Savvy Health Newsletter
July 31, 2009
President Obama's speech to the AMA (American Medical Association regarding prevention) :..." a step we can all agree on is to invest more in preventive care so that we can avoid illness and disease in the first place. That starts with each of us taking more responsibility for our health and the health of our children. It means quitting smoking, going in for that mammogram or colon cancer screening. It means going for a run or hitting the gym, and raising our children to step away from the video games and spend more time playing outside.
It also means cutting down on all the junk food that is fueling an epidemic of obesity, putting far too many A mericans, young and old, at greater " risk of costly, chronic conditions...
Preventative Care is the Key to Affordable Health Care
70% of all health-care costs are the direct result of behavior. 74% of all costs are confined to four chronic conditions (cardiovascular disease, cancer, diabetes and obesity). Furthermore, 80% of cardiovascular disease and diabetes is preventable, 60% of cancers are preventable, and more than 90% of obesity is preventable (IHS).
The following information is from Mayo Clinic in Rochester, MN. If you are interested in receiving these informative pamphlets, contact Mayo Clinic at 507-284-2511
"Health Care In a Pinch" (from Mayo Clinic Women's HEALTHSOURCE)
August 2009, Volume 13, Number 8
Providers
- Develop a good relationship with a primary care provider
- See a specialist only when recommended by your primary care doctor
- Ask in advance about fees. If you're not sure what insurance covers, ask
- Use in-network providers
- Use nurse lines, if available, at local hospitals or physician's offices
Insurance
- Read your policy carefully to find out what is and isn't covered
- Be your own advocate. Read your benefits information to make sure your health plan is paying everything it should. Appeal the decision if you think a claim has been denied in error.
- Use a flexible spending account (FSA). This is a tax-sheltered account you can use for prescription copays and other out-of-pocket medical expenses.
Medications
- Choose generic drugs. They cost less than brand-name drugs but have the same active ingredients. Some large retailers sell generic drugs for as little as $4 for a month's supply. Ask your doctor to consider costs when prescribing.
- Split pills in half if possible. Ask your doctor if you can safely cut the pill in half.
Hospitals
- Avoid the emergency department unless absolutely necessary. Instead, consider a nurse line or urgent care facility (i.e. Prompt Care located on N. Henderson St.).
How do you become a better health care consumer without sacrificing quality of care?
- Yearly Health Screenings Thanks to all who participated in the health evaluation in April. We hope these evaluations assist you in recognizing potential health concerns and initiate an open dialogue with your physician on treatment and lifestyle changes.
- See your dentist Routine dental care (cleanings and x-rays) can prevent costly procedures down the road and can actually reduce health costs.
- Wellness Take advantage of Knox's Wellness screenings and services (mammograms, prostate exams, and flu shots). Call Marcy at X7121 for information on ongoing and upcoming events or watch for Marcy's e-mails.
- Make a decision to address one health issue (ie. lowering cholesterol or high blood pressure or losing a few pounds). Compare your results with next year's screening.
- Enroll in a HealthFocus Program This free service provided by Interactive Health Solutions allows participants to confidentially work directly with a Health Coach for personalized education and support. There are many topics to sign up for including smoking cessation, weight loss, diabetes, cholesterol, nutrition, stress management, etc. Call 1-800-840-6100 for information. You can also check out the Interactive Health Solutions (www.interactivehs.com) website for valuable health information. There is a wealth of valuable information at your fingertips (the topic section is great).
- Enroll in Disease Management If you or a family member has diabetes, asthma, heart disease, high blood pressure, high cholesterol or pulmonary problems take advantage of the Disease Management benefit. Call 1-800-367- 9938, ext. 238, to find out how to become a participant in the Optimal Health benefit program. This free program will provide various tools and services to help you or a family member manage their chronic disease.
Medical
- Vaccinations Using the Knox County Health Department for (KCHD) your children's vaccinations (under the age of 19) can save hundreds of dollars. The cost for vaccines--$8. Your receipts can be turned in to BAS for reimbursement under your $400 routine exam benefit. KCHD phone-344-2224.
- Examples of charges:
- HPV vaccine (series of three shots). Local clinic $160 each plus $20 for administering -KCHD $8 each
- Hepatitis A: (series of three shots). Local clinic $150 each plus $20 for administering - KCHD $8 each
- Meningitis: Local clinic $128 plus $20 for administering - KCHD $8
- MRI's/CT Scans The least costly scans are those performed in the physician's office. When that is not an option, Peoria Imaging is less expensive than a hospital. Address: 6708 N. Knoxville Ave., Ste. 2. Ph. (309) 692-7674. Also, note that scans performed at Peoria Imaging will not have a radiology charge. If a local hospital performs the scans/x-rays, OSF will generally be less expensive than Cottage Hospital.
