Sue Schick's Blog

2012-01-23T13:12:00.000-08:00

It’s alarming! More than one-third of all children between the ages of 10-17 in Pennsylvania are obese or overweight, according to the 2007 survey by the U.S. Department of Health and Human Services, putting them on the road to lifelong chronic conditions like diabetes and heart disease.

If left unchecked or untreated, obesity will affect 43 percent of adults by 2018 and add nearly $344 billion in that year alone to the nation’s annual direct health care costs, accounting for more than 21 percent of health care spending, according to America’s Health Rankings^®.

The numbers are staggering – but we can help slow or reverse this trend by altering the path we are currently on – by eating better, exercising more and making wellness a priority, especially for our children. Young people are leading the way to a healthier lifestyle through the UnitedHealth HEROES grants program, which we are involved in with Youth Service America.

Through this program, one of my favorites here at UnitedHealthcare, young people receive grants to implement solutions to help fight obesity in their schools and local communities. By focusing children’s energy, creativity and problem-solving capabilities, we are helping young people take action to improve their overall health and quality of life in a way that’s not only educational, but beneficial for their entire community.

This year, more than $187,000 in HEROES grants was awarded to 282 schools and community-based youth organizations nationwide, including these seven Pennsylvania programs:

· DeSales University in Center Valley to support the “Films for Fitness” program, a part of the University’s HOPE mentoring program that will educate middle school students about childhood obesity in the community and help them develop their own public service announcements about preventing it.

· The Nonprofit Partnership in Erie to work with a group of 16 high school students representing different Erie high schools and help them develop their own projects to mobilize and educate area middle school students about nutrition and healthy activity.

· Lionville Community YMCA in Exton for its “Kids 4 Community Health” campaign to help children in YMCA after-school programs learn about nutrition and physical activity and provide tools to help kids and families become healthier.

· Ligonier Valley YMCA to expand its nutrition education initiative with cooking demonstrations during its after-school program. The program also exposes kids to activities like rock climbing, swimming, jump rope, high ropes courses and running.

· Greater Susquehanna Valley YMCA: Milton Branch to support its weekly TGIF program and to purchase aquatic basketball hoops for its indoor pool and pamphlets outlining nutrition and exercise recommendations for kids.

· The Police Athletic League of Norristown for its 3-H AGE (Athletics, Garden & Education) program, in which students participate in academic tutoring, track and field and a youth garden that will grow vegetables for the local community.

· Diversified Community Services of Philadelphia for its “Food Fit Philly” program, a hands-on nutritional education and cooking club for students between the ages of nine and 11.

We can’t wait to join these groups during the 2012 Global Youth Service Day (GYSD) on April 20-22, as they roll out their programs – and look forward to ongoing work, ensuring that the benefit of these programs will continue to have a positive long-lasting impact on these young people and their health.

To read about all the 2011-2012 UnitedHealth HEROES grant recipients and their projects, go to www.ysa.org/HEROES.

The UnitedHealthcare Children’s Foundation (UHCCF), a nonprofit 501(c)(3) public charity, also strives to help children live healthier by providing grants to pay for medical services, treatments and equipment, and prescriptions that are not covered, or are only partially covered, by grant applicants’ commercial health insurance. For more on UHCCF, go to www.uhccf.org.

For 2012, Resolve to Keep it Simple

2012-01-09T07:28:00.000-08:00

It happens every year. We make resolutions to get healthier, exercise more, take better care of ourselves – and quickly break them. We’re “well”-intentioned, but we actually sabotage our own efforts by setting goals that are too big (e.g. vowing to hit the gym at 6 a.m. every day when you’ve never worked out before) and by wanting results too quickly. Change – and the willpower to sustain it – does not come that easy. That’s why I was particularly interested in a recent article that suggested taking baby steps to better health.

The Futures Company, a global research and consulting firm, notes that – “For a healthy 2012, think ‘simple.'” The Company stated that individuals view getting healthy as a complicated process. But, in order for New Year’s goals to stick, they must be as “simple, easy and seamlessly integrated into people’s lifestyles as possible.”

With this advice in mind, one of the simplest steps you can take to get moving in a healthy direction is to review your health insurance plan. Many plans offer health and wellness programs and other value-added benefits and resources at no additional cost.

Depending on your policy, you may be able to:

• Enroll in health reminder and other wellness programs to receive alerts as to when it’s time to visit the doctor for check-ups and annual preventive care, such as mammograms, vaccinations and physicals. In addition, many insurance plans offer education, health assessments and personal-support resources that can help guide expectant mothers through their pregnancies and individuals with diabetes and pre-diabetes, for example.

• Utilize electronic health records and prescriptions to more easily track medications and health histories. Tools such as these may help reduce medical errors, increase cost savings and improve health outcomes.

• Compare treatment costs – Some health plans offer tools that enable individuals to compare the quality ratings among physicians who participate in your health plan’s network, in addition to their cost, like UnitedHealthcare’s Treatment Cost Estimator® and its UnitedHealth Premium® designation program.

• Access 24/7 nurse care lines where trained, licensed nurses are available to answer basic health questions. They are especially helpful during after-hours or for minor health issues that do not require an immediate trip to the urgent-care clinic or emergency room.

• And most importantly, take a health risk assessment. Many health plans offer online health self-assessments that help people learn more about their current conditions and risks.

And while you’re on a roll, take a few minutes to schedule health appointments and screenings now. Let’s use the whole month of January, not to make empty resolutions, but to resolve to get in control of our health – and end the cycle of guilt and failure.

I want to wish all of you a very happy – and healthy – New Year!

A Time to Be Grateful

2011-12-22T06:03:00.000-08:00

I relaunched my blog this past September so I could share some of my thoughts on topics and issues that impact businesses and individuals in the Commonwealth, in particular health care. And, I thank all of you for joining in that conversation. Please keep your comments and feedback coming!

But now – as we continue through the holiday season – I wanted to share with you what I am most grateful for this year.

I am grateful to all the business, community and civic leaders who have embraced our efforts to help improve access to quality health care and help individuals here live healthier lives. Stay tuned – there is much more to come in 2012!

I am grateful for our team at UnitedHealthcare. Their tireless efforts to help improve the lives of individuals in the region through the work they do and the community efforts they support are an inspiration to me. We created our holiday card as a tribute to our team and the many community organizations they supported in 2011. Click here to see it.

I continue to be grateful for the endless words of wisdom my parents have imparted to me over the years – and their love and support. Those who know me have heard me say over and over, "There's always a way, if you are committed." Well, that's the voice of my father who's influenced me all these years.

And, most of all, I am grateful for the four men in my life – my husband and my three sons and the countless joys they bring me. I am so proud of them each day.

I want to wish you all a very happy holiday and a healthy New Year…

And look forward to continuing our dialogue around growing businesses here in the Commonwealth and building healthier communities in 2012.

Until then, be well.

Health Benefits Exchanges: Balancing Competition and Choice

2011-12-19T09:09:00.000-08:00

Over the past few weeks, there has been a lot more discussion surrounding health benefits exchanges here in the Commonwealth and across the country… and more people asking me about my views on them.

UnitedHealthcare is committed to be an active partner in the reform and modernization of the health care system. I would like to share our initial thoughts on the development of exchanges – ones that seek to maximize choice and competition inside and outside the exchanges.

“In order to provide affordable choices, exchanges must be developed in a way that supports competition among health plans by balancing the need for national uniformity with state flexibility and employer/consumer demands, while promoting responsible consumer behavior. This can be accomplished by:

• Developing fair marketplaces that provide a level playing field for all health plans, such as by applying the same open enrollment period rules both inside and outside the exchange and ensuring that exchange governance policies are not politicized.

• Fostering consumer choice by allowing insurers to offer a variety of plans for consumers both inside and outside the exchange.

• Promoting consumer and health plan participation in exchanges, including allowing employees eligible to enroll in small business health exchanges to choose any health plan offering within a specific level of coverage set by the employer, and maintaining a separate risk pool from the individual market to encourage participation among health plans.

• Avoiding duplication of existing state regulatory functions such as rate review to reduce administrative redundancies and delays in product availability, and to ensure seamless consumer eligibility, verification and enrollment.

• Standardizing health plan certification to promote competition among plans, improved administrative efficiencies and predictable product offering choices for consumers.”

To read more about health care reform, visit the UnitedHealth Center for Health Reform and Modernization -- http://www.unitedhealthgroup.com/main/generalcontent.aspx?id=997ff2df-71cc-4d13-a8df-87f55588f03d.

We look forward to engaging with you all in a robust discussion on exchanges and other reform measures as we look to provide access to high quality, affordable health care both here and around the country for all individuals.

I wish you all a very happy holiday season!

Pennsylvania Gains One in America’s Health Rankings, But Shows Little to Cheer

2011-12-09T06:13:00.000-08:00

Earlier this week, the United Health Foundation released the 22nd Edition of America’s Health Rankings®: A Call to Action for Individuals and Their Communities.

Pennsylvania moved up one spot to #26 from last year’s rankings, but this is certainly nothing to celebrate. While we saw an overall decrease in the number of smokers and improvement in high school graduation rates and other indicators, Pennsylvania, like the rest of the country, saw significant increases in the number of residents who have diabetes and/or are obese. But we do not have to continue this downward slide.

I would like to share with you the blog that Reed Tuckson, M.D., United Health Foundation board member and executive vice president and chief of medical affairs, UnitedHealth Group, posted earlier this week that not only illustrates the dire predicament we as Americans find ourselves in, but ways in which we can together address our stagnating health. I hope you find it as thought-provoking as I did.

Dr. Tuckson writes:

“Disappointingly, our nation’s health is stagnating. Today’s report finds that troubling increases in obesity, diabetes, and children in poverty are offsetting modest improvements in smoking cessation, preventable hospitalizations, and cardiovascular deaths. What this means is that the overall health of the nation did not improve at all between 2010 and 2011 – a decline from the 0.5 percent average annual rate of improvement between 2000 and 2010 and the 1.6 percent average annual rate of improvement seen in the 1990s. A compelling example of this stagnation is smoking and obesity: The Rankings found that, for every person who quit smoking in 2011, somebody became obese.

The result is millions more individuals with preventable illnesses, a veritable tsunami of chronic disease washing into an already overburdened health care system. With chronic disease affecting 130 million Americans and accounting for nearly 75 percent of these costs, we owe it to ourselves and future generations to act more urgently and creatively to confront these issues.

When it comes to challenges of this magnitude, it’s important to realize that 'we’re all in this together.' Government leadership is essential, but government cannot do it alone. The private sector, philanthropy and community-based organizations all need to join in a data-driven process to determine priorities and then recruit the broad range of assets necessary to address these priorities.

Individuals clearly play a role too. The subtitle of this report remains A Call to Action for Individuals and Their Communities. These are not just words but an urgent plea for comprehensive, innovative and sustained engagement. Whether it’s making a personal change like quitting smoking or exercising; supporting community initiatives that create safe and healthy environments in which to live and work; or creating health enhancing policies or programs, the point is that too much is at stake to leave these issues unaddressed. Now is the time!”

To find out more about the 2011 America’s Health Rankings, visit http://www.americashealthrankings.org/. You can also find and follow America’s Health Rankings on Facebook at www.facebook.com/AmericasHealthRankings and Twitter at @AHR_Rankings. Dr. Tuckson encourages us all to exchange ideas, share information and learn from each other as we work to turn the tide on the health challenges facing the nation – and Pennsylvania.

Recognizing Women of Distinction

2011-12-02T14:27:00.000-08:00

Earlier this week, I was honored to be among 25 women business executives being recognized by the Philadelphia Business Journal as “Women of Distinction.”

The Philadelphia Business Journal celebrated its 14th anniversary of recognizing women leaders who are having a positive impact on our businesses, our communities and our families here in the region – and I am humbled to be among the outstanding women who have received this honor. The women I shared the dais with this year are paying it forward, because, as fellow honoree Clara Rivas of WWSI Telemundo Philadelphia said, “We owe it to other women to light the road.”

In lieu of acceptance remarks, Lyn Kremer, publisher of the PBJ, challenged each us to write an 11th Commandment. Each and every response was inspiring, providing us a glimpse of what makes each woman a great leader and a sense of where her passions lie. For example, Patricia Miller of Nobel Learning Communities, Inc. deemed that “Thou shalt provide educational opportunities for all children – the cornerstone of a strong society.”

Improving our communities and ourselves, and educating our young people, were common themes, and each honoree was taking significant steps to address these issues – putting her words to action.

But like Clara, many of these distinguished ladies focused on their responsibility to lend other women a “helping hand” so they also might achieve their own lofty goals in business, the community and the home. Here are a few that stood out to me, and, while they may not be verbatim, I hope I have captured their essence.

Kamil Ali-Jackson of Yaupon Therapeutics Inc., reminded us all to do no harm to women who are trying to balance their lives, while Eunice Heath of The Dow Chemical Co. encouraged us to remove barriers so women can reach their full potential. That means helping those in need as well as accepting help from others, as encouraged by Irene Chang Britt of Campbell Soup Company.

We all cannot be Wonder Woman – and should not strive to be – but we can be the best CEO of our own lives, which means having a great team around you. In talking with many of these very special women, this philosophy is key to their success. While enabling others to reach their goals, they are also confident enough to ask for help in reaching theirs.

I think Lisa Nutter, awarded for her work with Philadelphia Academies, Inc., summed it up best – “Those who say it could not be done should not interrupt those who are doing it.” These inspiring women are helping change Philadelphia, the Commonwealth and beyond – so get out of their way.

I leave with you with my 11th Commandment, which partially echoes a UnitedHealthcare mantra and I try to remember it every day:

Don’t sleepwalk through life. Be present. Be here now. As Maya Angelou said, “Life is not measured by the number of breaths we take but by the moments that take our breath away.” I'm trying hard not to miss a single one of those moments, like tonight.

