From Mistletoe to Root Canals: Have a Better Health Plan for 2013

For many people, December conjures up an image of family time and relaxation as the year comes to a close. And while that’s the ultimate goal, December seems to throw a lot of obstacles in our way to that winter peace.

With the holiday season comes a stress level all its own. Will it be possible to get the family together for the holiday card photo sometime before January? Do you use your mother or mother-in-law’s Latke recipe? Do you really need to spend $50 on a new Furby for your nephew, or can you just re-gift the one your child stopped playing with 10 years ago?

If the holidays weren’t enough to drive you crazy, the end of the year puts you face-to-face with the past January’s good health intentions. You put enough money in your health savings account for that root canal and you were going to plan your annual dermatologist checkup and yearly mammogram. But then life happened, and that big meeting came up when you were thinking of calling the dentist, and the kids needed you to make something for the bake sale the morning you were going to schedule your appointments. Now it’s December 14 and between the Christmas cookies and holiday shopping, you’re trying to squeeze in that appointment to have your teeth drilled or that adjustment at the chiropractor to avoid losing the $400 you socked away in your health savings account.

We’ve all been there. As they say, life is what happens when you’re busy making other plans. But this year, I have a solution for you. It may not clear up the latke showdown, but it can make your 2013 health plan flow a bit smoother.

This January, make a list of all your preventative care screenings. Once you get them all in one place, pick a logical date, month, time of year, etc. that will help you remember when to schedule your appointments. For example: October is Breast Cancer Awareness Month – call now to make your appointment for October 1. Or, in May, Memorial Day marks the unofficial start of summer (it’s also Skin Cancer Awareness Month), get to the dermatologist for your yearly skin check and stop at the drug store afterward to stock up on sunscreen. Or, pick the first week of the New Year or your birth month – whatever date or time of year to that you can attach some meaning to as a way to help you remember to make – and make it to –your appointments.

‘Tis the season for making lists, so what better time than now to take a few moments and plan out your 2013 year in health.  You’ll be able to avoid an end-of-year mad dash to the doctor and stop worrying about having to decide between your health and money.

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With the passage of the Affordable Care Act, there has never been a better time to organize your preventive care visits, for which, thanks to the new law, there is either no cost or a co-pay. Check out this UHC TV video for some clarification on what’s considered preventive care.

Employees like specialty benefits

I’ve lost track of how many times I’m asked by small business owners, “how can I cut my health care costs?”  Many businesses looking to cut employee health care costs sometimes consider eliminating specialty benefits like vision, dental, disability, life insurance, critical illness, and accident; if they offer them at all.

But there really is no reason why employers can’t add specialty benefits to the health plan they offer employees without raising their own costs.

Many health insurers, including UnitedHealthcare, now offer packages that allow employees to select from several plans, with the employer paying a set amount and employees picking up the difference if they select more expensive plans. With this plan structure, sometimes referred to as a “private exchange,” it is easy for employers to add specialty benefits options to the mix without incurring any additional costs.

And, there is a very good reason to offer specialty benefits: employees like them!  Surveys show that they help to attract and retain employees and also improve morale.  Specialty benefits are especially attractive to employees in special situations, such as someone with two teenagers who need braces or a middle-aged person whose vision is slowly diminishing. They can even help an employer’s bottom line. For example, an effective disability program can return people to work and improve a company’s productivity.

Health insurers continue to introduce new specialty benefits to the marketplace.  The most recent innovation is critical illness coverage. Critical illness insurance pays cash benefits for living expenses and out-of-pocket medical costs if covered employees or family members contract a specific illness or condition such as cancer, heart attack, stroke or paralysis. Another recent innovation is the introduction of Accident insurance; a policy that pays cash benefits for medical care resulting from an accident. Both products can be combined with a traditional or high deductible health plan to help offset a member’s potential out-of-pocket costs from deductibles and coinsurance.

Offering specialty benefits as part of the menu of options that an employee can select maximizes the effectiveness of a company’s health care dollars. A suite of voluntary benefits offered alongside medical insurance enables the employee to focus the employer’s contribution towards his or her family’s specific needs.

Finally, when evaluating voluntary options, look for a company that offers low participation requirements and a comprehensive enrollment program to help you communicate these benefits to your employees. 

For more information on local, affordable health care solutions go to http://www.uhctogether.com/philly/index.html.

Heroes to Your Health

It’s not always easy to live healthy. Between work and family, sometimes it’s easier to skip the gym or head to a drive-through for dinner. When we’re busy and stressed, we often reach for a candy bar instead of an apple or decide to catch up on our DVR instead of taking a family walk. We’ve all been there and understand how hard it is to make health a top priority. That’s why it’s so important to recognize people in the community who are dedicated to not only living healthy lives themselves, but helping the rest of us stay on track. I’d even go as far as calling them heroes – in fact we did!

UnitedHealthcare is proud to have teamed up with Philadelphia magazine to present the first-ever Be Well Philly Health Hero Challenge. We asked Philadelphians to tell us who their health heroes are. After 492 nominations we asked people to vote for their favorite health hero. To really get those hearts pumping, UnitedHealthcare donated one dollar to the American Heart Association for every vote cast up to $5,000. Nearly 10,000 votes later, the pool was narrowed down to just 16 nominees, followed by four finalists.

