WellCare of Nebraska Goes Live!

By Lauralie Rubel

WellCare of Nebraska is proud to announce that after months of hard work by dedicated associates in Nebraska and throughout the WellCare family, we are ready to share our decades of experience coordinating managed care for in-need families and children as well as elderly and disabled persons.

Nebraska’s Heritage Health program went live Jan. 1, 2017. For the first time, the state’s Medicaid managed health care delivery system combines physical health, behavioral health and pharmacy programs into a single comprehensive and coordinated system to improve health outcomes for approximately 230,000 Medicaid and Children’s Health Insurance Program (CHIP) enrollees.

WellCare will offer Nebraska members several programs specifically designed to help them get healthy and stay healthy. In addition to covering preventive services like annual routine exams, mammograms and well-child visits, our members have access to one-on-one support to help with chronic conditions like asthma and diabetes. We also provide support in managing lifestyle changes such as weight loss or smoking cessation.

We have a broad statewide network of providers and health care facilities to ensure that our members get care when and where they need it, such as access to a telemonitoring management system that measures and sends data to a WellCare nurse, provider or care manager.

We are especially pleased to present our community “Wimg_0035elcome Rooms,” which serve as local health information, education and activity centers. Our four WellCare Welcome Rooms in Nebraska, which are located in Kearney, Norfolk, Omaha and Scottsbluff, are scheduled to open in February and March of 2017. These centers have already begun hosting events, and were open to residents for gift wrapping stations and holiday treats last month. We are also planning activities in January for National Drug and Alcohol Facts Week (Jan. 23 – Jan. 29).

These brick-and-mortar locations will help us improve and strengthen the communities we serve and illustrate our commitment to offering health and well-being activities at no cost to area residents. Equally exciting is the fact that these communities have already expressed appreciation for WellCare’s repurposing of buildings, one of which that stood empty for more than seven years.

At WellCare, our members are at the center of everything we do. Approximately 100 people will be working day in and day out in the state to coordinate care for our WellCare of Nebraska members. We are committed to doing our part to help ensure Nebraska’s new Heritage Health program delivers better health outcomes, while helping our members live better, healthier lives.

rubel_lauralieLauralie Rubel is WellCare of Nebraska’s state president. She serves members of Heritage Health, Nebraska’s new integrated Medicaid managed care program that combines physical health, behavioral health and pharmacy programs under a single coordinated delivery system.

Live Well – Meditation for the Holidays

By Maggie Perritt

While the holidays bring fun and festivities, they can also lead to stress and challenges. In fact, the holidays are considered a “top 10” stressful situation—among moving, changing jobs and even divorce.

This year, consider adding something new to your routine to help you manage the stress of the holidays—meditation.

Meditation is a mind and body practice that has a long history of use for increasing calmness and physical relaxation, improving psychological balance, coping with illness, and enhancing overall health and well-being. Research suggests the benefits of practicing meditation may include reduced blood pressure, anxiety, depression and insomnia.

While there are several types of meditation, the actual practice is simple, doesn’t require any special equipment, and can be done anytime, anywhere.

At WellCare’s Tampa headquarters, we have implemented a monthly open yoga class that includes guided meditation to help our associates meet their own personal wellness goals.

So how can you get started and try meditation?

  1.  Learn the Basics of Meditation. First, find a quiet place. Next, assume a comfortable position and close your eyes. Then focus on your breathing. Pay attention to your inhale, the gentle pause at the top of your breath, and your exhale, the gentle pause at the bottom of your breath. This will help clear your mind. If you become distracted, remember to refocus your attention on your breathing.
  2. Start a Routine. Even if it’s only a couple of minutes, try to set aside time each day to meditate. And make sure it works for your schedule. Initially, you may only be able to do a couple of minutes, but in time, it will become easier and part of your routine.
  3. Give Yourself a Break. Establishing any new routine can be a challenge. You may not be able to meditate every day. When this happens, take a step back and breathe. Then, using the techniques of meditation, bring yourself back to the present moment and get back on track for a successful and happy holiday season.

