UnitedHealthcare to educate adults and children on the importance of healthy lifestyle choices and develop new programs and initiatives to help make those choices easier. But it’s a nationwide epidemic, which means it will take a nationwide effort from all kinds of companies to really put an end to obesity.

At this event, I had the opportunity to talk with Doug Conant, chief executive officer of Campbell’s Soup and Denise Morrison, the president of Campbell’s North America, who I’ve come to know.

Doug and Denise are really focused on engaging the employees at Campbell’s in a team effort to create good tasting, more nutritious products. They know foods have to be delicious or consumers won’t buy them, but they also know the importance of giving consumers the option to make healthier choices. That’s why everyone at Campbell’s is working together to find ways to maintain the quality of they’re products while improving nutritional value, especially by reducing sodium levels.

And Campbell’s isn’t the only company making the shift to healthier goods. Especially now that First Lady Michelle Obama has launched her “Let’s Move” campaign to battle childhood obesity, more and more major players in the food industry are pledging to do their part and improve the nutritional value of their products.

Take Pepsi for example, which recently pledged to reduce sugar by 25 per cent, salt by 25 per cent and saturated fat by 15 per cent in its soda drinks and other products by 2015. The company also announced that it plans to remove all its sugary drinks from schools worldwide by 2010 and add new healthier products to its roster of Pepsi, Tropicana, Gatorade, Frito Lay and Quaker goods that include more whole grains, fiber, fruit, vegetables, key vitamins and minerals.

Kraft Foods made a similar announcement. The company, which is the largest food maker in North America, said it plans to cut sodium levels in its North American products, including Oreo, Jell-O, Chips Ahoy!, Oscar Meyer, Ritz and Velveeta brands, by about 10 percent over the next two years -- eliminating more than 10 million pounds, or 750 million teaspoons of salt!

If more food and beverage makers, restaurants and other companies throughout the U.S. step up to the plate, I know we can put a stop to these deadly rates of obesity. As long as we keep working to develop new products, encourage healthy choices and educate consumers on the importance of nutrition and exercise, we can have a healthier America.

Our new office challenge will get employees throughout Philadelphia working for better health.

On your mark, get set, go! It’s the Indy 500 of weight loss challenges, and it’s happening right here in Philadelphia. This summer, my company is teaming up with Philadelphia Magazine to launch a new get-fit office challenge.

Here’s how it’s going to work: Teams of ten employees from four different offices will compete to lose the most total pounds and improve their overall wellness. To help them through the process, we’re giving them a free eight-week gym membership and tons of nutrition and healthy lifestyle tips from some of Philly’s top health and fitness experts. The winners will earn the coveted title of Philly’s Fittest Office!

And because we want the winners of our “Be Well Philly Office Challenge” to keep up their new, healthier lifestyles, the grand prize is jam-packed with health and fitness gifts from local businesses. The prize includes a free year membership to Sweat Fitness, makeovers from Joseph Anthony Retreat Spa and Salon, Zoom! teeth whitening from Pennsylvania Center for Dental Excellence, new workout gear and much more.

What’s so great about this contest is that the team named Philly’s Fittest Office isn’t the only winner in the end. Everyone who competes has the chance to reap the benefits of adopting healthier eating habits, improving their physical fitness and taking a more active role in maintaining their overall health. The more employers and employees we can help get excited about making changes and living a healthier life, the closer we’ll be to better health for everyone.

You can find us on the road, connecting people across the country with the latest innovation in health care – Part 2

In my last post, I started talking about the Connected Care mobile demonstration clinic, a moving showcase of our telehealth initiative designed to make health care more accessible to underserved communities. It’s a truly remarkable program that could drastically improve our health care system, so I want to say a little more about it.

Right now, we’re working on building Connected Care into a national system of permanent telehealth clinics that will give patients across the country access to physicians and specialists when in-person visits are not possible, practical or convenient. As I mentioned before, the clinics can be set up in office buildings, town hall buildings, other medical clinics, government centers, retail locations or wherever else more convenient and affordable medical care is needed.

The Connected Care clinics combine video conferencing with sophisticated medical devices designed for remote use to expand the scope of physicians’ practices by enabling them to care for patients who are tens, hundreds or even thousands miles away. High-tech, integrated equipment coordinates with electronic medical records and other health information technology. Besides an examination camera, the telehealth location has a full range of medical office equipment, such as a dermascope, vital signs monitor, glucometer and electrocardiogram (ECG).

Here’s how a telehealth visit works: After the patient checks in to a clinic, a nurse or health care professional administers a pre-exam workup. A doctor then joins the visit live on a high-definition screen while the onsite professional administers the exam using diagnostic tools, creating a virtual yet personal experience remarkably similar to a face-to-face meeting. At the end of the exam, the onsite professional works with the physician to develop a treatment plan if necessary, coordinate educational materials and respond to any questions or concerns the patient might have.

Connected Care clinics can help make health care more efficient and affordable for patients by minimizing expensive visits to the emergency room, eliminating long trips to see specialists and making preventive services like flu shots, biometric screenings and healthy checkups more convenient. It’s a step forward for higher quality, lower costs and a better health care system for everyone.

You can find us on the road, connecting people across the country with the latest innovation in health care – Part 1

Pop quiz: What has 18 wheels, works by satellite and makes it possible for a doctor to examine a patient from thousands of miles away?

It’s UnitedHealthcare’s Connected Care demonstration truck, setup as a mobile showcase of our latest innovation. Wherever it parks, the truck opens up for tours and demonstrations of the telehealth technology we’re using to establish permanent “Connected Care” clinics in cities across the country.

These Connected Care clinics combine audio and video technology and cutting-edge health care resources to greatly expand physicians’ reach into rural, urban and other underserved areas. The clinics can be set up wherever needed: in the workplace, in a city center, at a retail location or in rural areas to create a virtual office visit for people who don’t have the means or ability to travel to a doctor for an in-person examination. Doctors can see and hear the patient live from their locations in real time, and patients can see and hear a doctor live on a high-definition screen at their telehealth clinic location.

So far, we’ve launched a few pilot clinics around the country, but we’re still working on building Connected Care into a national network. That’s why we’re taking our mobile truck around to show doctors and other medical professionals, employers, insurance brokers and the general public how telehealth technology works.

The UnitedHealth Group Connected Care mobile clinic is on a nationwide tour. After setting up shop in Erie, Pa last weekend outside of Jerry Uht Park, home of the Erie SeaWolves minor league baseball team, the truck will be here in Philadelphia on Thursday for our Summer Splash event with Mayor Michael Nutter!

The mobile demonstration clinic is pretty impressive to see in person – at 80 feet in length, the truck is longer than a standard tennis court and can send voice, video and data to a satellite 22,300 miles above the Earth in about a quarter-second. And with stops across the country scheduled all the way into the winter, it could be on its way to a city near you. Make sure to stop by and experience firsthand how telehealth technology can transform our health care system.

UnitedHealthcare improves another online aid to help consumer better estimate medical costs.

Last time I told you about recent improvements we have made to our Quicken Health Expense Tracker software, which helps UnitedHealthcare’s consumers manage and pay their health care costs. 

More big news! Health Expense Tracker is not the only online software we’ve upgraded.  We also just expanded our Treatment Cost Estimator to include physician-specific pricing on numerous medical procedures.

The Treatment Cost Estimator pinpoints fees for treatments and procedures specific to individual network physicians and geographic areas.  Covering 116 diseases, 90 surgeries and procedures, and more than 500 individual services, the program provides cost estimates for thousands of physicians in more than 400 different markets. 

Now, the Treatment Cost Estimator also incorporates UnitedHealthcare customers’ specific health plan information to estimate what portion of those costs they would be responsible for paying and remind them of any available funds in their health care accounts.  The program provides a more complete view of how a treatment cost differs from doctor to doctor, giving UnitedHealthcare plan participants the power to comparison shop for health services. 

Health Expense Tracker and Treatment Cost Estimator both reflect UnitedHealthcare’s commitment to employ user-friendly technology to make health care and health insurance information more accessible and easier to understand – the key to making health care more efficient and effective.  

New version of Expense Tracker software lets people pay medical expenses online with credit/debit card.

