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Carenet Insights

How Are You Handling the Growing Access to Care Issue?

9/21/16 2:00 PM

The throbbing and pressure in Jack’s head was relentless. Not one to typically get sick, he was becoming concerned about his intense headaches that started a week ago. An online search sent him into a panic when self-diagnosis tools led to worst-case scenarios.

As Jack hadn’t seen a doctor in years, he wasn’t sure where to turn. He called a handful of physicians on his new health plan only to be told appointments weren’t available for another few days, or that the doctor wasn’t accepting new patients. Scared that something was really wrong, he went to the ER. He figured it was the fastest way to get help.

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Topics: ER Diversion, telehealth, ER Utilization, health literacy, access to care, er avoidance

What Can Curtail the High Cost of ACA Exchange Enrollees?

9/7/16 2:00 PM

More than 11 million Americans have insurance coverage via the Affordable Care Act (ACA) marketplaces—and they’re bringing with them extremely high health costs and subsequent financial losses by plans participating in the public exchanges.

As a result, many health insurers are proposing double-digit premium increases to offset high medical claims and drug costs, while some plans are substantially decreasing their participation or withdrawing completely from the ACA exchanges.

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Topics: telehealth, health insurance exchanges

Are Employee Benefits Helping People Make Better Healthcare Decisions? They Need To.

8/24/16 2:00 PM

While company perks such as tuition reimbursement, flexible hours and free meals are highly attractive to job seekers and employees alike, two out of three workers prefer better health and wellness benefits, according to recent survey conducted by One Medical Group.

The survey of 1,000 U.S. professionals also revealed that 64 percent of employees believe one of the top goals of their company’s benefits program should be keeping its workforce healthy. Yet, nearly half of the survey respondents say their employer is falling short in this area. Only 52 percent feel “their company is making a sufficient investment in their wellness and preventive care” and only 25 percent think “their company’s health and wellness programs are actually making them healthier.”

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Topics: Employers, Healthcare Navigation

Generic Drug Sticker Shock Now Driving Medication Nonadherence

8/10/16 1:00 PM

Cheryl thought she misheard her pharmacist. The price he stated for her thyroid medicine—a generic drug—was three times higher than what she had been paying every month for the past four years. Shocked, she closed her wallet, left the refill on the counter, and walked away.

Although she felt uneasy about skipping her medication, Cheryl simply couldn’t afford to pay the higher price indefinitely, especially on top of the two blood pressure medications she was already purchasing each month. She was astounded that her generic medication had become unaffordable when she had heard for years that generics would offer the cost relief she very much needed. And because she was so angry about the price hike, she went weeks before the discomfort of her low thyroid symptoms finally forced her to call her doctor to discuss other options.

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Topics: Medication Adherence

Are You Getting the Most Out of Your Nurse Advice Line Performance Tracking?

7/28/16 2:30 PM

When it comes to your nurse advice line, it’s imperative to consistently collect, analyze and monitor key performance metrics to know whether you’re meeting your goals, such as reducing avoidable ER visits and hospital readmissions, increasing enrollment in case or disease management programs, improving member satisfaction and clinical outcomes, cutting costs—or all of the above.

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Topics: nurse advice line

How High is too High? Deductibles Causing Employees to Think Twice About Necessary Care

7/14/16 1:00 PM

Lucy was driving home from work when her husband Mike called to tell her he needed to go to the emergency room right away. He was very worried about his blood pressure; it was extremely high according to his at-home monitor. Saddled with a $6,000 per person deductible via her employer-sponsored health plan, and fearing what an ER visit would cost, Lucy instructed Mike to call their plan’s nurse line for advice on what to do.

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Topics: Employers, Healthcare Navigation

What We're Reading - Week of 7/11

7/11/16 1:00 PM

This week, we examine what could become the next big issue in healthcare: coverage adequacy. With 91 percent of Americans now covered by health insurance, access to adequate care may become a major challenge, especially as consumers shoulder a much larger share of their healthcare costs. Learn how Carenet’s Healthcare Navigation solution can help commercial health plan members smoothly navigate today’s complex healthcare system and find cost-effective, easily accessible care options by downloading our e-book, Revamping the Healthcare Experience for Today’s Healthcare Consumer.

In other news, we look at some of the new provisions under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), including new analysis- and data-sharing rules and interoperability measurement requirements. Also in this week’s headlines: tips for veterans for making the most of telehealth—a topic we covered in our last blog article, “PTSD Support through Virtual Care.”

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Topics: What We're Reading

What We're Reading - Week of 7/5

7/6/16 1:00 PM

Seventy-seven percent of consumers are looking forward to virtual healthcare, according to a recent survey, which also found that convenience and cost-savings are the top two benefits consumers are most excited about. Another study highlighted in this week’s news illustrates how telehealth can help meet the critical need for pediatric and adolescent behavioral healthcare services in underserved rural and urban areas. 

As consumer demand and readiness for virtual care rises, an increasing number of health insurers are partnering with telehealth providers to offer their populations easy access to virtual MDs and behavioral health specialists. To learn more about the growing need for virtual care, download Carenet’s e-book, Telehealth: Market Forces Driving Innovative Delivery Models.

In other news, a Kaiser Family Foundation report shows significant net growth in Medicaid and CHIP enrollment under the Affordable Care Act, with nearly 73 million Americans now enrolled.

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Topics: What We're Reading

PTSD Support Through Virtual Care

6/28/16 1:00 PM

By Linda Raileanu, RN, MM/PA, BSN, Vice President, Clinical Services, Carenet Healthcare Services

June is Post-Traumatic Stress Disorder (PTSD) Awareness Month, a national initiative to raise public awareness of this serious mental health disorder, including its symptoms and treatment options. PTSD occurs following exposure to a traumatic event, such as a serious accident, violent physical assault, sudden death of a loved one, natural disaster, terrorist attack or military combat. Severe anxiety, flashbacks, nightmares, avoidance, depression and emotional numbness are some of the condition’s common symptoms.

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Topics: nurse advice line, telehealth

What We're Reading - Week of 6/27

6/27/16 1:00 PM

Major changes to Medicare’s outpatient prescription program have been proposed by the Medicare Payment Advisory Commission (MedPAC) in response to skyrocketing drug costs—spending rose nearly 60 percent from 2007 through 2014, from $46 billion to $73 billion. MedPAC estimates at least $10 billion could be saved within the next five years, partly by encouraging the use of generic drugs. Switching patients from brand-name to generic drugs is an area Carenet Healthcare Services is well-versed in. To learn more, download our e-book, Overcoming Barriers: The Faces of Medication Nonadherence.

In other news, we look at the link between hospital employee engagement and patient satisfaction and the strategies an Accountable Care Organization (ACO) employed to achieve cost savings and care quality. Lastly, we’re excited to see how telehealth is successfully providing subspecialized care for rural patients.

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Topics: What We're Reading