Wellness Comes to Philly Businesses – With Healthy Results

2011-11-23T05:48:00.000-08:00

Well, we all know that an apple a day is no longer the trick. Maybe because we dip that apple in caramel. Maybe because a day has morphed into a week.

Whatever the reason, we know that it’s become more difficult to get healthy and stay healthy, and the cost of keeping the doctor away has reached new heights.

And, if you watch certain reality TV shows, it looks like if you want to be fit and healthy, you need to work out seven hours a day and eat cardboard. So it is no wonder that millions of Americans throw up their hands and quit before they start.

But studies have found that it is the small, incremental changes that have the most long-lasting impact on our health. Employers can play an instrumental role in helping employees live healthier lives, which may also have a positive impact on their bottom line. The Wellness Council of America estimates that for each $1 invested in a wellness program, employers can save as much as $3 in health care and productivity costs.

This is why we teamed up with Philadelphia magazine for its Be Well Philly Challenge, an eight-week corporate wellness competition. The results were outstanding! The four finalists lost a combined total of almost 1,000 pounds! These teams came together at Lucky Strike last Wednesday to crown the 2011 Be Well champion, enjoy healthy food and bowl. Advance Audio Visual Sales took the top prize, garnering almost 1,500 pound and wellness points.

To build an effective wellness program, consider what the Be Well Philly Challenge participants and other area businesses are doing to create sustainable wellness programs:

• Develop a detailed plan that includes short- and long-term objectives.
• Set up a wellness committee and identify wellness champions who will help drive the program’s scope and implementation.
• Review data from past insurance claims, employee surveys, health assessments and biometric screenings to make sure you select wellness programs that combat the most common health challenges affecting employees.
• Offer onsite wellness programs, such as biometric screenings, health fairs and walking clubs.
• Encourage employees to participate in wellness programs by offering incentives like gift cards, lower health insurance premiums, cash bonuses, discounts and contributions to health savings accounts.
• Make sure you communicate often.
• Provide employees with online tools that simplify important tasks like keeping track of health care costs.
• Track results to evaluate both the wellness programs and how individual employees in the programs are doing.

We are committed to helping individuals live healthier and supporting companies that share that goal. While following these tips may help employers and their employees achieve results like our Be Well Philly finalists did, we look forward to partnering with more companies and community organizations to improve the health of our employees, families and friends here and across the country.

Have a very happy and healthy Thanksgiving holiday weekend!

Learn more about Philadelphia magazine’s Be Well Philly Challenge

Reform Through Cultural Transformation

2011-11-18T06:50:00.000-08:00

Last Tuesday, I had the pleasure of participating in the Philadelphia Business Journal’s inaugural “Health Care Innovation Awards” program. The event not only recognized some of the most innovative thought leaders in the area but hosted one of the most engaging health care panels I have heard in a long time.

When we talk about fixing the health care system, we often hear about innovation and technology driving change, but the panelists discussed a novel concept for the health care industry – the need to change the health care culture.

The main premise – to achieve long-lasting positive change, we need a culture in which ideas, visions and responsibilities are shared across all key stakeholders. When we can do that, we can break down barriers, develop multi-faceted approaches to solving problems and take advantage of opportunities to improve health care in this country.

But, cultural change is slow. It will require hard work and investments on many levels. Will it be worth it? The panel of experts said, “absolutely,” identifying five areas in which health providers, insurers and regulators could come together now in a “culture of collaboration” to improve our health system:

• Establish universal access to electronic health records;
• Improve coordinated care;
• Make hospitals safer;
• Share outcomes data and develop best practices to improve quality of care; and
• Enable nurse practitioners, pharmacists and other medical experts to practice to their fullest training.

I draw on the insights of one of the panelists, Rich Miller, CEO of Virtua and the Philadelphia Business Journal’s 2011 Health Care Innovation Awards’ “CEO of the Year,” to illustrate the concept. In the past, hospitals set goals based on occupancy rates – “heads in beds,” as he described it. Today, hospital leaders are discussing the need to keep patients out of those beds. Physicians will need to change their practice patterns, providing greater focus on wellness than sickness. Patients must change how they think and act when accessing the health care system. For example, non-critical care and preventive care services can be performed outside the hospital or doctor’s office – at their local pharmacies, for example.

Insurers will need to move away from their fee-for-service model, which rewards activity without regard to outcome. It will require that insurers become less transaction oriented and engage more as an insurer-activist… embracing sophisticated technology that leads to more and better data that is shared broadly to improve the health of the system and society as a whole.

Our collective goal should be a culture of care in which the five improvements mentioned above play a critical role, where patients receive the most clinically efficacious, cost-effective care in the right setting and at the right time by an appropriate medical professional to ensure the best clinical outcome.

We have learned from cultural changes of the past that results come from actively working together toward common goals – in the case of health care, an economically stable health care system and healthier Americans.

To learn more about the Philadelphia Business Journal’s Health Care Innovations Awards and the 2011 winners, go to http://www.bizjournals.com/philadelphia/news/2011/11/11/business-journal-healthcare-innovation.html.

Take a Stroll Down Health Care Lane

2011-11-04T13:51:00.000-07:00

With snow comes thoughts of the upcoming holidays, and walking down shopping streets and malls looking for the ideal gifts. But for UnitedHealthcare and millions of Americans, thoughts are on annual open enrollment season – and selecting the best health benefits for them and their families. But, according to a 2010 study by UnitedHealthcare, Americans spend more time choosing a car than they do selecting health benefits.

In a recent National Assessment of Adult Literacy (NAAL) survey, approximately 36 percent of all U.S. adults lack the necessary skills to read and understand basic information to manage their health. The study also revealed that 88 percent of all adults are less than proficient when it comes to understanding complex health care topics.

At UnitedHealthcare, we’re working to change that by arming employers and consumers with resources to help them make informed choices about their health plan options. We’ve found that accessibility to such information leads to better decisions and better health, which ultimately promotes affordability.

So we invite you to take a stroll down Health Care Lane.

Health Care Lane is both an online experience and a “brick-and-mortar” exhibit that bring the interactive website to life. Both versions of Health Care Lane are designed to improve consumer health literacy and help employers experience the many different health care programs they can put in place for their workforce.

As individuals stroll through this highly interactive town – either in person or online, they may visit the “Public Library” to learn about various health insurance terms and what UnitedHealthcare is doing about health literacy; the “Pharmacy” to get more information on managing prescriptions, keeping costs low and understanding the differences between brand-names and generics; the “Fitness Center” to find out more about wellness and preventive programs and healthy lifestyles; the “WiFi Café” to use online health tools and cost calculators; and the “Town Bank” to learn about financial tools and accounts, such as Health Savings Accounts.

While Health Care Lane is an engaging way to learn about health benefits, it is one of hundreds of Internet sites that provide consumers with good basic health and health benefits information. Or, visit a real library or fitness center or doctor’s office to get more information for better health.

As we near the beginning of the holiday season and the end of benefits open enrollment season – and our pending New Year’s resolutions, we encourage a trip down Health Care Lane or other health information destinations to get more educated and more engaged – so you and your family can live healthier lives.

Health Care Lane arrives in Philadelphia on Tuesday, November 8. For more information, visit www.healthcarelane.com/philly. We look forward to seeing you there. If you cannot join us in person, please take a stroll down Health Care Lane at www.healthcarelane.com.

The Challenge to Lead Change

2011-10-28T06:25:00.000-07:00

Last Friday, I had the honor of spending the morning with Gail Boudreaux, UnitedHealthcare’s CEO, while she was in Philadelphia keynoting The Forum of Executive Women’s 2011 Leadership Breakfast. Gail asked

the 600 business leaders, both women and men, in attendance to consider taking a more active role in transforming the health care system.

Gail encouraged the group to engage in the health care conversation as leaders, knowing that rising to the challenge involves change – not just thinking or talking about it, but accepting its inevitability, believing in its possibilities, and leading the charge to use it for inspiration.

Gail shared with the audience her own experience of adapting to change, describing UnitedHealthcare’s recent partnership with Sesame Street Workshop. “Accepting change urges us to think differently. Did I think a year ago that my business partner would be a Muppet?” Over the giggles of the audience, Gail added how excited she was that Elmo and the gang have joined forces with UnitedHealthcare to promote healthy eating in a fun and engaging way. She emphasized that it is partnerships such as this and opportunities to work collaboratively that will help solve the tough problems facing our health care system today. Remaining optimistic and solution-focused are also critical to making a positive difference in the future of our health care system.

I thought Gail struck a chord with her three challenges to the group:

· Go beyond your boundaries and embrace collaboration in a transparent way. Breaking new ground, we have to be open to something uniquely different to take advantage of the expertise inside all of us.

· Drive change through your organization. Each person casts their own ”leadership shadow” – and your actions can inspire others.

· Take time to personally make your employees aware and engaged in their health care choices. Do you take time to ensure that your employees are utilizing their health care benefits the way they should? Do you make your own health and wellness a priority, and do you see yourself as a role model?

One of the key themes that resonated with me from Gail’s presentation was that there are steps we can all take – both in and out of the office – that will help us be informed and engaged consumers, including understanding the costs of health care and making decisions based on research and data. In essence, Gail challenged the group to embrace what we tell our customers and employees as our own personal health care model.

I accept the challenge. Will you do the same?

UnitedHealthcare is bringing Health Care Lane to Philadelphia on Tuesday, November 8. For more information, visit www.healthcarelane.com/philly. We look forward to seeing you there!

Evolving Role of the Broker

2011-10-21T13:57:00.000-07:00

As temperatures begin to cool and the days get shorter, thoughts turn to the holidays and the hope for some time to reenergize before kicking off a new year. However, at UnitedHealthcare, we are busier than ever helping businesses find high quality, affordable health benefits solutions options for 2012.

But I did take time out of this hectic schedule to pause and spend some time looking beyond January 1, 2012. Recently, I had the pleasure of joining leading health insurance executives at a panel discussion hosted by the Greater Philadelphia Association of Health Underwriters. I thank GPAHU president Jerry McGlone and all GPAHU leaders for once again hosting a lively discussion on the issues impacting health care coverage today and in the future, including the evolving role of technology to empower consumers, the increasing focus on evidence-based guidelines, the heightened emphasis on wellness and the post-2014 benefits plans mix.

We also spent some time talking about health care exchanges and the ever-changing role of the broker. I have a special place in my heart for health insurance brokers since I spent about half my career working as a broker. A lot is being made about the imminent demise of the broker, but as Mark Twain once said “reports of my death are greatly exaggerated.”

Brokers are needed more now than ever before… and that will only increase as health care reform continues to roll out throughout the states. Brokers already have a “trusted adviser” status with many of their client businesses yet must evolve even further.

Employers will still play an integral role in either offering plans themselves or helping employees navigate as-yet developed health care exchanges. Businesses, especially smaller ones, will not have the time or resources to wade through the myriad of plan options, reform regulations and business incentives that will continue to roll out across the states and/or through federal health care reform… and this will be to their detriment.

Brokers can help employers take advantage of certain changes but must shift away from low-value tasks to make time for ones of greater importance to clients, such as helping create health and wellness solutions to address unique health and affordability needs. For example, our brokers have played an important role in helping us develop new plan designs and wellness programs and we stand ready to partner with them as we continue to meet the benefits needs of businesses.

And, brokers will become the “consumer educators.” Consumers who traditionally have been given one benefit plan – or maybe two options – will now have many choices especially when exchanges roll out in 2014 – and many are ill-prepared to make the best choice for themselves and their families. Who better to help them make those decisions than someone who has a unique vantage point on health benefit offerings? Enlightened brokers may become the best stewards to help clients and their employees navigate the ever-more turbulent health care market.

We look forward to enhancing our relationships with brokers and playing a vital part in their transformation – as we all hopefully share a goal to help individuals live healthier lives.

UnitedHealthcare is bringing Health Care Lane to Philadelphia on Tuesday, November 8. We look forward to seeing you there!

Breast Cancer Awareness Month - Who Needs It? WE DO!

2011-10-14T04:47:00.000-07:00

One year ago: 136 former cheerleaders, 1 pop singer and 2 passionate organizations launched a campaign to put the AWARENESS back into Breast Cancer Awareness Month.

Before I elaborate, I must first thank Sue Schick for this wonderful opportunity. Sue has been on the Komen Philadelphia Affiliate Board of Directors for two years... UnitedHealthcare of Pennsylvania, an avid supporter for longer. It is no exaggeration when I say that in that short time, Sue and UnitedHealthcare have helped bring revolutionary approaches to our breast cancer movement.

From simply sharing a blogging forum, to putting us on the worldwide stage, UnitedHealthcare invests incredible passion to create opportunities that empower our fight against breast cancer. They are always thinking of ways to do things bigger and better. This type of ambition drives our victories, for we can evolve, but breast cancer cannot… it has no new strategies to throw at us.

A look at National Breast Cancer Month (NBCAM) demonstrates this perfectly. Over the past several years the concept of this month has become harder for people to wrap their heads around. This is both good and not-so-good.

The positive: unlike 15 years ago, entire communities have grown so aware of breast cancer issues, and so vigilant in practicing early detection, they don't feel a need for a one-month observance to motivate action in the cause. The negative: huge populations still exist for whom this is not true; it is critical the communities that are "well aware" continue to talk about the disease and bring the rest into the awareness that saves lives.

Last summer, the Affiliate was feeling the negative impact of this lax attitude toward awareness. As you know, you can't go anywhere in October without being bombarded with pink. Every newscast contains breast cancer messages. Every church, school and organization holds a fundraiser. This inundation actually made people increasingly unresponsive to our calls to action. We asked ourselves: How do we engage our communities without giving them more of what they already tell us they have too much of?

Our answer was to do something we never did before – create a video. “Team Ra-Ras Kicks Breast Cancer” was launched on Youtube on October 4, 2010. As Exclusive Video Sponsor, UnitedHealthcare of Pennsylvania committed to donate 10 cents to Komen Philadelphia Affiliate each time the performance was viewed on YouTube up to a total of $100,000, or 1 million views…a benchmark obtained in under four weeks! UnitedHealthcare immediately presented us with a $100,000 check.