- Outpatient surgery? Generally OSF will be less expensive than Cottage Hospital. To compare costs ask your physician for the CPT and Procedure Codes. The hospitals should be able to give you an estimate of the costs.
- Bone Density Scans (for osteoporosis) The Galesburg Clinic now has the equipment to perform bone density scans. With the PPO discount, the charges will be less than both local hospitals.
- Emergency Room Overuse of the emergency room for non emergencies is an ongoing, expensive problem. Last year over $174,000 in charges for ER visits were incurred. To save a lengthy and costly ER visit, consider first calling the ER or your physician (even at home) or visiting Prompt Care (located at 1707 N. Henderson, 343- 1000).
- Questions to Ask Before Surgery The following website from the University of Rochester Medical Center lists important questions to ask your physician/surgeon before surgery. www.stronghealth.com/questions/surgery.html
Prescriptions
- Questions to Ask Before Your Doctor Writes a Prescription (from Health.com " Money & Health " )
- Are there any lifestyle changes I can try before starting a drug regimen?
- Can I try the least expensive option first?
- Will I be able to afford this long-term?
- Talk to your pharmacist to figure out the least expensive option.
- Should I take the free samples? No . The University of Chicago Medical Center found that patients who had received free samples had significantly higher prescription cost than patient who didn't. Why? Because samples will always be the newest and most expensive brand- name drug, and after the samples run out, you are more likely to continue buying that brand.
- Prescriptions The utilization of generic prescriptions, when appropriate, continues to be one of the easiest ways to reduce plan costs. Every 1% increase in generic use lowers total prescription costs by 1%. Total prescription costs last year: $850,150. Talk with your doctor and/or pharmacist to see if a generic or less costly equivalent is available.
Cost of a brand versus trade (generic) for the most common antidepressant/anxiety medications. It is clear that the use of a trade name drug results in significant savings. Cymbalta is over 5 times more costly than Paroxetine.
| Medication |
Brand or Trade Name |
Yearly Cost
(Per Prescription) |
| Cymbalta |
Brand |
$1,638 |
| Effexor XR |
Brand |
$1,625 |
| Lexapro |
Brand |
$1,160 |
| Fluoxetine |
Trade name for Prozac (available for $4 at participating pharmacies |
$521 |
| Sertraline HCL |
Trade name for Zoloft |
$358 |
| Paroxetine |
Trade name for Paxil (available for $4 at participating pharmacies) |
$298 |
|
$4.00 CoPay for over 400 generics at participating discount stores
Over 400 generics are available at participating discount pharmacies (Hy-Vee, Target, Walmart, K-Mart). These programs can have a tremendous effect on reducing total health care dollars for all Knox health plan participants. A complete list is available at each pharmacy. Walgreens also offers discounts for a small yearly fee. A 90 day supply of listed generics at the above pharmacies is available for $8-$10 .
Are Generics As Effective? Read what the Center For Drug Evaluation and Research says: "Generic Drugs: Safe, Effective, FDA Approved."
Something to Brag About- Once again Knox Wins a "Healthiest Company" Award
Interactive Health Solutions provides health programs to over 2,000 companies to identify health risks of their participating employees. Knox College will receive an award for having an aggregate Health Index Score of zero or less.
Are You Taking a Heartburn (PPI) Medication?
Interesting information
Stressed? Depressed? Anxious?
At one time or another most people feel stressed, overwhelmed, or depressed. Knox employees and their family members may receive counseling for a wide range of personal problems, including marriage and family problems, alcoholism, drug abuse, financial problems, eating disorders, stress, depression, and anxiety. The Employee Assistance Program (EAP) provides up to five hours of assessment and counseling with no cost to Knox employees. Services are provided by Advanced Behavioral Health and are completely confidential. For additional information or to make an appointment, phone (309) 342-6852.
Notice of HIPAA Privacy Practices Reminder
The HIPAA privacy rule requires health plan to remind individuals - once every three years - that a Notice of Privacy Practices is available at: http://www.knox.edu/Offices-and-Services/Human-Resources.html
Summary of Annual Reports
Knox College's Summary Annual Reports for the period January 1, 2008 through December 31, 2008 can be accessed at the Human Resources Office Resources & Links page. The reports have been filed with the Internal Revenue Service, as required under the Employee Retirement Income Security Act of 1974 (ERISA).
Questions about coverage or benefits?
I encourage all employees to contact my office at x7474 with questions regarding your health benefits and coverage. Unexpected charges may be avoided or reduced by knowing your benefit coverage. Also you may contact Benefit Administrative Systems directly at 1-800-843- 3831.
