Consumers should pay close attention to new benefits in Medicare Advantage (MA) plans in 2019. New benefits may include transportation, and home health visits.

At the same time, CMS is beginning to consider Medicaid demonstration waivers covering short-term stays for acute care provided in psychiatric hospitals or residential treatment centers in exchange for expanding access to community-based mental health services.

Eligible United Healthcare members participate by;

1. Asking your doctor about lower cost prescription drug alternatives.

2. Filling an eligible prescription.

3. Activating your My ScriptRewards.

4. Continuing your medication for 6 months.

You should receive a $250 gift card in the mail, and another $250 gift card when you complete 6 months of your prescription. Self-insured customers should be added to the the list of participants in Nov. Stay tuned to see if this program is expanded to other high cost specialty medications in 2019.

 

2019 Medicare Advantage plan purchasers should be looking carefully for new benefits that help diagnose and manage health conditions. Important benefits included are; transportation to physicians, over-the-counter drugs, adult day care, in-home support and home modifications, support lines and wellness programs.  The Kaiser Family Foundation (KFF) estimates almost 1/3 of Medicare Advantage plans will have some additional benefits for their members.

Your doctors and health providers can not manage your chronic illness for you. Patients who self-manage their chronic illnesses spend less time in hospitals and emergency rooms, have fewer doctor appointments, and lower their health care costs. For more information on how to manage your chronic disease use this resource from the U.S. Centers for Disease Control (CDC), or go to the Healthcare Help index at aPatientPlace.com.

Much is being said about treating cancer with marijuana. Facts are easily confused with opinions, advertising, and compelling personal stories. Click here to get the facts according to the National Cancer Institute’s “Overview” on Marijuana research.  You also have free access some of the very best sources for medical research and information at aPatientsPlace.com.

 

Learn what matters most to Americans in this July 2018 poll from the Kaiser Foundation.

Two questions that patients should ask far more than they do are;

 “How often have you seen, diagnosed, and treated someone with symptoms like mine,” and, “how successful were you at diagnosing and treating the related illness or condition?”

After a review of countless articles on top and best doctors including related research studies on what qualities make a good doctor, it’s shocking how few mention the doctor’s recent experience or success at diagnosing and treating the condition or illness. Yet, doctors who diagnose and treat a specific illness or disease frequently perform better than other doctors without similar experience, and the outcomes have a greater variation among low-volume clinicians. [i]

Experience is not the only key quality that is often missing in the links presented on page one of major search engine results.

Here’s a list of four key qualities that are often missed, yet are very important if you want the best outcome possible from your doctors and clinicians ;

1. Your clinician has recent and successful experience diagnosing and/or treating your illness or condition. The higher the volume the better, in most cases.
2. You have access to your clinician and/or their staff and support whenever needed; 24/7.
3. Your primary doctors or their staff coordinate your medical information and care plans with other clinicians, and your care providers. This is especially important during transitions from one care setting to another. Specially after a hospital or acute care discharge.
4. Your clinicians and/or their staff will help you understand your financial obligations as you consider your options for tests, treatments, and care.

No doubt that research indicating that clinician confidence, empathy, humanity, personality, honesty, respect, curiosity, and thoroughness are among the key qualities of an ideal doctor are all relevant.

Although, it’s hard to believe that a doctor with all the qualities mentioned in the previous paragraph would be more ideal than a doctor without all of them who had successfully diagnosed and treated 100% of their patients, was available to answer your questions 24/7, had staff that coordinated all your healthcare needs, and made sure that you understood the financial implications of your options given your health insurance and personal circumstances.

Learn more about how to get your doctor working as your partner.

[i] Institute of Medicine. 2000. Interpreting the Volume-Outcome Relationship in the Context of Healthcare Quality: Workshop Summary. Washington, D.C.: The National Academies Press. https//doi.org/10.17226/1005

Not all tests and treatments are necessary and appropriate. Choosing Wisely by the American Board of Medical Specialties (ABIM Foundation) has developed a searchable and indexed database of patient education for more than 120 conditions, tests, and treatments to help patients understand their situations, and speak with their health care providers.

Here are simple tips to minimize the chances of mistakes in your diagnosis, treatment, and healthcare finances:

1. Ask your doctor(s) questions about everything that you do not completely understand until you do understand.
2. Find a primary care doctor who listens to you, you trust, and you can contact when needed.
3. Request copies and keep your own medical records. Do not trust any insurance provider, Medicare, or health system just because they have a system that lets you access your information. Make copies, and/or make sure that your medical records are in a system that you control.
4. Prepare for appointments with doctors by sharing your goals and questions with them at least 1 day before your appointment.
5. Verify any abnormal medical tests with a second test. Labs make mistakes, too.
6. When given any serious diagnosis do these two things; 1. ask if “based on my medical history and what you know about my circumstances, could my condition be something else?” and Get a second opinion.
7. Always review your medical bills and ask for an itemized bill if anything looks suspicious. You will need an itemized bill to dispute any charges.

There is a lot of free, expert help available. Use it when you need it.

The Council of Accountable Physician Practices (CAPP) conducted focus groups across the country to compare the perceptions of patients and physicians. CAPP, which is made up of many of the leading medical groups in the country, followed the focus groups with a survey of 30,000 patients and 700 physicians.

Based on some discouraging results on physician access to their patients electronic medical records and the communication of the importance of avoiding and managing chronic illness through better diet, exercise and prevention CAPP conducted additional focus groups in 2018.

One of the most encouraging outcomes of the follow up research was that patients and physicians agreed that the patient-physician relationship, using evidence-based medicine, and care coordination were the highest ranked priorities. It’s also worth noting that both patients and physicians chose technology as the lowest priority.

Regardless of the areas of agreement, the fact the patients and physicians agreed on what they value as the highest priorities, and that patients have increased their understanding of the healthcare delivery system and evidence–based decision making are leaps forward in our quest to strengthen the patient-physician relationship, and improve healthcare costs and outcomes.