There’s a Good Chance You’re Not Taking Your Medications Correctly!

By Laura Hungiville

Think of the last time you visited the doctor when you were sick. Odds are, she examined you – gave her diagnosis – and wrote a prescription to help you get better. Most likely, you immediately headed to the pharmacy to have it filled. You then took your medication exactly as prescribed. For the first few days, you followed the prescription to a tee – but as you felt better, you may have started missing a few doses.

Well, imagine if you had an existing condition like diabetes, high cholesterol or hypertension that required you to take regular medications, only the symptoms weren’t obvious. You might be getting better or worse and have no idea. Unfortunately, almost 7-out-of-10 Americans with these conditions think they’re taking their medications correctly – but are not. Many assume they don’t need to take them as prescribed because they can’t physically feel their condition.

So how can a doctor ensure patients with chronic conditions actually ‘take’ their RxEffect Side Image for Blogmedications correctly? Surely, making hundreds of house calls isn’t the answer! Fortunately, WellCare partnered with RxAnte to offer RxEffect, an online tool that analyzes patient pharmacy claims to help doctors with this very issue.

Simply put, RxEffect allows doctors online access to a real-time list of patients and their medications. The tool realizes that not all patients are the same. Some will always take their medications, some will take them off-and-on, and others will simply forget. RxEffect uses a feature called ‘predictive analytics’ to help doctors pinpoint patients who are likely to need the most help. This allows them to keep better track of their patient prescriptions and intervene before problems arise. RxEffect even alerts doctors to increase prescription lengths from 30 to 90 days to help patients with the hassle of monthly refills.

Not only is RxEffect essential for patients, but doctors also benefit through improved communication, higher satisfaction scores (CAHPS), and a recently introduced bonus that offers them $50 per patient in three therapy areas: diabetes, high cholesterol and hypertension, for a maximum of $150.

To say RxEffect has been helpful would be an understatement. In 2015, doctors who used the tool increased the likelihood that patients would take their medications as directed. It is our most effective intervention and we have seen improvement of up to 8 percent in our highly engaged practices! This figure is impressive, as similar nationwide programs typically show less than a 2 percent increase in a given year.

WellCare always works to make sure our provider network has access to tools, like RxEffect, that make it easier for people to get and stay healthy. It’s our responsibility to help doctors better educate our members on why, when and how to take their medications without fail – their health depends upon it!

Laura Hungiville Web Post2Dr. Laura Hungiville serves as WellCare’s chief Pharmacy Officer. She leads the pharmacy team and is responsible for our PDP business. This includes the pharmacy spend, oversight of the PBM, pharmacy network, formulary, clinical programs, coverage determinations and appeals, as well as growth and profitability. 

Your Best Shot for a Healthy 2017!

By Dr. Mark Leenay

Think of the last time you felt ‘really’ sick. Not just your run of the mill cold, but totally out of commission with a fever, chills, headache, cough, sore throat, runny nose, fatigue and dizziness. If you’ve had the flu at any time in your life, odds are it’s still fresh in your mind. You’re not alone. The flu is so common that 2-out-of-10 people in the U.S. will catch the virus in 2017, typically in February – the last peak month of flu season.

When we are younger, infections like the flu come-and-go – but as we get older, the virus can become much more than a passing illness. The truth is seniors 65 and older are at a much greater risk of serious complications from the flu because their ability to fight off complications is simply weaker. It’s estimated that up to 85 percent of seasonal flu-related deaths have occurred in people 65 years and older; and up to 70 percent of seasonal flu-related hospitalizations have occurred in that same age group.flublogimage2

Regardless of age, one thing is certain – we should ALL get a flu shot. It’s been almost 80 years since the vaccine has been available, yet fewer than half of Americans get an annual flu vaccine! That means half of everyone reading this still needs to get their shot!

Flu season can last as late as May, so now is the time to get the vaccine. It takes about two weeks for your body to develop protective antibodies after getting vaccinated. While getting a flu shot is your single best defense against catching the virus, you can also prevent getting and spreading it by:

  • Avoiding close contact with people who are sick
  • Staying home when you’re sick
  • Covering your mouth or nose with a cloth or your sleeve (rather than your hand)
  • Not touching your eyes, nose or mouth
  • Washing your hands frequently to help protect you from germs

At WellCare, we encourage all members to visit your primary care physician or participating pharmacy to get vaccinated to not only protect yourself; but your family, friends and coworkers. Here’s to a healthy 2017!

dr-mark-leenay

Dr. Mark Leenay was named chief medical director of care model in August 2016. He provides strategic leadership for the company’s care model and is accountable for the efficiency and effectiveness of WellCare’s clinical programs and services. He also works to improve the health and care experience of WellCare’s members while reducing overall health care costs.

Big Brothers Big Sisters of America and WellCare Partner to Bring “Bigs in Blue” to Seven U.S. Cities

By Pam Iorio

Over the past couple of years, tensions between police and the communities they serve have been in the news on an almost weekly basis. Many community leaders are calling for all of us to be more empathetic, see the world through our neighbors’ eyes, or unite to heal after tragedy.

Continue reading “Big Brothers Big Sisters of America and WellCare Partner to Bring “Bigs in Blue” to Seven U.S. Cities”

Disillusioned with Your Resolution?

By Dr. Richard Petrucci

So the holidays came and went, and odds are you ate a lot more than you normally would. While you probably ‘felt’ like you gained tons of weight, studies show that a person of ‘average size’ only gains about one pound between Thanksgiving and the New Year. If you’re overweight, that number jumps to about five pounds. While a pound here and there doesn’t seem like much; they can add up quick!

Continue reading “Disillusioned with Your Resolution?”

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.

Continue reading “WellCare of Nebraska Goes Live!”

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.

Continue reading “Managing Diabetes during the Holiday Season”

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.

Continue reading “Raising Awareness on Prematurity in the U.S.”

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.

Continue reading “A Physician’s Office Staff Plays an Integral Role in Patient Health and Satisfaction”

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”