Sunday, October 28, 2012

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

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?

Wednesday, October 24, 2012

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 or  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. 

Friday, October 19, 2012

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 12th 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

Friday, October 12, 2012

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.

Monday, October 8, 2012

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

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