Dr. Beth DuPree, breast surgeon and medical director for Holy Redeemer’s Breast Health Program, was voted our 2012 Health Hero at a special Be Well Philly Health Hero Challenge party. Beth was inspired to lead a healthy lifestyle by her patients. Five-and-a-half years ago she found a mass in her breast – that was luckily benign – it served as her wake-up call. She always made lifestyle improvements a part of her care plan for patients, but was failing to care for herself. After her scare, she permanently changed the way she eats, exercises and deals with stress. For Beth, being physically, emotionally and spiritually “buff” has become a way of life. She put her $2,500 prize into her organization -- The Healing Consciousness Foundation -- which develops lifestyle enhancement programs including VMS Thrivers fitness classes (with Vaughn Hebron), Healthy Cooking for Life series of education, yoga, Zumba, Thrivers retreats and meditation.

The three runners-up—Students Run Philly Style’s Heather McDanel, Leukemia & Lymphoma Society’s Stephen Brown, and Marino’s Body Shop’s Chris Marino -- each took home $250 for their charities. All 16 nominees serve an important role: They inspire and challenge those around them to be their best selves. And for that they all deserve our gratitude.

And the nominees were…

*Beth DuPree – breast surgeon and medical director, Holy Redeemer’s Breast Health Program *Heather McDaniel – director and founder, Students Run Philly Style
*Chris Marino – owner and personal trainer, Marino’s Body Shop
*Stephen Brown – triathlete, Team in Training coach with the Leukemia & Lymphoma Society and cancer survivor
Cate Dorr and Ford - Magee Rehabilitation Hospital
Bob Carrozza - school nurse at Penrose Elementary
Michele Redrow - CGI Racing
Kim Fortunato - Campbell Soup Company
Deborah Hirsch - Philly Dance Fitness
Alice Bast - National Foundation for Celiac Awareness
Nicole Marquis - Hip City Veg
Jillian Bullock - Fighting Spirit Warriors
Bob Schwelm - Bryn Mawr Running Company
Jeff Middleton - First Tee of Philadelphia
Carolyn Kaufmann - Stroller Strides
Sally Andersen - fitness instructor at KendrickRecreation Center

Read their stories.

*Finalist

Health Hero Challenge from Dave Tavani on Vimeo.

The Gratitude Challenge

If your household is anything like mine, you spent the greater part of this week in throes of planning your Thanksgiving dinner, figuring out what football games you will be watching and trying to decide how to keep the best leftovers for yourself. It's hard to believe that Thanksgiving Day has come and gone. But I’d like to believe that for the rest of this year and well into the next that from time to time I will take a breath and think about those things for which I am most thankful.

 

Earlier this year, I invited my team to participate in a “Gratitude Challenge”.  I got the idea after hearing Shawn Acor, author of The Happiness Advantage speak on the value of Performance. His research confirms that optimism and happiness are universal predictors of success. Good news: the research also showed that happiness can be cultivated and is contagious. He suggested five simple actions that if practiced for a few minutes a day, for 21 days, would significantly improve your happiness over the upcoming year.

 

So we tried it as a team.  It was surprisingly simple; we set up a shared site to post our thoughts.  I suggested that every morning, for 21 consecutive days, we each paused for a moment and posted three things that for which we were grateful.  I asked them to be specific.  For example, they wouldn’t simply post, “my family," but a more detailed grateful statement like, “my son is home from college this week and we got a chance to visit."   Some chose to post, others preferred to make notes in a personal journal that they would not share, but no matter what method they chose, for all it was an amazing experience! I feel compelled to share with you the following post.

“I have been practicing a gratitude journal for years and find it inspiring that UnitedHealth Group has introduced it to the "corporate" world.  It is so easy in our everyday lives to get caught up in the craziness and think "why me"" and slip into a funk.  Many years ago I had slipped into a deep funk and decided it was time for a positive change.  Someone introduced me to the concept of writing down 5 things that I am grateful for and 5 things that I want.  They told me that I would slowly start to see the things I wanted become the things I was grateful for.  I thought what a bunch of hooey but with nothing to lose but a few minutes every day and the cost of a notebook, I set on my journey.  In the beginning it felt good just to write down "I am grateful to have made it through another day".  As time went by, it was magical to watch the transition as my wants became my thanks.  If you made it to this point in my post there is a reason you read the whole thing.  Nothing happens by chance.  Perhaps it is time for you to start on your journey and realize that all great things come from gratitude.”

 Well, not much else for me to say, I think you get it.

 

Gratefully,

 

Sue

Sue Schick and some of her grateful team members

 

 

Collaboration: The Key to Making Health Reform Work

What do you get when you put physicians, hospital executives, non-profit administrators, and health insurance leaders in the same room?

A whole lot of innovation.

I’m talking about the Philadelphia Business Journal’s 2012 Health Care Innovation Awards, which were held this past Thursday in Philadelphia.  UnitedHealthcare was a proud sponsor of the program, now in its second year, which recognizes the most innovative health care leaders in the region. Organized with the outstanding leadership of Philadelphia Business Journal publisher Lyn Kremer and editor Craig Ey, the event opened all of our eyes to the enormous potential that lies ahead in the health care field to bring better care to patients.