A few months ago I told you about some really neat software called Quicken Health Expense Tracker, a free online program we offer all UnitedHealthcare plan participants that helps them understand their medical expenses at a glance.
Big news! We just announced an exciting new Health Expense Tracker capability that will make managing medical costs even easier.

The Health Expense Tracker software now has a new bill pay feature that lets health plan participants pay their medical expenses online by credit or debit card or with a qualified health care account. The software sends payments directly to the care-giver and records the amounts in the consumer’s Health Expense Tracker records.

Health Expense Tracker automatically assembles a complete financial picture of an individual’s medical-related savings and expenses in one convenient location by continually updating current claims information. The program sends email alerts for outstanding balances, tracks medical expenses for tax reporting and helps determine proper funding levels for pretax savings vehicles such as flexible spending accounts or health savings accounts. Health Expense Tracker also helps consumers understand the total cost of health care services t by keeping track of deductibles and out-of-pocket costs, and breaking down calculations behind the amount billed.

With information written in clear, non-medical language, Health Expense Tracker simplifies records of an individual’s care and medical benefits, making it a great online resource to help all of us become better health care consumers. Maybe that’s why an average of more than 10,000 plan participants have signed up to use the tools each month since we introduced the program in December of last year.

We have to start with our children if we want to lower the rate of obesity in the Keystone State.

Obesity is tipping the scales as one of Pennsylvania’s biggest health challenges. Over the last 20 years, the percentage of the state population that is obese has increased from 12.5 percent to 28.3 percent.

That’s an alarming trend, and it’s playing out in communities across the Commonwealth. According to the 20th Annual America’s Health Rankings™ released recently, if current trends continue, nearly 41.8 percent of Pennsylvanians will be obese within the next decade, costing our state a projected 13.5 billion – or $1,455+ per adult – for state health care spending. Most of that spending comes from obesity-related health conditions such as heart disease and diabetes.

We have to do more in Pennsylvania to reduce the prevalence of obesity in our communities, especially for our youth, among whom the rates of obesity have more than doubled in the last three decades.

Overweight adolescents have a 70-percent chance of becoming overweight or obese adults and are far more likely to face risk factors associated with cardiovascular disease such as high blood pressure, high cholesterol, and Type 2 diabetes. Experts increasingly agree we must intervene early in life, if we are to reverse the trend in obesity rates in our country.

Research has shown that young people who participate in service-learning programs improve their academic performance and critical-thinking skills, increase their confidence and sense of potential, and accept leadership roles. Such programs are a crucial part of the solution to the serious dangers posed by our growing waistlines. That’s why we started our UnitedHealth HEROES grant program, which helps young people, working through educators and youth leaders, to create and implement local hands-on programs to address the issue of childhood obesity. As I detailed in a blog a few months back, many HEROES grants have been awarded to organizations across Pennsylvania.

We should commend the young people in our area who are already making a difference and join them in taking action on this important issue. Our physical health as a community, and our fiscal health as a nation, depends on it.

Cooperative marketplace reform is making health care more affordable and accessible.

I’ve been talking a lot recently about how marketplace reform can and is already improving the health care system, as insurers, employers, physicians and health care facilities work together to implement new programs and initiatives. One last example involves the cooperation of employers and insurers to actively engage employees in making health care decisions: the high deductible-health savings account (HSA) combination that is catching on like wildfire across the country.


A high deductible plan is typically the least expensive healthcare insurance option for a business, while the HSA enables employees to pay for their share of health care with pretax dollars. The HSA empowers people to become better health care consumers by gaining a greater understanding of the actual cost of their health care.

The HSA concept is great, but to make it work as well as it can requires both insurers and employers to step forward. Insurers have helped make HSAs more affordable and beneficial to employees by offering plans that do not make people pay for preventive care such as annual physicals and pap smears as part of the deductible, thus encouraging people to get the tests needed to identify health problems in their earliest stages. And many employers are contributing funds to the HSA accounts their employees open to encourage the employees to get started.

The result has been rapid acceptance of the HAS concept. Recent America’s Health Insurance Plans (AHIP) studies report that in the past two years, the number of people enrolled in HSA plans has grown by 90% and now stands at 6.1 million nationally. AHIP reports that 27% of people with HSAs in employer-based plans were previously uninsured.

HSAs, closed networks, crunching clinical data—some may find the improvements I’ve been talking about to be piecemeal, but they represent just the tip of an enormous iceberg of marketplace innovation that is reshaping health care.

Insurers, employers and doctors working together will bring marketplace reform to health care.

In my last blog entry I made the point that employers, insurers, physicians and health care systems are working together in various combinations to develop innovative ideas that raise the quality of care or cut health care costs or both. I call it marketplace reform and I believe that over time it will do as much if not more to improve health care as legislation.

The example I gave last time was of insurers working together with employers. An example of insurers working with health care providers to improve health care is in the collection and analysis of clinical data to determine the best treatment options.

As I mentioned a few weeks back, UnitedHealthcare recently announced that we have launched our Oncology Care Analysis (OCA), the first program to combine clinical and claims data to gauge the quality of cancer patient care based on approved treatment guidelines from the National Comprehensive Cancer Network (NCCN), an alliance of 21 leading cancer centers. Our cancer registry includes clinical and claims data from more than 2,600 oncologists and 8,600 patients across the country with breast, colon or lung cancer.

OCA represents a true collaborative venture that would not be possible if UnitedHealthcare was not working hand-in-glove with health care systems and physicians. UnitedHealthcare provides the claims data and number-crunching capabilities; the medical community provides the clinical data and clinical standards.

We are sharing the results with participating oncologists to help improve the quality of cancer care and lead to better outcomes for patients. And it goes without saying that in doing so we’re complying with every privacy law.

Marketplace reform may improve the health care system more than the new law does.

The federal legislation recently signed by our President aside, changes to our health care system are occurring every day in the marketplace. Employers, insurers, physicians and health care facilities are communicating and collaborating to come up with new programs and policies that lower the cost of health care and increase the quality of care for those who are already covered.

Take, for example, UnitedHealthcare’s new Diabetes Health Plan, which I wrote about a few weeks ago.

Employers saw that a rise in obesity and unhealthy lifestyles has caused the numbers of diabetic and pre-diabetic employees to spike, increasing sick days and raising health care costs. To meet this growing workforce challenge, we developed a first-of-its-kind health insurance plan that rewards diabetic and pre-diabetic employees who routinely follow steps to help manage their condition – such as regular blood sugar checks, routine exams and preventative screenings – and use wellness coaching.

By working together to implement the Diabetes Health Plan, employers and insurance carriers are helping employees better manage a personal health condition and improve their quality of life. This collaboration not only saves employers and employees money, but also helps lower overall health care costs by increasing the use of preventative care and disease management initiatives.

Marketplace reform is always incremental: someone gets an idea and tries it out. If it works, others imitate and improve. If it fails, the market moves on.

I’m not saying that there is no place for federal reform. But I don’t think anyone should underestimate the power of the market to lead change. Each small step in the market carries us closer to a more ideal health care system that insures more people and does it more cost-effectively.

On a side note, I want to take a moment to thank all of you who contributed to our March of Dimes "March for Babies" walks. We raised $2,778.00 to improve the health of babies! I really enjoyed walking this year and sincerely appreciate your support.

But what good is health care coverage if patients can’t find a suitable doctor?

In my last entry, I talked about my company’s latest research paper that shows how we can save $366 billion in Medicaid spending. What’s great is that a portion of these savings could be reinvested in primary care, resulting in better access to high-quality care for newly covered populations and underserved communities.
Ensuring primary care availability is a major concern for states and physicians. According to one of our national surveys, 67 percent of primary care physicians think that the new Medicaid patients will struggle to find a suitable primary care doctor.

But the same survey finds that alongside other policy reforms, states could increase the number of primary care physicians treating Medicaid patients by permanently raising reimbursements to at least match those of Medicare. Our research suggests actively managing the health care of Medicaid enrollees and then recycling some of those savings to strengthen primary care is a better solution to states’ budget pressures than continuing to artificially depress Medicaid provider reimbursements, which in turn affects patients’ ability to find a primary care doctor.

