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Agent and Consultant Briefing: December 2010/January 2011

In this issue:

On My Mind:
Following Up on the Mid-term Elections

By: Cheryl DeMars, President & CEO

Typhoon. Landslide. Seismic shift. These were some of the metaphors used to describe the results of the November 2 mid-term elections. The shift in power in many parts of the country raises more questions and continues to fuel the fires of the debate about how health care reform will unfold.

Although Governor-elect Scott Walker has announced that Wisconsin will join in the lawsuit challenging certain provisions of the Patient Protection and Affordable Care Act, as a practical matter, planning for many aspects of health care reform implementation continues — most notably exploration of options for an insurance exchange in Wisconsin. 

The Alliance Health Policy Committee met with outgoing Department of Health Services Secretary Karen Timberlake on November 11 to provide feedback on options for Wisconsin’s insurance exchange.  Consistent with our health policy platform, we encouraged policymakers to make the exchange a vehicle that helps control costs and increase transparency of information.  We also stressed the importance of pursuing strategies that will accomplish these goals for all citizens of Wisconsin, not only those who are eligible to purchase health insurance through the exchange. 

The Health Policy Committee is in the process of drafting a resolution regarding the design of health insurance exchanges that will articulate the priorities of Alliance members. Once drafted, the resolution will be sent to The Alliance Board of Directors for review and approval. Watch for a copy of this resolution in an upcoming issue of the Agent and Consultant Briefing. We will use this resolution as we introduce The Alliance to the many new legislators who will take office next year. 

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Ask the Right Questions to Get the Right Answers

Helping clients determine which network is the right one for them and their employees is an important step. It’s what you pay — not what you save. Here are a few questions to guide the process:

• Disruption analysis. How many employees will have to choose a new provider?
• Savings analysis. It’s not just what you are saving, but also what you are paying? What's my ROI?
• Contract structure. What’s the risk transfer? Are there incentives to improve? What’s the motivation of the provider?
• Network structure. Is the provider group exclusive? Is it direct or leased? How stable is it?
• Market baskets and sample claims. Are these representative CPTs? Is the sample large enough? Is it geographically precise as possible?
  

Get the Tools to Evaluate Networks
The Alliance can provide you with a disruption analysis report to show you how many of your client’s current health providers are in The Alliance network and how disruptive it would be for their employees to change networks. An employee disruption analysis will show you how many providers are within the mileage threshold set by you. Request a disruption analysis or other information.

You can also access an online network evaluation savings tool .

For more information you may also contact Jesse Oberloh, 800.223.4139 x 6645 (current Alliance members) or Diane Loram (prospective Alliance members), 800.223.4139 x 6643.

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GINA Final Regulations Issued

The U.S. Equal Employment Opportunity Commission (EEOC) recently issued final regulations implementing the employment provisions (Title II) of the Genetic Information Nondiscrimination Act of 2008 (GINA). GINA prohibits use of genetic information to make decisions about health insurance and employment, and restricts the acquisition and disclosure of genetic information.

The regulations include clarifications and refinements made in response to comments received during the notice and comment period. Many Alliance members submitted comments regarding the ability to ask family history questions on health risk assessments (HRAs) or incentives to employees who complete HRAs that have family history questions.

The final GINA regulations clarify that employers may offer financial inducements for employees to complete a health risk assessment that includes questions about family medical history or other genetic information, as long as:

• The assessment identifies the questions that request genetic information (including family history) and
• The HRA tool makes clear, in language that is reasonably likely to be understood by those completing it, that those questions identified above are optional and the financial reward will be provided to employees regardless of whether they answer those questions.

Read more about the final regulations and find links to resources in our Fact Sheet on The Genetic Information Nondiscrimination Act.  

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Join Us January 20 for Coming Up for Air: Coping with Stress and Change at the Worksite

Stress — epidemic at the worksite — is often cited as the number one reason for absenteeism, presenteeism and workers’ compensation claims. Research suggests that stress not only affects worker productivity, it is associated with as much as 85% of disease and illness, and most recently insomnia.

