United Healthcare- Anthony Harris

Sometimes, the best care one can receive is at home. Frequently going to a care facility can be disruptive, especially if there are barriers to transportation. And for those living with complex chronic conditions like congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD), ongoing, active management is essential to prevent flare-ups and urgent trips to the hospital.People living with multiple chronic conditions (MCC) account for:64% of all clinician visits70% of all inpatient stays83% of all prescriptions71% of all health care spendingIn order to help this population spend more time in the comfort of their home, UnitedHealthcare Community Plan of Tennessee and Spiras Health are collaborating to support members with complex, chronic conditions using the Spiras Health Care-at-Home model. Led by nurse practitioners, this clinical model addresses both health and social risks with UnitedHealthcare members and helps coordinate care with the members personal physician.Previous models of care for people with complex conditions have been much more linear, with care systems designed to treat one condition at a time. Lack of communication among providers can also make care more difficult. Research has shown that emerging MCC care models should include:Team-based careCare coordinationCommunity partnershipsShared decision-makingHome-based supportUnderstanding the patients treatment burden, including social risk factorsContinuous communicationOne of the key benefits of the home delivery model is improved self-care, said Dr. Kiffany Peggs, Chief Medical Officer for the UnitedHealthcare Community Plan of Tennessee. Traditionally, a patient might visit their practitioner a few times per year. The Spiras home-based model provides several touchpoints a month and creates a greater incentive for patients to adhere to their treatment plan and self-monitor for symptoms.Lisa, a respiratory therapist with Spiras, said she saw one patient with COPD and other chronic conditions, who had been in and out of the ER many times over the course of a year. With a home visit, Lisa, along with Sarah, a nurse practitioner, were able to assist the member by reviewing her medications and helping with her weekly injections. They also communicated with her primary care provider to coordinate care.           Spiras Health and UnitedHealthcare share a commitment to addressing the needs of patients with complex chronic conditions. Our unique and specialized home-based approach focuses on improving the members health and quality of life while reducing costs, said Scott A. Bowers, CEO, Spiras Health. We are excited to work with UnitedHealthcare to bring a value-based approach to their members right in their homes, improving access, engagement and outcomes.Spiras clinical team members see how this model makes an impact on their patients, with empowerment and hope. Sometimes, patients with chronic conditions feel disenfranchised or overwhelmed by their treatment. Having a trusted team visiting their home, where theyre most comfortable, can help alleviate these stressors and thus provide better care.All they want is for someone to come into the home and listen, Lisa said. I feel like were making a huge difference with our patients.To find out more, visit Spiras Health.

Historically, the choice in health care funding for a smaller business has been between the higher-cost predictability of a fully insured plan and the potential savings, albeit with risks, of self-funding.Now theres an alternative called the level-funded health plan.A level-funded plan is an option for employers that want to move away from fully insured health care but are not yet ready to completely self-insure. Health insurers have designed level-funded plans to offer two main upsides: predictability and potential savings, including through a possible surplus refund.Use of these plans is on the rise. According to a recent survey, 42% of small firms report that they have a level-funded plan, a steep increase from previous years.  Here are four key points of level-funded plans1. A level-funded plan offers predictability and mitigated risksEmployers with a level-funded plan pay a fixed monthly fee, which covers the maximum claims liability, administrative fees and stop-loss insurance to protect against unexpectedly large claims and high utilization. With a level-funded plan, if the costs of individual or aggregate medical claims exceed the plans maximum, the plan covers the difference.2. A level-funded plan may have a surplus refundIn a traditional fully insured plan, the insurance company assumes the financial risk for providing health services. At the end of the plan year, if actual health care claims are higher than expected, the insurer covers the costs. If theyre lower, the insurer keeps the difference. By contrast, an employer with a level-funded plan is insured against higher-than-expected claims and may get a surplus refund in the end, if annual medical claims are lower than expected.3. Level-funded plans offer greater insights on costsUnlike most fully insured plans, employers with level funding can get complete monthly data reports to help them better understand employee utilization of health services. These reports offer a look at things like emergency room visits, virtual care usage and prescription drug utilization. This data may lead to a faster understanding of issues that are driving costs.4. Member experience can be key within the level-funded modelLevel-funded plans also typically include resources and programs that may increase member engagement and reduce costs. For example, level-funded plans from UnitedHealthcare include wellness programs and 24/7 virtual care options, which may make it easier for employees and their families to play a more active role in their health care and, as a result, save on out-of-pocket costs.For small business owners seeking a health plan designed with affordability in mind, an alternative like level-funding may be a solution. 