People who are eligible for Medicaid need access to top quality health care, so we must find a way to strengthen primary and community care services. Many states are already taking important steps in this direction, now we just need to build on those innovations across the country.

We can save billions while extending health care coverage to millions of Americans.

Medicaid is already the nation’s primary source of health care coverage for low-income children and families, and now it’s one of the two main building blocks for expanding national health care coverage. The program is estimated to grow by 16 million people once reform is in full effect, with enrollment in 10 states to increase by more than 50 percent.

Expanding Medicaid to all of these new people is expected to cost more than $430 billion over the next ten years. Though the federal government will fund most of the initial expense, the cost of keeping the program going will put major pressure on states, where Medicaid is already the second largest budget item.

The good news is there’s a way to cut a big chunk of those costs while ensuring that underserved populations can readily access better quality care. By building on what already works and fixing what doesn’t, we can save billions in Medicaid spending.

In our research at UnitedHealthcare, we’ve found that by taking steps to modernize the Medicaid program, state and federal governments can save an estimated $366 billion over the next decade. States’ $149 billion share of the savings would go a long way toward alleviating budget pressures.

It’s all outlined in our newest research paper, Coverage for Consumers, Savings for States: Options for Modernizing Medicaid. The report shows how states can expand access to higher-quality, well managed health care, increase funding for primary care physicians and cut overall costs, based on proven approaches already adopted in some states. Our set of best practices focuses on three categories:

• Broader use of coordinated care techniques to improve access to high-quality care for both existing and expanding populations of Medicaid-eligible Americans, with projected savings of $93 billion ($36 billion for states).

• Greater use of managed care to support people with long-term care needs, with projected savings of $140 billion ($60 billion for states). Examples include targeted home-and community-based care programs to support people living longer in their own homes, and better coordination between Medicaid and Medicare.

• Modernizing Medicaid’s administrative and transactional processes, with projected savings of $133 billion ($53 billion for states). Examples include applying new health IT systems, including Medicaid in-state health information exchanges, encouraging electronic claims submission, and validating claims prior to payment.

If we can implement these innovations more widely across the Medicaid program, we can not only help make sure Medicaid is sustainable for future generations, but also reinvest our savings in improving the health care system for all. More on that next time!

Don’t let asthma keep you locked indoors this spring, a few simple steps will help you breath easier.

It’s that time of year again. Many of us fall victim to allergy-induced sniffles and watery eyes in the spring and early summer, and it can be an even more miserable time for the more than 23 million Americans – including more than 7 million children – who live with asthma. Unfortunately, experts say this year might be worse than ever, with plants and trees producing more pollen and spores than in years past thanks to an especially wet winter.

But Dr. Philip Benditt, one of our medical directors here in Pennsylvania, tells me you can still enjoy the season and live a healthy, active life all year round if you have asthma by following a few simple steps to avoid triggering attacks. Here are some of the tips Dr. Benditt shared with me:

• Understand your asthma. While indoor factors may spur an asthma attack for some, outdoor factors may trigger an attack for others. Keep a journal to track triggers, frequency and duration of asthma attacks, use of maintenance medications and rescue inhalers and other breathing-related data to share with your physician.

• Take your medications. At UnitedHealthcare we’ve found that about half of our health plan participants who take asthma medicines don’t follow their prescriptions. Not taking needed medications or not taking them on time can put you at risk for more frequent and possibly more severe attacks.

• Check for cost savings on your medications. Cost is one of the biggest reasons people don’t refill their asthma prescriptions, but there are solutions. Talk to your physician about more effective and affordable asthma drugs including maintenance inhalers such as Asmanex, Pulmicort Flexhaler and Qvar, and rescue inhalers like Ventolin HFA - all on the lowest copay level of UnitedHealthcare’s prescription drug list. UnitedHealthcare also recently introduced the “Refill and Save Program,” which offers $20 discounts off certain prescription drug copayments – a 40 percent savings on a typical copayment plan – including copays for asthma drugs Advair and Symbicort.

• Think ahead. If pollen is a trigger for you, check the daily pollen count often provided by the local newspaper, radio weather service or television news channels, and plan your activities accordingly. If traveling, research environmental factors that might affect your asthma and locate local health care providers in the event of an emergency. Whether home or away, make sure you have enough of your asthma medications on hand.

According to Dr. Benditt, the key to dealing with asthma is vigilance. Patients with asthma (or any other chronic disease for that matter) who take their medicines regularly and follow prescribed treatment plans will not only feel better but also potentially avoid costly medical problems down the line. So follow these steps, breathe a little easier and get out there and enjoy the season!

Mother’s Day got me thinking about the need to help slow the trend of elective C-sections so more women have safe, healthy pregnancies.

I had a wonderful time this past Sunday celebrating Mother’s Day with my family. But now that the festivities are over, I can’t help but think of all the expecting and future mothers who could be putting their newborns and their own health at risk by not recognizing the dangers associated with elective Cesarean-section deliveries, especially those performed before 39 weeks of gestation.

Elective C-sections are at an all-time high in the United States, with 1.4 million newborns delivered surgically in 2007, according to the Centers for Disease Control and Prevention. For whatever reason, more women than ever are choosing to schedule C-section deliveries, many before reaching the full 39 week term.

That’s a dangerous trend, considering babies born prematurely are more likely to end up in the NICU, develop lifelong health problems and in too many cases, don’t survive.

The problem is, a majority of first-time mothers are unaware of the risks. As I’ve mentioned in previous posts, our recent study with Drexel University revealed more than 90 percent of first-time mothers believe it’s safe to deliver a baby before 37 weeks of gestation. Many see no danger in delivering before 38 weeks or even 37 weeks, and 24 percent incorrectly believe full term is reached before 37 weeks. In fact, nearly one in four women surveyed considered a baby to be full-term at 34 to 36 weeks!

The study findings underscore how important education is to improve health and well-being. Other studies have already shown that efforts to educate physicians make a positive impact in helping to reduce the rate of elective pre-term deliveries. We should also consider similar outreach among women to help stem the rise in such deliveries.

The decision to induce labor early or perform a C-section before a pregnancy is full-term should take clinical recommendations into account and reflect the baby’s and mother’s health and medical needs, not convenience. To be sure, the last few weeks of pregnancy for many mothers can seem endless and often uncomfortable. But expectant parents should take the opportunity to learn just how important the last few remaining weeks are for their baby’s development and health.

This Cinco de Mayo, Hispanic-Americans should consider how their heritage can affect their health

As I take a moment to recognize that Hispanics in the Philadelphia area, Allentown, Lancaster and elsewhere across Pennsylvania celebrate their shared heritage on Cinco de Mayo, I feel it is appropriate to take a look at the shared health conditions and risk factors that are a part of being Hispanic.

According to Centers for Disease Control and Prevention, the top three causes for death among Hispanics are heart disease, cancer and unintentional injuries such as those suffered in the workplace.

The good news is many of these risks can be reduced through proper knowledge and some life-style changes. Look at cancer. Hispanics have lower survival rates than other ethnicities for most forms of cancers. That’s in part because of language and cultural barriers, employment in jobs that often do not provide health insurance, and a lack of access to preventive care and to primary care providers.

There are basic things that can be done: eliminate risk factors such as the use of tobacco and alcohol; schedule regular medical checkups and screenings; initiate regular self-examination; develop an awareness of cancer warning signs; and seek prompt medical attention when cancer is suspected. Good nutrition and exercise also are important.

Also, cancer can carry warning signs, such as a sore that doesn’t heal, a lump or thickening anywhere on the body, any unusual bleeding or discharge including in the stool, any change in a mole or a wart, persistent indigestion or difficulty swallowing, and persistent hoarseness or coughing.

While Cinco de Mayo is an ideal time to celebrate the heritage and uniqueness of Mexican culture, it can also serve as a springboard for improved health and wellness. Some simple steps such as watching your diet, seeing your doctor regularly for preventive screenings and becoming more active can begin to close the gap on some of the health disparities that affect Hispanics. Doing so will help ensure that many Hispanic-American families have happy and healthful Cinco de Mayo celebrations for years to come.

Please support me as I participate in two “March for Babies” walks for the March of Dimes.

