Wellpoint to Improve Primary Care Reimbursements

The Los Angeles Times has reported that health insurer WellPoint Inc. plans to increase the fees it pays to doctor practices, and it will start paying for services like preparing care plans for patients with complex medical problems.  They report that they will  also will offer doctors an opportunity to share in some savings when better patient care leads to a reduction in costs.  Wellpoint is the parent company of Anthem Blue Cross.
 
WellPoint said it wants to give doctors a chance to do more for patients outside of episodic care, or just treating people when they become sick.   Under the concept, doctors will be able to spend more time with patients, listening to them and understanding their concerns, said Jill Hummel, WellPoint’s vice president of payment innovation.WellPoint also expects a return on this investment. The insurer said the approach should cut down on some of the priciest forms of medical care, emergency room visits and hospital admissions.
  
 

Wellness Ideas to Reduce Employer Health Insurance Costs

There are some new approaches to wellness that employers are starting to utilize to reduce their spending on health insurance premiums.  Some of the new ideas to reduce costs by using a wellness program include:

1. Employers may require that employees pass biometric screenings to receive discounts on their health insurance premiums. Those who don’t meet the necessary biometric levels would have to enroll in a wellness program and after achieving a healthy body mass index and other biometric numbers, would then be eligible for the discounts.

2. More employers may use the services of a health care advisor to teach employees how to make better treatment choices, find quality providers and make better use of their employers’ health management programs, thereby reducing health care costs.

3.Employers may begin to  use social media to reinforce healthy behaviors, such as  losing weight, exercising more and  becoming healthier.

4.In spite of the economic downturn, one-third of employers plan to increase their  spending on wellness programs  in order to reduce overall premium expenditures.

Our President, Gary Whiddon is well workplace certified from Welcoa University.  He would be happy to assist in the implementation of any employer wellness program.  Please call him at (888) 474-6627 x 116, or email him at gary@hpo.biz

 

How to Be a Slimmer Santa This Holiday Season

 

Happy Holidays to everyone.  May you and your family enjoy the best in 2012!!

In order to avoid the naughty list this season and possibly fit down the chimney, here are a few suggestions to avoid the tempting treats of the holidays:

 

1. Avoid all the candy, cakes and sweets that you may be sent.  instead, sample from the fruit basket or have a handful of almonds.

2. Limit the fattening meats and gravies on your holiday plate.  Why not have more vegetables instead?

3. Get up and move!  It is so hard to want to be outdoors in cold winter weather.  If you cant go outside, why not try a few laps around the office hallway or a few sit-ups at lunchtime?

4. Bring a healthy entree or salad to the next pot luck.  Your will be surprised how many people will really want to have something healthy as an alternative to all the heavy and fattening treats of the season.

5. When baking or cooking, try low fat or sugar alternatives such as Splenda or apple sauce instead of sugar or margarine instead of butter.

6. Try to de-stress and not expect so much of yourself.  It is so easy to fall off the healthy eating wagon when under stress.  Try yoga, walking or calling a friend instead of that cookie.

7. Don’t wait for a New Years resolution, don’t even make them! Just try your best to maintain a healthy diet and exercise program.  Even if you slip and don’t work out for a while or gobble down junk food during the season or the year, its important to try again.  Better to not maintain for two weeks than two years, right?

Employers Can Help Battle Chidlhood Obesity

As childhood obesity in the United States has tripled over the past 30 years.  Obesity is a growing epidemic affecting children, their families and the nation. The United States currently has the highest percentage of overweight youth in its history. More than one-third of children in the United States are considered overweight or obese, leading to increased health risks, higher health care costs and decreased parental productivity at work., now is the time for employers to take the lead in the battle against the growing problem of overweight and obese children, according to the National Business Group on Health.

“Child obesity is impacting employers today and will into the future as these children become the workforce of tomorrow,” says Helen Darling, president and CEO of NBGH, whose members include 329 large U.S. employers. “Parents have an enormous impact on the childhood obesity epidemic. The good news is that employers can play a critical role in fighting the childhood obesity epidemic by helping families develop healthy lifestyles at work and in the home”.

A recent survey of 83 of the nation’s largest companies conducted by the National Business Group on Health identifies the following programs employers currenlty have in place to help fight childhood obesity:

- One third of employers (33%) offer online weight management tools to children.

- More than one in four employers (28%) offer telephonic or online coaching for weight management to children

Beyond promoting healthy lifestyles in the home, employers will soon face a growing demand for obesity treatment in children.

“With the new guidelines for screening under The Patient Protection and Affordable Care Act, many more children nationally will be identified as overweight or obese,” says LuAnn Heinen, vice president and director of NBGH’s Institute on Innovation in Workforce Well-being. “Employers can provide tools and resources to support and empower employees and work with health plans and community resources to develop and promote new approaches to childhood obesity prevention and treatment.”

Employer toolkit expanded

NBGH also announced that it has updated its employer toolkit, “Childhood Obesity:  It’s Everyone’s Business,” to include examples of family-focused wellness programs that four forward-thinking companies are doing to fight childhood obesity. The toolkit also includes a new section on how employers can design their benefit programs to ensure that they are in accordance with new screening guidelines required by PPACA and support obesitytreatment options for children.