A growing number of people nearly half of eligible Medicare beneficiaries choose Medicare Advantage for their Medicare coverage.So, whats the difference between Original Medicare and Medicare Advantage? Check out this chart for a helpful overview.

Technology is making it easier to enjoy the benefits of a group workout class without the hassles of commutes or crowds. These days, a subscription to a digital fitness service like Apple Fitness+ can put hundreds of fitness options at your fingertips, virtually anywhere and anytime you want to access them.If youre looking for ideas to launch or switch up your exercise game, consider five online fitness classes that may help with your wellness goals:1. High-intensity interval trainingCommonly called a HIIT workout, high-intensity interval training is alternating short bursts of intense activity with intervals of less intense exercise. HIIT can be part of stationary cycling, elliptical, treadmill running or walking routines. The health benefits of these time-efficient workouts may be as good or better than endurance training.2. StrengthStrength training with resistance bands or weights may help to maintain and increase muscle mass, which tends to decline with age. Strength training may also increase your metabolism to help you burn more calories and potentially shed pounds. It may also be beneficial for your joints, bone density and overall balance.3. CoreYour core is a group of muscles that stabilizes and controls your pelvis and spine. Core exercises train these muscles to work in harmony, while also helping to create better balance and stability. Strong core muscles can make it easier to do all kinds of physical activities and may also help alleviate back pain.4. YogaYoga classes generally emphasize physical postures, breathing techniques and meditation. The intensity of classes can vary greatly from gentle practices to physically demanding poses. Yoga may offer physical perks, such as strength, balance and flexibility, and mental benefits like improved mood and alertness.5. DanceBesides the calorie burn, which may be a couple of hundred calories in just 30 minutes, dance-focused exercise may strengthen your muscles and improve your balance. Plus, you might pick up a few new moves for the next time you hit a real dance floor.Worth notingEligible UnitedHealthcare members with an iPhone1  who are enrolled in a fully insured plan can sign up for Apple Fitness+ and access a 12-month subscription at no additional cost.2  The subscription unlocks access to a library of over 3,500 workouts and meditations with workout types including HIIT, Strength, Core, Yoga, Treadmill, Kickboxing and many more, all led by a diverse and inclusive team of trainers.Apple Fitness+ workouts and meditations can be streamed on iPhone1 , iPad and Apple TV. Users with an Apple Watch can continue to take their experience to the next level with personalized real-time metrics that display on iPhone, iPad, and Apple TV. Fitness+ motivates users from start to finish with music by todays top artists.One more thingTo help make the most of your fitness routine, some UnitedHealthcare members may be able to use their Apple Watch as part of UnitedHealthcare Rewards. This new wellness program can enable eligible members to earn up to $1,0003  per year for meeting various daily and one-time healthy activities, including walking more than 5,000 steps each day and tracking sleep.