For me, Marching for Dimes is a family tradition. In the 50’s, my grandmother “Marched for Dimes” as a school teacher to help eradicate polio. And I’ll be marching this year, in two March of Dimes walks. One starts on the steps of Philadelphia’s world-renown Philadelphia Museum of Art on April 25, the other starts at PNC Park in Pittsburgh on May 23.

For my company, UnitedHealthcare, the March of Dimes underscores our commitment to both treating and preventing illness, which is why the company and individual employees have gotten so involved with this year’s marches. We’re marching and raising money to support the March of Dimes mission of improving the health of babies, by preventing birth defects, premature birth, and infant mortality. As a company, our goal is to raise $1 million for the March of Dimes this year. I don’t know if we’ll make it, but it won’t be for lack of trying.

Besides upholding a family tradition and participating in a company initiative, I have another very personal reason to march: Out of sheer gratitude and appreciation for my three healthy sons, Andy, George and Will. Here’s a picture of them. The green one isn’t mine!

The March of Dimes stands for babies. All babies. This wonderful organization needs our help to continue making a difference in the lives of our families. Can I count on your help? I've set a big goal and would really appreciate the support of all my blog readers in achieving it.

Just click here for my donation site!

Thanks in advance for helping the March of Dimes give all babies a healthy start!

If seeking advice and information about health care, surf the Internet at your own risk.

The Internet has made it easy for consumers to access health care information and interact with health care providers and insurers. But with such easy access to so many resources comes a greater risk of listening to the wrong advice or going to the wrong provider.

For most people, the Internet is the go-to when they want to learn about personal health – the place to track down answers to their most pressing questions. What exactly is cholesterol? Could this cough be a symptom of H1N1? A simple search instantly returns an endless array of articles, studies, definitions and discussions.

But it could be a case of Google gone wrong. Links to thousands of health care resources all seem at the surface to hold the answers, but many of these websites may contain inaccurate or outdated information.

A good way to tell if a resource is credible is to consider who sponsors the website. For example, it’s probably best to think twice about advice on how to control high blood pressure from a company selling hypertension medication. More trustworthy sources might be websites for government or state health departments, health insurance companies, major health care facilities such as the Mayo Clinic and Cleveland Clinic or certain accredited commercial sites like WebMD.

The truth is, no matter how they use it, the Internet has made it possible for consumers to be more connected to health care. And as long as they’re smart about it, online resources can be an important, simple first step to making the most of online health care resources.

The Internet is a powerful tool that is reshaping health care every day. Consumers can and should take full advantage of everything it has to offer to become more informed, more involved and better equipped to make the right decisions for themselves and their families – they just have to think before they click.

UnitedHealthcare has a new partner in fighting poor childhood nutrition: Elmo and Big Bird.

Over the past three decades, childhood obesity rates have tripled to nearly one in three children in America being overweight or obese. And a recent study by the Food Research and Action Center, found that more than one in five children in the U.S. have insufficient access to nutritional and affordable food today.

For some time now, UnitedHealthcare has wanted to get more active in the fight against poor childhood nutrition because it puts children at risk for obesity and a range of disorders in later life such as diabetes and heart problems.

Now we have a partner and it’s a biggie, Sesame Workshop, the nonprofit educational organization that creates “Sesame Street” and other educational fare for children.

Sesame Workshop and UnitedHealthcare recently announced that we are partnering to develop a bilingual education outreach program aimed at helping low-income families make food choices that are affordable, nutritional and set the foundation for lifelong healthy habits.

The initiative will offer support and resources for families with children between the ages of 2 and 5 to cope with “food insecurity,” which is defined by the USDA and the U.S. Department of Health and Human Services as “households where there is a lack of access to enough food to fully meet basic needs at all times due to lack of financial resources.”

Program outreach will include bilingual (English and Spanish) Healthy Habits kits with an original DVD starring the Sesame Street Muppets and a documentary of families using a variety of strategies for maintaining healthy habits despite limited financial resources.

AmeriChoice, a UnitedHealthcare company and the country’s largest provider of personalized health care programs for low-income and vulnerable populations, will send Healthy Habits for Life messages and information to low-income and vulnerable populations in public sector health care programs via the Internet and newsletters that will go to the 3 million people who AmeriChoice serves.

With the Healthy Habits for Life partnership, AmeriChoice and Sesame Workshop could potentially see the day when parents and caregivers have a greater understanding of the relationship between healthful food habits and children’s healthy growth. And what a sunny day that would be!

Money is available for children’s uncovered medical expenses… and no one is using it!

Money is available to help pay for kids medical expenses not covered by health insurance, but few families are using it! In fact in the entire state of Pennsylvania, not one family took advantage of this opportunity to get help paying for expensive medical equipment and therapy.

The UnitedHealthcare Children’s Foundation (UHCCF) program seems too good to be true! Families in need can receive up to $5,000 to help cover an entire range of medical needs from speech therapy to wheelchairs that are not covered by their health insurance plan.

Last year, UHCCF awarded grants to more than 450 families across the country for treatments associated with medical conditions such as speech and developmental delays, hearing loss, autism, diabetes, cystic fibrosis, Down syndrome and cerebral palsy, yet no one in Pennsylvania took advantage of this program!

We recognize some families experience gaps in coverage for certain medical treatments and equipment, and we are committed to helping fill this void. Since expanding our grant program nationwide in 2007, we have provided more than 1,500 grants to families in need of financial assistance.” UHCCF is dedicated to facilitating greater access to medical-related services that can help improve children’s health and quality of life.

So if you know of anyone who might be eligible, give them the website address, www.uhccf.org, where parents and legal guardians can apply for grants online. And tell your physician friends about the UHCCF grants, because it’s likely one or more of their patients may qualify. To be eligible for grants, children must be 16 years of age or younger. Families must meet economic guidelines, reside in the United States and have a commercial health insurance plan.

ESync shows that better information can help people make better decisions which result in better health care.

In my last blog entry, I talked about the UnitedHealthcare position that by providing better information we can help people make better decisions which result in better health care.

One example of what I mean is a new UnitedHealthcare program called eSync.

ESync is a new technology platform that helps us build a detailed health portrait of each person we serve and then deliver customized health care management solutions directly to them. eSync allows us to combine a wide range of health data, like medical claims, health and lifestyle choices, and demographic factors, and turn it into a practical blueprint that helps people improve their daily lives. eSync lets us offer people effective, personalized care plans – based on their actual needs.

It’s really a simple concept that connects well to what UnitedHealthcare believes: eSync makes it easier for the people we serve to take action and live healthier lives. ESync helps them find the right care, see the right provider, take the right medication, and live the right lifestyle. Based on the data that eSync crunches and manages, we may send the patient:
• Background information about an upcoming medical procedure

• A reminder to schedule an annual exam

• Tips on starting an exercise plan

In each case the outreach is based on the actual needs of individuals.

ESync also gives us the capability to offer proactive outreach for high-risk members. We know they are high risk because the platform pulls together information like claims data, health assessments and referrals from other programs. One of our personal care consultants can then reach out and offer these members a chance to participate in programs specifically designed to reduce their health risk.

ESync helps our members get engaged in healthier lifestyles for a better quality of life, something we all strive for.

By providing better information we can help people make better decisions which result in better health care.

What is it going to take to cut the cost of health care while increasing the quality of care? I believe that the answer is conceptually quite simple. By providing better information we can help people make better decisions which result in better health care.

That seems like a bold statement. Don’t people get good information now? Aren’t people making good decisions about their health already?

Let’s look at the facts, which are based on a number of studies by UnitedHealthcare and others. As it turns out, for many conditions there is a great variance in how different physicians treat their patients. Evidence-based medicine uses real-world experience to determine which treatment works best for a patient or a group of patients with similar medical situations.

But according to studies:
• 45% of all physicians make decisions that are not based on evidence-based medicine,
• 43% of employees, families make less than optimal decisions related to doctors, treatments, prescription drugs and other aspects of health care.

You want to really improve quality? Reduce costs? Then improve decision making – based on the proven data sets.

I sincerely believe that if health insurance companies and medical caregivers work together, we can identify from real-world experience the best practices for a wide variety of medical conditions. And with this information will come better decision-making.

The future costs of addressing obesity could account for 21% of all health care costs before the end of the decade.