The program also featured a discussion on the future of health care by a panel of experts who are pushing our medical community forward, including our own Dr. Deneen Vojta, senior vice president for business initiatives and clinical affairs at UnitedHealth Group.

We also had the pleasure of having Philadelphia Business Journal healthcare reporter John George in our midst. John’s tweets and blog are full of the latest must-see stories in health care.  You can follow him on Twitter at JohnGeorgePBJ.

This year’s award winners demonstrate creative programs that bring healthy solutions to people who might not have access to them otherwise. Some of the innovative programs included a center for young refugees where they are treated by culturally sensitive staff, free dental screenings for underserved children, a new hospital to serve patients in Central Montgomery County where market research showed 60 percent of the patients traveled more than 30 minutes for medical care, and podiatrists who make house calls. These programs and the executives, health systems, doctors, nurses, volunteers and nonprofits who create them are what drives the health care industry forward, giving every member of the community the chance to live a healthy life.

The awards reminded me of the many tweets I received last Tuesday, election night, asking what’s next for health care reform.  My tweet, the law is only a part of health care reform.  The movement to modernize the health care system did not begin and will not end with the Patient Protection and Affordable Care Act.  The real future of health care reform is in the group of health care innovators that stood with me in that room, and the hundreds of thousands of people like them across the country who are working together each day to improve the health care system.

Through innovation and collaboration, we can not only modernize the health care system to comply with the current laws, but continue to make improvements so that care becomes more affordable, accessible, and produces better patient outcomes.

In the next decade, we’ll continue to see more collaboration and partnerships among all of us in the health care industry as we work to use capital smartly and focus on non-traditional approaches to traditional methods of care. It’s this idea of sharing, not going it alone, that will ultimately make health reform work.

You can review and read more about the health care innovation award winners at

http://www.bizjournals.com/philadelphia/feature/2012-health-care-innovation-awards.html

Sue Schick, Dr. Deneen Vojta (left) and Innovation Panel Members

Being Part of the Community is Part of Our Corporate Culture

What would get me out of my warm bed on a Sunday morning to stand on the steps of the Art Museum as Hurricane Sandy was threatening? Only one thing: the Annual Juvenile Diabetes Research Foundation (JDRF) Walk to Cure. But, I’m getting a bit ahead of myself here.

 

I’ve written at length about diabetes, and UnitedHealthcare’s commitment to stemming the rising epidemic of type 2 diabetes by supporting innovative programs working to diagnose, treat and prevent this disease.  According to the Centers for Disease Control and Prevention, there are 26 million adults living with diabetes in the U.S. An additional 79 million adults – or one in four Americans – are estimated to have prediabetes, a precursor to Type 2 diabetes.  We continue to build relationships with like-minded partners, such as Comcast and the YMCA, who have the ability to reach and help educate broad numbers of individuals throughout the communities we serve.

 

We are also committed to another form of diabetes – type 1, formerly known as juvenile diabetes, because it is more commonly, but not exclusively, diagnosed in childhood. Unlike the type 2 form of the disease, which is more related to lifestyle choices and can be prevented or reversed, type 1 cannot – at least for now. In Philadelphia, UnitedHealthcare is working to help change that through its ongoing support of the Juvenile Diabetes Research Foundation (JDRF). 

The JDRF's "Walk to Cure Diabetes" event is a wonderful example of what collaboration for a cause can do.  Proudly sponsored by UnitedHealthcare, this year's event was held last Sunday at two locations: the Philadelphia Museum of Art on the Benjamin Franklin Parkway and Bucks County Community College in Newtown.  Despite the looming threat of Hurricane Sandy, the nearly 8,000 participants helped raise almost $2 million to fund treatment, support and research.

But, our involvement in chronic disease prevention and helping individuals and their families lead healthier lives goes even further. From the leadership team to individual employees, we “walk the walk” -- literally, in the case of JDRF, with more than 25 of us coming out to the event. Among them was Scott Johnson, key accounts director for Eastern Pennsylvania, who has been have been involved with JDRF for 15 years, and a member of its board for the past 4, as well as the immediate past chair of the Walk. The Juvenile Diabetes Research Association named Scott Volunteer of the Year in 2010 for his pivotal role in raising more than $4 million on the organization’s behalf.  

Such active volunteer engagement by members of the UnitedHealthcare family is not unusual.  It is at the core of our mission to be more than just a great health insurance company. That’s why we’ve created a special website that offers resources to help make families aware of what can be done to prevent or manage diabetes. It even includes a couple of really cool sweepstakes.  Check it out at http://www.uhcdiabetes.com/healthy-recipe-contest/

Sue Schick and the dedicated UnitedHealthcare team brave the weather to walk for the Juvenile Diabetes Research Foundation

Coffee and Danish…with a Side of Innovation

It feels like déjà vu, but I’m writing again about a thought-provoking breakfast I attended this week. As with the Forum of Executive Women‘s Leadership Breakfast, the Drexel University LeBow College of Business Lifelong Learning Series, the Business of Healthcare, event titled “Healthcare Reform: How it Affects Your Organization,” brings up a topic hot on the minds and lips of many, and one I want to continue exploring.