What to know about women's heart healthHeart disease is often thought to be more of a health issue affecting men.  However, its the most common cause of death for women in the United States, causing more than 314,000 deaths in 2020. Because symptoms in women can differ from those in men, it may be more difficult to spot the signs.By understanding the symptoms and making healthier lifestyle choices, you may help prevent your risk.   Many women do not realize that heart disease causes about 1 in every 3 female deaths, said Dr. Lisa Saul, chief medical officer at UnitedHealthcare. Women are often not diagnosed with heart disease as quickly as men are, which means being aware of the risks and making heart-healthy habits part of your daily life is crucial for prevention.    Heart disease symptoms for womenSymptoms may include common signs like pressure in the chest, which is similar for both men and women. However, women are more likely than men to experience a variety of other symptoms. This may be because women tend to have blockages in smaller arteries, as well as their main arteries. This is a condition called small vessel heart disease or coronary microvascular disease.Symptoms include:Pain or discomfort in the neck, jaw, shoulder, upper back, abdomen or backNauseaVomitingSweatingLightheadednessUnusual fatigueYou may not experience any symptoms if your heart disease is silent. This could mean you may not be diagnosed until you experience more severe symptoms, such as:Heart attackArrhythmiaHeart failureIf you experience any of these symptoms, call 911 right away.Help lower your risks of heart diseaseWhile there may be risk factors you cant control, a heart-healthy lifestyle is one way to help make an impact. In fact, studies show that healthy choices have resulted in 330 fewer women dying from heart disease per day.Consider these changes to help lower your risk:1. Quit smokingSmoking damages the heart and blood vessels, which may cause heart disease (pdf). Even long-time smokers may see rapid health improvements and reduce their heart attack risk, if they quit.2. Exercise regularlyThe American Heart Association (AHA) recommends adults get at least 150 minutes each week of moderate-intensity aerobic activity or 75 minutes each week of vigorous aerobic activity.  You should consult your physician before beginning any exercise program.3. Eat healthierA diet emphasizing fruits and vegetables, whole grains, low-fat dairy products, poultry, fish and nuts may help control your weight, cholesterol and blood pressure. Limit saturated fats, trans fats, sodium, sweets and sugary beverages.4. Manage your stressThe most common types of stress that can impact your heart include, workplace stress, financial stress, caregiver stress and disaster-related stress. Sleep, exercise and meditative breathing can all help ease stress.5. Limit alcoholThe AHA recommends that if you drink alcohol at all, it should be in moderation, which means consuming an average of at most one drink per day for women. Excessive drinking may lead to increased heart health risks.6. Monitor your blood pressureBlood pressure numbers of less than 120/88 mm Hg are considered within the normal range. If your numbers are outside of the normal range, home blood pressure monitoring may be beneficial to help keep tabs on your health, but dont substitute it for regular visits with your doctor.7. Manage your blood sugar and lower cholesterolOver time, high blood sugar can damage blood vessels and the nerves that control your heart. High levels of cholesterol can also increase your risk of heart disease through the development of fatty deposits in your blood vessels.One more thingTake the time to understand heart disease, your family history and whether you may be at increased risk. Heart disease doesnt just occur in older women. Young women, especially those with a family history of heart disease, should also take precautions. Dont wait for the symptoms to appear take preventable action to help maintain your heart health.