More than 40% of all adults in Pennsylvania will be considered obese in 2018 if trends do not change.

That’s the result of a report that the United Health Foundation, the American Public Health Association and the Partnership for Prevention put together as part of their November 2009 American Health Rankings study.

The report, based on research by Kenneth Thorpe of Emory University and the Partnership to Fight Chronic Disease, looks at what the rate and cost of obesity will be nationwide and in each of the 50 states in 2018 if trends stay the same.

If you’re frightened by the thought of more than 40% of all Pennsylvanians needing to lose a lot of weight to get healthier, think about Oklahoma, Mississippi, Maryland, Kentucky and South Dakota. The study predicts that all of these states will have adult obesity levels of more than 50%!

The report says that obesity is currently growing faster than any other health issue our nation has ever faced and that its rapid increase cuts across all socio-economic groups.

Here are some of the major findings of the report:
• If current trends continue, 103 million adults will be considered obese in 2018.

• If the current trend of rising obesity rates continues, the U.S. is expected to spend $344 billion a year in health care costs attributable to obesity in 2018, or more than 21% of all health care spending.

• If we could hold obesity levels to the current rates, we will have saved $820 per adult per year by 2018.

Here are the obesity numbers for the Keystone State, which use 2008 at the starting point. The study gives high, low and mid-point estimates, but I’ll just give the mid-way point: The prevalence of obesity in 2008 was 32.6% with an annual health care cost attributable to obesity per adult of $393.00. If current trends continue, the prevalnce of obesity in 2018 with be 41.8% with an annual cost of $1,455.00 per adult. If able to keep current rate of obesity, Pennsylvania will save $796 per adult annually.

It’s not going to be easy to keep obesity rates at their current levels, let alone lower them. The Center for Disease Control and Prevention describes our current society as “obesogenic,” which is a fancy way of saying that our society promotes the causes for most obesity: increased food intake, nonhealthful foods and physical inactivity. We see our “obesogenic” society every time we drive through a suburban business district and see rows and rows of fast food joints. We see it whenever we click on the TV and see all those ads for less than healthy foods. We see it when we read surveys of how much time children spend daily in front of the TV, game console or computer and how little time families spend on physical activity.

I’m therefore delighted that our first lady has decided to make fighting childhood obesity one of her major goals. At UnitedHealthcare, we also keep an eye on adult obesity. That’s why we are pushing a wide range of nutrition, fitness and other wellness programs and it’s why so many employers are including these programs as part of the coverage they offer employees.

Pittsburgh human resource executives brave snow to hear panel talk about health care and health insurance.

“It was snowing and it was going to snow.” That’s how the American poet Wallace Stevens once described a scene, and it certainly applied to Pittsburgh when I was there on February 16th to be part of the panel at the Pittsburgh Business Group on Health (PBGH)’s 8th annual Health Care Executive Leadership Forum.

All that snow on the ground and more falling, and yet the house was packed with human resource, benefits and finance executives from a wide range of western Pennsylvania employers. They had come to hear the views of 8 speakers, including representatives of 6 regional health insurance companies.

Christine Whipple, PBGH’s smart and savvy executive director, moderated the panel, which included:

• John F. Delaney, Jr., MD, DrPH, Chair, Department of Psychiatry, West Penn Hospital and President, Allegheny County Medical Society
• Diane Holder, President and CEO, UPMC Health Plan
• Patrick McGinn, Regional Head, MidAtlantic & Southeast National Accounts
• Norman F. Mitry, President & CEO, Heritage Valley Health System
• Dan O'Malley, Market President, Pennsylvania Western Region, Highmark Blue Cross Blue Shield
• Mary Lou Osborne, Regional President, HealthAmerica
• Marcie Popek, New Business Manager, Great Lakes Market, CIGNA Healthcare

And me.

We each had about 7 minutes to make a state of the union message about our organizations, after which there was a lively and long Q&A session. The questions reflected what I’m routinely asked by employers throughout the state: How we can use technology to lower cost in the health care system? What is the future of “accountable care organizations,” which are health care systems that reward doctors for teamwork and patient outcomes? What are the advantages of consumer-directed health plans such as health savings accounts (HSA)? The questions show that like UnitedHealthcare and many other insurers, employers are interested in both cutting costs and improving the quality of care.

A funny thing happened, though, in the informal settings like registration and during the break. I fielded a lot of questions in these less formal settings, and it was mostly the same question, “What is it going to take to create real competition in the Pittsburgh marketplace for health insurance?”

My answer was and is simple: You don’t have to wait for real competition. It’s here now! UnitedHealthcare is not new to the market. We’ve been here for six years. We’re an established presence and we’re already bringing innovative options to the market. We have a strong network of over 85 hospitals and more than 20,000 health care providers serving Pennsylvania. We’re one of the few health plans that are growing statewide.

The PBGH is a great forum for asking and answering the tough questions about health care and health insurance. As it says on its website, PBGH “strives to improve the delivery, cost and quality of health care through its quality and data initiatives, and by providing forums for the exchange of ideas and viewpoints.” You can find more about PBGH and an audio recording of the speaker remarks at the PBGH website.

There are lots of ways to fight cancer and we’re trying to identify the best ones for each patient.

A few days ago I told you about our new Oncology Care Analysis (OCA) program, which is the very first program to combine clinical and claims data to gauge the quality of cancer patient care based on approved treatment guidelines.

I wanted to write a little bit more about how OCA is going to help improve how physicians treat cancer.

Treatment of cancer varies widely among doctors and hospitals in the United States. The Oncology Care Analysis program’s goal is to help improve quality and coordination of cancer patient care by providing oncologists with information and feedback relevant to the care they are providing to their patients.

The OCA electronic medical record delivers coordinated patient information to the treating physicians that they may not have in their existing medical records, such as patient compliance with medications. For example, physicians may not be aware if their patients are not filling prescriptions for essential cancer medications. The record also contains important information about procedures performed by other specialists, including radiation oncologists and surgeons.

In November 2009, UnitedHealthcare initially shared OCA program patient data with 1,500 participating oncologists to help them better understand the strengths of their patient care along with areas for improvement. Each participating oncologist received aggregate national program results in addition to their individual results, along with relevant guideline data for each eligible patient under their care. UnitedHealthcare also shared aggregate national results with 12,000 additional oncologists within its health care provider network in an effort to introduce the tool and the cancer registry program.

UnitedHealthcare creates a national cancer care registry to help oncologists cure cancer.

One of the leading ways that we as a nation are going to improve the quality of health care while putting a firm brake on cost increases is to collect and analyze clinical data to determine the best treatment options. Health insurers have a large role to play in this process because we have both the numbers-crunching capabilities and enormous data banks of claims information.

Historically it’s hasn’t been easy for insurers to look at the quality of cancer care because cancer is so complicated and claims information tells us so little about the patient. UnitedHealthcare went to work on this challenge three years ago.

And now we have some results!

A few weeks ago, UnitedHealthcare announced that we have launched our Oncology Care Analysis (OCA), which is the very first program to combine clinical and claims data to gauge the quality of cancer patient care based on approved treatment guidelines from the National Comprehensive Cancer Network (NCCN), an alliance of 21 leading cancer centers.

UnitedHealthcare’s cancer registry includes clinical and claims data from more than 2,600 oncologists and 8,600 patients across the country with breast, colon or lung cancer. The powerful combination of cancer stage data and claims information creates a coordinated electronic medical record of a patient’s care and then compares that treatment regimen to existing NCCN guidelines.

We are sharing the results with participating oncologists to help improve the quality of cancer care and lead to better outcomes for patients. And it goes without saying that in doing so we’re complying with every privacy law.

UnitedHealthcare’s OCA program incorporates the NCCN Clinical Practice Guidelines in Oncology™, a widely accepted source of guidelines for cancer care in the United States, and the NCCN Drugs & Biologics Compendium™, which is based on the NCCN guidelines and contains scientifically derived information designed to support decision-making about appropriate use of drugs and biologics for cancer patients.

Developing the OCA data base was a collaborative effort between NCCN, UnitedHealthcare and Ingenix, UnitedHealth Group’s health information, technology and consulting company.