The breakfast featured a panel including myself, Elizabeth Weber, vice president of benefits at Comcast and Tom Todorow, executive vice president for corporate services and CFO at The Children’s Hospital of Philadelphia. It was a great opportunity to be able to discuss the effects of health care reform on businesses with those on the front line. The way to really get to the bottom of an issue and what needs to be done – in this case, to modernize health care – cannot simply come from one source. Real progress can only be made when those in the trenches are given a chance to reflect on the changes and discuss their impact.

One of the main topics of conversation is something I’ve blogged about numerous times – innovation through collaboration. Now more than ever, stakeholders all have a vested interest in making our health care system simpler and smarter – allowing for a better patient experience, delivering the best possible outcome and reducing the overall costs of care.

Innovative payment methods, through accountable care organizations and value based contracting, was another area we focused on. These approaches will help increase collaboration while reducing costs, improving patient outcomes, and sharing risk and responsibility for controlling medical fees. While the transformation of industry-wide payment models is still evolving and will require a variety of strategies to suit the needs and diversity of consumers and health care providers in individual communities across the country.

Wellness programs also came up. Prevention is key to lowering costs and improving consumer health. One stat I’ve used before that bears repeating here is that it costs about $3,700 a year on average to treat prediabetes; if the condition ultimately progresses to advanced diabetes, those costs jump to more than $20,000. Beyond just the financial figures, the emotional and physical toll of dealing with prediabetes is much more feasible than dealing with the disease itself.

You can view our discussion at http://www.lebow.drexel.edu/video/healthcare-reform-how-it-affects-your-organization-sue-schick.

Everyone knows breakfast is the most important meal of the day. These meetings are an opportunity to bring together different stakeholders with a common goal. Whether advancing women in business, or modernizing health care, what better way to trade ideas than over coffee and danish?

It’s time for affordable, quality and innovative solutions to health care

When my boys were still young, getting them to bed was sometimes a frustrating struggle. My husband and I would keep saying, “It’s time for bed….It’s time!” and sometimes the kids just wouldn’t listen.

“It’s time…” can be a mantra of frustration for any parent: It’s time for school…It’s time to straighten your room…It’s time to do your homework.

When I go around the Commonwealth and listen to people talk about their health care situation, they tell me that it’s time for health insurance to be simpler.  It’s time for responsive and compassionate customer service. It’s time for better and easier access to physicians and other health care providers.  It’s time for some innovation and some flexibility.

I’m writing to tell you that the time is now.

As those who regularly follow my blog know, over the past few years UnitedHealthcare has beefed up our already strong network of providers across Pennsylvania and used technology to improve our already award-winning customer service. We’ve added a mind-boggling array of online tools and smartphone apps that help consumers select physicians, evaluate the costs of treatment, gather tips for keeping themselves and their family well, and track their physician visits and health care costs.

We’ve also introduced a number of innovative health plans, like Multi-Choice, which gives employees of small businesses up to 30 different plans from which to select while capping costs for the employer.  And now it’s time to shout it out to the world, which is what we’re doing in our new statewide ad campaign, “It’s time.”

We’re launching the campaign now because for many employees and businesses it’s the time of the year for evaluating their health care insurance plans.  

Our ads, which you can see on buses or bus shelter boards and hear on most radio stations, turn the frustration of the “It’s time” mantra into a positive happy decision to take control of health care and health care costs.  When it comes to considering their choices during open enrollment, I want people to say, “It’s time” with a smile on their face, like “It’s time to go on vacation” or “It’s time to enjoy the weekend.”

Every ad has a call to action and the call to action of our new ads is to visit a website that has been localized to meet the specific needs and concerns of folks in different regions of Pennsylvania, like www.uhctogether.com/pittsburgh/index.html or www.uhctogether.com/philly/index.html.  At the website, you can click through to webpages to learn about our innovations, hear testimonials from physicians and consumers, get information about preventive care, go to a special website focused on women’s issues and watch UHC.TV, the first online television network with health and wellness related content.

The basic message of our “It’s time” ad campaign is simple: It’s time for affordable, quality and innovative solutions to health care and that’s what people will get by switching to UnitedHealthcare.

Now it’s time for me to get back to my day job.  And I say it with a huge smile on my face, because I love working with my UHC colleagues at our 14 offices across Pennsylvania who collaborate with the 223 hospitals and more than 30,000 health care providers located in the Keystone State to make sure that the almost one million Pennsylvanians covered by UnitedHealthcare get the affordable quality health care they need. 

Gender Matters

As a mother of three boys, I often simply smiled when my friends who had girl children would say, “gender matters”.  As far as I was concerned raising kids was pretty much gender neutral and I had my hands full!  But as I have risen to the leadership ranks at UnitedHealthcare, I realize that gender does in fact matter.  So much so that the focus of the Forum of Executive Women’s 2012 Leadership Breakfast, that I attended earlier this week,  was on the  need to intensify efforts to bring more gender diversity into boardrooms and executive suites. 

The issue of women and leadership always takes center stage at this annual event, during which the Forum releases its Women on Boards regional report. The 12^th edition shows that while there has been some progress for women, a year-over-year look at the numbers continues to show the difficulty of bringing about change in the upper ranks. There are indications both regionally and nationally that efforts to increase the influence of women in corporate America are gaining traction, but it is a slow progression. Encouragingly, even as the number of board seats and executive positions decreased at area companies over the past six years, the proportion of board seats held by women increased by nine percent.  During that same period, the proportion of female top executives rose by 25 percent and female top earners by 53 percent. So, while things are happening for women in business, it’s clear that more work can be done to increase the number of women leaders across the Pennsylvaia region and the country.