A fast-growing class of therapeutic drugs called biosimilars is creating expanded treatment options in certain instances. The result may help lower costs for some patients and the health care system overall.For example, the availability of Humira biosimilars is one of the biggest opportunities in years to lower costs and increase accessibility for people who need high-cost specialty drugs.Biosimilars are safe, effective medications for treating many illnesses, including, certain types of cancers, diabetes, Crohns disease, colitis, psoriasis, and rheumatoid arthritis, according to the U.S. Food and Drug Administration (FDA).What are biosimilars?Biosimilar drugs are biological products, meaning they use living organisms as ingredients. While they arent identical to their brand-name counterpart, sometimes called the reference product, they are highly similar and have no meaningful clinical differences in their active components.Compared with a reference product, biosimilars:Are made with the same types of natural sourcesHave the same strength and dosageProvide the same treatment benefitsHave the same potential side effectsWhat makes biosimilars different from generic drugs?Unlike biosimilars, generic drugs are created from synthesized chemicals. They include the same active ingredients as their brand-name comparisons and work to create the same clinical benefits.Biosimilars are sometimes compared to generic drugs because both are versions of other FDA-approved medications that the agency says may provide more treatment options and potentially reduce costs for patients.How are biosimilars approved for use?All FDA-approved biological products, including reference products and biosimilars, undergo a rigorous evaluation so patients can be assured of their efficacy, safety and quality. More than 40 biosimilars have been approved, although some are not commercially available.Its worth noting, a 2010 law does allow for an abbreviated regulatory process for biological products, including biosimilars. However, manufacturers of proposed biosimilar products still must generate data comparing the proposed product to the FDA-approved reference product to demonstrate biosimilarity and obtain approval.How do biosimilars help drive down costs?Congress created the FDA approval pathway for biosimilar medications, in part, to help bring down prices. Because of the legislation, manufacturers do not need to conduct as many expensive and lengthy clinical trials, which may mean faster access to products, more therapeutic options and potentially reduced costs for patients.Additionally, biosimilars may create a more competitive pricing environment (pdf) among drug manufacturers, which may also help drive down drug costs. For example, UnitedHealthcare has announced that up to three biosimilars for Humira, a drug commonly used for conditions like rheumatoid arthritis and plaque psoriasis, will be added to the same tier as Humira on Prescription Drug Lists.Is it safe to take a biosimilar if I originally started treatment on the brand-name counterpart?The FDA says biosimilar medications can generally be used even if you were originally treated with the reference product. The agency recommends talking to your health care provider about available treatment options and potential risks and benefits.

You slipped on the stairs and feel your ankle throbbing. Or your child spikes a high fever in the middle of the night. You call your primary care doctor first, but you can't get a same-day appointment. So do you go to the emergency room (ER) or urgent care? Or would a virtual visit work best?If its not actually an emergency situation, rushing to the ER can cost two to three times more than care in a providers office. In addition, seeking care in the ER may mean longer wait times and an increased exposure to germs, plus potentially unnecessary tests or treatments. Using the ER for all your health care needs may also mean youre missing an opportunity to create a long-term relationship with a primary care provider who can address preventive needs before more serious issues arise.Thats why understanding the most appropriate care setting is an important step to help you receive the simplest experience for your situation.Heres what to consider when deciding where to go for care:Urgent care centerUrgent care centers are not for emergencies but can help you when you need care quickly. If you cant get in with your primary care physician, this may be another option. Remember, its first-come, first-served. You may consider urgent care if you have symptoms like the following:Fever without a rashModerate flu-like symptomsSprains and strainsSmall cuts that may require stichesThe average cost for an urgent care visit is $185.1Emergency roomThe hospital emergency room provides medical care for life-threatening injuries or illness. While some people may be tempted to utilize ER services because its open 24/7, the wait time is typically two hours on average, and can vary greatly based on time of day and location. Patients with life-threatening emergencies or critical conditions will be treated first so if youre experiencing a minor ailment, it may not be the best place to seek care. Some of the symptoms that require an emergency room visit include, but are not limited to:Chest painNumbnessSlurred speechFaintingSerious burnsConcussionBroken bones and dislocated jointsFever with a rashSeizuresThe average cost for an emergency room visit is $2,600.1Have you considered a virtual visit?If you are faced with a non-emergency health condition like a migraine, possible COVID-19, sore throat or stomachache but your doctors office is closed, you may consider a virtual visit. This allows you to virtually chat face-to-face with a doctor, day or night, and may save you up to $1,500 when compared to a visit to the ER.2The average cost for a virtual visit is less than $50.1Still not sure?UnitedHealthcare plan members can also compare quick care options with UnitedHealthcares online resource, and get more information to help with COVID-19 concerns. If you or a loved one are experiencing what you feel to be life-threatening symptoms other than those listed, go to the emergency room or call 9-1-1.

