Thursday, June 30, 2011

Vision Care Benefits

When we moved our health insurance coverage from Guardian to UHC, we moved our vision coverage as well in order to keep it bundled. UHCs vision care benefits appeared to be comparable to what we had with VSP when we were with Guardian; however, a number of staff have expressed some dissatisfaction with the provider network. I talked with representatives from UHC and learned that most of their customers like the large box store vision providers, so that's who they target to include in their network. ASHA staff tend to prefer to see private practitioners, so I think we're experiencing a bit of a mismatch. I've asked our broker, Mark Sager, to obtain a quote from VSP for us this fall so that we can consider making a change for 2012. In the meantime, I encourage staff and their family members to share their experience with our current coverage.

UHC Vision Plan Summary

Wednesday, June 29, 2011

Roadblock to Food Revolution

I've followed Jamie Oliver's Food Revolution to improve school lunches and was excited to learn about his expanded focus on cooking in the workplace. He teamed up with IDEO to teach employees how to cook. This new venture is called Cooking & Company, and it’s mission is to bring food revolution into the workplace. (BTW, I love the Cooking for All mindmap on the main page of the site.) One of my colleagues, Nina Kranz, is an excellent cook, so she agreed to take the lead in developing a program for ASHA. 

To learn more about Cooking and Company, I participated in a #co_health tweet chat with IDEO’s Aaron Sklar and Helena Cohen and Nina corresponded with Helena. Helena encourages employers to create a hands on experience for employees. They've been keeping the recipes simple with things like omelettes and fajitas. 

So, Nina and I were excited. We were gearing up for a big fajita cook off when, oof, we were told we could not use an electric heat source or a butane burner in our LEED certified green building. Evidently the wiring can't accomodate the electricity and the butane compromises the air quality. So, we have no source of heat for cooking. (Well, nothing other than a microwave.)

We want to encourage people to cook for themselves and their families at home, but this roadblock has thrown a monkey wrench in our plan. We're bouncing around other ideas -- maybe a knife skills class or a pizza dough making class. What suggestions do you have for us?

Monday, June 27, 2011

What to Expect When a Nurse Calls and Why You Should Take the Call

Most of us are suspicious when we get a phone call from our insurance company. Our first thoughts are often that they're going to try to get out of paying for care that we need. And, some of us are reluctant to share our personal health information with our insurance company. UHC has a program called e-sync that I saw a demonstration of last week at the UHC Customer Forum. E-sync is a platform that UHC developed using hundreds of algorithms to identify opportunities for members to improve their health. 

In the demonstration, the nurse reached out to a member because she had not filled a prescription recently for medication to control her blood pressure. When the nurse talked with the member, she learned that the members' doctor had retired, so she found a preferred provider for her and made her an appointment. The nurse also asked if the woman was monitoring her blood pressure at home and when the woman indicated that she did not have a blood pressure monitor, the nurse ordered one to be sent to her free of charge. She also sent her a log so that she could record her blood pressure and take it to her doctor appointment. Then, she arranged to follow-up with the member after she saw the new doctor to find out how her appointment went. UHC's focus is on personally appropriate interactions. In other words, they'll help you take the steps you wish to take. 

If you get a phone call from a nurse at UHC, there was something in your record that caused you to be flagged by one of the algorithms. These generally fall into one of the following eight categories:
  1. Disease-Drug Interactions: Member filled prescription that is not recommended for their condition. For example, NSAIDs are contraindicated for individuals with chronic renal failure.
  2. Disease Monitoring Gaps: Member has a condition or is on a medication which requires follow-up care. For example, Member is taking digoxin and national standards call for testing their kidneys and blood potassium.
  3. Therapy Duplications: Member has filled two or more prescriptions for the same class of drug. For example, Member is filling prescriptions for two or more statin-containing medications.
  4. Missed Therapy Intervention: Member does not have a needed medication for the treatment of their condition. For example, Antiplatelet therapy compliance for a member who has received a stent. 
  5. Potential Medication Adherence Issue: Member not taking recommended dosage of prescribed medication. For example, Member with rheumatoid arthritis is not compliant with their medications.
  6. Medical Management Consideration: Member whose specific condition requires follow-up care or testing. For example, woman with a history of breast cancer should be receiving yearly mammograms. 
  7. Drug-Drug Interactions: Member who is concurrently taking two contraindicated medications. For example, Nitrates and Phosphodiesterase. 
  8. Money Savings Tips: Opportunities for over-the-counter drugs, lower-tier switching and half-tablet alternatives. For example, Member taking Crestor may save money by participating in the half-tablet program.  
These calls from a nurse can be informative and helpful. You won't be bound to act on the information the nurse provides and the nurse is not in a position to dictate what care you receive or limit your access to care or medications. If you're hesitant to talk to the nurse because you don't want to share your personal health information, well -- that train has already left the station. UHC knows what medications you take, the results of your last lab tests, the doctors that you see etc... E-sync integrates all that data so that they can assist you in a holistic way. So, why not take the call? You might learn something that helps you improve your health. 

