Poindexter's Points:
Advanced Plan for Health's News and Updates

November 2018
In The News
We’re very pleased to share that our Yvonne Daugherty , VP of Development for APH, had an article featured in BenefitsPro in October:

The article addresses inappropriate ER visits and how employers can proactively mitigate non-urgent ER utilization through ongoing multi-channel education of alternative services such as urgent-care centers, telehealth and outreach programs.

Recaps From the Road
3 topics that generated the most buzz at RISE West 2018

APH was fortunate to have our Rick Scheel participate in the important discussions at the RISE West 2018 Summit . He said the agenda was filled with valuable information and best practices, and the energy for innovation was palpable.

Below is a summary of an article penned by Ilene MacDonald from RISE on three topics that generated the most buzz at that conference:

1.   Models of care to address social determinants of health

While there were only a couple of sessions specifically devoted to initiatives that health plans have taken to address their members’ social determinants of health, the topic frequently came up in other speaker presentations and networking sessions.

More and more health plans are beginning to pay attention to the impact a person’s lifestyle, living conditions, and employment have on his or her overall health and outcomes. Indeed, interest in social determinants of health is now so strong, one speaker predicted it will drive rapid change throughout the health care industry, a business that typically takes a wait-and-see approach to new models of care.

2.   Strategies to improve Star ratings

A respected Medicare Advantage plan with a 4.5 Star Rating presented strategies they utilized to improve ratings. They attributed the high ranking to the fact that the entire staff is responsible for quality and their goal is to see improvements in member satisfaction, retention rates, and outcomes.

The plan is also “member-centric” and not “measure-centric.” This means it focuses on member goals and worries. Because members often trust doctors more than they do their insurance company, the plan coordinates with providers to send out reminders or information about member preventive care benefits. For example, to encourage members to get their flu shots, the plan posted signs in doctors’ offices that encouraged patients to ask about the flu shots and had staff give out magnets that reminded members to make an appointment for a vaccination for the next flu season.

They also took engagement to the next level at the annual member-only event by offering members a $10 gift card if they got their flu shots before they left the meeting.

3.   Innovative ways to engage providers

In a session on provider engagement, a health plan presenter explained how the plan not only wanted to achieve the Triple Aim goals to provide better care, improve population health, and lower costs, but also a fourth goal—to help providers find meaning in their daily work.

To better engage providers, the organization conducts monthly “lunch and learns” the same day each month. The meeting included a chart review and a discussion of what was working well for them and what wasn’t working well. The health plan made changes based on that feedback.

A representative from another plan , said her organization focuses on quality care and combines education of all programs and measures together. But she offers training in smaller segments. For example, her team created a 15-minute webinar that gave an overview of risk adjustment that physicians can watch on demand, whenever they have downtime. Training is conducted throughout the year and the team provides physicians with monthly feedback on all performance measures.

Read the full RISE article here .
World Health Congress -
Employee Health, Benefits, & Well-Being Congress

Our Denis Cremin was a delegate at the Employee Health, Benefits, & Well-Being Congress in October, where Employers, Providers, Payers, TPAs, Brokers, Benefits Advisers and Solution providers like APH engaged in two days of presentations and dynamic discussions focused on improving employee health and containing rising health care costs.

Primary focus areas were: Enhancing employee well-being; Making data-centric decisions; Adoption of value-based models including employer-led Centers of Excellence and ACOs to maximize savings; Leveraging stakeholder partnerships; Integrating digital technology within workplace health to ensure on-demand care.

There was a significant focus on success with worksite clinics and the emergence of direct employer relationships with providers. With worksite clinics, best practices were shared around driving employee utilization and weaving clinics into overall wellness and financial goals.

Learn more about the conference topics here .
For any further questions related to our experience and learnings at these conferences, please feel free to reach out to us at (888) 600-7566 or  marketing@mypoindexter.com .
Blog Insights

By 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 is associated with long-term complications that affect almost every part of the body. The disease often leads to blindness, heart and blood vessel disease, stroke, kidney failure, amputations, and nerve damage. Uncontrolled diabetes can complicate pregnancy, and birth defects are more common in babies born to women with diabetes.

By 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.

APH, On the Road
Upcoming Tradeshows and Conferences
February 4 – 6, 2019 l Las Vegas, NV

This annual conference for the self-funding industry offers a program covering strategic ideas focused toward third party and benefit administrator executive leadership. The conference provides critical points of view, often disruptive, which are meant to challenge and to provoke thought, while providing education for all attendees.
September 30 - October 2, 2019 l San Francisco, California

Advanced Plan for Health will be exhibiting and conducting Poindexter demos at booth #714. We will also be participating in the conference as delegates.

The SIIA National Conference & Expo is the world’s largest event focused exclusively on the self-insurance / captive insurance marketplace and typically attracts more than 1,700 attendees from around the United States and from a growing number of countries around the world.  
The APH team would welcome the opportunity to meet you in person at any of our scheduled tradeshows and conferences. Contact us here , email us at marketing@mypoindexter.com or call (888) 600-7566 to arrange a time to meet with us.