The company then presented us a challenge. It agreed to contribute an additional $50,000 when views of the “Team Ra-Ras” video reach 5 million, plus another $50,000 when it reaches 8 million views, for a possible $200,000 total contribution. So click on http://www.youtube.com/user/KomenPhilly#p/a/u/0/cfRSDbV8Adw and help us reach our goals.

Thanks in large part to UnitedHealthcare's ingenuity and generosity, the video exceeded our expectations, helping us rise above the disenchantment and mobilizing people worldwide to embrace breast cancer awareness. Reactions continue to demonstrate people of every generation long for connection and the knowledge they are not alone in a world where breast cancer takes 1,252 lives every day.

When asked to explain the real power of the video, I reference a Blog-Talk discussing about it. A caller from China saw the video and was confused as we talked about survivors living normal lives. In her understanding, a woman diagnosed with breast cancer had only two choices: cut off your breasts and live in shame, or die. This woman lived in such horrible fear, and there are millions like her. In took just four minutes to change her life… to make her AWARE of the reality… to instill HOPE that her children's world will not be one darkened by the shadow of breast cancer.

THIS is why we celebrate NBCAM every October… and I hope you continue to celebrate it with Komen, UnitedHealthcare and your loved ones until breast cancer is eradicated from our world. You can start right now by viewing – and sharing – Team Ra-Ras Kicks Breast Cancer.

Elaine Grobman, Executive Director
The Philadelphia Affiliate of Susan G. Komen for the Cure®

Paying Tribute to Nurses Who Make a Difference Every Day

2011-10-07T07:48:00.000-07:00

My job as CEO of UnitedHealthcare Employer & Individual of Pennsylvania has provided me the opportunity to meet so many special individuals – all striving to make a difference in the lives of the people they touch. The DAISY Award recognizes such people – nurses who provide exceptional levels of care and compassion.

This past Friday, I was pleased to represent UnitedHealthcare at The DAISY Award ceremony at Children’s Hospital of Philadelphia – or CHOP – and recognize nurses who insist that “they are just doing what they are trained to do” but truly go above and beyond the call of duty. I thank CHOP’s Steven Altschuler, M.D., CEO, and Kathy Gorman, R.N., chief nursing officer, for allowing us to be a part of this wonderful event.

The Barnes family established The DAISY Foundation in 2000 in memory of their son J. Patrick Barnes to create a lasting legacy to Patrick and to spotlight the extraordinary care that many of the more than three million nurses across the country provide to their patients and their families every day. Each month, nurses are selected by their nursing administration, peers and patients to receive “The DAISY Award for Extraordinary Nurses.” As of March 2011, more than 8,000 nurses at more than 800 hospitals have been recognized with this award. I’m proud to say that UnitedHealthcare provides financial support to The DAISY Foundation and that CHOP was our 94th DAISY hospital and 22nd children’s hospital to receive these grants.

Like many families, I have an extraordinary nurse story. Mine began when my first son, George, was born and we learned he would need six surgeries over eight years. After his first surgery, at age six, recovery was tough – but Nurse Gail was with us every step of the way, as health care provider, patient advocate, emotional rock, and, most importantly, friend. When George returned six months later for his second surgery, he was very scared – and as a young mother, I didn’t know what to do or say to comfort him. Then, out of nowhere, Nurse Gail appeared. She knew we would be there and had to check in on “her George.” When he saw her, he knew – and I knew – everything would be all right. My son is 23 now and perfectly healthy.

Throughout the years, we’ve reflected from time to time on the health care professionals who supported George. But almost every day, I remember Nurse Gail and the difference she made in George’s life.

I thank the Barnes family for turning their heartbreak into a “call to action,” encouraging those touched by nurses and their compassionate care to recognize these special caregivers. Bonnie and Mark, Patrick’s parents, have told hundreds of nurses over the past decade, “You may think what you do every day is routine, but please do not take what you do for granted. Appreciate the impact you have on so many people. Your patients and families – and everyone in their lives – surely do.”

While The DAISY Award recognizes nurses who work in a medical setting, I want to recognize the more than 7,000 nurses at UnitedHealth Group who help put our mission into action by improving the way health care works for people. The DAISY ceremonies spotlight nurses as part of the foundation to help people stay well, get well or live with illness.

To all DAISY Award winners – to my Nurse Gail – and all nurses for their extraordinary commitment to quality care and compassionate service – a heartfelt thank you.

Have you thanked a nurse today? To learn how, visit www.DAISYfoundation.org.

Embracing Innovation in Health Care…We’re All Turning Over a New Leaf

2011-09-30T07:23:00.000-07:00

On Tuesday, UnitedHealthcare of Pennsylvania was proud to join the Philadelphia Chamber of Commerce in presenting "Embracing Innovation in Health Care to Help Your Business Grow Healthy." The meeting’s keynote presenter -- our own Jeff Alter -- offered attendees a unique perspective combining his role as national CEO for UnitedHealthcare Employer & Individual and one of the company’s first executives “on the ground” when we entered the market more than eight years ago.

Jeff and the other panelists were there to talk about innovation but as I walked back from The Downtown Club contemplating the coming of fall, I realized that the overriding message each was imparting was about change – more specifically, that the constant change taking place in health care today is a good thing, provided we embrace it. It’s a great time to be in the health care business because we are in a position to affect positive, meaningful change if we collectively focus on simplifying the health care system for consumers, focusing on high quality, cost-effective evidence-based care and enabling Americans to live healthier lives.

This week’s program reinforced for me some key principles about change:

1) Thriving in a constantly changing environment requires embracing innovation;
2) Attitude plays an integral role in innovation; and
3) A positive can-do attitude needs to be shared by everyone.

Happily, the health care industry already has created a strong foundation on all three. Technology and other innovations like DocGPS and other consumer health apps, eSync, Premium Designation and “episode of care” treatment cost estimators demonstrate that innovation practically applied can help support consumers and businesses as they make more informed decision about health care. As for attitude, from physicians and hospital CEOs, to brokers, consultants and members, we share one goal – to improve the health of our communities – and are building partnerships to make that happen.

How can businesses leverage all this? What should you be doing to now to prepare for changes that will come as health care reform continues to roll out?

• Embrace consumerism. The next phase of innovation in health care truly centers around the consumer so everyone along the health care continuum must share information, simplify processes, and provide affordable health care coverage options so consumers can access health services in a more thoughtful way as each works to live a healthier life.

• Advance connectivity. Health insurers, physicians and hospitals, brokers and health educators have lots of information on health care costs, quality care, wellness initiatives and other programs that can make businesses and consumers smarter purchasers of health care – and hopefully more healthy. Innovative solutions utilizing innovative technology must be created so that access to knowledge is tailored to an individual’s needs so it becomes part of a health-conscious lifestyle.

In wrapping, Jeff challenged businesses to raise their collective voices to ensure that the needs of our economic drivers are being heard. Since the health care reform debate started in earnest in 2009, the business community has been relatively quiet. But it will be in the workplace – armed with tools from insurers, physicians, brokers and others in health care – where innovative solutions and ongoing education will have the greatest impact in driving down health care costs, enabling individuals to live healthier lives and addressing the long-term economic health and prosperity of businesses in the commonwealth and across the country.

I Don't Do It Alone - And That's OK

2011-09-22T13:52:00.000-07:00

Last week, while millions flocked to movie theaters to see Hollywood’s interpretation of a career woman trying to balance the often-times competing demands of work and family in “I Don’t Know How She Does It,” I was addressing the same topic in a more reality-based setting at a meeting of professional women in downtown Philadelphia. While we were all at different stages in our personal and professionals lives, we were seeking answers to the same questions. “How do I make my life what I want it to be?” “How do I ‘stay present’ in a frantic world?” “How do I set boundaries and priorities – and stick to them?”

I want to thank the Philadelphia Business Journal and its publisher Lyn Kremer, for hosting this wonderful event – and for the selection of venue. It seemed so appropriate to be talking about this topic at this place given that the present – and first female – president of the Union League Club, Joan Carter, was also a speaker.

As a full-time working mother of three sons, I ask myself the same questions our speakers and attendees were, and none of us claimed to have all the answers. But I do know this. Trying to balance your work and personal lives is a dynamic process requiring life-long adjustment, and you can’t do it alone.

My “aha” moment happened in a parking lot. Needing to work late, as I transferred my first two boys from my car to my husband’s, I received a wonderful chocolate pudding-mixed-with-goldfish crackers kiss from my six-year old. I asked myself “What am I doing?”

As sweet (literally and figuratively) as that kiss was, I thought, this craziness is not how it is supposed to be. After that, my husband and I decided that he would be a stay-at-home dad – and he is great! And, as a result, I was able to build my consulting work, and we were able to have our third child.

It was that experience, along with other changes I’ve implemented and mistakes I’ve made that have helped me keep work from overturning the “life boat." I'd like to share with you some key elements that have made my life-career balance possible.

Be intentional. Frequently ask yourself – “am I going in the right direction to make my life the way I want it to be?” If not, changes are in order.

Be honest. I was so busy trying to be Wonder Woman that I wasn’t being true to myself or anyone else. Remember, you don’t have all the answers and you can’t do it all – and that’s okay. Create a set of realistic priorities against which you compare all opportunities. At UnitedHealthcare, we call this our “Blue Chip Test” – whatever we have planned must stand up against this, or we don’t do it.

Be present. Take a few minutes before the end of each work day to quiet your mind, and just focus on breathing, counting backwards from 10. Then, when it’s time to go home, you’ll truly be present for your family. As part of our corporate culture at UnitedHealthcare, we ask our employees to be “Be Here Now,” requiring that individuals shut off cell phones, pagers, laptops and iPads to be mentally, as well as physically, present at meetings. And we encourage employees to apply such boundaries in their personal lives too.

It's hard to prescribe what "balance" is to each person. The solutions that worked for me may not be right for someone who gets her greatest joy and satisfaction from working 24/7. The most important thing is to find fulfilling work where flexibility is welcome. Don't be afraid to talk to your manager, your spouse and your children about your needs, and keep the conversation going about expectations of everyone involved in your life.

My best advice is to make whatever you define as balance work for you. What have you done to find your balance?

- Kenneth Frieson, Photographic & Media Arts

Ride 2 Recovery

2011-09-16T13:22:00.000-07:00

This past Sunday, we remembered those who lost their lives on September 11, 2001 and paid tribute to the many who helped in the days, months and years following that tragic day to reflect and rebuild.

In the days following 9/11, we turned to one another – family, friends, co-workers and even strangers – seeking comfort and drawing strength – to make some sense of this tragedy and begin recovering and rebuilding. We also were reminded about the many rights and privileges we so often take for granted.

Over the last decade, thousands of our servicemen and women have fought to protect and defend these freedoms from those who wish to take them away. Often they have returned home with devastating physical and emotional injuries. As part of the healing process, many of them have turned to cycling through an organization called Ride 2 Recovery.

Riding specially modified bikes, whether hand cycles, recumbents or tandems has proven to be a catalyst in healing physical and emotional injuries. I am proud to say that UnitedHealthcare is helping support their rehabilitation. For the second consecutive year, it is our great honor to be the presenting sponsor of Ride 2 Recovery events, most recently the 9/11 Challenge.

On Sunday morning under a hazy sky, more than 350 injured veterans and their families, friends and supporters, including 9/11 survivors and first responders, pushed off from Liberty State Park for a 540-mile, eight-day journey. The cyclists rode into Philadelphia on Monday afternoon and my team and I were so honored to join these brave men and women for an evening dinner cruise. I felt humbled talking to them and hearing their stories. Many told me that they were grateful for the support we provided to the Ride 2 Recovery but it is we who are most thankful.

The riders left Tuesday morning from the steps of the Art Museum – many of them stopping for a quick photo in front of the Rocky statue – before heading off to Lancaster. Today – Friday, September 16 – the riders will stop for a ceremony at the United Flight 93 Memorial in Shanksville, Pa., and on Sunday, September 18, arrive at the final destination -- the Pentagon. While they will celebrate having completed this ride, they also will remember their fallen comrades and reflect on the journey will all have taken over the last decade.

Throughout the ride, these cyclists face uphill battles, but through camaraderie and spirit, they will push through to the end. This shared determination reminds us that we gather strength from each other, and that connection to community is good for the mind, body and soul.

To all first responders and those in the military who continue to demonstrate bravery and self-sacrifice every day to keep America safe – a profound thanks.

Welcome Back

2011-09-09T05:51:00.000-07:00

Don't you think the first day of school is really like the first day of the year? A sharp Number Two pencil. New school shoes. A spring in your step. A renewed commitment to work hard and do well following a summer of rest and relaxation.

I feel the same way about business post-Labor Day... except we at UnitedHealthcare of Pennsylvania did not take a break this summer.

While you haven’t heard from me a lot over the last several months, we’ve been busy here at UnitedHealthcare. We've updated our product portfolio to include a broader array of high-quality, affordable health benefits options, enhanced our wellness programs, and expanded our network of hospitals, and physicians and other health care providers.

As with your lives, fall promises to be just as busy.

We’re excited to welcome our corporate executives to Philadelphia this fall to speak at the Greater Philadelphia Chamber of Commerce in September and the Forum of Executive Women in October. We will be recognizing leaders throughout our own region through events like the Philadelphia Business Journal's “Innovation in Healthcare" awards and Philadelphia Magazine's "Healthiest Workplace” competition. And, stay tuned for the return of "Healthcare Lane," our mega healthcare expo, which is coming to Center City Philadelphia in November.

Finally, be on the look-out for UnitedHealthcare’s "Grow Healthy" advertising campaign launching on billboards, radio and buses near you... just in time for back-to-school.

I look forward to reconnecting with all of you and will be here every Thursday, sharing insights into what is going on here at UnitedHealthcare across the Commonwealth and what we are thinking about for the future.