The attached flier describes the Nurseline service. You can also reach out to a nurse by calling the Care 24 number on the back of your insurance card (888-887-4114) or clicking on the Live Nurse Chat button in the bottom right hand corner of 

Note: UHC shared that they are able to close a gap in care 95-96% of the time once they get the member on the phone. Their ability to get the member on the phone varies from 2-60% and is largely dependent on how much the employer has done to educate people about the program. 

UHC's NurseLine

Friday, June 24, 2011

UnitedHealthcare's Customer Forum

I had the good fortune to attend UnitedHealthcare's (UHC) customer forum this week. UHC invited representatives from approximately 100 employers to attend a two day program in Minneapolis. We were grouped by region, so I spent time with other people from the mid-atlantic. It was a nice opportunity to connect with HR folks from other employers that use UHC. And, I have to say that the experience made me feel great about choosing UHC. I talked about the selection process in a previous post. I was told UHC had identified ASHA as a "key account." (Seriously, we're a great place to work and all, but I was a bit skeptical about what that could mean to us.) Well, they really put their money where their mouth was by inviting me to the customer forum. It was a great learning experience and a great networking experience.

The first day we heard the following presentations:
  • Focused Agenda and Vision for UnitedHealthcare: Gail Boudreaux, Chief Executive Officer, UnitedHealthcare and Executive Vice President, UnitedHealth Group
  • Innovation: Unlocking the Future of Healthcare: Karen Piacentini
  • Network payment strategies of the Future: Lisa McDonnel, Regional Vice President Network Management
  • Employee Education and Engagement Tools: Diane Slayton, Vice President Member Acquisition & Retention Marketing
  • Leveraging the Power of Analytics to Maximize the Health of your Employees and your Business: Craig Kurtzweil, Assistant Vice President, Health Analytics
  • Healthcare in America: Dr. Reed Tuckson, Executive Vice President and Chief of Medical Affairs (Everyone in America would want UHC to be their healthcare provider if they heard Dr. Tuckson speak.)
The agenda on the second day had us downtown Minneapolis as well as at UHC's National Operations Center.
  • Health Care Lane: Walk through a life-size replica of the website that helps educate individuals on the basics of health care.
  • Optum eSync: Learn how our data and unique approach allows us to talk a holistic approach to patient care.
  • National Operations Center: Monitor how UnitedHealthcare Operations are prepared to service you in any situation. (I didn't know a call center could be so cool.)
  • Innovation Showcase: Experience a few of the tools that helped UnitedHealthcare earn the top ranking on FORTUNE Magazine's Most Admired List for Innovation in health insurance and managed care.
My head is still spinning from everything that I learned. I have 13 pages of notes and a 16 item "to do" list. I expect this will all come together in multiple blog posts and communications to the ASHA staff, so stay tuned.

Many thanks to Matt Kurtz, Eugenia Perna, Linda Crandall, Rich Perrier, Chris Mullins, Seung Baick and all the folks at UHC who put the customer forum together. You've made me feel confident in our selection of UHC.

Related Posts:

Saturday, June 11, 2011

143 Calories per Day

I know we all want the quick fix, but did you ever stop to think that you could lose 15 pounds over the course of a year if you created a 143 calorie per day deficit? Seriously, do the math.
1 lb = 3,500 calories
3,500 x 15 = 52,500 calories/365 days = 143.83

There are roughly 143 calories in:

  • one flour tortilla 
  • six hershey kisses 
  • 21 almonds 
  • 1 oz of potato chips
  • 1/4 cup of chocolate ice cream
  • one grande skim latte 
  • 6 oz of red wine or one beer 
Most of us could cut 143 calories a day out of our diet and not feel hungry or really even miss them. 

On the flip side, it's not that hard to burn an extra 143 calories a day.