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Maggie Perritt is WellCare’s senior director of compliance, overseeing delegation oversight. She is an accomplished author and certified group fitness instructor. She is also a 200-hour certified yoga instructor who has been practicing yoga and meditation for more than 20 years and teaching yoga and meditation for more than 6 years.

 

Managing Diabetes during the Holiday Season

By Dr. Traci Ferguson

diabetes_resizedThe holidays are upon us! It’s a time to gather with family and friends to indulge in some of our favorite holiday foods and beverages. But for the 29 million Americans living with diabetes, this time of year can be particularly challenging.

Diabetes—the seventh leading cause of death in the United States—is a metabolic disorder that affects the way the body uses and stores glucose, or sugar. That’s why people living with diabetes have to keep their blood sugar levels under control.

Holiday parties, vacation plans and travel can disrupt our regular routines, making it harder to manage blood sugar levels. So it’s especially important for people living with diabetes to diligently avoid overeating rich foods and to follow a regular exercise regimen.

Below are some steps you can take to keep your health in tip-top shape this holiday season:

  • Multi_104732257_PeopleWalking.jpgPractice Portion Control – People living with diabetes can enjoy the holiday foods they love, but in moderation. First, fill the majority of your plate with healthy vegetables. Next, if your favorite side dish is sweet potato casserole, slow down and savor a small portion. Then, you can skip the slice of pumpkin or sweet potato pie for dessert.
  • Get Moving – Regular exercise not only helps to reduce stress during this time of year but helps manage weight gain. Get moving with family and friends, such as taking a walk after a big meal.
  • Get Some Zzz’s – Between parties, holiday shopping and family get-togethers, the holidays can leave you stretched for time and sleep, but sleep loss can make it harder to control blood sugar levels. When we’re sleep deprived, we tend to eat more and prefer high-fat, high-sugar foods. Aim for seven to eight hours of sleep per night.
  • Check Your Blood Sugar – If you are taking insulin or medications that lower your blood sugar, check your blood sugar levels more frequently during the holidays.

Still unsure about how to manage your diabetes this holiday season? Talk to your doctor and create a plan that’s right for you.

ferguson_traciDr. Traci Thompson Ferguson is WellCare’s chief medical director, medical management and the company’s executive sponsor of its fundraising initiative for the American Diabetes Association. Read more to learn why Dr. Ferguson and WellCare associates are on a mission to support the American Diabetes Association and to help WellCare’s more than 3.8 million members live better, healthier lives.

Raising Awareness on Prematurity in the U.S.

Did you know more than 380,000 babies are born prematurely in the U.S. each year?

According to the March of Dimes, the United States earned a “C” on its annual premature birth report card. It is the first time in eight years that the preterm birth rate in the U.S. worsened, dropping from 9.57 percent to 9.63 percent in 2015.

The report also reveals prematurity rates were significantly higher among minority populations. The preterm birth rate among African-American women was 48 percent higher than the rate among all other women.

The preterm birth rate was even worse here in the state of South Carolina, which earned a “D” on its annual report card.

Babies born before 37 weeks of pregnancy are called “premature.” Born this early, babies can have serious health problems, including increased risk for lung and respiratory issues, heart issues and development delays.

November is Prematurity Awareness Month®, and it’s an important time to remind all women and families to understand their risk for preterm labor and premature birth. Risk factors include:

  • Drinking alcohol and abusing drugs, such as street drugs or prescription medications;
  • Socioeconomic status, including having little education or low income; being unemployed; or having little support from family and friends;
  • Experiencing domestic violence;
  • Working long hours or having to stand for long periods of time; and,
  • Being exposed to pollutants, like air pollution and harmful chemicals.

Other risk factors for preterm labor and premature birth include being younger than 17 or older than 35. Race and ethnicity can play a role as well.