Welcome back and have a great fall!

Timing: Take 10 Healthy Steps to Resolution Success

2011-01-03T08:00:00.000-08:00

Whether it’s weight loss, exercise or quitting smoking, it’s easy to discard New Year’s resolutions as quickly as the New Year’s Eve party favors. This year, however, you can set yourself up for success with these simple suggestions:

Consider the spirit in which your resolutions are made. If you make a resolution on a whim, you're not likely to remember it after the clock strikes midnight.
Choose carefully. Make a potential list of resolutions. Choose one or two that you feel are most important. Balance a difficult resolution with one that will be easier to keep.
Take baby steps. Small changes over time can add up to big results. To exercise more, simply start by stretching during TV commercials. To eat healthier, begin by eating a piece of fruit every day after work. To clear clutter, set aside 15 minutes a day to organize your files.
Get it on paper. Jot down the steps you'll take to reach your resolution and include a timeline.
Enlist a friend. Knowing that you’re accountable to someone other than yourself for that morning walk can help keep you on track.
Complete the resolution in your mind’s eye. Visualize your resolution coming to life. See the positive impact it will have.
Be patient. Major changes take time, energy and dedication. These changes won’t happen overnight.
Reward yourself for the resolutions you’ve kept. Treat yourself to something special, such as fresh flowers, a good book or a massage.
Look for ways to keep your resolutions fresh. If your resolution is to eat healthier, don't bring the same boring salad for lunch every day. Try a new dish once a week to spice up your diet.
Focus on yourself. The changes are yours to make, and the rewards are yours to enjoy!

We wish you all a very happy and healthy 2011!

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

2010-12-27T08:00:00.000-08:00

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

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

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

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

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

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

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

2010-12-21T11:42:00.000-08:00

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

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

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

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

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

2010-09-24T08:27:00.000-07:00

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

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

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

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

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

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

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

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

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

2010-08-26T09:26:00.001-07:00

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

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

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

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

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

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

Companies can and do make wellness work on the job

2010-08-11T12:35:00.000-07:00

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

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

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

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

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

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

Here is a complete list of Healthy Workplace Award winners.

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

2010-08-04T06:35:00.000-07:00

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

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

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

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

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

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

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

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

2010-07-28T06:59:00.001-07:00

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

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

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

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

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

2010-07-20T12:53:00.001-07:00

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

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

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

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

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

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

2010-07-14T08:15:00.001-07:00

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

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

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

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

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

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

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

2010-07-08T14:39:00.001-07:00

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

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

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

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

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

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

2010-07-02T05:24:00.001-07:00

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

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

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

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

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

2010-06-22T07:31:00.000-07:00

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

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

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

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

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

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

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

2010-06-16T08:14:00.000-07:00

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

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

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

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

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

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

2010-06-09T11:02:00.000-07:00

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

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

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

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

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

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

2010-06-02T08:04:00.001-07:00

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

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

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

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

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

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

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

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

2010-05-25T05:34:00.000-07:00

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.

2010-05-20T08:18:00.000-07:00

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.

2010-05-17T11:54:00.000-07:00

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.

2010-05-10T07:02:00.000-07:00

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

2010-05-05T06:14:00.000-07:00

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

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

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

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

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

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

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

2010-04-13T10:31:00.000-07:00

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

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

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

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

Just click here for my donation site!

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

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

2010-04-09T05:12:00.000-07:00

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

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

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

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

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

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

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

2010-04-06T06:55:00.000-07:00

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

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

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

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

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

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

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

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

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

2010-04-01T09:02:00.000-07:00

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

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

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

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

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

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

2010-03-30T10:34:00.000-07:00

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

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

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

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

• A reminder to schedule an annual exam

• Tips on starting an exercise plan

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

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

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

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

2010-03-25T08:48:00.001-07:00

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

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

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

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

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

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

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

2010-03-23T09:09:00.000-07:00

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

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

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

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

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

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

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

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

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

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

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

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

2010-03-18T08:55:00.001-07:00

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

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

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

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

And me.

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

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

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

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

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

2010-03-17T05:48:00.000-07:00

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

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

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

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

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

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

2010-03-11T06:18:00.000-08:00

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

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

And now we have some results!

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

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

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

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

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

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

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

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

2010-03-09T06:06:00.000-08:00

Here’s something that’s really cool!

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

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

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

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

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

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

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

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

2010-03-04T08:43:00.000-08:00

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

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

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

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

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

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

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

• Closed networks bring down the cost of medical care.

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

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

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

2010-03-02T09:45:00.000-08:00

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

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

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

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

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

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

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

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

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

2010-02-25T05:47:00.000-08:00

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.

2010-02-23T06:11:00.003-08:00

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.

2010-02-23T06:11:00.001-08:00

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

2010-02-18T12:54:00.000-08:00

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.

2010-02-17T05:48:00.000-08:00

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.

2010-02-11T08:11:00.000-08:00

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.

2010-02-09T07:27:00.001-08:00

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.

2010-02-04T05:49:00.000-08:00

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.

2010-02-02T05:50:00.000-08:00

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.

Health savings accounts are growing and health care reform probably won’t change that.

2010-01-28T08:20:00.000-08:00

I recently read a study by Aon Consulting that shows once again how quickly the health savings accounts (HSA)-high-deductible model is growing as an alternative to traditional health plans. I’ve blogged about HSAs before, but as a reminder, an HSA enables employees to pay directly for their share of health care costs such deductibles, co-pays or other medial costs with pretax dollars, but can only be used in conjunction with a high-deductible plan. HSAs have only been around since 2004, when a federal law first allowed consumers to open HSA accounts.

Aon studied all consumer-directed health (CDH) plans. CDH plans allow routine claims to be paid from a consumer-controlled account, giving consumers greater control over their health budgets. Having payment responsibility encourages consumers to better understand the actual cost of their health care.

The Aon survey reveals that for the first time since health savings accounts (HSA) were made available in 2004, they have become the choice of more than half of the employers offering consumer-driven health (CDH) plans. Aon found that in 2009, 56 percent of all employers offering CDH plans paired them with HSAs, compared to a little less than 50 percent in the prior three years.

By contrast, only 35 percent of the employers opted for health reimbursement arrangements (HRA) in 2009, down from 44 percent three years ago. An HRA allows an employer to pay employees’ medical expenses with pretax dollars, however the employee does not have control over the account. Like HSAs, employers can only offer HRAs in conjunction with high deductible health insurance policies.

According to the Aon study, 44 percent of those surveyed currently offer CDH plans, up from 28 percent three years ago. These plan designs can be attractive to employers, especially for small businesses, because of lower insurance premiums.

I expect more employers will begin offering HSA plans as individuals become better health care consumers and play a more active role in how their health care is delivered and paid.

Have you improved your health or the health of others? A Villanova Wildcat fan? Tell us your story!

2010-01-26T12:35:00.000-08:00

Some Villanova Wildcat basketball fans are going to score big when they make a fast break to a healthier lifestyle or assist others in doing so.

UnitedHealthcare and Villanova University have teamed up to recognize people who have improved their health or the health of others in their family, community or work place. An "All-Star of the Game" will be selected based on submissions throughout the 2010 Villanova Wildcat basketball season.

UnitedHealthcare encourages "All-Stars" to submit their stories of improving their own health or the health of those around them. The Jay Wright radio show will announce the winners, each of whom will receive a $100 gift card to The University Shop and have a chance to win the grand prize of a $200 gift card to The University Shop, a basketball autographed by Jay Wright, and four tickets to the West Virginia-Villanova game on March 6, 2010.

Our All-Star program is an opportunity to put a spotlight on some of the great things people are doing to improve their health and the health of others in the community. This program really gets to the heart of everything that is important in health care today and is a visual demonstration of UnitedHealthcare’s commitment to help people live healthier lives.
Submit stories and get more details about UnitedHealthcare’s All-Star of the Game program at: www.uhctogether.com/nova

Are you ready to commit to a wellness program? Take the test and find out.

2010-01-26T09:53:00.000-08:00

One of the most important trends in employer-sponsored health insurance over the past few years is the growth of wellness programs. In fact, a number of recent surveys show that from 75% to 86% of all employers now offer wellness programs to help employees improve their health and lower future health care costs.

But offering programs and getting employees to use them are two different kettle of fish: A 2008 study by HR consultant Hewitt Associates found that few employees sign up for wellness programs.
     • A mere 4% of smokers took part in employer-sponsored smoking-cessation programs.
     • Only 5% of overweight employees signed up for weight-reduction programs.
     • Just 10% of employees with chronic ailments such as diabetes, asthma and heart disease took part in programs that address these problems.

There are many theories for why more people don’t sign up for wellness programs and experts have made many recommendations for pumping up that number.

But in my opinion these theories have very little to do the average person facing the very hard challenge of quitting cigarettes, losing weight or dealing with a chronic disease.

The simple truth is that if you’re not ready for a wellness program, it’s not going to work for you. Deciding to enroll in a wellness program is like anything else that represents a major life change. It’s tough to do. It’s tough to change your daily patterns, tough to get into a new routine, tough even to get yourself up for every session of the class.

So how do you know if you’re ready or not? Here’s a simple quiz we put together that will assess your readiness for a wellness program.

1. Do you have an illness or health issue for which you want to seek treatment or help?
Knowing you have an illness or health issue and resolving to do something about it is the first step in preparing for a wellness program.

2. Have you completed a health assessment?
Many companies and health plans that have wellness programs offer health assessments that typically can be done online or over the phone. The health assessment identifies any health issues that may require medical attention or a change in lifestyle. According to National Compensation Survey data, 55 percent of employees who take health assessments end up enrolling in wellness programs.

3. Have you tried to address your health issue by yourself and failed?
Many people who successfully lose weight, quit smoking or get their diabetes under control first had to endure a series of failed efforts on their own before considering getting help to tackle their health issue.

4. Is your health issue having a negative impact on your life?
It’s hard to change habits such as poor nutrition or smoking. But people often find the motivation to change when it’s taking a toll on their health and preventing them from doing the things they love to do.

5. Does your employer give you incentives for completing the program?
Positive feedback in the form of cash and other incentives can be a great motivator. For example, UnitedHealthcare offers employers a program called “Simply Engaged” that gives employees $75 for completing a health assessment, $25 for completing an online coaching program, and an additional $75 for completing a telephonic coaching program.

6. Does your company offer the program you need?
Don’t be surprised if they do. The programs that are most popular reflect the most pressing health challenges we face as a nation such as obesity, nutrition, smoking, diabetes, heart disease, and women’s health issues. A quick check with your human resources department or your company’s health benefits online tools can help you find the program that’s best for you.

Now you’ve taken the quiz and it’s time to score it. The more “yes” answers you gave, the more ready you are. If you answered “yes” to four or more questions, sign up right now!

Most women incorrectly think it’s safe to deliver a baby before 39 weeks.

2010-01-22T06:36:00.000-08:00

A couple of times I’ve blogged about the need to cut down on elective C-sections performed before women reach the full term of 39 weeks. It’s a risky procedure that ends up putting far too many newborns in neonatal intensive care units (NICU).

I have always wondered why women allow themselves to undergo a procedure that’s so risky for their newborn instead of waiting until full term.

A new survey answers the question. The survey reveals that most women don’t know delivering a baby before the full term of 39 weeks puts the newborn at greater risk than waiting until full term.

The study, by UnitedHealthcare and the Department of Obstetrics and Gynecology at Drexel University College of Medicine, found that 92.4 percent of the women surveyed believe that it is safe to deliver before 39 weeks despite the American College of Obstetricians and Gynecologists (ACOG) recommendation that scheduled deliveries should occur only after 39 weeks of gestation.

The study of 650 insured first-time mothers also found that 51.7 percent of respondents believe it is safe to deliver before 37 weeks of gestation, while73 percent believe that it is safe to deliver before 38 weeks. Shockingly, 24 percent believe full term is reached before 37 weeks of gestation.

Tina Groat, a physician who is the national medical director of Women’s Health for UnitedHealthcare, said it best: “The results of this study are quite compelling and underscores the importance of proactively educating female patients on the dangers associated with elective deliveries prior to 39 weeks.”

Research shows that babies born between 34-36 weeks are not only more likely to die than full term infants; if they survive they are more likely to develop cerebral palsy and have developmental delays than babies born full term. Also, a growing body of recent research reveals that newborns delivered prior to 39 weeks are up to two-times more likely to end up in NICU than babies born at 39 weeks, and are at increased risk for complications including respiratory problems, feeding difficulties, delayed brain development, and death.

Even though ACOG cautions against elective delivery by induction or C-section before 39 weeks of gestation, the rates of early births (between 34-36 weeks of gestation) are on the rise. Currently, more than 1.3 million C-sections are performed annually in the United States, often at an increased risk to newborns, according to the federal Agency for Healthcare Research and Quality (AHRQ).

A nationwide study published in the January 2009 edition of the New England Journal of Medicine found that 35.8 percent of elective C-section deliveries were performed before 39 weeks of gestation, while a recent review of UnitedHealthcare data for mothers and their newborns showed that 48 percent of newborns admitted to the neonatal intensive care unit were from scheduled admissions for delivery – many before 39 weeks gestation.

The objective of the new UnitedHealthcare attitudinal study was to determine women’s understanding of the definition of full term pregnancy, the gestational age at which it is safe to deliver an otherwise healthy pregnancy, and in turn, investigate consumer knowledge and attitudes related to C-sections and induced deliveries. The study, which used data from a survey commissioned by UnitedHealthcare, is part of an 18-month analysis by UnitedHealthcare of elective deliveries and the associated neonatal complications for babies delivered by early scheduled C-sections.

Based on the data of this study, UnitedHealthcare will begin to focus on engaging and empowering women through education and other resources to ensure that women understand the implications of the timing of delivery. Patient-focused initiatives will round out our effort to implement a holistic approach, both provider- and consumer-driven, to reduce neonatal risk. Over the past year or so, we have focused efforts on educating providers, including physicians and hospitals regarding the risks associated with these scheduled procedures.