  • 30 minutes of walking, about 1.5 miles or 3,000 steps
  • 15 minutes of stair climbing
  • 30 minutes of gardening
  • 30 minutes playing with kids (moderate effort)
  • 15 minutes of swimming
  • 15 minutes of biking
Think in terms of spreading this additional activity throughout the day. It doesn't have to be done all at one time. Slap on a pedometer and try to get in an extra 3,000 steps. 

I've been contemplating how fine the line is between gaining and losing weight quite a bit lately. No wonder the pounds tend to sneak up on us. 

And, a little more about the wine in this two minute news segment.

Update 10/13/2011:
Extra Tastes Can Turn Into a Pound of Weight Gain in a Week

Thursday, June 9, 2011

Our Trip to the Rockville Farmers' Market

Foraging for a Healthy and Sustainable Meal

As part of our Heart Health Initiative, I planned an outing to a local farmers market in Rockville. We passed out shopping bags, talked about what questions we would ask the farmers: (1) Is the produce grown locally? (2) Is the produce organic? We also took a quick look at a cookbook that I like, Simply in Season and this months Everyday Food to get an idea of what we might expect to find. (By the way, Everyday Food has has the best magazine iPad app. Easy to navigate with gorgeous pictures and instructional videos.) Then, 14 of us piled into two ASHA vans and headed out.

This is a smaller market, but there were two farms with a nice selection of wonderful looking fruits and veggies -- Scenic View Orchards and Mountain Valley Orchard. I didn't see anyone buying kale even though I kept telling them how yummy Cindy Mann's kale chips are, but everyone seemed to find something to try.

I hope ths will be the first of many ASHA staff trips to the farmer's market.

Tuesday, June 7, 2011

Journaling to Achieve Your Goals

Terry Harris and I have been talking about jornaling lately because it's part of a change program we currently have underway. This is a contest and the winner will be awarded a week long trip to St. Thomas. (Compliments of our very generous broker, Mark Sager.) Participating staff completed an intention card with their goal at the beginning of the program. In July, they'll submit a reflection statement and a journal that tells their story. The journal can be in any form -- blog, video, photographs, diary, scrapbook, anything someone can think of to convey their journey. An external panel of experts will review the entries and select the best wellness story as our winner.

We included journaling as part of the program because we believe it will help people achieve their goals and help them share their journey with others. Terry has done so much reading on the topic, I asked her to author a guest blog post to share some thoughts that our contestants might find helpful.

Is journaling your thing?

I remember being around 10 years old and my mom giving me my first diary (complete with a lock and key). I was so excited to write in it each night before going to bed. My friends and I would meet the next morning at school and talk about our diary entries, which always seemed to include the boys that we had secret crushes on. Well, for me, that ritual of writing in it each night lasted all of a month or so before I got bored with the whole routine, stopped writing, and put the diary on a shelf someplace.

Fast forward to the Oprah age and a few years ago when she started talking about how she’d kept a journal since the age of 15. She started encouraging everyone to keep a gratitude journal. I thought that was a wonderful idea since I had so much to be thankful for. I went out and purchased a nice journal and tried to get into the habit of writing three things that I was thankful for on a daily basis. Again, the novelty of that soon waned.

Over a year ago, I started working out and wasn’t going to classes consistently. I’d think of every reason imaginable not to go; it looks like rain, it’s sunny out, I ate too much for lunch, or whatever. Someone suggested I keep a journal and write down my thoughts about attending afternoon fitness classes each day. I did that for a few weeks and stopped. However, what I did realize was that I’m a morning person and by late afternoon my energy level is low. Did I come to that realization through journaling? To be honest, I think not!

I’ve come to the conclusion that the traditional approach to journaling just isn’t my thing. However, had I been aware of these tips (such as write in different conditions: awake, sleepy, tired, sick, etc.) and this Writing Through Life site, I may have thought differently about it. I may not have been very successful with the typical paper-and-pen journal method, but I strongly believe that the act of conscious reflection in whatever form is the real benefit.

Journaling provides ways to shape inspiration, examine feelings, brainstorm, provide clarity, and provide a means for reflective thinking, but there are other methods that can be used to serve the same purpose. A blog is the first that comes to mind. I’ve come across some great blogs; one of my favorites is Iowa Girls Eats. It’s well written and always has nice pictures. Check it out and see what you think.

What do you think about using photos, paintings, pictures, videos, and so on in the place of traditional paper-and-pen journaling? Share your thoughts in the comment section below (text only please!).