When you go to the doctor for a routine physical, your primary care provider might have you get your blood drawn to check your cholesterol. Those numbers are important as they help you understand your risk of heart disease or stroke.However, the different types of numbers might seem confusing at first glance, and it may be difficult to know the difference between good cholesterol and bad cholesterol. High cholesterol increases your risk for heart disease and stroke, two of the leading causes of death in this country, said Dr. Nicole Brady, chief medical officer for UnitedHealthcare. Getting your cholesterol levels checked is an important part of staying healthy and should be checked starting early in life. Being aware of your cholesterol status can help you stay in control of your health.To help you understand when you may be at risk, here is a brief run-down on measuring cholesterol and what it might mean for your health particularly your heart health.What is cholesterol?Cholesterol is a waxy substance that your body needs to make hormones and digest fats. Although your body does make all the cholesterol it needs, you can also get it from a range of foods everything from meat and poultry to dairy products.However, not all cholesterol is the same. There are two different types of cholesterol that can have a much different impact on your body. This is the good (HDL) and bad (LDL) cholesterol you might have heard about. Different foods you eat that have cholesterol can either be higher in HDL or LDL cholesterol. For example, foods like eggs, sardines, nuts and berries are high in HDL cholesterol, while processed meats, fast food and sugary desserts can be high in LDL cholesterol.What is a cholesterol check?Your provider may check your cholesterol through a blood test called a lipid panel (or profile). In order to accurately check your cholesterol, youll need to follow instructions from your provider and may need to fast before having your blood drawn.Your lipid panel or cholesterol check will also look at your levels of triglycerides. This is a type of fat that your body uses for energy. High levels of triglycerides along with high levels of LDL cholesterol or low levels of HDL cholesterol could mean a higher risk for heart attack and stroke.What is a good cholesterol level?Here is what your doctor might be looking at as ideal cholesterol numbers:Total cholesterol: about 150 mg/DLLDL (bad cholesterol): about 100 mg/DLHDL (good cholesterol): more than or equal to 40 mg/DL in men and 50 mg/dLTriglycerides: less than 150 mg/dLHow do I lower my cholesterol?If your cholesterol numbers are in an unhealthy range, your primary care provider may recommend lifestyle changes, or certain medications, to help keep your cholesterol in check. This may include:Making healthy food choices: Since your body makes all the cholesterol it needs, you do not need to get cholesterol from foods. Limit eating foods high in saturated fat and focus on foods naturally high in fiber.Maintain a healthy weight: Talk to your doctor about what a healthy weight is for you. Excess body fat may affect how your body uses cholesterol and could slow down how its able to remove LDL cholesterol from your blood.Get regular physical activity: Being active can help you maintain a healthy weight and lower your cholesterol and blood pressure.Avoid smoking and limit alcohol: Smoking can damage your blood vessels and increases your risk of heart disease. Too much alcohol may raise your cholesterol levels and the levels of triglycerides.

If you think the health care system is too complicated and due for an overhaul, you may be pleasantly surprised by Surest a health plan designed to help simplify care with upfront pricing.This is a common-sense approach created by listening to what people want and then giving it to them, said Surest CEO Alison Richards. When people hear the details, they often ask, So, whats the catch? Im happy to say there isnt one.Whats different with the Surest health plan?For starters, your benefits work for you immediately. Theres no deductible to chip away at and no coinsurance to worry about paying weeks after receiving care.With most traditional plans, these charges can be financial barriers to care for some members, and theyre often just confusing, Alison said. We removed them from the plan to simplify things.Eliminating deductible and coinsurance charges has helped clarify coverage for people who use the Surest plan, offered by UnitedHealthcare. For one large employer, 82% of members reported a better understanding of their Surest plan compared to their previous health plan.1The other differentiator: Upfront pricingThe Surest plan lists a single, all-in price for hundreds of services. Members can review and consider their options before deciding on care. This upfront pricing also helps avoid billing surprises that, with a traditional health plan, might show up weeks or months after a service or procedure.Based on data-driven recommendations displayed in the Surest app, members may be able to pay less and receive more effective treatments from quality care providers, as determined by national standardized measures.The Surest health plan addresses many of the obstacles that consumers face, including by eliminating complicated math with clear, upfront costs, Alison said. The plan enables choice and flexibility that can fit personal needs and lifestyles.People whove tried the Surest plan usually like itMembers cite ease of use, price clarity and cost savings as some of the top advantages. One analysis of a large employer showed out-of-pocket expenses for Surest plan members were 46% less than a matched comparison group, while the cost for the company declined by up to 15%.2  Those savings were driven, in part, by Surest members more frequently selecting high-value treatments, including opting for virtual care appointments and avoiding costlier settings, such as emergency departments.3Through the Surest plan, weve shown you can simplify things, retain the quality care within it and still lower costs, said Brandon Cuevas, chief growth officer at UnitedHealthcare. The Surest plan makes health benefits more transparent and easier to use, helping people to make more informed health care choices with the aim of lowering the total cost of care.UnitedHealthcare is now offering the Surest plan to employersWith self-funded health plans nationwide, as well as to employers in 19 states with fully insured plans that include 51 or more employees.

