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The Growing Need for Better Access to Behavioral Health Support

The Growing Need for Better Access to Behavioral Health Support

Mental and substance abuse disorders and their downstream impacts are becoming a growing concern for employers – with costs to employers estimated at $225.8 billion each year. Notably, the financial impact goes beyond absenteeism to include presenteeism as well. Presenteeism, or individuals working with untreated illnesses, is estimated to cost employers $1,601 per person each year according to the same Inc. Magazine article.

Many employers are actively looking for better ways to offer their employees support in this area –  as they do for overall wellness and chronic conditions such as diabetes and high blood pressure.

Unexpected Unreasonable Claims Costs in Intraoperative Neurologic Monitoring (IONM)

Unexpected Unreasonable Claims Costs in Intraoperative Neurologic Monitoring (IONM)

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

Several of our Health Plan clients and their members have experienced unexpected and very unpleasant surprises following certain complex surgical procedures – usually spine-related. So we wanted to get a cautionary word out a bit more broadly on this topic to our clients and others who may be facing similar situations. The surprises are coming in the way of bills for intraoperative neurologic monitoring (IONM).

In one case, the billing technician was not a physician, and the member’s bill for monitoring services was an unreasonable, non-negotiable $120,000.

Part 2 - Consumer Guide to High Blood Pressure to Share with Your Population

Part 2 - Consumer Guide to High Blood Pressure to Share with Your Population

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

The team at Advanced Plan for Health (APH) is passionate about improving the health and well-being of as many healthcare consumers as possible, so in honor of Heart Health Month, we created a Consumer Guide to High Blood Pressure for you to use to share details on the risk of hypertension and some preventative measures with your member, employee and patient populations. We encourage you to share any of this information as you find appropriate.

Informed and Healthy Employees Make for Healthy Benefit Plans

Informed and Healthy Employees Make for Healthy Benefit Plans

Employers have found that it is not only the catastrophic conditions inherent in the high risk employee cohort, but also individuals who have reached the high risk group as a result of many different health issues (co-morbidities), lacking a personal physician, and inappropriately using the hospital or emergent care services for preventable problems. Plan members who are bouncing from one physician to another, because they may not understand what they need or where to obtain the requisite services, also present opportunities to improve clinical and financial metrics.

 

New Year's Company Resolutions

New Year's Company Resolutions

Most company resolutions come in the form of strategies and goals that become the focus for the year ahead. They include wellness programs for employees, benefit changes that will hopefully inspire amendment to employee behavior and “better pricing” from providers and networks.

Congratulations Hill Country Memorial

Congratulations Hill Country Memorial

Congratulations to our partner/client, Hill Country Memorial—located in Fredericks, Texas—for emerging as a recipient of the 2014 Malcolm Baldridge National Quality Award, our nation’s highest Presidential honor for performance excellence through innovation, improvement and visionary leadership.

Introducing Poindexter

Introducing Poindexter

Poindexter is no ordinary predictive modeling engine typical of the Population Health Market. Poindexter is APH's industry-leading phenotype, cross-dimensional predictive modeling engine that examines the entire population.

Three Ways To Improve Employee Health, Reduce Costs

Three Ways To Improve Employee Health, Reduce Costs

From our article in Information Week: Chances are 10% of your employees are generating 70% of your company's healthcare costs. Analytics and partnerships can improve their health and reduce your expenses.

Harmful, Fake Health Foods

Harmful, Fake Health Foods

Dr. Lee decided to take action and has dedicated her life’s work to making the nonviable, viable, when it comes to sustainable health. In an engaging and educational viral video, Dr. Lee addresses risk factors for fatigue and weight gain, its resulting complications, and discloses weight loss strategies and ways to promote healthier lifestyle changes that yield maximum results.

CAR-T Immunotherapy – the Newest Cancer Warrior Cells

CAR-T Immunotherapy – the Newest Cancer Warrior Cells

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

CAR-T Immunotherapy is a treatment which optimizes the body’s ability to target, attack and kill tumor cells. On August 30, 2017, the Federal Drug Administration (FDA) approved the Novartis version of CAR-T cell therapy for children and young adults with B-cell acute lymphoblastic leukemia (ALL), which is the most common form of childhood cancer in America. While current chemotherapy, radiation and bone marrow transplants result in remission for about 80 percent of people with ALL, there are still about 20 percent who do not respond to current treatment. These individuals are said to be refractory to treatment. For them, CAR-T is a lifesaving option. However, medical miracles come at a large cost to health plans and Payors.