The employer toolkit was developed and updated with support from the U.S. Department of Health and Human Services, Health Resources Services Administration’s Maternal and Child Health Bureau. It’s available free of charge and can be found at www.businessgrouphealth.org.

Gary Whiddon is a wellness consultant affiliated with WELCOA university and can assist you in forming a wellness program for your employees.  Please contact him at (888) 474-6627 for information on setting up a prgram for your employees.

 

New HHS Guidelines for Women’s Preventative Services

 On Aug. 1, 2011, the Department of Health and Human Services (HHS) released new health  plan coverage   guidelines that will require health insurance plans to cover women’s preventive services such as well-  woman visits, domestic violence screening, and U.S. Food and Drug Administration (FDA)-approved contraception, without charging a copayment, coinsurance or a deductible.

Authorized under provisions of the Patient Protection and Affordable Care Act, these guidelines, developed by a committee of the Institute of Medicine of the National Academies, expand the previous list of preventive services that must be covered without charging a copayment, coinsurance or a deductible to include:

  • Well-woman visits
  • Screening for gestational diabetes for all pregnant women
  • Human papillomavirus DNA testing for all women 30 years and older
  • Annual sexually transmitted infection counseling for all sexually active women
  • Annual counseling and screening for HIV for all sexually active women
  • FDA-approved contraception methods, sterilization procedures and contraceptive counseling
  • Breastfeeding support, supplies, and counseling, including costs for renting breastfeeding equipment
  • Domestic violence screening and counseling

New health plans and non-grandfathered plans and issuers are required to provide coverage consistent with these guidelines in the first plan year (in the individual market, policy year) that begins on or after August 1, 2012.  It is possible that your current health plan covers these services now, but may have a copay or co-insurance percentage.

When Do You Need to Take Your Child to the ER?

The typical emergency room experience can be difficult or scary for a sick child.  When is it best to take your child to the ER or wait for your pediatician’s office to open the next day?  Below are a few tips to help you decide:

1. Bumps on the head- every new walking toddler (or those that are already walking or running) hit their heads and get a few bumps and bruises during the early years. If your child gets right back up after the impact and stops crying after some serious soothing, an ice pack and some TLC is probably all she needs. Go to the ERor call 911 if your child loses consciousness or has an indentation in her head for emergency medical attention.

2. Mouth injuries – Why do all parents panic over mouth injuries?  The mouth is rich in blood vessels, so cuts and scrapes bleed a lot (and it’s often hard to see where all that blood is coming from at first). Applying ice, having her suck on an ice pop or  drink some cold water will soothe and stop bleeding.  Go to the ER when there is a gaping wound or a cut that won’t stop bleeding after you’ve applied ice is a true emergency.

3. Fever – Most fevers, even high ones, are just a sign that your toddler is fighting off an infection, but many parents worry that a fever signals something worse.  The American Academy of Pediatrics says Moms and Dads need to make a feverish tot comfortable, instead of trying to bring the temperature down to normal. Don’t be alarmed if that pain reliever doesn’t bring down her temperature right away. Instead, keep giving your little one plenty of fluids (and hugs) and check in with your pediatrician.  Go to the Pediatrician when your child has a fever higher than 102.2°F or has had a fever for more than 24 hours (for a child younger than two) or 72 hours (for kids two and older). Go to the ER if your child’s fever is 102.2°F and she has a stiff neck, can’t stop crying or vomiting, is so lethargic it’s difficult to wake her up, or has a blue tongue or blue lips or nails (which means she’s not getting enough oxygen). Also go to the ER when a baby under three months has a fever of 100.4°F.

4. Vomiting-  Persistent vomiting is another common reason parents head to the ER. But vomiting is usually caused by a stomach bug or infection and isn’t serious in and of itself. A bigger danger is dehydration, so be sure to offer your tot extra fluids (or Pedialyte), even if she just takes a sip at a time, as well as liquid-based foods like soups, fruits, and fruit pops. Most stomach bugs that cause vomiting last only 24 hours, so if your child is throwing up for more than a full day, call your Doctor. Call the pediatrician or go to the ER if there are signs of dehydration, such as : dry mouth, lack of tears, and dry diapers (or not much pee in the potty). Call your doctor or 911 if your child is vomiting after she’s hit her head, or is throwing up greenish fluid, blood, or what looks like coffee grounds (blood mixed with stomach acid).

5. Skin Rashes – Most rashes are not dangerous.  Some are caused by allergies, while others are symptoms of viruses like fifth disease. It is recommended that your pediatrician  check out a nasty or weird-looking rash, most rahses are not a cause for alarm.  Go to the ER if your tot breaks out in a rash and has trouble breathing at the same time. Another rash that warrants an emergency room visit and a call to the doctor is petechiae, which is flat purplish dots caused by broken blood vessels that are usually a sign of a serious infection or bleeding problem.

Please always remember that there may be increased charges on your insurance coverage for emergency room visits.  Please consult your plan booklet for information regarding the benefits available.