As people age, our hearing tends to decline for multiple reasons, including repetitive exposure to loud sounds and genetic factors. In fact, hearing loss ranks as the third most common chronic condition among all Americans. For older Americans, nearly a quarter of those aged 65 to 74 have hearing loss. That number increases to 50% for those 75 and older.For people in this situation, obtaining treatment as soon as possible is crucial, as hearing is vital to staying connected with friends and family. Studies have shown that hearing loss can contribute to social isolation, cognitive decline, trouble communicating and more. While there is no cure for certain types of hearing loss, there are options to treat it and help you maintain an active lifestyle.Three tips to help prevent further hearing lossLearn ways to help avoid potential medication-related complications and make more informed decisions about testing and treatment:1. Continue to focus on preventionEven if you are already experiencing hearing loss, its important to avoid exposure to one-time or prolonged loud sounds. When attending events such as concerts or sporting events, use protection such as foam or custom ear plugs.There may be other activities in your day-to-day routine causing damage, too. Prolonged exposure to noise over 70 decibels over time can damage hearing health. Sources of sound above this decibel level can include lawn mowers, power tools or listening to music at high volumes. When using earbuds or headphones, follow the 60-60 listening rule, which promotes listening to audio devices at no more than 60% of maximum volume for no more than 60 minutes a day.2. Consider your overall healthBefore starting any new medications, it is important to know that more than 600 prescriptions and over-the-counter (OTC) drugs have the potential to impact hearing. These medications are known as ototoxic, which means they can contribute to hearing loss, worsen tinnitus (ringing in the ears) or contribute to balance disorders.Make sure you check with your primary care provider to review any potential side effects of new medications that could cause further harm to your hearing, as well as make sure to follow the guidance from your prescribing physician. Importantly, hearing health is connected to overall health, with untreated hearing loss linked to higher rates of depression, dementia and increased risk of falls.3. Seek treatmentIf you or a loved one believe you may be experiencing hearing loss, it is important to access care as soon as possible. Wearing hearing aids when the condition first arises may help your ears adapt to the re-introduction of lost sounds more effectively, preserving the brains ability to process language.A good place to start is by completing an online hearing test. You can also check with your primary care physician, who may be able to provide a basic test, check for earwax and refer you to a hearing health professional for a comprehensive exam. on your specific needs, an audiologist or hearing health professional may be able to fit you for a prescription hearing aid.To help make hearing aids more affordable, check with your health plan to determine if any discounts may be available. For instance, people enrolled in most UnitedHealthcare Medicare Advantage plans can purchase custom-programmed hearing aids with little to no out-of-pocket costs.1 Other potential ways to save on hearing aids include through membership organizations, including AARP Hearing Solutions provided by UnitedHealthcare Hearing. Following these tips can play an important role in protecting your hearing health as part of a comprehensive approach to healthy aging.