By the way, the NCCN is quite an impressive group of cancer-fighting organizations. It includes City of Hope Comprehensive Cancer Center, Los Angeles, CA; Dana-Farber/Brigham and Women's Cancer Center Massachusetts General Hospital Cancer Center, Boston, MA; Duke Comprehensive Cancer Center, Durham, NC; Fox Chase Cancer Center, Philadelphia, PA; Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT; Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, WA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL; Memorial Sloan-Kettering Cancer Center, New York, NY; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute, Columbus, OH; Roswell Park Cancer Institute, Buffalo, NY; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO; St. Jude Children's Research Hospital/University of Tennessee Cancer Institute, Memphis, TN; Stanford Comprehensive Cancer Center, Stanford, CA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL; UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; UNMC Eppley Cancer Center at The Nebraska Medical Center, Omaha, NE; The University of Texas M. D. Anderson Cancer Center, Houston, TX; and Vanderbilt-Ingram Cancer Center, Nashville, TN.

Wow, that’s a lot of intellectual fire power!

Newest cool iPhone App is a way to find doctors and other medical resources.

Here’s something that’s really cool!

Ever been away from home and needed a doctor and you didn't know where to go? Now all you have to do is get on your iPhone and look at a list of doctors, hospitals, clinics and other health care services all over the country. It’s all at your fingertips with the newest iPhone App, DocGPS.

You may be asking why a blog on health care and health insurance would talk about a new iPhone App. It’s because UnitedHealthcare is involved: The new DocGPS App for Apple Inc.'s popular mobile device enables users to tailor their search to their specific health plan and locate nearby doctors, clinics and hospitals within the UnitedHealthcare network using the GPS functionality of iPhone 3G and 3GS.

The App can make searches on 23 types of health care facilities and 58 types of physician specialties. After locating a doctor or hospital, the application can then show the office location on a map, provide detailed directions, and enable the user to call the medical professional or facility with a single tap on the search result.

DocGPS is ideal for individuals on the road who are not familiar with health care providers in their area, such as families traveling on vacation or professionals on business trips.

DocGPS also works with first-generation iPhones running 2.0 software or higher, enabling users to search UnitedHealthcare's health plan networks by zip code, or city and state. The application is available for download free of charge from the App Store on iPhone or at itunes.com.

I think the DocGPS App puts a powerful tool in the hands of consumers so that they can make more informed health care decisions whether they are at home, at work or on the run.

DocGPS is UnitedHealthcare's latest consumer-friendly innovation to modernize, simplify and make transparent health care information. An October 2009 study by CTIA-The Wireless Association showed nearly eight in 10 Americans (78 percent) said they are interested in receiving health care services via their mobile devices.

A new survey says that we may be able to reduce about half of the growth in health care costs.

Working for an insurance company, a lot of interesting surveys come across my desk. Here’s one that’s really mind-boggling from the Lewin Group.

Lewin Group researchers looked at data from the Office of the Actuary of the Centers for Medicare and Medicaid Services, which is a US federal agency which administers Medicare, Medicaid and the Children's Health Insurance Program. They were trying to figure out what specific factors led to the annual increases in the cost of health care in the United States.

The bad news is that they found 51% of health care inflation to be uncontrollable because it resulted from general inflation (32%), the aging of the population (5%) and other demographic factors (13%). There is really nothing that we can do about any of these factors.

The good news is that Lewin researchers found that 49% of health care cost increases resulted from excess utilization of medical resources (19%) and excess medical inflation (30%), which is inflation in medical services that goes beyond normal inflation.

That means that we have a real opportunity to make significant inroads against health care inflation by introducing new programs and concepts that reduce medical inflation and excess use of health care resources.

Much of the innovation in health insurance recently has been directed at least in part at one or both of these two challenges. Some examples:
• Pill-splitting, mail order pharmacies and use of generic drugs all work against inflation in drug prices.

• Disease management programs ensure that patients get the right care they need.

• Closed networks bring down the cost of medical care.

• The high deductible-health savings account (HSA) combination tends to create consumers who are more savvy about and involved with their health care decisions.

But there is so much more that we can do to reduce the impact of excess medical inflation and excess utilization on health care costs. For example, I’ve mentioned several times that we wrote two white papers last year in which we proposed a number of very doable innovations that would cut over $500 billion in health care costs over the next 10 years without sacrificing any quality of care whatsoever. Now that would take a big chunk out of health care cost inflation.

Why UnitedHealthcare decided to put together a special health insurance plan for diabetics and pre-diabetics.

Disease-management programs have traditionally focused on complications for people already known to have diabetes. With the new Diabetes Health Plan that UnitedHealthcare has just started offering we are targeting a much bigger segment of the population. Our objective is to slow the progression of the disease for people with diabetes, and in as many cases as possible to reverse the condition for people in the pre-diabetes stage.

We’re offering a special health insurance plan for diabetics and pre-diabetics for two reasons:
1. To provide better care to diabetics and pre-diabetics
2. To save employers and employees money.

A decades-long epidemic of obesity in the U.S. is a major reason for the sharply rising numbers of diabetic and pre-diabetic adult Americans. Diagnoses of people with diabetes increased by 13.5 percent between 2005 and 2007, with 1.6 million new cases reported in 2007 alone, according to the ADA.

The key to our program is to engage individuals as soon as possible and design personalized, specific self-management steps for them that can decrease the odds they will move into higher-cost categories of treatment. For example, research shows that a typical person in the pre-diabetic group who reduces body weight by 7 percent through activities such as adopting better eating habits or walking 150 minutes per week reduces the risk of becoming diabetic by 58 percent.

There is a massive, untapped opportunity for millions of American who have pre-diabetes diagnoses to stop, and perhaps even reverse, the progress of the disease before its too late. By encouraging people to take the right preventive steps, with clear incentives including lower out-of-pocket costs, we can help people improve the quality of their lives.

UnitedHealthcare anticipates that increased preventive steps by Diabetes Health Plan participants can also help lower health care costs for employers and employees. Total estimated annual cost of a diabetic is greater than $22,000 a year, which is 13-times higher than the average cost of a “healthy” employee (defined as an individual with no chronic disease), according to UnitedHealthcare data.

The cost of diabetes to the U.S. economy has increased 32 percent since 2002, or $8 billion a year, reaching $174 billion in 2007, according to estimates by the ADA. The disease also takes a significant toll on the resources of the U.S. health care system. One out of every five health care dollars is spent caring for someone with diagnosed diabetes, while one in 10 health care dollars is attributed directly to diabetes, according to the ADA.

What a win-win the Diabetes Health Plan is for employers and employees. It will do what health insurance innovation is supposed to do: improve the health of those covered while reducing overall costs.

UnitedHealthcare launches the first health care plan focused on diabetes with incentives for preventive care.

UnitedHealthcare has just taken a major step outside the box of health insurance. It’s a health insurance plan customized to help the rapidly growing numbers of diabetics and pre-diabetics manage their conditions more effectively while controlling employers’ escalating costs of insuring them.

This first-of-its-kind Diabetes Health Plan will reward diabetic and pre-diabetic individuals who routinely follow independent, medically proven steps to help manage their condition – such as regular blood sugar checks, routine exams and preventive screenings – and use wellness coaching.

Benefits include some diabetes supplies and diabetes-related prescription drugs at no charge, as well as lower co-payments for related doctor visits, at an estimated savings of up to $500 a year.

According to the American Diabetes Association (ADA), in 2007 nearly 24 million people in the U.S. had diabetes, 24 percent of whom were undiagnosed. Another 57 million are considered pre-diabetic, with about a fourth of them unaware of their condition. Data from the Centers for Disease Control and Prevention show that two-thirds of all diabetics do not follow their physicians’ advice on how to manage their disease. Experts say out-of-pocket costs for recommended supplies, medicines and physician-visit co-pays are a key reason why many diabetics do not follow treatment guidelines. Another is lack of knowledge about diabetes and pre-diabetic conditions.

By lowering financial barriers and providing wellness coaching, training and information, and a real-time compliance monitoring system and personal health record,
UnitedHealthcare’s Diabetes Health Plan provides many new incentives to help people better manage their health. Diabetes Health Plan participants who regularly follow their treatment plans can receive access to online monitoring and education tools at no charge, in addition to self-monitoring training and certain diabetes-related drugs (insulin, oral anti-glycemics, angiotensin receptor blockers and angio converting enzyme, anti-depressants and statins) and services.
Business Week had a good article a few months back about the pilot program we did with General Electric to evaluate the Diabetes Health Plan.