MLK Day health and wellness fair empowers people to take an active role in their health

2010-01-20T09:01:00.000-08:00

For 15 years, the Martin Luther King Day of Service in the Philadelphia area has honored Dr. King by encouraging others to help make positive changes in the community. The Philadelphia Inquirer reported that some 70,000 volunteers were taking part in about 1,000 projects in the region during this past Monday’s MLK Day celebration. About 3,000 volunteers alone were at various activities at what was the epicenter of this year’s celebration, Girard College, where Dr. King once gave a speech to civil rights marchers.

UnitedHealthcare and AmeriChoice, another UnitedHealth Group company, were proud to be at Girard College this past Monday sponsoring one of the largest of the projects celebrating King Day, a health and wellness fair that focused on showing how much fun adopting a healthy lifestyle can be.

More than 35 health organizations in total offered exhibits and health screenings at the fair, including dental, vision, and health screenings, cooking demonstrations, a blood drive and a fitness workshop. Information was available on a variety of topics including Sickle Cell Disease, healthy bones, and organ donation.

Besides sponsoring the Greater Philadelphia King Day of Service Health and Wellness Fair, AmeriChoice and UnitedHealthcare provided:
• Healthy activities such as line dancing and music to help encourage people to adopt an active lifestyle.
• Children’s Activities such as a carnival and organized physical fitness activities.
• “Rapping about Prevention,” a program that teaches children about nutrition and food.
• The opportunity for parents to enroll their children in CHIP (Children's Health Insurance Program) and learn more about free and low cost health insurance for children 19 years of age and under.

What do health and wellness have to do with Dr. King, you might ask? The answer: Quite a bit. The Dr. Martin Luther King, Jr. holiday offers an opportunity to remind all Americans and especially African-Americans that health and wellness are a critical part of social and economic justice. Through line dancing, music, rapping and other fun activities, UnitedHealthcare’s Health and Wellness Fair encouraged people to take an active role in their health. AmeriChoice and UnitedHealthcare of Pennsylvania’s will continue to remind the Pennsylvania community to adopt a healthy lifestyle through its year long program, "Moving to a Healthier Lifestyle. I’ll share some of the good ideas from this program with you in a future blog. Together, we can be healthier!

Self-insurance can cut company costs

2010-01-14T13:08:00.001-08:00

Another way that larger employers can cut health insurance costs is by establishing a self-insured plan.
With a traditional health insurance plan, a company pays monthly premiums to the insurance carrier and the carrier pays for treatment costs and medical claims. If the claim costs exceed the premium amounts collected from the employer, the carrier pays the difference.

More and more employers are reducing their health insurance costs by turning to self-insured plans. Under a self-insured arrangement, the employer incurs the expenses for treatment costs and medical claims. The employer pays a specific amount to the insurance carrier to act as the claims administrator, process the employees’ claims and manage the benefit plans.
By not asking someone else to assume the health insurance risk, a self-insured plan typically lowers the overall program costs.

Self-insured plans typically work best for larger organizations, because the larger employee population enables the employer and insurance carrier to more accurately predict the expected claim costs. A large organization can also make the most use of the cash flow advantages created through self insurance.

To self insure, employers should find a health insurance carrier that can provide administrative support to a wide variety of health care plans and innovations, including health savings accounts, health reimbursement accounts, out-of-network options, preventive care and wellness programs. The carrier should also be able to provide fast and accurate claims processing, courteous service, periodic claim activity reviews and coordination of benefits when a spouse or significant other has other health insurance coverage.

Some ways to cut the cost of prescription drugs

2010-01-12T11:03:00.000-08:00

One of the factors contributing to healthcare inflation is the cost of prescription drugs. But employers can help lower the cost of their prescription drug plan by making sure that it allows employees to try some simple cost-cutting measures:
• Use of generics: Employees should be encouraged to ask their physicians to prescribe generic drugs when they are available and appropriate. With generic drugs, employees can get many of the prescriptions they need at the same level of quality, strength and purity as their brand-name counterparts at 30-60 percent less in price than the equivalent brand name product.
• Pill splitting: Under the guidance of a physician, pill-splitting programs can save individuals half of their copays. Pill-splitting programs, first introduced by UnitedHealthcare, allow physicians to prescribe twice the dosage and have the employee split them in half to get their regular dose, allowing the employee to pay one 30-day copay for a 60-day supply.
• Mail-order pharmacy: Ordering a 90-day supply by mail can often cut the copay cost, while saving monthly trips to the pharmacy for maintenance medications.

Even if an employer does not offer a prescription plan benefit, it can still suggest these cost-savings approaches to their employees to help them reduce the cost of their family’s health care.

Many small businesses don’t offer health insurance to employees. Here’s why they should.

2010-01-07T11:38:00.000-08:00

A sobering statistic popped out at me from the 2009 version of the Employer Health Benefits Survey annually done by the Kaiser Family Foundation and the Health Education and Research Trust: only 47% of businesses with 3-9 employees offer health care benefits, compared to 72% of firms with 10-24 employees, 87% of firms with 25-49 employees and 95% of firms with more than 50 employees.

Another recent survey, this one by the Association for Healthcare Research and Quality, found that the most likely small businesses to offer health insurance are those in mining and manufacturing, wholesale trade and professional services.

With or without health care reform, there are several good business reasons why all small firms should consider offering their employees health insurance as a benefit:
· Offering health insurance makes it easier to attract and retain good employees.
· If they purchase a consumer directed health care plan with a health savings account, employees and save for and pay for health expenses on a pre-tax basis.
· A healthier work force tends to be more productive and miss fewer days of work because of illness.

Most health insurance companies now offer a range of health care plans for small companies, including the innovative health savings account (HSA)-high deductible plans. A high deductible plan is typically the least expensive healthcare insurance option for a small business, while the HSA enables employees to pay for their share of health care with pretax dollars.

Know what that medical procedure is going to cost

2010-01-04T06:09:00.000-08:00

I just found out about another super-cool web-based tool that UnitedHealthcare is offering people in our health insurance plans that can make it easier to manage health care and health care costs.

It’s called a Treatment Cost Estimator and it can analyze data on hundreds of medical services, including 116 diseases and 3,000 prescriptions to help consumers estimate the potential cost of treatment. The Treatment Cost Estimator pinpoints fees for treatments and procedures specific to individual network physicians and geographic areas. It also shows real-time calculations of what their insurance will cover, including deductible balances and potential out-of-pocket costs. The Treatment Cost Estimator is particularly useful if someone is considering several treatment options.

UnitedHealthcare is now making the Treatment Cost Estimator available to all our members, striking another blow for simplicity and transparency in health care!

Intelli-series is making health insurance more competitive in Western Pennsylvania

2009-12-28T05:27:00.000-08:00

I think many people know that Pennsylvania, and in particular western Pennsylvania, is one of the most uncompetitive health insurance markets in the country. It’s a problem that the Pennsylvania Insurance Commission has recognized and is trying to address under Commissioner Joel Ario.

Competition always leads to lower costs and higher quality. Having more meaningful choices for health insurance gives individuals, employers and providers more negotiating power. This forces insurers to compete for customers by adding services, enhancing choices and reducing costs.

Pittsburgh’s healthcare insurance market became more competitive about 18 months ago when UnitedHealthcare and West Penn Allegheny Health System began offering Intelli-series health insurance plans.

Intelli-Series offers a wide variety of health care plans that encompass every recent innovation in health insurance, including health savings accounts (HSA), health reimbursement accounts (HRA), out-of-network options, disease management, preventive care and wellness programs.

Intelli-series enables employers and their employees to select traditional or more innovative plans that combine high deductible, open access insurance with either an HSA or HRA. A high deductible plan is typically the least expensive healthcare insurance option for a business, while the HSA or HRA enables employees to pay for their share of health care with pretax dollars.

Participants in any of the Intelli-series health insurance plans have access to a core network of providers that includes West Penn Allegheny Health System facilities such as Western Pennsylvania Hospital, Allegheny General Hospital and Forbes Regional, and other hospitals including those in the Excela Health System and Heritage Valley Health System. They can also access healthcare services at other regional hospitals and facilities for higher deductibles and copays.

In addition to this extensive local network, participants in any Intelli-series plan can also use UnitedHealthcare’s national network of more than 560,000 healthcare professionals and 4,800 hospitals.

The Intelli-Series is available to employers in nine western Pennsylvania counties: Allegheny, Armstrong, Beaver, Butler, Fayette, Greene, Lawrence, Washington and Westmoreland.

I keep getting asked about wellness programs and I keep saying the same thing: we have them and they’re effective… when people use them

2009-12-21T07:23:00.000-08:00

Sometimes I think we at UnitedHealthcare take it for granted that everyone knows about wellness programs. But maybe not so much, judging from some of the questions I get from clients, prospects and news reporters.

Wellness programs have become a really important part of health care. The theory behind wellness programs is that they lead to a healthier workforce and a healthier workforce leads to lower overall health care costs for employees and employers. In addition, healthier employees are more productive because they miss work less.

Like many large national health insurance companies, UnitedHealthcare offers a full range of wellness programs, including many online and some conducted by third-party vendors who are experts in their field. Our most popular programs are those that reflect the most pressing health challenges we face as a nation:

Weight reduction and nutrition
Diabetes management
Smoking cessation
Heart disease management
Women’s health issues

Wellness programs are part of many of the health care plans we offer both large and small employers. We have had wellness programs for decades, but over the last 10 years our wellness offerings have expanded significantly due to research that’s proven that preventive care and active involvement in one’s health care decisions are key drivers of better health outcomes and lower overall health care costs.

We can cure it, so why can’t we prevent it?

2009-12-14T05:44:00.000-08:00

One thing struck me as I perused through the 2009 America’s Health Rankings survey, which ranks the states on how healthy their citizens are: As a nation, we have become adept at treating many illnesses and diseases, but Americans are not modifying risk factors that contribute to chronic diseases.

Two risk factors, tobacco use and obesity, have emerged as the two leading preventable causes of chronic illnesses that threaten the health of the nation.

While tobacco use dropped from 19.8% of the population last year to 18.3% this year, approximately 440,000 deaths annually are still attributable to this preventable behavior. Over the past year, more than 3 million people have quit smoking, suggesting that smoke-free laws, smoking bans, increased cigarette taxes, access to smoking cessation programs and other interventions can make an impact.

Obesity is growing faster than any previous chronic health issue our nation has ever faced. Today, more than one in four Americans are considered obese. Obesity has increased nearly 130% since the first edition of America’s Health Rankings was issued 20 years ago. Currently, 27% of the population is obese. If current trends continue, 103 million American adults — or 43% of the population — will be considered obese in 2018, making obesity the nation’s next health battle.

The United States currently spends more per capita than any other nation on health care, including $1.8 trillion in medical costs associated with chronic diseases, such as diabetes, heart disease and cancer, which can be linked to tobacco use and obesity.

Every year, United Health Foundation teams up with the American Public Health Association and Partnership for Prevention to conduct the America’s Health Rankings survey. This year, United Health Foundation commissioned a supplemental report to help understand the financial impact of obesity. This supplemental “Future Costs of Obesity” report, written by Kenneth E. Thorpe, Ph.D., Emory University professor and Partnership to Fight Chronic Disease executive director, is the first to provide projections around future health care costs directly attributable to obesity that have been individually calculated for each state, as well as the nation. Left unchecked, obesity will add nearly $344 billion to the nation’s annual health care costs by 2018 and account for more than 21% of health care spending.

So how does Pennsylvania rank when compared to other states when it comes to our two biggest health challenges since 1990, smoking and obesity?

Here are the results.
2009 Pennsylvania State Ranking: 28th
2009 Smoking and Obesity Rankings: (based on a comparison of the incidence rates among all 50 states)
Prevalence of Smoking: 38th
Prevalence of Obesity: 36th

20-Year Ranking in Smoking and Obesity: (based on a comparison of the incidence rates in 1990 among all 50 states to today’s rates)
Prevalence of Smoking: 8% decrease in smoking from 29.3% in 1990 to 21.3% in 2009
Prevalence of Obesity: 15.8% increase in obesity from 12.5% in 1990 to 28.3% in 2009

It looks as if we in Pennsylvania have a long way to go in reducing the preventable causes of chronic illnesses.

New study shows that Pennsylvanians need to improve our health

2009-12-11T05:51:00.000-08:00

Every year, UnitedHealthcare’s foundation teams up with the American Public Health Association and Partnership for Prevention to conduct the America’s Health Rankings survey. The 20th edition was just released and the news for Pennsylvania is mixed. Pennsylvania ranks 28th among all states in terms of the health of its citizens (the lower the number, the better the ranking in all cases), which is in the lower half of all states.

One thing I noted in the survey is that in the past ten years, the incidence of obesity among Pennsylvanians has increased by an alarming 46%. And there has been a mind-boggling 59.5% increase in obesity among our African-American population. If obesity rates in Pennsylvania continue to rise at their current levels, obesity is projected to soon cost $13.5 billion or $1,455+ per adult, for state health care spending.

Here are some other areas in which Pennsylvania lags behind other states:
· High incidence of infectious disease – 40th/19.6 cases per 100,000 pop.
· High levels of air pollution – 47th/13.9 micrograms per cubic meter
· Low per capita public health funding – 41st/$49 per person

The study shows that Pennsylvania does have some strengths compared to other states when it comes to the health and wellness of our citizens:
· Low rate of uninsured population – 7th/9.7%
· High rate of high school graduation – 7th/83.5%
· Low geographic disparity within state – 8th/7.9 relative standard deviation

America’s Health Ranking” is the longest running report of its kind. For 20 years, the Rankings has provided an analysis of national health on a state-by-state basis by evaluating a historical and comprehensive set of health, environmental and socio-economic data to determine national health benchmarks and state rankings. The Rankings employs a unique methodology, developed and annually reviewed by a Scientific Advisory Committee of leading public health scholars.

