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.