Coming Up for Air: Coping with Stress and Change at the Worksite, our Alliance Learning Circle on January 20, will explore the epidemic of worksite stress and the connection between stress and disease. Our speaker, Brian Luke Seaward will discuss the essential tools for stress decompression in the workplace from optimism and assertiveness to humor and relaxation, so your employees can finally catch their breath, regain a sense of balance and reclaim a sense of empowerment to navigate gracefully in life and at the worksite.

Brian Luke Seaward is regarded as one of the foremost experts in the field of stress management and a pioneer in the field of mind-body-spirit healing. He began his career as the associate director of Cardiac Rehab at the Gunderson-Lutheran Hospital and has served as a sports psychologist for many Olympians. He has worked with many corporate clients including Hewlett Packard, Procter & Gamble, Conoco Oil, Motorola, Quaker Oats, John Deere, BP-Amoco, Blue Cross/Blue Shield, Maxtor-Seagate, and Organic Valley Dairy.

Also Includes Wellness Vendor Fair
The event will also feature a resource fair to connect members with vendors and other organizations that can help employees manage stress in the workplace and their life. We’re inviting a number of vendors including those that offer on-site financial education, yoga, chair massages and other services.

See complete invitation (.pdf) and register today.

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From Health Solutions, Ltd.:  Winter Weight Gain

It is no secret that Midwestern residents tend to “hibernate” during the long, cold winter. Unfortunately, this tends to lead to weight gain. On average, Americans gain five pounds between Thanksgiving and Christmas due to holiday eating and lack of exercise; however, employer-sponsored wellness initiatives can help combat the winter bulge.

Try to imagine a typical office setting November through January; almost everyday someone is bringing in homemade cookies, cakes, and bread to “treat” their co-workers. Holiday parties yield high-fat, high-calorie consumption from fried appetizers to alcoholic beverages. This year employers can aim to make the holidays healthier for employees. Encouraging employees to bring less fattening treats or having healthy potlucks throughout the winter months that highlight nutritious slow cooker meals can help everyone get through the holidays with fewer  extra pounds. For company-sponsored holiday parties, employers will want to evaluate the menu ahead of time and select foods with health in mind.

The cold weather and snow can be a significant barrier to exercise. For those without a gym membership, activity may drop when the snow starts to fall. Employers can encourage seasonal exercise among employees by promoting local resources such as low-cost gyms, recreation department classes, local run/walk events, fitness DVD rentals, or plan a company outing that includes cross-country skiing or snowshoeing.

Company-wide challenges can be a great way to motivate and encourage employees to prevent winter weight gain. Health Solutions, Ltd^® offers challenges such as Trim to Win, Charity Weight Loss, Blitz to Fitness and Road to Fitness that can all be instrumental in avoiding the holiday bulge. For more information about Health Solutions, or about their partnership with The Alliance, contact Bobbi Jones, product management specialist, 800.223.4139 x 6638.

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Health and Wellness Discounts for Alliance Members

It pays to be a member of The Alliance — in more ways than one! Did you know many health clubs and fitness centers will give our members’ employees a discount just for being a part of The Alliance? They don't need to sign-up through their health plan; they simply show their Alliance medical ID at the door.

Discounts on services are available at more than 50 fitness locations in south-central Wisconsin. The same savings extend to hearing centers, nutrition and weight-loss clinics, karate classes, yoga sessions and massage therapy.

Offers vary, so employees will want to check with participating businesses for details. Information about this program can be accessed directly through this link, and can also be found by clicking "Improve Your Health and Wellness" under the "Quick Links" on the home page, and then clicking the "Healthy Living Discounts" link.

If you have ideas for vendors, please let us know.

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Feeding Those in Need this Season with a Donation to Second Harvest

When you think of the holiday season, it is often associated with food. Gathering around the table to share a warm and well-prepared meal that brings loved ones together is one of the fondest times for families and friends. For most, it is hard to imagine a holiday without the food essentials. Yet, in reality, hunger is all too local, especially in these economically trying times. It’s estimated that as many as 100,000 of our neighbors in southern Wisconsin will go to bed hungry tonight. That’s why The Alliance is proud to support the Second Harvest Food Bank of Southern Wisconsin again this holiday season.