Younger Employees Want Health Care on the Job

2009-12-09T05:27:00.000-08:00

Not that there is a lot of hiring going on, but I recently read another study, this one about what college seniors want in a first or second job.

Believe it or not, despite that old myth that young people think they’re invincible, more graduating students want health care benefits than want a retirement plan.

In the study, 19,000 graduating students from all 50 states ranked having a good insurance package a strong third behind opportunities for advancement and job security.

And when the same group listed which benefits were most important to them, medical insurance finished in first place, ahead of even annual salary increases and having access to a 401(k) plan. Moreover, only medical insurance, salary increases and 401(k) plans were mentioned by more than 50% of those surveyed. Women tended to think having a good insurance package was more important than men did.

These findings counter the long-time conventional wisdom that younger people prefer benefits that give them either more opportunity to develop their careers, like tuition reimbursement and bonuses, or more lifestyle flexibility, like vacations and flex-time.

The study was conducted by the National Association of Colleges and Employers, a national resource center for information about the employment of college graduates for more than 50 years.

Employers Still Paying Most of Healthcare Premiums

2009-12-07T11:06:00.000-08:00

I saw a recent survey that told me what I knew already: that even as employers seek to reduce costs, they still continue to pay most of the premium cost of their employees’ health care insurance.

That’s what the Kaiser Family Foundation and the Health Education and Research Trust (HRET) say in the 2009 version of their annual snapshot of employee health benefits, which just came out.

The study found that premiums on average rose about 5% across the country over the past year, and now stand at $13,375 per year for family coverage. Individual coverage now averages $4,824 per year across the country. Since 1999, the cost for family coverage nationally has soared by 131%.

Even as premiums continue to outpace overall inflation, employers are standing by their traditional commitment to help employees pay for health care insurance. Employers now pay about 73% of the cost of the premium for family coverage, the same percentage as in 1999. Employers currently pay about 83% of the premium for individual coverage, according to Kaiser and HRET.

And it looks as if employers on the whole are committed to holding the line on employee costs as much as possible. When asked for their plans for the coming year, only 21% of employers offering health care insurance said they were very likely to raise their employees’ contribution and only 16% were very likely to raise the deductible.

The survey reports that offering health care insurance remains a challenge to the very smallest businesses. Only 47% of businesses with 3-9 employees offer health care benefits, compared to 72% of firms with 10-24 employees, 87% of firms with 25-49 employees and 95% of firms with more than 50 employees. These numbers demonstrate that a lot of people in the work force remain uninsured. Health care reform similar to what the insurance industry is proposing would do a lot to address that challenge.

Another amazing online tool that helps people manage their healthcare

2009-12-04T05:10:00.000-08:00

The computer jockeys at UnitedHealthcare just came up with another online tool to help people manage their health care and their health care expenses…and it’s completely amazing!!!

It’s called the treatment cost estimator, and it can estimate the potential cost of many medical treatments.

The treatment cost estimator analyzes the cost data related to hundreds of medical services, including the treatment of 116 diseases and also 3,000 prescriptions. It can tell the user the fees for treatments and procedures specific to individual network physicians and to geographic areas, showing calculations and real-time adjustments for insurance coverage.

The treatment cost estimator can be especially helpful when considering alternative treatments. Patients now can know what it will cost before they see the doctor, which should help them get the best value for the care they need. Sweet!!

Planning to travel this winter? Take along more than a bathing suit and party clothes

2009-12-02T13:12:00.000-08:00

Whether it’s a week of relaxation on a quiet beach in the Bahamas or a weekend getaway to the Big Apple for a concert at Lincoln Center and some shopping—or at least window-shopping—, nothing can turn a dream vacation into a nightmare faster than a medical emergency. And with the swine flu epidemic raising concerns about the potential health risks of traveling, it’s important for winter vacationers to be prepared.

Travelers with a medical condition for which they take prescription medication or might need special attention in the event of an emergency should:

Carry prescription medications in their original containers in a carry-on bag and label them clearly.
Have their physician write a letter explaining the condition, its limitations, and prescriptions to carry with them in case of an emergency.
Obtain a copy of their personal health record and carry it with travel documents.
Always carry their health insurance card and understand the insurance company’s process for seeking medical care when traveling.

Understanding your health care insurance is especially important when traveling abroad on a winter vacation. To be fully prepared for a medical emergency when away from home, travelers should:

Carry an insurance identification card and a claim form with other important travel documents.
Understand how their health insurance coverage works outside of the United States. For example, some insurers like UnitedHealthcare offer extended coverage for international medical expenses.
Find out how the health care system and emergency treatment works in the country they plan to visit.

Anyone planning a trip out of the country should consult with his or her physician about additional vaccinations that may be recommended or required prior to traveling. Also check with your health insurer because not all travel-related vaccinations are covered. Physician visits should be scheduled four to six weeks prior to departure because most vaccines take time to become effective, and some must be given in a series, over a period of days or sometimes weeks.

When traveling abroad, keep in mind that in many foreign destinations there will be obstacles to communication that could make finding help in an emergency difficult. To ensure a language barrier doesn’t stand in the way of getting help, travelers should:

Contact the International Association for Medical Assistance to Travelers at the nearest U.S. embassy to find medical facilities and English-speaking doctors in the area where they plan to travel.
Learn the words for doctor, emergency, and hospital in the native language.

Now, “Bon Voyage” and don’t think about your job while you’re having fun!

AIDS in African-American Women Reminds Us Why We Need World AIDS Day

2009-11-30T05:12:00.000-08:00

As we approach World AIDS Day on Dec. 1, the troubling incidence of AIDS among African-American women serves as a potent reminder about how far we must travel on the long journey to eradicating this disease.

Health care professionals like to highlight the tremendous progress we’ve made in treating people with HIV and AIDS. The prescription drugs, long-term care plans and innovative treatments we’re providing to patients are all getting better. In general, Americans with HIV and AIDS are living longer and stronger lives. We’ve come a long way in the 25 years since the AIDS epidemic began. The World AIDS Day website, worldAIDSday.org has a lot of information about the history of our battle against this dreaded disease.

But we’ve so much more work to do to battle the spread of HIV among African-Americans, and particularly among women. The Centers for Disease Control and Prevention (CDC) reports that nearly half of the more than 1 million Americans living with HIV/AIDS are African-American and that 40 percent of the nearly 563,000 Americans with AIDS who died in 2007 were black.

Among all women in the U.S. living with HIV/AIDS, 64 percent are African-American. In fact, the rate of AIDS diagnosis for African-American women nationwide is 22 times the rate for white women.

The situation in Pennsylvania reflects the national trend: 67 percent of all women with AIDS or HIV in the Keystone State are African-Americans. This problem is even more pronounced in places like Washington, D.C., where the prevalence of HIV and AIDS among African-American women rivals that of Nigeria.

What’s most frustrating to health care professionals is that AIDS is generally preventable through simple changes in behavior, including increased use of safer-sex practices and testing.

Sadly, too many people – especially African-American women and young people – are not getting the message. According to the CDC, the U.S. has the highest rate of teenage infection in the developed world. Every hour, two Americans between the ages of 13 and 24 contract HIV.

We know that regularly testing those most at risk for HIV – and then providing antiretroviral drugs for HIV/AIDS patients – dramatically reduces the number of people who become infected. Without treatment or education, people will continue to transmit the virus to their partners.

Preventing HIV is not complicated. It takes the individual decision by every person who is sexually active to use safe sex techniques and to get tested. It takes people avoiding IV drugs and drug users vowing never to share needles. Treating AIDS is equally simple: it takes going to health care providers and following their instructions on how to manage the disease and slow its spread.

Many people avoid discussions of diseases that can be spread through sexual contact. But it’s better to talk about sensitive subjects than to let a lack of information threaten lives. Let’s hope that people everywhere, especially African-American women, hear the message of World AIDS day and find out how to protect themselves from HIV and AIDS.

A Checklist of Vaccinations to Keep You Healthy

2009-11-25T05:41:00.000-08:00

Earlier this week, I was talking about the fact that many adults forget to get booster shots for the immunizations that they had years ago. I came across a complete list of recommended vaccinations that I thought I would share with you. It’s at www.cdc.gov/vaccines.

Here’s some of the vaccines every adult should have, with a schedule of when they should get them and how often:

Tetanus, diphtheria, pertussis - Booster of Td every 10 years from age 19-65+
Human papillomavirus (HPV) for women - 3 doses between ages 19-26
Varicella (chicken pox) - 2 doses between ages19-65+
Zoster (shingles) - 1 dose for ages 60+
Measles - 1 or 2 doses between ages 19-50 yr, 1 dose after age 50
Influenza - 1 dose annually
Pneumococcal - 1 dose ages 65+
Hepatitis A, Hepatitis B, Meningococcal - based on medical and occupational risk factors

Don’t forget to follow the advice of your physician when it comes to both vaccinations and boosters.

Don’t Forget Your Other Vaccinations

2009-11-23T12:44:00.000-08:00

There has been lots of media attention on flu vaccines this year, and especially the vaccine for the N1H1 (or swine) flu, which has reached pandemic proportions throughout the world. People most susceptible to the swine flu should get the H1N1 vaccine, and that includes children, adults under 65 years of age, healthcare workers, pregnant women and people with asthma, other lung disease or heart, liver, kidney, blood or immune system problems.

But, even as people are clamoring for their flu shots, many adults are forgetting another important part of preventive medicine, booster shots for those immunizations most of us got as children years ago. Childhood immunizations can fade over time, and some vaccinations require boosters in order to stay effective. Depending on age and medical history, it may be time to update your own vaccination record.

According to 2008 data from The Center for Disease Control and Prevention’s National Health Interview Survey, only 63% of adults under age 50 have received a tetanus shot (Td) in the last 10 years, while only 52% have had a recent vaccination for tetanus, diphtheria and pertussis (Tdap). Only 25% of adults under age 65 with a high-risk status report having ever received a pneumococcal vaccination and just 17% of those between 19-49 received an influenza vaccine this past flu season, according to the NHIS (http://www.cdc.gov/nchs/nhis.htm).

A new kind of tetanus booster now offers added protection against pertussis, also known as whooping cough, and can help prevent the spread of pertussis among children who are too young to be fully vaccinated. Other recommendations include vaccines that protect against shingles, meningitis, hepatitis and human papillomavirus (HPV), which causes cervical cancer in women.

And the winner is…

2009-11-19T05:33:00.000-08:00

In my last blog, I bragged about UnitedHealthcare’s “All Star of the Game” program that honored Penn State football fans who have done something to improve their own health or someone else’s…but I didn’t mention the winner! Ooops!!

And the winner is…

Susan Day of Gardners, Pa., for leading her team in tackles against a devastating disease. And for her tireless work, UnitedHealthcare and Penn State Sports Properties awarded her the Penn State football “All Star of the Game” grand prize.

Day received the grand prize for working with family and friends to start the Angels for Alyssa foundation to raise research funding for Methylmalonic Acidemia (MMA), a rare genetic disease that causes developmental delays, seizure, hypoglycemia, stroke, coma and even death. Day had lost her nephew Blake to MMA and later became a champion for a cure when her niece Alyssa was diagnosed with the disease.

In addition to naming her All Star of the Game, UnitedHealthcare donated $2,000 to the Angels for Alyssa foundation to help it continue its commitment to finding a cure for Methylmalonic Acidemia.

All of us at UnitedHealthcare are inspired by Susan’s work with Angels for Alyssa. Her dedication gives other children and families suffering from this debilitating disease hope that someday there will be a cure. She is a true All Star in the fight against MMA.

The real all-stars who help other people

2009-11-17T05:30:00.001-08:00

UnitedHealthcare of Pennsylvania just completed what’s called a promotional program that allowed me to get to know a little bit about some very special people, this season’s nine Nittany Lion Fan “All Stars of the Game.”

UnitedHealthcare partnered with Penn State Sports Properties at the beginning of the 2009 college football season to honor Nittany Lions fans who are working to improve their own health or the health of others in their family, community or workplace.

Each “All Star of the Game” received a $100 gift certificate for Penn State merchandise and a chance to win the grand prize, a $200 gift certificate plus tickets and tailgate passes to the Nov. 14 game against Indiana University.

We recognized a total of nine All Stars this Penn State football season: Susan Day of Gardners, Pa, John Page of Downers Grove, Ill., Katrina Domkowski of Dallas, Pa., L. Ramon Beiler of New Berlin, Pa., Greg Underkoffler of Myerstown, Pa., Dan Mosel of Harrisburg, Pa., Peter Augulis of Wayne, N.J., Cynthia Wolf of State College, Pa., and Yvonne Dunn of Lewistown, Pa.

All nine of these All-Stars did something great in their community. John Tull of Penn State Sports said “it was one of the most meaningful community promotions I have ever been involved with in my 20-year sports marketing career.”

More Neat Stuff: Medical Swipe Cards

2009-11-13T06:18:00.000-08:00

There is a simple way to reduce health care costs and improve coordination of care and patient satisfaction: widespread adoption among doctors, hospitals and health insurance companies of magnetic stripe health care ID cards.

Everyone with health insurance has a card that they give to the receptionist at the doctor’s office. The receptionist usually makes a photocopy of the card and then fills out all the forms by hand or through repetitive data entry to file a claim with the insurance company.

With a health care ID card that uses magnetic stripe technology, the patient simply swipes the card through a device similar to a credit card terminal, and the physician’s office has access to all appropriate patient-eligibility information and personal health records. Some of the information will even automatically populate into the claim form for the physician’s office staff with the swipe of the card, enabling them to submit claims online and receive approvals from the insurance company in a matter of seconds.

The new cards have a number of built-in protections for consumers – information is never stored directly on the card, and access through the card can only be made with the patient’s permission.