Now it’s no longer a pilot program, but a full-fledged health plan. Employers have the option of offering the program as a standalone health plan or as an enhancement to an existing traditional plan. The Diabetes Health Plan is also available to self-insured commercial health plan customers and their family members with diabetes or pre-diabetes.

What UnitedHealthcare is doing in Pennsylvania: a progress report.

I’ve hit the ground running in 2010 and as I round the corner to the end of the first quarter, and wonder how it got here so quickly, I realize I should stop and take a moment to share what’s happening in 2010 at my company, UnitedHealthcare.

We spent a lot of time in 2009 positioning our health plans in local Pennsylvania market and that’s paid off. There is a real focus on affordability and I think our leading position in consumerism has helped as employers look to make sure that employees are thinking about and adapting healthy behaviors. As a commercial enterprise, we continue to invest in practical innovation that leads to improved medical outcomes, better service and lower costs. All of these factors make me very optimistic that UnitedHealthcare will continue to grow its business in the Keystone State.

We are also ramping up our community activities throughout Pennsylvania. I’ve recently told you about our UnitedHealth HEROES program that provides micro grants to local organizations to help fight childhood obesity; our $5,000 UnitedHealthcare Children’s Foundation grants for child health care treatment, services or equipment not covered or not fully covered by their health insurance benefit plans; and our All-star programs that reward sports fans who improve their own health or the health or others. We also contribute to a number of other charitable causes in Pennsylvania, including the Juvenile Diabetes Association and the March of Dimes.

We will continue to support the efforts of the Pennsylvania Insurance Commissioner, under Commissioner Joel Ario, to bring competition to Pennsylvania insurance markets. The people of Pennsylvania deserve a more competitive health care marketplace and at UnitedHealthcare, we’re eager to play our part in bringing the benefits of competition to the people of Pennsylvania. UnitedHealth Group does business in every state, and we find that in most states there is a competitive health care marketplace that helps restrain costs. We believe that competition leads to higher quality and more affordable health care and will cooperate in any way possible with the Insurance Commission as it studies the face of competition in the state.

What UnitedHealthcare is doing in Pennsylvania: a progress report.

I’ve hit the ground running in 2010 and as I round the corner to the end of the first quarter, and wonder how it got here so quickly, I realize I should stop and take a moment to share what’s happening in 2010 at my company, UnitedHealthcare.

We spent a lot of time in 2009 positioning our health plans in local Pennsylvania market and that’s paid off. There is a real focus on affordability and I think our leading position in consumerism has helped as employers look to make sure that employees are thinking about and adapting healthy behaviors. As a commercial enterprise, we continue to invest in practical innovation that leads to improved medical outcomes, better service and lower costs. All of these factors make me very optimistic that UnitedHealthcare will continue to grow its business in the Keystone State.

We are also ramping up our community activities throughout Pennsylvania. I’ve recently told you about our UnitedHealth HEROES program that provides micro grants to local organizations to help fight childhood obesity; our $5,000 UnitedHealthcare Children’s Foundation grants for child health care treatment, services or equipment not covered or not fully covered by their health insurance benefit plans; and our All-star programs that reward sports fans who improve their own health or the health or others. We also contribute to a number of other charitable causes in Pennsylvania, including the Juvenile Diabetes Association and the March of Dimes.

We will continue to support the efforts of the Pennsylvania Insurance Commissioner, under Commissioner Joel Ario, to bring competition to Pennsylvania insurance markets. The people of Pennsylvania deserve a more competitive health care marketplace and at UnitedHealthcare, we’re eager to play our part in bringing the benefits of competition to the people of Pennsylvania. UnitedHealth Group does business in every state, and we find that in most states there is a competitive health care marketplace that helps restrain costs. We believe that competition leads to higher quality and more affordable health care and will cooperate in any way possible with the Insurance Commission as it studies the face of competition in the state.

Small businesses with health care are still covering employees, but there are fewer employees to cover.

A few people have asked me if many small businesses are cancelling coverage of their employees as a way to react to current economic conditions and the continuing inflation in health care costs.

Although it might seem to make sense that a lot of small business would drop coverage, that’s not what’s happening. We haven’t seen many small businesses backing off their commitment to provide health insurance benefits to employees, but a lot of small employment groups UHC covers in Pennsylvania have gotten smaller, with 10-employee companies often shrinking to 6 or 7 since the recession began.

While still committed to health care, small businesses have looked for ways to cut costs to the company and employees. Smaller healthcare networks, closed networks, higher deductible plans tied to innovative health savings accounts—these are just some of the ways that small businesses are trying to cut costs in the current economic environment while still providing health insurance benefits to their employees.

I’m pretty confident that once companies start hiring again, small businesses will continue to explore the innovations in health insurance that have been developed to meet the changing needs of the marketplace.

My Health HEROES brag list. It’s long but that’s a good thing.

As I let everyone know the other day, UnitedHealth Group has just announced that 24 groups in Pennsylvania are winners of 2010 UnitedHealth HEROES grants. HEROES grants are awarded to student and youth organizations for developing programs that get friends, classmates and community members moving toward a healthier lifestyle.

So many youth organizations across the state proposed thoughtful, creative programs that we awarded more grants in Pennsylvania than we originally planned, 24 in all.

I want to do a little bragging now and tell you a little bit about all of this year’s winning projects. Whether you read a sampling of these projects or plow through the entire list, I think you’ll share my sense of pride in the youth of Pennsylvania. There are truly some innovative programs on the list, all of which propose creative ideas for fighting childhood obesity that can be easily implemented in their schools and communities.

Here goes:
• Sixth Grade students at Abraham Lincoln Elementary School in Levittown, who will photograph “unhealthy signals” in their community such as fast food restaurants and the placement of junk food in grocery store aisles for a display and presentation to local parents, school boards and legislators.

• High school students from the Agatston Urban Nutrition Initiative (AUNI) Youthworks Program in Philadelphia who will transform an abandoned plot of land into a community orchard and amphitheater that will provide a common green space and public source of fresh fruits and vegetables.

• Students in Alvernia University's Wellness Core Physical Education 304 class in Reading, who will study the factors that contribute to obesity and organize a health fair and field day to promote healthy lifestyles for children in their community.

• Lawrence County Social Services, Inc. in Newcastle, which will help students enrolled in the local VOTECH high school become wellness mentors to low-income preschoolers, develop a newsletter and design programs to encourage parent involvement.

• The Urban Nutrition Initiative Philadelphia, which will purchase mortars and pestles for middle school students to explore different herbs and spices and learn about healthy methods to enhance the taste and aroma of food.

• Camp Fire USA Adahi Council Mohnton, which will help students in Southeastern Pennsylvania educate their community about healthy lifestyles through informational flyers, newsletter articles, exhibits and demonstrations.

• Students in grades 3-5 at Claysville Elementary School, who will create a “Healthy Living” informational DVD focused on the three main areas of “Healthy Snacks,” “Healthy Habits,” and “Healthy Activities” and distribute it to classmates, community members and local media outlets.

• YMCA of York County, which will host two programs, “Look Who’s Cooking” and “Teen Iron Chef,” to teach elementary and middle school students about how to prepare healthy meals.

• Middle school students at El Centro in Gettysburg, who will start a program to educate younger children on healthy lifestyles that includes several projects, such nutritional programs with computerized tracking, Zumba classes, a healthy cookbook and an activity day.

• Students at the Wayne County YMCA who will work together to compile a book of recipes and group games that promote a healthy lifestyle.

• Connoquenessing Valley Elementary School students in Seneca Valley, who will start a youth mentoring program to encourage healthy habits, respectful relationships and caring hearts.

• The Boys and Girls Club of Easton, which will hold after-school events for low-income youth, ages 5-19 featuring healthy snacks, physical activities, guest lecturers and opportunities to join dance and fitness classes.

