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What's all the Fuss About Avoiding Flu Shots?

With this season’s flu season starting, we’re asked more and more by clients why there is so much resistance to getting the flu shot, and how they can counter the objections.

Coming out of the record-breaking flu season of 2017, we know this is important and very serious to address. The CDC said 2017's Influenza Death Toll Was the Highest in 40 Years! “The flu, as well as flu-related complications, was responsible for 80,000 U.S. deaths last winter. That’s the highest flu-related death toll in the U.S. four decades.” Of the estimated 80,000 who died of flu and its complications, 180 were children – and “approximately 80 percent of those deaths occurred in children who had not received a flu vaccination.”

What's all the Fuss About Avoiding Flu Shots?
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Diabetes Facts and Resources

Barbara Rutkowski, EdD, MSN, CCM - Vice President, Clinical Operations, Advanced Plan for Health & Joy McGee-Cory - Senior Vice President, Advanced Plan for Health

Diabetes is a serious, lifelong condition. It is widely recognized as one of the leading causes of death and disability in the United States. More than 100 million U.S. adults are now living with diabetes or prediabetes, according to a report released in 2017 by the Centers for Disease Control and Prevention.

Diabetes Facts and Resources
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Assessment of 2019 Medical Cost Trends

Chris Galanos, Director of Medical Services, Advanced Plan for Health

Our customers and partners rely on us to keep our finger on the pulse of what’s coming in the marketplace, and what we’re seeing trend within the member population in our Poindexter advanced and predictive analytics platform.

I recently performed a market scan and Poindexter information synthesis in support of providing a read-out on 2019 Medical Cost trend predictions, and felt it would be helpful to share a summary via the APH blog.

Assessment of 2019 Medical Cost Trends
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Would Your Health Plan Pay for a Transplant with an HCV-Infected Organ?

Barbara Rutkowski, EdD, MSN, CCM - Vice President, Clinical Operations, Advanced Plan for Health and Yvonne Daugherty, VP of Development, Advanced Plan for Health

There are about 99,000 Americans listed for a transplant, some for many years. Unfortunately, about 4,800 die each year while they wait for their transplant. Not everyone is at the top of the transplant list nor do they have the remaining life and / or health to undergo the procedure if the wait is too long.

Expanding the available organ pool can save lives and reduce overall costs in many cases.

There is a relatively new source of organs available from deceased individuals infected with Hepatitis C (HCV-infected). These organs were formerly discarded, but they are now being utilized... 

Would Your Health Plan Pay for a Transplant with an HCV-Infected Organ?
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Influence on Lifestyle Change Does Have an Impact on Outcomes

Once populations are targeted for support and intervention via our Poindexter advanced and predictive analytics (via current state and predicted risk factors), we’ve found that one of the most effective ways to support targeted employees and members is through live or telephonic nurse influence and intervention.

Nurses are able to deliver individuals the education and support they need to make important lifestyle and preventative care changes. This is one of the most effective programs that we’ve seen in delivering needed outcomes.

Influence on Lifestyle Change Does Have an Impact on Outcomes
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Ongoing Education on Alternate Sites of Care Can Reduce Inappropriate ER Utilization

With higher and higher ER bills coming in to the plan and members, employers are learning that it’s more important than ever for them to make sure that continual reminders are sent to their employees and members about which conditions can be handled by more convenient and lower cost sites of care such as a nurse advice line, telehealth (which often also covers behavioral health), on-site or retail clinic or urgent care. They’re also sharing details on how to reach these resources, and how much lower out-of-pocket costs will be to members who utilize them versus the ER. Keeping this information top of mind when it’s needed is the key to effective communications in this area.

Ongoing Education on Alternate Sites of Care Can Reduce Inappropriate ER Utilization
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Keys to Truly Impactful and Measurable Employer Health & Wellness Programs

With medical costs rising, pharmaceutical costs quickly meeting or exceeding medical costs and miraculous specialty drugs coming in at nosebleed costs, optimizing employee health and saving for catastrophic events is paramount to afford expensive lifesaving medicines and treatments, along with inevitable catastrophic cases that plague nearly every employer’s health plan.

Keys to Truly Impactful and Measurable Employer Health & Wellness Programs
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Pre-Emptive and Analytics-Based Early Action Can Delay Kidney Dialysis, Reduce Plan Costs and Improve Quality of Life

Barbara Rutkowski, EdD, MSN, CCM - Vice President, Clinical Operations, Advanced Plan for Health & Joy McGee-Cory - Senior Vice President, Advanced Plan for Health

Early intervention is the key to slowing or stopping chronic kidney disease (CKD), improving the quality of lives for those at risk and containing health plan costs. Avoiding dialysis for just one member represents a health plan savings of $350,000 to $700,00 per year, which more than pays for the CKD program by itself.

Pre-Emptive and Analytics-Based Early Action Can Delay Kidney Dialysis, Reduce Plan Costs and Improve Quality of Life
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What more do employer groups expect from their health plan or TPA?

In this busy selling season for TPAs and health plans, we wanted to share an updated eBook that outlines some of what the Advanced Plan for Health is hearing from our TPA, health plan and employer clients related to what employers are really looking for as they’re shopping for benefits.

Here’s an excerpt:

Providing your employer clients with the right mix of services and support boosts your chances of standing out and winning and retaining their business. Fortunately, most self-insured employers want the same thing: healthy employees, positive employee healthcare experiences and reduced costs. Sounds simple enough, but how can you be sure that you are offering the best solutions in today’s strained and ever-changing healthcare environment so that you can continue to differentiate yourself and show value?

What more do employer groups expect from their health plan or TPA?
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Combatting the Crisis in Drug-Resistant Infections and Treatment

Barbara Rutkowski, EdD, MSN, CCM - Vice President, Clinical Operations, Advanced Plan for Health

A lot has happened since Alexander Fleming accidentally discovered Penicillin in 1928 after a chance exposure of staphylococcus to penicillin mold.  For his discovery, he won the Nobel Prize after penicillin was commercialized in 1945, used successfully for war wounds and surgery in World War II and hailed as the “miracle drug”. In his acceptance speech, Fleming admonished the world to beware that bacteria would become resistant in time.

Combatting the Crisis in Drug-Resistant Infections and Treatment
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