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.
Tuesday, June 22, 2010
Wednesday, June 16, 2010
Cooperative marketplace reform is making health care more affordable and accessible.
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.
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.
Wednesday, June 9, 2010
Insurers, employers and doctors working together will bring marketplace reform to health care.
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.
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.
Wednesday, June 2, 2010
Marketplace reform may improve the health care system more than the new law does.
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.
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.
Tuesday, May 25, 2010
But what good is health care coverage if patients can’t find a suitable doctor?
In my last entry, I talked about my company’s latest research paper that shows how we can save $366 billion in Medicaid spending. What’s great is that a portion of these savings could be reinvested in primary care, resulting in better access to high-quality care for newly covered populations and underserved communities.
Ensuring primary care availability is a major concern for states and physicians. According to one of our national surveys, 67 percent of primary care physicians think that the new Medicaid patients will struggle to find a suitable primary care doctor.
But the same survey finds that alongside other policy reforms, states could increase the number of primary care physicians treating Medicaid patients by permanently raising reimbursements to at least match those of Medicare. Our research suggests actively managing the health care of Medicaid enrollees and then recycling some of those savings to strengthen primary care is a better solution to states’ budget pressures than continuing to artificially depress Medicaid provider reimbursements, which in turn affects patients’ ability to find a primary care doctor.
People who are eligible for Medicaid need access to top quality health care, so we must find a way to strengthen primary and community care services. Many states are already taking important steps in this direction, now we just need to build on those innovations across the country.
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.
Thursday, May 20, 2010
We can save billions while extending health care coverage to millions of Americans.
Medicaid is already the nation’s primary source of health care coverage for low-income children and families, and now it’s one of the two main building blocks for expanding national health care coverage. The program is estimated to grow by 16 million people once reform is in full effect, with enrollment in 10 states to increase by more than 50 percent.
Expanding Medicaid to all of these new people is expected to cost more than $430 billion over the next ten years. Though the federal government will fund most of the initial expense, the cost of keeping the program going will put major pressure on states, where Medicaid is already the second largest budget item.
The good news is there’s a way to cut a big chunk of those costs while ensuring that underserved populations can readily access better quality care. By building on what already works and fixing what doesn’t, we can save billions in Medicaid spending.
In our research at UnitedHealthcare, we’ve found that by taking steps to modernize the Medicaid program, state and federal governments can save an estimated $366 billion over the next decade. States’ $149 billion share of the savings would go a long way toward alleviating budget pressures.
It’s all outlined in our newest research paper, Coverage for Consumers, Savings for States: Options for Modernizing Medicaid. The report shows how states can expand access to higher-quality, well managed health care, increase funding for primary care physicians and cut overall costs, based on proven approaches already adopted in some states. Our set of best practices focuses on three categories:
• Broader use of coordinated care techniques to improve access to high-quality care for both existing and expanding populations of Medicaid-eligible Americans, with projected savings of $93 billion ($36 billion for states).
• Greater use of managed care to support people with long-term care needs, with projected savings of $140 billion ($60 billion for states). Examples include targeted home-and community-based care programs to support people living longer in their own homes, and better coordination between Medicaid and Medicare.
• Modernizing Medicaid’s administrative and transactional processes, with projected savings of $133 billion ($53 billion for states). Examples include applying new health IT systems, including Medicaid in-state health information exchanges, encouraging electronic claims submission, and validating claims prior to payment.
If we can implement these innovations more widely across the Medicaid program, we can not only help make sure Medicaid is sustainable for future generations, but also reinvest our savings in improving the health care system for all. More on that next time!
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!
Monday, May 17, 2010
Don’t let asthma keep you locked indoors this spring, a few simple steps will help you breath easier.
It’s that time of year again. Many of us fall victim to allergy-induced sniffles and watery eyes in the spring and early summer, and it can be an even more miserable time for the more than 23 million Americans – including more than 7 million children – who live with asthma. Unfortunately, experts say this year might be worse than ever, with plants and trees producing more pollen and spores than in years past thanks to an especially wet winter.
But Dr. Philip Benditt, one of our medical directors here in Pennsylvania, tells me you can still enjoy the season and live a healthy, active life all year round if you have asthma by following a few simple steps to avoid triggering attacks. Here are some of the tips Dr. Benditt shared with me:
• Understand your asthma. While indoor factors may spur an asthma attack for some, outdoor factors may trigger an attack for others. Keep a journal to track triggers, frequency and duration of asthma attacks, use of maintenance medications and rescue inhalers and other breathing-related data to share with your physician.
• Take your medications. At UnitedHealthcare we’ve found that about half of our health plan participants who take asthma medicines don’t follow their prescriptions. Not taking needed medications or not taking them on time can put you at risk for more frequent and possibly more severe attacks.
• Check for cost savings on your medications. Cost is one of the biggest reasons people don’t refill their asthma prescriptions, but there are solutions. Talk to your physician about more effective and affordable asthma drugs including maintenance inhalers such as Asmanex, Pulmicort Flexhaler and Qvar, and rescue inhalers like Ventolin HFA - all on the lowest copay level of UnitedHealthcare’s prescription drug list. UnitedHealthcare also recently introduced the “Refill and Save Program,” which offers $20 discounts off certain prescription drug copayments – a 40 percent savings on a typical copayment plan – including copays for asthma drugs Advair and Symbicort.
• Think ahead. If pollen is a trigger for you, check the daily pollen count often provided by the local newspaper, radio weather service or television news channels, and plan your activities accordingly. If traveling, research environmental factors that might affect your asthma and locate local health care providers in the event of an emergency. Whether home or away, make sure you have enough of your asthma medications on hand.
According to Dr. Benditt, the key to dealing with asthma is vigilance. Patients with asthma (or any other chronic disease for that matter) who take their medicines regularly and follow prescribed treatment plans will not only feel better but also potentially avoid costly medical problems down the line. So follow these steps, breathe a little easier and get out there and enjoy the season!
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!
Subscribe to:
Posts (Atom)