Our special guest, Mayor Michael Nutter, agreed, saying that diversity is not about including women or minorities merely as a token, but realizing that it is what a company truly needs to be successful in this age of globalization.  And this year’s keynote speaker Ellen Kullman, CEO of DuPont – a company where a third of its directors are women -  made a point I hope becomes more common as we move forward. Ellen noted that she never felt like a “woman leader” until someone pointed it out. As far as she was concerned, she was just doing her job. 

I am proud to represent UnitedHealthcare as a member of the Forum of Executive Women. UnitedHealthcare is commited to advancing women in the workplace.  One of the most visible demonstrations of this can be found in the state of Pennsylvania where 72% of the 2,600 employees are female and women make up 52% of the leadership population.  In addition, the leader for each of our major business lines is a woman.  These women ascended to the top of the nation’s largest health insurance company, a company that provides a work environment that allows women the flexibility they may need to meet the demands at work and home.  And our commitment isn’t just to the women we hire, over 62% or our 2011 spending with diverse suppliers went to women owned businesses.

Organizations like UnitedHealthcare, the Forum for Executive Women and role models like Ellen Kullman, are essential to increasing the number of women in leadership positions for decades to come.  Gender does indeed matter.

Sue Schick and the next generation of leaders

Health Insurance 101

If someone stopped you on the street and asked you what an HRA was, could you define it? How about PDL? Do you know the difference between brand name and generic drugs? With the passing of the Affordable Care Act, the upcoming presidential election and open enrollment season in full swing, health insurance is a hot topic these days. Everyone seems to have an opinion on the issue, but how many of us really know what insurance is all about? When UHC-TV interviewers took our cameras to the streets it was clear that lots of people aren’t really sure what many health care terms mean and how they impact their wallets.

Spending more time to better understand health insurance terms is key to determining the best plan for you and your family. You wouldn’t cast a vote for president without first researching the candidates, so why would you just pick a plan without really knowing what it means? Take a minute to “attend” my Health Insurance Terms 101 crash course below and brush up on some basic health insurance terms. A deeper knowledge of these terms will help you better understand your financial responsibilities and benefits under each plan offered by your employer or, if you’re a small business owner, by your broker:

• Premium: the amount you pay each month to have health insurance coverage. This amount is usually taken out of your paycheck.
• Deductible: your portion of the costs before insurance kicks in. Preventive care, such as annual screenings and physicals, do not apply to the deductible.
• Copay: a fixed amount that you pay each time you see a doctor or fill a prescription. The amount of your copay may vary depending on whether you are seeing a primary care physician or specialist, or seeking emergency care.
• Coinsurance: a predetermined percentage of the total cost you pay for medical services, such as office visits, lab work and emergency room care. Coinsurance will apply up until you hit your out-of-pocket maximum.
• Out-of-pocket Maximum: the maximum amount you have to pay for health services every year. Once you have paid this amount, your insurance company usually pays 100% of your health care costs, subject to any policy limitations.

So that’s what the basic terms mean, but how do they translate to real life and your pocket book? Say you enroll in a traditional health plan with a monthly premium taken out of your paycheck. The plan has a $500 deductible, 20 percent coinsurance and a $2,000 out-of-pocket maximum.

If your doctor refers you to a dermatologist after finding a suspicious mole on your back during your annual physical, the physical is free because it is preventive care, but you have a $25 copay at the dermatologist’s office (considered a specialist visit) - which counts toward your deductible.

The dermatologist removes the mole, a procedure that costs $1,475. You pay the remaining $475 of your deductible first. After that, your insurance kicks in to apply to the remaining $1,000 balance. Because your coinsurance rate is 20 percent, the insurer will pay $800 and you will be responsible for $200 of that portion. Your total cost would be the $25 copay, plus the remaining $475 deductible, plus the $200 coinsurance rate, for a total of $700.

Then suppose that later in the year, you end up in the hospital for 4 days with an illness.  Your total bill from the hospital is $20,000.  Your coinsurance rate means that you are responsible for $4,000, but your maximum out-of-pocket for the year is $2,000.  You’ve already paid $700 earlier in the year, so you would only have to pay the remaining $1,300. 

Once you hit the $2,000 maximum out-of-pocket, all of your eligible medical expenses for the rest of the year will be covered 100% by your insurance.

Whew, that's a lot of numbers!  But don't rely on my math - check out the video below and tune into UHCTV to find out more about various aspects of health insurance.

Embracing Change

Last week I attended the Greater Philadelphia Association of Health Underwriters (GPAHU) annual conference and had the priviledge of sharing ideas with some of the most respected local health insurance leaders through a panel discussion. Joining me on the panel were representatives from Coventry, HealthAmerica, Independence Blue Cross, CIGNA and Aetna. The theme for this year’s conference was Embracing Change – obviously a very appropriate topic with the passage of the Patient Protection and Affordable Care Act (PPACA). This paradigm shift in the health care industry requires that we put aside our differences and align our shared objectives to improve the quality, cost and delivery of health care.

