Friday, August 31, 2012

September is National Infant Mortality Awareness Month

For most of the country, September is synonymous with back to school.  But what most people don’t know is that September is also National Infant Mortality Awareness Month, so it’s a great time to talk about what can be done to help expectant mothers increase their chances of delivering healthy babies.  To get the conversation started, I’ve enlisted the help of Dr. Anju Sikka, regional medical director for UnitedHealthcare in New Jersey.

According to Dr. Sikka, when it comes to pregnancy, what mothers don’t know really could hurt them and their babies.  That’s why we’ve launched the Healthy Pregnancy program to help connect expectant mothers, insured by UnitedHealthcare, with the care and education they need. 

One of our areas of focus for expectant mothers is to help them understand the process of a baby’s development and avoid risk factors for giving birth prematurely.  Some risk factors are entirely avoidable.  For instance, we discovered from a survey that many new moms don’t have a clear understanding of when a baby is “full term.”

The American College of Obstetricians and Gynecologists (ACOG) classifies a baby as “full term” at 37 weeks, but advises against elective deliveries before 39 weeks.  But the UnitedHealthcare study, which surveyed 650 insured, first-time mothers from varied geographic, ethnic and socioeconomic backgrounds, found that more than 90% of respondents thought that it was safe to deliver a baby before 39 weeks.  Furthermore, nearly one in four women surveyed believed that a baby was full term at 34-36 weeks.

When UnitedHealthcare reviewed claims data from 2006, we discovered that 48% of newborns admitted to the neonatal intensive care unit were from scheduled admissions for delivery, many before 39 weeks of gestation.  While many mothers will try to schedule the birth of their baby around other events or around their doctor’s schedule, planning a birth before the baby is full-term comes at a risk to the infant’s health.  When doctors at these hospitals were notified of UnitedHealthcare’s findings and altered their practices to avoid scheduled deliveries before 39 weeks, the hospitals saw a 46-percent decrease in admissions to the NICU in the first three months - a decline that has held stable.

Dr. Sikka strongly emphasized the fact that, the decision to induce labor early or perform a C-section before a pregnancy is full-term should take clinical recommendations into account and reflect the baby’s and mother’s health and medical needs.  Expectant parents should take the opportunity to learn just how important the last few remaining weeks are for a baby’s health and development.

More information about women’s health and healthy pregnancies can be viewed at

Friday, August 24, 2012

Health insurance apps put important health care information at your fingertips

Before you left for your son’s soccer tournament, did you check where all the medical centers are near the soccer fields, just in case he gets hurt?

And if he does get hurt, will you remember to tell the doctor the name of the drug that he had an allergic reaction to that one time?  Tetra-something?

And of course, you didn’t leave the insurance card sitting on the kitchen table, did you?

Health emergencies can arise anytime, anywhere, and everyone should be prepared.  But if you had to check all of your health information every time you left the house, you’d never get out the door.

Fortunately, many health insurers are making things easier by providing health apps that help consumers manage their health plans on the go.  I know it may not sound like as much fun as a round of Angry Birds or Fruit Ninja, but when you suddenly find yourself dealing with a health situation, you’ll be glad you have it.

At UnitedHealthcare, we have an app that’s called Health4Me.  The app is free and available at http:/  It offers information on a variety of health topics and helps plan participants to manage their health care needs and expenses, including:
  • Contacting a registered nurse 24/7 for information regarding any kind of medical topic;
  • Downloading your health plan ID card to your phone and emailing it or faxing it directly to the physician’s office or hospital;
  • Viewing information on the status of your deductible and out-of-pocket spending, and checking account balances for health reimbursement, flexible spending and health savings account;
  • Requesting a callback from the health insurance carrier on specific questions about claims and benefits;
  • Saving information about your favorite care providers and recording personal notes during a doctor’s visit;
  • Locating nearby physicians, hospitals, emergency rooms and urgent care centers using the phone’s GPS function.
Later this year we will add UnitedHealthcare’s Cost Estimator to the app.  The Cost Estimator is a new integrated online service that brings a retail shopping experience to health care and helps people find quality care while being able to estimate the cost of more than 100 common treatments and procedures with maximum accuracy. Estimates are also personalized to reflect an individual’s own health plan benefits, including their real-time account balances when applicable.

Mobile apps are making health care simpler and more accessible.  So the next time you pull your smart phone out for a quick game, take a moment and get your health plan in order.  It’s like killing two pigs with one angry bird.

Monday, August 6, 2012

Back to the basics: primary care system gets a boost in New Jersey

A primary care practice is a key point of contact for patients’ health care needs. Primary care is critical to promoting health, improving care, and reducing overall health care costs, but in the more widely used  pay-for-service system, it is hard to put a value on the primary care relationship.  Fewer physicians are entering into and remaining in primary care.

As a result, consumers have less access to primary care and are using higher-cost settings such as the emergency room, urgent care and specialty care for situations more effectively addressed by primary physicians and facilities. According to the Centers for Medicare and Medicaid Services (CMS), spending on hospital visits, medications and other health care rose an estimated 3.9 percent in 2011 and consumed about 17.9 percent of U. S. gross domestic product.

But now the way doctors deliver primary care is changing rapidly in the United States, and UnitedHealthcare, other health insurers  and select physician practice groups are leading the way by participating in a CMS pilot program that is testing new models of primary care.  The Comprehensive Primary Care Initiative (CPCI) is being introduced this year in eight states including New Jersey.

Under CPCI primary care physicians will receive financial support based on the number of patients that a practice is caring for, regardless of how many visits or services the patients are receiving.  They will also have the opportunity to receive an additional payment based on the cost, utilization and quality health care services they provide.   These additional fees help physicians hire care coordinators to monitor care plans and help better manage patients with chronic diseases.  Approximately 75 primary care practices will be selected by CMS to participate in the program.  

UnitedHealthcare believes programs like CPCI are important to helping improve the overall quality of health care and reducing medical costs for all Americans. Our healthcare system has long operated on a fee-for-service basis, meaning that every time a physician or other health care professional does something, someone or some combination of people and organizations pays for it. Pay-for-service naturally leads to a focus on helping sick people get better, as opposed to preventing the illness in the first place.  Fee-for-service also encourages the medical industry to organize itself around specific services—operations, procedures and prescriptions—instead of dealing holistically with people.

Many of the changes in health care have tried to address the tendency of fee-for-service to lead to a fragmented, healing only -focus approach to health care. For example, UnitedHealthcare was a pioneer in covering preventive medicine such as colonoscopies, mammograms and annual physicals without co-pay, coinsurance or deductible, a principle now enshrined in the Affordable Care Act. The CMS primary care initiative is the latest step in the slow and steady transformation to a more patient-centered health care system.

For additional information on the CMS program and to see if your state is one of the  participating states go to