• The Elise Joseph Foundation in Philadelphia and the Christian Fellowship Center of Philadelphia, which will partner with Taylor’s Wholesome Foods Workshop, L.L.C. and the Haitian community to start a hands-on nutritional cooking class.

• The Pennsylvania Migrant Education Program for children of migrant workers in Downingtown, which will provide obesity prevention and proper nutrition workshops for students in a Saturday education series culminating in a field trip to the BODIE WORLDS 2 exhibit where students will learn about the effects of obesity and disease on human organs.

• Woodland Hills Junior High in Pittsburgh, where a group of obese teenage girls will learn about making healthy choices and incorporating a fun activity into their daily routine by participating in a dance class and, after learning various popular dances, organize and instruct their own exercise class at a community center.

• The Mon Valley YMCA in Monongahela, which will host weekly meetings for volunteer members to discuss how to inspire local kids to lead healthy lives, connect with community leaders, incorporate physical fitness activities and culminate in a community-wide Healthy Kids Day event.

• The Allegheny Valley YMCA in Natrona Heights, which will start a “Youth Strength Training” program to help young people struggling to overcome inactivity through a mentor exercise program that features a circuit of weightlifting, body sculpting, cardiovascular exercise and nutritional classes.

• PartnerSHIP For a Healthy Community in Erie, which will partner with a local martial arts/fitness studio to offer rigorous exercise classes to students two days a week along with personal exercise and nutritional charts to help keep track of progress.

• The Brookville YMCA, which will host a special triathlon for kids ages 5-15 in April 2010 after a series of training sessions at the YMCA to help youth participants prepare for the race.

• The Child Health Project at the Drexel University School of Public Health in Philadelphia, which will develop a program that address wellness, safe physical activity and healthy eating while respecting children’s and families' cultural values and traditions.

• Philadelphia Youth Action, Inc., which will implement the "Healthy Choice/Healthy You" project to engage students age 8 – 18 in identifying the factors that contribute to childhood obesity and provide the resources they need to learn about healthy eating choices.

• Students in the “SMT Reaches for Wellness” project at St. Martin of Tours School in Philadelphia who will plan and lead demonstrations and activities at various school-wide events, including a Dance-a-thon, Family Soup Night and a community Health and Wellness Day Fair.

• Students on the Holy Trinity High Flyers Jump Rope Team in Ligonier, who will show their friends, classmates and parents how to jump rope and have fun while exercising in a demonstration at the local YMCA.

• The City of York, which will host a three-part nutritional series for local children in which a nutritionist will lead discussions about the participants’ favorite foods, demonstrate how to incorporate them into healthy meals and compile the recipes into a healthy eating cookbook.

If you want to find out more about the Health HEROES program, visit http://www.ysa.org/.

We couldn’t decide which deserving HEROES to fund so we supported them all.

We just completed the process of evaluating applications for 2010 Health HEROES grants, which are cash awards that UnitedHealthcare gives to schools and youth-focused, community center-based programs that demonstrate a clear understanding of the health risks associated with childhood obesity and propose creative solutions that can be easily implemented in their schools and communities.

It was a very uplifting process because the many exciting projects reminded me of how many creative kids and great organizations for kids that there are in our great state. We were thrilled to see that though UnitedHealth HEROES is only in its second year, we had a significant increase in grant applications for 2010.

But it also presented us with a very tough decision on which projects to fund—we were selecting from 24 finalists, a bit more than we had budgeted for.

But all the programs asking for funding seemed to offer importat contributions to addressing childhood obesity on a grass roots level. We wanted to make sure that whether it involves slicing and dicing, digging and planting or grinding and spicing, that all these Health HEROES throughout Pennsylvania will have the tools they need to lead the fight against childhood obesity.

So we decided to fund all 24 programs!

UnitedHealth HEROES is a service-learning, health literacy initiative designed to encourage young people, working through educators and youth leaders, to create and implement local hands-on programs to address the issue of childhood obesity. According to the Center for Disease Control and Prevention, more than 30 percent of young people are obese, which means they are at an increased risk for heart disease, diabetes, high blood pressure and numerous other life-altering health conditions.

Each year, the UnitedHealth HEROES program awards grants to schools and youth-focused, community center-based programs that demonstrate a clear understanding of the health risks associated with childhood obesity and propose creative solutions that can be easily implemented in their schools and communities. Youth Service America administers our UnitedHealth HEROES program.

Healthcare change will continue in the marketplace no matter what happens to the current legislation.

When I first started this blog, I wrote that no matter what happens with health care reform legislation that there would be changes driven by the marketplace. We can already see that happening.

For example, we have been working with the American Hospital Association to facilitate more timely communication between hospitals, insurers and physicians.

Timely communication helps to make sure that all clinical and administrative resources are activated as quickly as possible for the patient. For example, quickly engaging the patient’s primary care physician can go a long way in ensuring a fully coordinated treatment plan is activated in real time. Clinical teams have more time to put effective case and disease management programs in place for the patient.

The most important element of timely communication is notification by the hospital to the insurer that a patient has been admitted to its facility. It has long been a standard practice across the industry for insurers to require notification when a member is admitted to the hospital. The exact requirements differ based on the particular process of each insurer, but many programs require notification of hospital admissions and typically impose reimbursement adjustments if notification is not provided.

Our notification program facilitates timely communication so that we can quickly connect all parts of the health care system on behalf of patients. All it takes is a simple fax, phone, portal or online submission to notify the insurance carrier of a patient admission.

Our goal is to have real time 24/7 communication with hospitals. It’s not our intent for a single hospital to receive a reimbursement adjustment. Timely communication simply puts more focus and attention on patient care.

The employers with whom we have discussed our notification program understand it because they see that the sooner we can engage all the resources the patient needs, the more efficient care will be.

So what has happened is that insurers and health care systems are working together to become more efficient and to improve patient care, both of which drive down the cost of health care. It’s market-driven health care reform.

Why I’m so excited about Penn State Hershey Medical Center joining the UnitedHealthcare network of medical providers.

I’m still psyched about UnitedHealthcare adding Penn State Milton S. Hershey Medical Center to our network and here’s why. The Medical Center employs more than 650 physicians and 1,800 nurses as part of a team of more than 8,500 people who provide patient care, education, research and community outreach.

The Medical Center campus includes Penn State College of Medicine (Penn State’s medical school), Penn State Hershey Cancer Institute, and Penn State Hershey Children’s Hospital—the region’s only children’s hospital. The Medical Center campus is part of Penn State Hershey Health System, which also includes the Pennsylvania Psychiatric Institute, Penn State Hershey Rehabilitation Hospital, and other specialty facilities.

Founded in 1963 through a gift from The Milton S. Hershey Foundation, Penn State Milton S. Hershey Medical Center is one of the leading teaching and research hospitals in the country. The 484-bed Medical Center is a provider of high-level, patient-focused medical care. Annually the Medical Center admits nearly 27,000 patients, accepts more than 800,000 outpatient visits, receives more than 50,000 patients for emergency room visits and performs more than 23,000 surgical procedures.

I urge people to check out all the great medical programs at HMC by visiting the website at pennstatehershey.org.

Some great news for residents of central Pennsylvania! Hershey Medical Center joins the UnitedHealthcare network.

I’ve got some really great news for the more than one million people living in Pennsylvania who get their health insurance through UnitedHealthcare, especially for folks living in the central part of the state.

UnitedHealthcare has added Penn State Milton S. Hershey Medical Center and its hospital system to UnitedHealthcare’s network of health care providers. As many of you know, Penn State Hershey has a national reputation and is considered one of the premier medical institutions in Pennsylvania.

UnitedHealthcare health plan participants now have access to in-network care at Hershey Medical Center and all Penn State Hershey facilities. Before, UHC members who wanted to use HMC or a Penn State Hershey facility had to go out of network, which means that their health plan did not cover all the costs. What a great advantage for our central Pennsylvania and other members to be able to use the physicians, staff and technology without having to worry about any additional payments beyond their share of premiums and copays.

The addition of Penn State Hershey expands UnitedHealthcare’s provider network to more than 23,000 physicians and 185 hospital facilities statewide. Like most health insurance companies, UnitedHealthcare is committed to growing our network of health care facilities to ensure our customers have local, in-network access to a wide variety of quality doctors and other health care professionals.