Although the Supreme Court handed down its decision in June, the details of how the law will be enacted are still being ironed out. While it is imperative to work with others in the industry to determine what will affect positive change, the changes set forth by the decision also necessitates innovation by our companies to best enhance the quality of health care system. So during our panel discussion we talked about where we have been, where we are now and where we are going.

We discussed the chages to our minimum loss ratio (MLR), federal and state driven health exchanges, accountable care organizations, underwriting, distribution channels, consumer driven health plans and of course, wellness programs. Because one thing we all agreed upon is that a lot of the heavy lifting in the march towards a better health care system will have to be done by each of us individually.

And we got a lot of tough questions like, what is our position on self-funding alternatives for small businesses?, how do we envision the role of the broker in exhanges?, an what are some of our specific initiatives in the area of pay for performance?. Whew, can you say “hot-seat”?

What I shared with the panel and nearly 500 underwriters in attendance, is an overview of UnitedHealthcare’s position on health care reform. For starters, UnitedHealthcare is meeting all of the PPACA requirements to date. In Pennsylvania, we are reducing administrative expenses and increasing transparency across the health care industry by introducting innovative new products, like our Multi-Choice plan which allows small employers with less than 50 employees better manage their health care costs and at the same time offer their employees more health insurance options. Or helping in the battle against the wide spread of diabetes by partenering with organizations like Comcast and the YMCA to implement clincially based diabetes prevention programs that work! We have and will continue to make changes that support health care innovation while still maintaining our commitment to helping people live healthier lives.

By creating our own individual innovations, while rallying together to build partnerships, we can improve health care outcomes, lower costs, and increase overall access to care by navigating the changes the PPACA will continue to bring. While we may be competitors out on the field, when it comes to the future of health care, it’s important for us to all be on the same team.

To check out the full spectrum of ways UnitedHealthcare is doing it’s part in Philadelphia click on www.uhctogether.com/philly.

Sue Schick with panel of health insurance industry leaders at the Greater Philadelphia Area Health Underwriters Conference

Philadelphia transit buses carry UnitedHealthcare's healthy living message throughout the city

I Get By With a Little Help from My Family & Friends

Treatment for and recovery from a serious illness or injury takes a physical and emotional toll. It greatly impacts our ability to carry out the everyday tasks of daily living. The routines we take for granted -- caring for kids, cleaning the house, cooking meals, buying groceries -- can become an enormous obstacle. Well-meaning family and friends want to offer their support, but are often too overwhelmed with feelings of sadness, fear or helplessness, and often their own lives, to know what to do. Sometimes, unintentionally, their efforts are misguided, creating even more burdens.

Recognizing the importance of organizing and empowering the friends and family who want to help, UnitedHealthcare created the Many Strong network, which connects your circle of supporters online to keep everyone updated and involved. It takes some of the weight off of you and those closest to you so your main focus can be healing.

Many Strong presents three valuable services for patient support:

Stay Connected: Your Many Strong network enables you to keep everyone in the loop with one status update. As exciting as a positive check-up is, you probably don’t have the time to call everyone individually. The network offers one centralized place for those concerned to get instant updates as well as offer words of encouragement and support. Additionally, it brings all of your supporters together to help each other through this difficult time. Your neighbor may have never met your son’s teacher previously, but this gives them the chance to discuss the best way to talk with him about how he’s handling the situation.

Organize Volunteers: Everyone is happy to help, but what really needs to get done? Seven casseroles on the table for dinner one night while Julia is stuck at soccer practice isn’t the most optimal use of volunteers. Many Strong features a volunteer calendar to prevent that from happening. You can post whatever needs to be done – a ride to treatment, someone to pick up grandmom from the airport, dinner for Tuesday night – and members of your community can sign up for the task and keep track of their scheduled duties.

Raise Funds: Medical bills can pile up quickly. Loved ones are often willing to pitch in to help with the unexpected expenses and Many Strong gives them one centralized, secure place to do so. Monetary donations are automatically loaded onto Many Strong Convenient Cash Cards, which are accepted anywhere you can use Visa. Gift cards are another option, available from hundreds of top retailers. The financial burden of an illness can sometimes be more devastating than the sickness. Many Strong allows your loved ones the chance to help prevent that burden from affecting your family long after your illness has healed.

Beyond just medical issues, Many Strong can be used any time you need a helping hand. Whether it’s the aftereffects of a fire or natural disaster, a military deployment or a new baby, Many Strong can make the difference between coping and having the family unit fall apart. When life comes at you with a difficult situation, it’s human desire to want to do something. With Many Strong, you provide the love and comfort; we just add the technology to make it easier for us all to connect.

For more information, visit https://www.manystrong.com.

 

Sounds Like a Plan; And Then Some

A veteran staffer in her 50s with two grown children, a married woman in her mid-30s with three children under age 10 and a single 20-something bachelor, all working for the same small business is quite typical in today’s diverse workplace. What’s also typical is the narrow choice of health benefit options they have to choose from. Until now.  On October 1^st, small business employees in the state of Pennsylvania will join small business employees in twenty-three other states who can choose from up to 30 different health plans to meet their diverse health care needs.

UnitedHealthcare’s Multi-Choice health plan for small businesses in Pennsylvania offers 30 different health plan design choices to employers - from comprehensive plans to just the basics. Each plan has different coverage levels, deductibles and premiums to best fit companies’ differing financial and coverage needs.

