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.