Fortunately, women can help to reduce their risk factors for preterm labor:

  • Don’t smoke, drink alcohol or abuse drugs. Talk to your provider about programs in your area that can help you quit.
  • Schedule your first prenatal care appointment as soon as you think you’re pregnant. During pregnancy, go to all your prenatal care appointments. Prenatal care helps your provider make sure you and your baby are healthy.
  • Talk to your provider about your weight. Ask how much weight you should gain during pregnancy, or try to get to a healthy weight before your next pregnancy.
  • Get treated for chronic health conditions, like high blood pressure, diabetes and thyroid problems.
  • Reduce stress. Exercise and eat healthy foods. Ask for help from family and friends, and try to reduce stress in the workplace.
  • Wait at least 18 months between giving birth and getting pregnant again. See your provider for a preconception checkup before your next pregnancy.

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Dr. Robert London, a board-certified obstetrician and gynecologist, has served as the senior medical director for WellCare of South Carolina since 2014. In this role, he is responsible for overseeing the clinical direction of medical services and quality functions in the state. He provides medical leadership for the effective care integration of pharmacy operations; utilization, behavioral health, case and disease management activities; and quality improvement.

Five Tips for a Healthy Smile This Halloween

Candy is the undeniable star of Halloween, but don’t let it be a scary one. This Halloween, keep in mind that prevention and regular dental care is key to good oral health, which plays an important role in the health of the whole body.

Many health conditions have been linked to poor oral health, including heart disease; stroke and blood clots; respiratory disease; and diabetes. This is especially true for children. Three out of five children, or 60 percent, have tooth decay. This affects more children than diabetes, obesity, asthma, autism or cancer.

Prevention is the name of the game at all ages, but it is especially important for children ages 6 to 12, when baby teeth give way to permanent teeth. Help children avoid painful dental problems by teaching habits and routines that will be practiced no matter the special holiday or occasion.

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Here are five tips for a healthy smile:

  1. Brush at least twice per day, and floss daily.
  2. Make dental visits part of your child’s regular health routine.
  3. Talk to your dentist about dental sealants for your child’s teeth. A dental sealant is a thin plastic coating painted on the chewing surfaces of the teeth. The sealant can protect teeth from cavities. Although thorough brushing and flossing can remove food particles and plaque, they cannot always get into all the nooks and crannies of the back teeth. Sealants protect these areas by “sealing out” food, plaque and bacteria from invading teeth and causing further damage.  Staywell, WellCare’s Medicaid plan in my home state of Florida, covers dental sealants. To learn about WellCare’s pediatric dental coverage in your state visit WellCare.com.
  4. Fluoride varnish is another protective measure that parents can take. Fluoride varnish is a liquid that is painted on teeth. This is also covered by Staywell. Fluoride is a mineral that can make teeth strong. It can prevent decay, or keep decay from getting worse. Fluoride varnish should be put on a child’s tooth because cavities can begin as soon as each tooth comes in. Fluoride varnish is applied to the tops and sides of each tooth with a small brush. This procedure is painless and takes only a few minutes.
  5. Establish a dental home. A dental home is a dental office where families can get regular and continuous dental care. Children who have a dental home are more likely to get the care they need because patients get to know the dentist and dental hygienists, and early and regular preventive care and services are promoted.

Dr. Richard Goren, is senior vice president and chief dental officer for LIBERTY Dental Plan. With a vast majority of its membership enrolled in government-sponsored programs, LIBERTY is recognized as a specialist in administering dental care for Medicaid, SCHIP and Medicare beneficiaries. It is committed to promoting high-quality standards for key components of wellness, disease, case management, and care coordination programs as well as support services and materials.

A Physician’s Office Staff Plays an Integral Role in Patient Health and Satisfaction

Early in my nursing career, I worked in a variety of medical practices and saw firsthand the impact that office staffs have in establishing effective, collaborative relationships with patients and their families. These front-line employees are the liaisons between physicians and patients. Research shows that the personal relationship of a patient with his or her doctor and the clinic staff are the strongest predictors of patient satisfaction.

WellCare’s Harmony Health Plan in Illinois has developed two incentive plans designed to recognize this important relationship by rewarding staffs that promote positive health outcomes for our members. The plan targets two key quality measures:

  1. Referrals of newly pregnant members to the Harmony Hugs Program.
  2. Completion of vaccination requirements and well-child visits for children.