Being able to adjust premiums and deductibles allows small business employers to offer their employees choices without breaking the budget. The increased flexibility of the Multi-Choice plan actually makes health insurance more cost-effective and financially predictable, enabling small businesses to budget effectively for this important employee benefit. Providing an array of benefit options is becoming a crucial factor to meeting the affordability and cost predictability needs of small business employers while also serving the individual health care needs of their employees.

Employers can “one-stop shop” for any type of health plan they need without having to change carriers. They simply create a package of benefit designs, set the contribution level for those options, and then have each employee pick the option that best meets his or her needs. Based on the plans the employer selects, employees will have the option of buying additional coverage from their employer’s contribution level (or potentially purchasing less if they have fewer health care needs).

No matter which benefit designs employees choose, they will have access to UnitedHealthcare’s wellness and disease management programs, a 24/7 access to health advocates and a national network of more than 650,000 physicians and 5,000 hospitals. Small businesses also have the opportunity to combine the UnitedHealthcare Multi-Choice package with numerous specialty benefits, including dental, life disability and vision.

In the age of reform, health insurance is truly becoming more personalized. Companies are beginning to realize that the plan that keeps the bottom line healthy is the same one that will keep their employees healthy. Plans like Multi-Choice are taking workplace flexibility to a whole new level, with positive results for employees’ overall well-being.

 

 

Kids champion the fight against obesity

It’s that time again! UnitedHealth Group is putting out the call to all kids who want to be HEROES  by stepping into service to fight childhood obesity across the county and of course, where I sit in the state of Pennsylvania. We are partnering with Youth Service America to launch the fifth year of the UnitedHealth HEROES program, offering grants of up to $1,000 to youth-led, community-based programs and schools supporting the importance of health and wellness among our youth by encouraging kids to count their steps through walking, running, skipping or hiking. And we hope to have made it easier for them by encouraging them to use one of their favorite communication mediums…the social network.  Yes, we are suggesting that kids use the American Heart Association’s Walking Paths and/or OptumizeMe mobile phone apps to track their progress and invite their friends, family and community to join in the fun and fitness.

I’m proud to say that during the first four years of the program, nearly 1,000 UnitedHealth HEROES grants, totaling almost half a million dollars, have been awarded to groups across the country. Earlier this year I detailed the Pennsylvania 2011-2012 recipients. Last year’s programs were so innovative, I can’t wait to see what this year will bring!

To qualify for the grants, the youth-led childhood obesity prevention programs should include a service component that increases awareness, provides direct service, advocates an idea or raises funds to help slow the growing childhood obesity figures. The activities will, appropriately, begin on Martin Luther King, Jr. Day of Service (Jan. 21, 2013) and end on Global Youth Service Day (April 26-28, 2013).

More than 12 million children in the United States are obese, according to the Centers for Disease Control and Prevention. We’ve all heard such troubling stats before and recognize that childhood obesity is a serious danger. As adults, we know that healthy habits, including physical activity and proper eating, are the easiest and best way to treat and prevent obesity. But, we haven’t exactly been the best role models for our children. According to the CDC, more than one-third of U.S. adults are obese.

Maybe it’s time we let the kids give it a try. I know from my own experience as a mother that my sons are always teaching me something. Kids are dedicated, creative, focused and know what will work and inspire their peers, yet sometimes simply lack the means or adult attention to put their ideas in motion. That’s why these grants are so important. There are many young people out there trying to make a difference for themselves and their communities. Who better to mobilize into action against childhood obesity then children themselves?

Applications will be accepted until midnight EST on Oct. 15, 2012 and award recipients will be notified in November. To learn more about the UnitedHealth HEROES program and to apply for a grant, visit www.YSA.org/HEROES. Submit your application today and let’s give our kids a chance to set the example of healthy living for us all!

2010 UnitedHealth HEROES award winners

The Doctor Will See You…NOW

Yesterday I attended the Pittsburgh Business Group on Health’s 13th Annual Health Care Futures Symposium, “2014: Planning for the Short Term, 2018: Preparing for the Long Haul.” An employer-led, non-profit coalition of large, mid-size, and small businesses, PBGH promotes education, collaboration and innovation to drive and deliver value and quality in health care.  The symposium truly delivered on the Business Group’s mission.  Kudos to PBGH’s executive director, Chris Whipple for bringing a national agenda to Pittsburgh and creating and bringing an engaging day of cutting edge ideas to the largest Symposium audience to date, over 400 people.   

As a proud sponsor of the Symposium and a company committed to growing its business presence in the Pittsburgh community, UnitedHealth Group’s OptumHealth division, in partnership with Rite-Aid, presented its NowClinic initiative to the group.

As I mentioned in a previous post, NowClinic, which is available in 22 states, is a website where consumers can log on to their computer and connect with a physician using secure live chat and converse face-to-face using webcams. Doctors can review the patient’s health concerns and symptoms, discuss medications and assess the need for further treatment when necessary. In Pittsburgh and Harrisburg Pennsylvania, in addition to being able to log in from home, consumers can log in at their local Rite Aid stores. Many say virtual care concepts like NowClinic are transforming the delivery of primary health care by giving consumers access to inexpensive, round-the-clock care for routine problems, until they are able to see their primary care physician.  This is especially important in rural areas where primary care physicians can be scarce and in urban areas where it can be nearly impossible to get a same day appointment with your doctor.