Unlike many other industries facing revolutionary new technologies, the medical industry has been slow to adapt swipe card technology. In fact, according to a recent survey published in the New England Journal of Medicine, just 17 percent of all physicians’ offices use any kind of advanced card technology.

Imagine the savings in administrative costs to both health care providers and insurance companies if most or all health care facilities used swipe cards. Millions of administrative transactions per day would become faster and easier. In fact, the Medical Group Management Association (MGMA) estimates that machine-readable patient ID cards could save physician offices and hospitals as much as $1 billion a year by eliminating unnecessary administrative efforts and denied claims. MGMA recently launched a campaign to promote machine-readable cards.

The cost to install card readers is relatively minor, and once installed, the swipe card soon pays for itself in lower administrative costs.

I encourage all health care providers and insurance carriers to adopt swipe card technology using the new universal standards. Other industries have seen rapid adoption of information technologies that lead to cost savings and quality improvements. The health care industry has an opportunity to follow suit, and thereby make a tremendous impact in reducing costs, enhancing quality and playing a critical role in positive health care reform.

More Neat Stuff: Tracking Medical Expenses

2009-11-11T05:25:00.000-08:00

Employers have long asked insurance companies to make it easier for employees to keep track of medical expenses.

With the growing trend toward employees taking more ownership over health care decisions, employers have been concerned about getting their employees the information they need to navigate the complexities of health care. For example, research that Intuit Inc. conducted found that many people are overwhelmed by the paperwork associated with receiving medical care.

A number of health insurance companies have begun offering software that helps employees track their health care expenses online. This software works in real time to pull information from an employee’s health care claim making it easier to track doctor visits, prescriptions filled and account balances. The software complies with privacy laws and keeps the information confidential. At UnitedHealthcare, we use Intuit’s Quicken Expense Tracker.

Expense Tracker helps employees better navigate the health care system in several ways by:

Showing the calculations behind the amount billed and what is owed for each medical bill.
Giving the current status of the user’s deductibles and out-of-pocket spending and tracking medical expenses for tax reporting.
Sending email alerts if a claim has an outstanding balance after insurance payments.
Defining health care terms and codes in easy-to-understand language, which increases the user’s knowledge of health care.

Use of expense tracking software is voluntary on the part of employees. While larger employers have been the early adopters, more and more small business owners are making it available to their employees, too.

Women Have Arrived…

2009-11-09T05:24:00.000-08:00

We’re all the rage. Just pick up any business journal or life style publication and you’ll see why; as managers, executives and entrepreneurs, women are taking over as leaders in the corporate world. But what these articles don’t say is that it isn’t any different at home. In many households today, women are acting as the Chief Health Officer (CHO) and taking on the difficult job of managing their family’s health care.

I was recently appointed CEO of UnitedHealthcare’s Pennsylvania region, and nothing could have better prepared me for this role than my experience as the CHO of my own family’s health care. One of my three children was born with a serious health problem that has required seven delicate surgeries, so I have spent more than twenty years managing difficult decisions on both sides of the health care system.

As both a CEO and CHO, I know that keeping up with a family’s health care is a challenging job for any woman. Thankfully, UnitedHealthcare has launched an innovative new online community called Source4Women that has the tools a busy woman needs to simplify and personalize health care decisions.

The website has comprehensive information on health, wellness and disease management along with tips, checklists and support groups tailored for women at different stages of their lives. Interactive resources make everyday tasks like finding a doctor, keeping track of expenses and making healthier lifestyle choices easier with everything from physician ratings to recipes to open forums with health care experts.

Most importantly, Source4Women is a place where we, as CHOs and CEOs, can go to share our stories and show support. It’s an incredible challenge to make the right health care decisions for yourself and your family and we can learn a lot from each other’s experiences. That’s why I want to hear how other women are tackling the issues of health care today while also managing to move ahead in the business world. Feel free to share your thoughts and comments as fellow family health care gurus, and join the community at www.source4women.com.

Stop Elective C-sections, Reduce Infant Mortality

2009-11-05T05:08:00.000-08:00

A report I read about yesterday in the New York Times and heard on NPR reminded me of an earlier topic I blogged about a few weeks back: the alarming number of babies delivered through premature elective Caesarian sections (C-sections). According to the report by the National Center for Health Statistics, the United States has a disturbingly high infant mortality rate – a strain on the entire health care system – and it’s mainly because of premature births.

The report nails down the increasing number of C-sections used to deliver babies before the full 39 week term recommended by the American College of Obstetricians and Gynecologists as one of the major factors leading to such shocking mortality statistics. Newborn babies delivered before full term are at risk for serious health complications and in too many cases, don’t survive.

So why such a high number of premature C-section births? Research shows there is a sharp increase in C-sections and the reasons vary, ranging from avoiding holiday hospital stays to scheduling around vacation plans. But whatever the reason mothers and physicians schedule elective C-sections before a pregnancy reaches full term 39 weeks, it’s downright dangerous. A growing body of research reveals that newborns delivered prior to 39 weeks are two-times more likely to end up in the NICU than babies born at 39 to 42 weeks.

That’s why UnitedHealthcare is working with physicians, hospitals and the March of Dimes to reduce the number of elective C-sections. We’ve shared the startling data with all OB/GYN doctors and 4,800 hospitals in our national network and now inform all expectant parents of the risks in our pregnancy pamphlets and online resources. And it’s working. Since we began to spread the word, there has been a 46% decline of NICU admissions!

As anyone can see in the New York Times report, premature births are dangerous, costly, and far too common. If we keep working to eliminate elective C-sections and allow newborn babies to grow to full term, we can not only reduce the cost of health care, but also significantly lower the number of infant mortalities in the United States – a saving grace for the health care system, and a relief to all parents.

More Neat Stuff: Nurses manage chronic diseases over the phone

2009-11-04T05:01:00.000-08:00

Once a month like clockwork, thousands of people with UnitedHealthcare insurance get a call from a nurse about their chronic condition, usually heart condition or diabetes. The nurse discusses with them how they’re feeling, answers any questions and reminds the patient of prescription refills and doctor’s visits.

These people are all in UnitedHealthcare’s disease management program designed to help improve the health of members with heart failure, coronary artery disease and diabetes.

People in the program have told us they like the personal attention of the regular phone call because they get to talk to a medical professional about their problems without having to pay a co-pay. Some end up spending more time on the phone with the nurse than they would at a short office visit with a physician. And they have to go to fewer physician appointments, which saves them both time and money.

I know of one patient in our disease management program with heart disease, who developed a frequent cough. When he told the nurse, she thought it could be a side effect from one of his medications and suggested he check with his doctor. He followed her instructions and was prescribed a substitute that worked without the side effect.

UnitedHealthcare’s disease management program attempts to manage the “whole person,” by augmenting the calls from the nurses with referrals to social workers and dieticians. The goal is to assist the patient in integrating their physicians' treatment plans into their lifestyle. Some participants receive phone counseling once a month, others more often.

We're Giving Money Away

2009-11-02T12:08:00.000-08:00

Since it’s open enrollment season, I’ve been reviewing all the great new and recent programs we have at UnitedHealthcare that help our members lead healthier lives or cut costs out of delivering health care. I don’t want to break my arm patting UnitedHealthcare on the back, but it really is amazing how much neat stuff we’re doing! I think I’ll spend a couple of blog entries talking about some of it.

One really great program is SimplyEngaged, which offers incentives to people who take an active role in improving their health. Our members who participate in the SimplyEngaged program receive a $75 reward for completing a health assessment online or over the phone. Then, based on personal results they are given recommendations for how to go about improving their health. Those who take advantage of tools like online or telephonic health coaching receive an additional $25 reward.

When Cattron Group International, a Sharpsville, PA-based manufacturer of radio remote controls, began to offer SimplyEngaged as a way to make its new insurance plan more attractive to employees, an older workforce who never saw preventative care as a high priority, the possibility of earning cash in return for better health was a cause for action.

So far, 365 Catron employees have enrolled in SimplyEngaged, 93 have completed the health assessment and received the initial $75 reward and 69 have gone further to participate in health coaching and other programs. Some of the most popular programs among employees at Cattron are the healthy lifestyles and health trackers programs as well as the personal health record.

One of the keys to the program’s popularity is that participation is confidential. Employees initiate the program themselves by completing the assessment and receive the financial rewards directly from UnitedHealthcare. This ensures compliance with HIPPA regulations and creates a boundary between the organization and employees’ personal lives.

Cattron likes Simply Engaged because so far it has helped increase the health literacy of its workers and made them more proactive in managing health concerns like hypertension, high cholesterol, diabetes and arthritis while improving their overall wellness. With the help of Simply Engaged, they’re cashing in on better health.

But Do People Like It?

2009-10-30T10:51:00.000-07:00

I’ve spent a lot of blog space recently talking about the benefits and features of a new type of health care insurance, the HSA-high deductible combination. For those who just came on board, an HSA, or health savings account, enables employees to pay for their share of health care with pretax dollars and is offered in conjunction with a low premium, high deductible healthcare insurance policy. Employees can save money in the HSA tax-free and draw out funds anytime they want to pay for the premium, deductibles, co-pays or other medial costs. Employees don’t have to spend what they put into an HSA by the end of the year.

But do people like the HSA?

Survey says….Yes!!!

A 2009 study by OptumHealth shows that once employees open an HSA they are delighted with the coverage. In the study, 82% of the respondents—all HSA owners—said that they are fully satisfied with the plan, while 78% believe that the HSA option should remain a health care option no matter what happens in future health care reform.

America’s Health Insurance Plans (AHIP), the trade association of health care insurers, surveys how many people are covered by HSA-high deductible plans once a year. Recent AHIP figures demonstrate that in the past two years, the number of people enrolled in HSA plans has grown by 90% and now stands at 6.1 million nationally, broken down as follows:

Small groups: 1.8 million
Large groups: 2.8 million
Individuals: 1.5 million

Among these 6.1 million are large numbers of people who did not have health insurance before establishing an HSA and taking a high deductible plan. A 2007 AHIP study found that 27% of people with HSAs in employer-based plans were previously uninsured. A study by Golden Rule Insurance, a UnitedHealth Group company, found that an even larger percentage of individual-based HSA buyers—a whopping 40%—were previously uninsured. Based on these two studies, OptumHealth Financial Services estimates that nearly 2.5 million previously uninsured people have gained coverage through HSA plans through January of 2008. And a 2009 OptumHealth survey estimates that 3 in 10 holders of HSA plans say that if it weren’t for the HSA option, they wouldn’t have health care insurance at all.

The HSA-high deductible combination has been particularly popular with two groups that insurance carriers and brokers have had difficulty serving in the past: small businesses and employees with relatively low incomes. We find that among UnitedHealthcare participants, 74% of all small businesses now select the HSA-high deductible option, as do 64% of all employees earning less than $25,000 per year.

So yes, people like the HSA, and with reason: it saves money and if it’s structured right, also helps to improve the quality of care people receive.

Not Every HSA is Alike, Part 2

2009-10-28T06:12:00.000-07:00

In my last blog entry, I reminded you of the advantages of an HSA-high deductible health care plan that does not include preventive care in the deductible. If preventive care is not included in the deductible, then the employee does not have to pay anything additional (other than a co-pay) for annual exams, pap smears and other preventive care.

Here are some other variations in HSA plans that can make all the difference to the people in the plan:

The plan should allow the employer to make contributions to the HSA. Employers can facilitate employees opening HSAs by either giving them a one-time or regular contribution. The regulations governing HSAs enable anyone to contribute, but when employers make a contribution, a greater percent of employees are likely to open an account.
The plan should have those features employers want now. While some employers are interested in bare bones plans that may only pay for long-term hospitalization, we have found that among employers of all sizes, the current widespread attitude towards health care benefits is to provide certain core components of basic health care:
- Emergency care
- Preventive care
- Prescription drugs
- Long-term hospitalization
There should be online capabilities to manage HSA expenses. Many people are reluctant to try an HSA because of the increase in paperwork that’s required to figure out when the deductible limit has been reached. Being able to access all these records on-line 24/7 makes it much easier for employees to manage their health care costs.
The plan should include some access to wellness programs. Because HSA plans tend to make consumers more aware of costs, they also tend to influence consumers to take actions to maintain or improve their health. For example, a 2008 survey of its members by the Blue Cross and Blue Shield Association found that people with HSA plans are one-third to one-half more likely to use health screening, exercise and health coaching services, compared to traditional health plans that also offer these preventive and wellness services for free.
The insurance should include extensive training and support.

Employers and individuals cannot assume that all plans are alike. For the near future at least, carriers will continue to introduce innovative features to the HSA plans they offer.

Not Every HSA is a Alike

2009-10-26T05:58:00.000-07:00

I forgot to mention an important fact about health savings accounts. They’re not all alike, and the differences between many the plans that are offered may determine if people will actually benefit from this insurance innovation.

Surely the most significant difference in HSA-high deductible plans is whether or not the health care plan includes preventive health care such as annual checkups, pap smears and mammograms as part of the deductible. These routine exams help to find and prevent serious illness, but if they are part of the deductible, employees in the HSA have to pay for them, up to the high deductible limit. If they are not part of the deductible, they are covered 100% by the health plan, meaning that employees are more likely to go to the doctor for these important exams and thus more likely to remain healthy.

Our studies show that participants in HSA-high deductible plans in which preventive care is not part of the deductible receive preventive treatment at rates that are equivalent to or higher than people in traditional plans. In fact, people in HSA plans are:

16% more likely to get cervical or prostate cancer screening
20% to 40% more likely to get important tests for their condition if they are heart patients
15% more likely to have important diabetes tests, if a diabetic.

Another survey, this one by the Wellpoint Institute of Health Care Knowledge, shows that men, who typically lag in the use of preventive care, are more than twice as likely as women to increase their use of preventive care once in an HSA plan.

One More Change, and It’s a Biggie

2009-10-23T06:47:00.000-07:00

Last week, in my list of ways in which health care insurance has improved over the past few years, I didn’t mention one major change, because it’s kind of complex.