In Illinois, one in eight infants is born to a mother who received inadequate prenatal care. Without this care, mothers are three times more likely to have babies with health problems.

Harmony’s Hugs Program positively impacts our ability to encourage needed care. Mothers enrolled in the program were 15 percent more likely to obtain recommended prenatal and postpartum care. The program provides expectant mothers with their choice of a free stroller or a free portable play yard for completing a total of six prenatal visits. There is a small financial incentive for completing postpartum care.

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For every fifth program referral completed by the office staff within seven days of a member’s first visit, Harmony provides the entire staff with lunch. The same incentive is offered for every fifth medical flow sheet that is submitted to document children under the age of 2 who receive all recommended vaccinations or well child visits.

These unique programs are meant to inspire and reward office staffs that encourage actions designed to help women deliver healthy babies who have the care and support the need to remain healthy.

baker_marieAs the senior director of quality at WellCare’s Harmony Health Plan in Illinois, Marie Baker, RN, oversees quality improvement initiatives designed to ensure our members are receiving the best possible health care. She has more than 20 years’ experience in managed care and working with providers and members to improve access and quality of care.

My Perspective: Homeless for a Night in Honolulu

How did you sleep last Friday night? Was your air conditioning too cold? Did your neighbor wake you up too early mowing his lawn?

On any given night in Hawaii nearly 8,000 people sleep on the streets without any of the comforts we take for granted. On Friday, Sept. 16, five ‘Ohana Health Plan employees joined community and business leaders for a #CEOSleepout organized by The Salvation Army Hawaiian & Pacific Islands. More than 30 people slept on cardboard boxes at the State Capitol Rotunda in Honolulu to draw attention to homelessness, interact with this vulnerable population, discuss opportunities for collaboration to address this issue, and to raise funds to help The Salvation Army in its mission to support those in need of food, shelter and opportunity. Continue reading “My Perspective: Homeless for a Night in Honolulu”

What’s New at WellCare: Customer Service Goes Social

Research shows what most of us already know – people talk about the customer service they receive from a company. In fact, more than two in five consumers tell other people about their good customer service experiences all of the time. Conversely, at least half of consumers tell other people about their poor customer service experiences all of the time.

As vice president of channel communication services at WellCare, it is my goal each and every day to provide the best customer service experience possible for our members and providers. WellCare is committed to delivering the right care, at the right time, at the most appropriate place. In other words, our number one priority is to be there when they need us, and this means we have to be accessible. Continue reading “What’s New at WellCare: Customer Service Goes Social”

Collaborating for Better Health

At WellCare, our goal every day is to get our members the care they need. This can be much harder than it sounds.

Take, for example, a member who was recently hospitalized for a serious bout of pneumonia. This was not her first encounter with a breathing problem; she had suffered from severe asthma since childhood. Our goal was to provide her with a personalized, field-based care manager who could help her get and stay healthy. Continue reading “Collaborating for Better Health”

My Perspective: A WellCare of Florida Field-Based Care Manager

As a field-based care manager for WellCare of Florida, my goal each day is to help our members live better, healthier lives. I bring the health care system directly to the homes of our sickest and most vulnerable members.

At first many are surprised that a health plan would make house calls, but they appreciate the personalized service. Continue reading “My Perspective: A WellCare of Florida Field-Based Care Manager”

National Minority Mental Health Month: How WellCare Integrates Behavioral Health Care

As a psychiatrist practicing in the Chicago area for the past decade, I have seen firsthand the impact mental illness has on our communities, especially in minority and underserved populations.

Mental illness doesn’t discriminate and is almost equal in prevalence across racial and ethnic groups. The disparity is rooted in the fact that African-Americans, Native Americans, Asian-Americans and Latinos are less likely to receive diagnosis for their behavioral health issues and have less access to mental health services. Even when programs are in place, these groups may not take advantage of them due to social and cultural stigmas about mental illness. Continue reading “National Minority Mental Health Month: How WellCare Integrates Behavioral Health Care”