How many times have you suffered through the weekend with routine sinus infection, nagging cough or bladder infection until you could get an appointment with your doctor on Monday? With its convenience and affordability, $45 per visit, the Now Clinic is designed to address the all-too-common occurrence of avoiding the doctor’s office because of time or money constraints, and addresses medical concerns early before they grow into more serious – and costly – problems. To date, the average Now Clinic user is over age 40, needs service during the weekend and visits with the Now Clinic doctor online for just under 9 minutes.

UnitedHealthcare’s Now Clinic project with Rite Aid  is a clear sign of health care’s future direction in the age of reform. The next decade will be all about creative partnerships and taking advantage of technical innovations to transform the delivery of primary health care with a stronger focus on preventative care and more engaged and better-informed consumers. 

To view a demonstration of how the Now Clinic concept works and read what USA Today said about the virtual doctor concept go to http://www.usatoday.com/money/industries/health/story/2012-04-27/virtual-doctors-telemedicine/54791506/1.

A clear sign of health care's future direction - taking advantage of technical innovations to supplement primary care

A Woman’s Worth…

These days it seems like businesses are looking to cut costs every chance they get, while also seeking to raise productivity and their bottom line. As we all know, these two don’t usually mesh.

There is one situation however, when the stars align, and productivity and cost-cutting come together – in programs designed to improve the health of female employees, providing benefits not only to them, but to the business as well.

According to the Bureau of Labor Statistics (BLS), women are about 60 percent more likely than men to miss work because of illness or injury. BLS also reports that women are more likely to take prescription medications. Therefore, working to get women healthy, and keep them that way, is a business must-do.

So what kind of programs can companies participate in that are easy to implement and help women get healthy? Check out some of the following ideas:

For busy women on the go. Health insurers are now giving employees mobile apps that place health care and insurance information at their fingertips wherever they are, enabling them to make more informed health care decisions in a way that is more convenient for them.

Make managing health care easier. Many insurers offer online resources that help their members manage health care and health care expenses. Some offer online resources and programs that specifically address women’s health, such as UnitedHealthcare’s source4women.com, which features online seminars, health and nutrition tips, a chat room and several blogs, all dedicated to women’s health issues. www.source4women.com

Focus on issues most important to women. Employers should consider programs that address women’s specific health needs, such as healthy pregnancy programs. But, smoking cessation, nutrition and weight loss programs, aimed at overall wellness, can help both women and men alike.

An ounce of prevention is worth a pound of cure. Employers can encourage female employees to get health screenings such as Pap smears and mammograms by giving them time off from work or scheduling flexibility to see their doctor.

Work together for women’s health. While a financial contribution is always helpful, employers can make a more meaningful impact by encouraging employees to volunteer for charitable events or serve on the boards of nonprofit organizations focused on women’s health. A recent report by VolunteerMatch provides compelling evidence that volunteering not only enhances volunteers’ physical and mental health but also strengthens relationships between employers and employees. 

The first step to putting any initiative into place should be to survey your employees to determine what workplace and personal issues might be preventing them from maintaining good health habits.  By focusing on wellness for women in the workforce, a company can strengthen its bottom line as well!

 

A UnitedHealthcare employee takes advantage of the cafeteria salad bar for a healthy lunch

 

The Season of Wellness

The pools are emptying, the beach chairs are being shoved into the garage and the back-to-school sales commercials are once again filling the airwaves. With the end of the summer season comes another hotly anticipated season, one that presents much opportunity and often, brings up many questions. Who’s top ranked? What’s the winning combination? Which one will give me the best coverage? Will I have enough time to make my pick? …I’m not talking fantasy football, I’m talking about open enrollment season.

Open enrollment season is when employees review and select their health benefits package for the following year. It gives them a few weeks to evaluate the options presented by their employers.

Employees will naturally want to know if the Affordable Care Act has affected or will affect their coverage or their premiums and some may be confused about the impact of the new health care law.

Employers can help employees during open enrollment by having their human resource director, benefits consultant or health insurance representative make group presentations about what’s changing and, just as importantly, what’s staying the same.  Two of the most notable changes include 100 percent coverage for a wide number of preventive services, such as mammograms and colonoscopies, without charging a deductible, co-pay or coinsurance, as well as the ability to keep dependents on a parent’s policy until age 26.

This year may also mark the first time that employees of many small businesses, with anywhere between two to 50 employees, will have more than a couple of benefit plan choices to choose from.   In the past, small businesses would typically only be able to offer their employees one plan design. But over the past year, many health insurers have begun offering multi-choice packages to small businesses to better accommodate varied employee needs. So, a 20-something single employee might opt for a plan with a higher deductible, while someone with children might prefer a lower one.

Health insurance can sometimes be a daunting proposition with confusing terminology and seemingly impossible choices. It’s imperative, therefore, that employers take this time to help guide their employees, ease their concerns and answer questions brought up by new regulations and options. Employees should also be encouraged to do their homework to become better educated healthcare consumers, and use the many online and mobile device tools insurance companies provide to help them in the decision-making process.  Better information leads to better decisions and better health!

UnitedHealthcare representative is on site at a local business to help employees better understand their health benefits