Each year, instead of sending cards and gifts to our business associates, we make a donation to a charitable organization as a way of giving back to the communities in which our members live and work. Second Harvest distributes food to more than 400 charitable programs that feed the hungry in 16 southern Wisconsin counties. Our donation of $500 will deliver 3,500 meals to those in need this holiday season.

From all of us at The Alliance, we thank you for your continued support and wish you a very happy holiday and a most prosperous new year!

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DRIVE4COPD Raises Awareness of COPD Risk

DRIVE4COPD is a multi-year public health initiative to screen the millions of people who may be at risk for Chronic Obstructive Pulmonary Disease (COPD), the nation's 4th leading cause of death.

Through the campaign individuals complete a quick five-question screener which will tell them their risk of developing COPD. Those who score high are encouraged to bring their results to their health care provider.

The economic burden of COPD is high for employers, as approximately 70 percent of those with COPD are in the workforce. Employees with COPD cost an organization as much as 4 times as much as the average employee. COPD often contributes to absenteeism and reduces productivity.

Alliance members can access the screener here. 

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Building our Cooperative

Please join us in welcoming the following new member to our cooperative:

Chambers & Owens
Chambers & Owens is located on the north side of Janesville, Wis. They are a distributor of a complete range of inventory products for gas stations and convenience stores throughout the Midwest. They joined The Alliance in November.

Electric Coalition of Wisconsin
Electric Coalition of Wisconsin (ECWI) was founded in 1996 and is a non-profit trade organization that is made up of several electric cooperatives. ECWI is involved in rural electrification and utilizes the strength and knowledge of their members as the industry grows increasingly complex. ECWI joined The Alliance in September.

Quality Liquid Feeds
Quality Liquid Feeds (QLF) is a nationwide, innovative leader in developing and manufacturing liquid feed supplements for animals. According to their website, QLF is an American, family-owned company with 30 years experience in liquid feed manufacturing. They supply feeds in more than 30 states and pride themselves on providing supplements that are consistent, palatable, convenient, and cost effective. QLF joined The Alliance in June.

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Growing and Investing Together
-From Quantum Health

Quantum Health and The Alliance have made growth happen together. As a result, more than 5,000 employees are accessing information, guidance and assistance as they navigate the often complex health care process. Here are a few highlights:

Growth: In one year since developing the relationship with Quantum, six Alliance members have chosen the care coordination organization to help them reduce their health care spend. In total, Quantum works with nine Alliance members. Given the positive results that members have experienced thus far, we are actively partnering with The Alliance to bring this solution to additional employers in 2011. Early next year, we will release our 2010 year-in-review that will highlight our overall results and what they’ve meant for Alliance employers.

Investment: Recently, Quantum Health engaged Robert M. Honigberg, MD, MBA as our new consulting medical and healthcare strategy director. Dr. Honigberg is also the current chief medical officer of the Utilization Review Accreditation Commission (URAC) in Washington, D.C., and is a steering committee member of the Aspen Health Stewardship Project and on the Board of Directors of the Center for International Health. As Quantum Health’s medical and healthcare strategy director, Dr. Honigberg will evaluate strategic opportunities and review Quantum’s programs to ensure patient safety and promotion of health care quality as well as provide guidance on reporting and publication of data.

With growth in membership, investment in the business and our blossoming partnership with The Alliance, we are excited about potential for 2011 and believe that our ongoing collaboration brings proven results, higher quality and more affordable health care to members of The Alliance.

About Quantum Health/The Alliance Partnership
The Alliance’s partnership  brings members the Coordinated Health/Care™ integrated health management service. By combining the various aspects of care management and customer service into one robust system, Coordinated Health/Care™ delivers better experiences for individuals and a proven track record of cost savings for employers. Learn more here. 