The change was a piece of health care reform that Congress passed in 2003 that allowed employers to offer a new way to pay for health care expenses using a health savings account.

A health savings account (HSA) enables employees to pay for their share of health care with pretax dollars and is offered in conjunction with a low premium, high deductible health insurance policy. Employees can save money in the HSA tax-free and draw out funds anytime they want to pay for the premium, deductibles, co-pays or other medial costs. Employees don’t have to spend what they put into an HSA by the end of the year.

The benefits of the HSA-high deductible plan to employers are fairly obvious: By switching to the high-deductible plan, the employer lowers the insurance premium and can shift to a more cost-sharing arrangement with employees. The lower cost of the HSA may make it the only plan that some small employers can afford to offer. And if the prediction of many experts is correct, that the HSA-high deductible combination makes people more careful consumers of medical services, then switching promises to yield overall reductions in healthcare cost inflation in the future.

Most high-deductible plans set the deductible at $1,500 or $2,500 per year. Simply by adding a deductible of $1,500-$2,500 to a health care plan but maintaining every benefit and feature in the plan will cut the premium cost by about 25% on average over the same plan but with a zero deductible.

Over the course of a year, adding a high deductible leads to an average decrease in premium costs to employer and employee of $3,836 after switching from a PPO plan to the HSA/high-deductible combination, according to a recent study by the Kaiser Family Foundation. And a multi-year study my company, UnitedHealthcare, recently completed showed that after adjustment for demographic and health status, the HSA-high deductible plans lowered overall health care costs by 7% in 2006 and 9% in 2007. The employer’s share of health care costs was down 12%.

There are many benefits to employees of the HSA-high deductible combination:

The HSA account is portable, which means employees keep the money in the HSA account if they move to another employer.
Anyone else can contribute to an employee’s HSA account.
The employee has easy access to the funds, and with many plans may be able to pay for medical expenses using a debit card tied to the HSA.

A recent OptumHealth study demonstrates that those in HSAs are aware of overall health care costs, and in a sense become more informed consumers. For example, in the last year:

64% of HSA holders asked providers about generic options for prescription medications.
47% asked providers about the charges for visits or treatments.
30% used websites or other resources to research the range of costs for health care services in their area.

Like all of the recent innovations about which I have been talking, the HSA-high deductible combination does not solve all our health care problems. But it does offer a cost-effective option for both employers and employees.

It’s Getting Better, Part 3

2009-10-21T11:40:00.000-07:00

In my last few blog entries, I’ve been writing about how health insurance has improved over the past 5 years. I’ve cited examples of technological innovations and of initiatives that have helped consumers take greater control of their own health and health care.

Perhaps the most significant improvement in health insurance over the past few years has been the greater emphasis on prevention. People who don’t get sick not only are healthier, they also spend less on their health care.

Here are some of the most important recent improvements in health insurance that involve prevention of disease:

Wellness programs. From smoke cessation to exercise, from weight loss to managing diabetes, consumers now have a wealth of wellness programs available through their health insurance plan and/or their employer.
Health care advice over the phone. A number of insurance plans now offer health care advice over the phone. In the typical service such as NurseLine or one of UnitedHealthcare’s disease management programs, a nurse with experience can help the consumer find a doctor or hospital, understand treatment options and get medical questions answered.
Health care coupons. Some health care plans have begun offering discount programs that enable covered employees to get discounts of up to 50 percent on health care products and services, including lasik surgery, smoking-cessation programs, gym memberships and even fitness apparel.

I’ve mentioned 9 improvements, all of which share some common themes. For one thing, they all tend to save money while improving care. But beyond that holy grail of raising quality while lowering costs, we can see these other trends I’ve mentioned:

Many innovations such as real-time adjudication and swipe cards reflect the opportunity that new technology presents for streamlining and thereby cutting the cost of administering health care.
Some innovations such as personal health records and physician rankings tend to educate consumers and get them more involved in making health care decisions.
Running through many of these innovations, such as wellness programs and health care coupons, is a strong element of preventive medicine.

No matter what shape health care reform takes, I think we can take it for granted that these themes-technology, personal responsibility and prevention-will lead to a completely new list of innovations in just a few years.

It's Getting Better, Part 2

2009-10-19T05:39:00.000-07:00

In my last blog entry, I made the controversial statement that health care insurance has improved in many ways over the past 5 years. I started to prove my point by listing a few technology advances that have improved health insurance.

Here are some innovations that tend to educate patients and get them more involved in making health care decisions:

Physician rankings. Physician ratings can help consumers select the most appropriate doctor, but if and only if qualified medical professionals do the rating based on clinical standards and quality is rated first, with only those doctors who make the quality standard getting rated for efficiency as well.
Personal health records. A personal health record (PHR) provides a complete and accurate summary of the health and medical history of an individual using data gathered from many sources. The PHR is accessible online to the individual and anyone who has the necessary electronic credentials to view the information.
Generic drugs in formularies. Health insurance plans now routinely include generic drugs in their drug formularies resulting in a lower copay for consumers who use generics in place of higher-priced brand names that do the same thing. Consumers who get involved can cut their costs by selecting the generic version.

So far I’ve come up with six ways that health insurance is better than it used to be. And I’m not done yet.

It's Getting Better

2009-10-16T05:58:00.000-07:00

In my last blog, I pointed out that my industry —health insurers—takes a lot of heat for what’s wrong with our health care system. I admit that health care insurers have to change, like everyone else. That’s why my industry’s proposal for health reform brings everyone into the system, guarantees coverage for all Americans, does away with pre-existing condition limitations and ends ratings based on health status and gender.

But I also want to point out something that most people don’t realize: Quietly over the last 5 or so years, most health insurance plans have added features and programs that improve health, make it easier to deal with our complicated health care system or cut overall health care costs. These new features don’t solve all our health care woes, but they have made inroads into addressing some of our most complex challenges.

Many of the improvements to health insurance over the past few years result from the application of advanced data processing and other technologies. Here are some examples:

Real-time claims adjudication. Doctor’s offices can now submit their claims online and know within 10 seconds if a procedure is covered by the patient’s health plan, instead of having to wait days or weeks.
Medical data synchronization. New data processing software such as the eSync platform collects and synchronizes medical data from a variety of sources, analyzes it and converts it into individual health care recommendations for specific patients.
The medical swipe card. Patients swipe the medical swipe card through a device similar to a credit card swipe to give caregivers access to all appropriate patient eligibility information and to the patient’s health records. With the card, the physician is able to submit claim forms online and receive approvals from the insurance company in a matter of seconds.

All of these innovations have made maneuvering the health care system easier while reducing administrative costs.

But those aren’t the only changes that have improved health insurance. When I get more time, I’ll list a few more.

Everyone is to Blame

2009-10-14T05:56:00.000-07:00

One constant theme in the debate over health care reform has been the laying of blame for all of our health care problems at the door of insurance companies. Now that's just wrong and it's also inaccurate.

Everyone is to blame!

By everyone, I mean everyone! Individuals, physicians and hospitals, drug companies, the government and yes, insurance companies, all are partially to blame for the problems in our health care system, and everyone will have to change in some way to fix what’s broken.

All of us have played a role in making our health care system more expensive and less efficient than it should be, and it will take all of us to fix it.

Consumers have an important part to play. Many preventable diseases are caused by unhealthy lifestyles, poor diets and little or no exercise. Everyone who pays health care premiums is shouldering the burden of paying for the health care of those with preventable diseases.
Employers have fallen into the trap of shedding and shifting health care costs instead of thinking about helping employees stay healthy. But if more employers joined the growing ranks of those that create incentives for employees to live healthier lifestyles, health care costs would moderate.
Health insurance companies should develop reimbursement strategies that facilitate cooperation, such as increasing reimbursements to higher-quality and higher-efficiency physicians and hospitals. Insurers must also become more user-friendly. Transparency about reimbursement practices and benefit levels would help manage the expectations of both consumers and medical professionals.
Doctors and hospitals also play a critical role in improving the efficiency and affordability of our health care system. Market-based reforms such as physician ratings and reward systems for quality and efficiency could, over time, lead to a system that would improve care and increase efficiency making health care more affordable for everyone.
Pharmaceutical companies could lower health care costs with one simple step: stop giving consumers misinformation about generics. In many instances the generic is identical to the brand name drug and costs 60-80 percent less. Yet heavy advertising by drug companies influences consumers to view brand name drugs as better. Once convinced, employees pressure their employer to cover the higher-priced brand name drug – driving up the cost of the health care plan.
The federal government, the largest payer of health care benefits in the country, has perhaps the largest role to play in fixing our healthcare problems. In recent years, the government has engaged in cost shifting by capping or reducing physician and hospital reimbursements and reducing subsidies to the states. This cost shifting has ended up hurting smaller hospitals and people without insurance.

We all hold keys to open new doors to a better and more affordable health care delivery system. But it means that we will all have to give a little more of ourselves so that everyone benefits.

Can We Cover the Uninsured and Drive Down Costs?

2009-10-12T05:10:00.000-07:00

A few weeks back I participated in a panel discussion about health care reform sponsored by the Greater Philadelphia Association of Health Underwriters. A few of the questions we were asked I thought were important enough to ask myself again and then answer in my blog.

1. Ignoring the political viability of your solution, what do you think is the best solution to simultaneously cover the uninsured and drive down health insurance costs?
First to covering the uninsured: UnitedHealthcare supports the concept of universal coverage and thinks we can best achieve this goal by building on our current system of commercial insurers. We support reform proposals that guarantee coverage for all Americans and would require all individuals to have coverage. We are also in favor of expanding Medicaid to reach low-income adults.

Now to costs: To some degree covering everyone will help drive down costs, that is, if universal coverage leads to more preventive medicine, which as we know leads to healthier people, which in turn drives down future health care costs.

But we also believe that there are a lot of unnecessary costs in the system that can be eliminated by implementing advanced technologies and modernizing procedures and policies. In fact, UnitedHealthcare has contributed two well-researched studies based on real world case studies that clearly demonstrate how the government and private sector could save hundreds of billions of dollars while improving the quality of care. For example, over the next 10 years, an estimated $540 billion in federal savings can come from implementing changes in four main areas:

Incentives to patients for use of high-quality physicians
Improved Care Management
Physician Incentives & Information to help drive quality care
Evidence-Based standards applied to reimbursement

2. Are there any negative implications associated with mandating that all U.S. citizens be covered by at least some standardized level of coverage? There is a deep and profound interconnectedness between the various aspects of health care reform and nothing illustrates this interconnectedness more than mandating universal coverage. As long as we remember this interconnectedness and pass a global program that addresses both accessibility and cost, we should be able to address any negative implications. A personal mandate also requires targeted funding for lower income consumers, which in turn requires new revenues and cost containment. If we address these issues in an integrated manner, we will be able to deal with any potential negative implications. But if we address these issues in isolation, we could run into difficulties.

Open Enrollment Season is Here

2009-10-09T04:57:00.000-07:00

The next few months will be a busy time for everyone at UnitedHealthcare because it’s “open enrollment season,” which in the health care profession is as exciting as ski season is to my friends who ski.

The open-enrollment period gives employees the opportunity to re-evaluate the health care benefit plans that are available through their employers. For most companies, open enrollment occurs annually, usually at the end of the year for plan benefits effective the following calendar year.

Employers should look at open enrollment as an opportunity for both the company and its employees to make sure available health care plan options meet health and financial needs.

The first step that employers should make in preparation for open enrollment is to review the past record of health insurance claims. A claims review will identify treatments that employees rarely use and clusters of benefits that employees use frequently. This information can help the employer make adjustments to the health care plans they offer so that the plans truly address the needs of its workforce.

Claims review information may also suggest when it makes sense to bring in speakers for wellness seminars. For example, if there are a growing number of diabetes claims, the employer may want to hold classes in diabetes prevention and management. Employers can also help employees in open enrollment by having their benefits consultants make group presentations about the differences among the various plan designs.

Control the Cost of Drugs

2009-10-07T07:53:00.000-07:00

Perhaps the fastest growing factor in health care costs is the cost of filling prescriptions. Many health insurance policies have a prescription drug benefit, but both those with and without health insurance can save money if they:

Select generic over brand-name drugs. Beside many brand name drugs on the shelf are equally effective and equivalent generic versions. Equal in everything but name recognition, these drugs offer the same level of quality, purity and strength as their brand-name counterparts and cost 30- to 60-percent less. Ask the pharmacist for a generic version and we can save substantially on our prescription medications.
Mail it in and split it. Prescriptions delivered via the postal mail vs. buying them at retail locations may help reduce drug co-pays and even offer a 90-day instead of 30-day supply. Or consider pill splitting. By following the doctor’s instructions and using a special device to split and take only half of a pill prescribed at double the dose each time, we can save hundreds of dollars a year on medications.

Armed with the 10 suggestions I’ve listed over the last week or so, it’s now time to lace up the running shoes, go for an annual check-ups and, most importantly, know the options you have for reducing health care costs.

Work Your Health Care Plan

2009-10-05T04:49:00.000-07:00

It’s amazing how much money you can save on health care once you start to think about it. One thing I notice is that many people spend more money on their health care than they should because they don’t take the time to review their health care plan documents. Here are some suggestions:

Understand our health benefit plan. Read the fine print, or log on to the health insurance company’s Web site. Know what is covered and what is not, and learn about any available wellness programs that can help improve health, reduce overall costs or even provide monetary incentives.
Use in-network providers. Seeing a doctor outside of the health care plans network costs more than seeing one in-network. Most health plans have thousands of doctors in their networks. A quick visit to the insurance company’s Web site can help avoid a more costly visit to the doctor.
Review the doctor’s bill. Making sure we have been billed correctly after an office visit or procedure is a simple routine that can save money and reduce stress.

Keep it locked…I’ll give still more cost-savings tips next time post a blog entry!