If you are interested in learning more about Quantum Health, please contact Bobbi Jones, Alliance product management specialist, at 800.223.4139, x 6638 or John Bradford, vice-president of account services, Quantum Health at 800.257.2038  x 145.

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WIPHL Offers Webinar

The Wisconsin Initiative to Promote Healthy Lifestyles (WIPHL) is offering a free webinar, Behavioral Screening and Intervention (BSI) – A Win for Everyone on January 13, 2011 from noon – 1:30 p.m.

Tobacco use, excessive drinking, drug use and depression cost US employers hundreds of billions of dollars every year in health care and lost productivity. Health risk appraisals and employee assistance programs are helpful but lack the desired effectiveness, reach, and rigorously demonstrated ROI in addressing these problems. Systematic BSI in health care settings is recommended by many national authorities, with studies showing an excellent ROI within 12 months. 

WIPHL has helped integrate BSI into dozens of busy healthcare settings helping them conduct over 100,000 screens, deliver over 20,000 interventions, attain high patient and provider satisfaction, and elicit substantial declines in binge drinking and depressive symptoms.  The webinar will help you understand what you can do to take advantage of BSI. Topics include:

• What does BSI entail?
• How effective and cost-effective is BSI?
• How can BSI be integrated into busy health care settings?
• What barriers remain to bringing BSI to scale, and how can they be overcome?
• How can to ensure that your covered individuals receive BSI?

To register for the webinar e-mail Chanda Belcher with “BSI Webinar” in the subject line. Be sure to include your name, position, company, e-mail address and telephone number.

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Loram Receives RHU Designation, Elected to Board of WAHU and EWGA

Diane Loram, business development manager for The Alliance has received her Registered Health Underwriter^® (RHU^®) professional designation from The American College, Bryn Mawr, Pa.

Candidates for the RHU^® designation must complete three courses and six hours of supervised examinations. They must also fulfill stringent experience and ethics requirements.

Loram also has been elected to the Board of Directors South Central Chapter of the Wisconsin Association of Health Underwriters and the Board of Directors of the Madison Chapter of the Executive Women's Golf Association.

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Alliance Provider Update

The Alliance encourages employers to distribute the monthly Provider Update listing to their employees.

Just a reminder: Always check the online provider directory for the most current provider information!

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QualityCounts™ for Employees

The Alliance encourages employers to distribute the monthly QualityCounts for Employees informational piece to their employees.

This month, How much to you know about health care and cost? This month’s quiz is a fun way to challenge individual’s beliefs about the cost and quality of health care. Employers can use this as a poster or distribute in mailboxes or send to employees via e-mail. Employees may just learn a thing or two.

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News You Can Use

Each month, The Alliance highlights health care and benefit management news for employers in News You Can Use, with a link to take you to the original story or report.

1 in 10 Hospitalizations are Avoidable
The Agency for Healthcare Research and Quality’s (AHRQ) Healthcare Cost and Utilization Project (HCUP) measured  potential preventable hospitalizations and found that 1 in 10 were avoidable. 

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Don't Forget to Check Your 'Whitelist'

E-mail filters do a good job at keeping unwanted spam messages at bay. Sometimes, though, filters can be overeager in blocking important messages that you actually do want to read.

Now might be a good time to check and see if any of your colleagues should be receiving The Alliance member newsletter, and make sure our e-mail address (@the-alliance.org) is on their "whitelist". If you know of others at your organization who should be receiving our communications, contact Tierney Jensen.

While you're at it, you might want to ensure your own e-mail filter rules are in order. You may need to contact your network administrator to make any necessary changes.

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About The Alliance Agent and Consultant Briefing

Each month, The Alliance Agent and Consultant Briefing delivers the latest news to insurance agents and consultants about Alliance services, programs and events as well as information on health benefit trends, issues and ideas of interest to our mutual clients.

Subscriptions are available on a complimentary basis. To subscribe, please send an e-mail with your name, title and organization to the marketing and member services department.

Reader comments, suggestions and topics are always welcome.

Cathy Lanser, Editor
Tierney Jensen, Design
Diane Loram, Business Development Manager

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