 Agent and Consultant Briefing
March 2009 |
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| On My Mind: Health Care Delivery Innovation - Retail Clinics |
| By Cheryl Demars, CEO
 By now you've probably heard about retail clinics. These clinics, which are located in a retail store setting, are staffed by nurse practitioners and specialize in care for those 18 months and older. Shopko Fast Care Clinics and Walgreens' Take Care Clinics have been added to The Alliance network (for specific details on each, read the following article).
Researchers have been paying close attention to utilization patterns at these clinics. On one hand, they provide a convenient alternative for some basic health care services, leaving more room on clinic schedules for more complex care. On the other, some wonder if these clinics will have a negative impact on coordination of care.
Some early research by RAND Health seems to show that retail clinics are a popular choice for a younger population who does not have a primary care provider and that may rely on emergency care settings. According to their study, 43 percent of people visiting retail clinics are between the ages of 18 and 44, compared to 23 percent for primary care physician offices. In addition, just 39 percent of the patients at retail clinics said they had a primary care physician, compared to 80 percent nationally.
These clinics also provide an easy alternative for minor illnesses and conditions. In fact, according to the RAND study, about 90 percent of the visits to retail clinics were for the following 10 conditions: upper respiratory infections, sinusitis, bronchitis, sore throat, immunizations, inner ear infections, swimmer's ear, conjunctivitis, urinary tract infections, and either a screening test or a blood test. Other studies have shown them to be popular with mothers of young children.
As with any new care delivery method, employees may have questions about how to access these retail clinics. To help, we've created a flyer which will help explain to employees the difference between emergency care, urgent care, retail clinics and when it is best to choose each. Also read on for more information about these clinics below.
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Walgreens' Take Care Clinics Now a Participating Alliance Provider |
Walgreens' Take Care Clinics have been added as a participating in-network Alliance provider effective January 1, 2009. When an employee or dependent receives care from a Walgreens' Take Care Clinic, Walgreens will file a claim on their behalf to The Alliance for repricing. The claim will be treated as in-network and forwarded to the plan administrator for processing. Any co-insurance or deductible will be billed to the employee directly from Walgreens.
Our contract with Walgreens' Take Care Clinics covers all locations throughout the U.S. This means that employees and their dependents can receive care at any Walgreens' Take Care Clinic throughout the U.S., and the claim will be treated as in-network.
If an employee does not present their health plan identification card, they may be required to pay at the time of service. In these cases, Walgreens will refund any payments to the patient after receiving payment from the benefit plan administrator.
As a reminder, Take Care Clinics are staffed by nurse practitioners and provide treatment for minor conditions and symptoms, including:
- Respiratory Illness
- Skin Conditions
- Diagnostic Testing
- Minor Injuries
- Wellness
- Vaccinations
- Physicals
- Additional Treatments
Reminder about Shopko Fast Care Clinics
Shopko Fast Care Clinics are also participating Alliance providers. They are offering care for similar minor conditions at the following locations:
Beaver Dam Community Hospital Fast Care Clinic
Locations:
· Shopko - Beaver Dam
· Marshland Pharmacy - Mayville
Meriter Fast Care Clinic
Locations:
· Shopko - East Madison
· Shopko - West Madison
Monroe Clinic Fast Care Clinic
Location:
· Shopko - Monroe
As a reminder, employees who choose to receive care at a Fast Care Clinic will be required to pay the fast care clinic fee at the time of service. At that time they should ask the clinic to submit a claim to The Alliance, using the address provided on the back of their health plan identification card. Any payments will be made to the provider and they will reimburse the employee directly. We are working with these providers to ensure these refunds are made within 30 days of receipt by the hospital or clinic.
Use this flyer to help your employees understand this type of care.
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| Competition Rewards Those Who Help Others Make Better Health Choices |
A nudge may not seem like much, but to many, this little push is often the thing that leads to healthier choices. The Robert Wood Johnson Foundation and Ashoka's Changemakers have launched the "Designing for Better Health" competition to reward individuals and organizations that have successfully created an environment that nudges people toward healthier choices. Entries must be submitted by April 1, 2009. From all entries, 12 - 15 will be selected as finalists. Finalists will be posted on the Changemakers Web site www.changemakers.net and voted on by online users of that site. Learn more and download an entry form.
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| Tell Us What You Think |
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| Resources to Promote Health and Wellness in the Workplace |
As employers prepare for National Wellness month in May, don't forget about the following resources The Alliance has to help promote wellness: Health Risk Assessments (HRAs): The Alliance has a partnership with Interactive Health Solutions (IHS) for HRAs at a preferred price of $210 per individual. The HRA includes a blood draw, comprehensive blood panel, Web-based results, a mailed package with a letter that can be shared with a physician, e-mail follow-up throughout the year, access to the consumer Web site, health coaches on ten different areas, and one-on-one coaching sessions for 8 - 10 weeks. Blood Pressure Screenings: We offer on-site blood pressure screening at no cost to you. This simple painless test is one of the most important health indicators. Offering it onsite is a simple and easy way to make preventive care part of an employees' day. To learn more or to schedule a blood pressure screening, please e-mail Alliance member services mms@the-alliance.org or call 800.223.4139, x 6607.
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| Next Alliance Learning Circle: Don't Let Heart Disease Flatline
Your Bottom Line |
Please save the date for our next Alliance Learning Circle, focusing on heart disease. According to the CDC, of the top 10 most costly conditions to employers, four - high blood pressure, heart attacks, diabetes, and chest pain - are related to heart disease and stroke.
The event will be held on April 30. Watch for more information in the coming weeks.
Details of this event can be found on The Alliance Web site under Alliance Learning Circles. Watch for your invitation
in the next few weeks.
A separate Alliance Learning Circle related to Outpatient Costs, which was mentioned in the last newsletter, has been postponed. We plan to reschedule this event as necessary to coincide with the release of our QualityCounts™ Outpatient Procedures and Tests report.
Also, be sure not to miss the materials from the last Alliance Learning Circle - Mental Health and Addiction in the Workplace. We've posted materials from this event, including the Executive Summary, presentations, and relevant links.
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| New Resource: Health Care Decisions in Tough Economic Times |
The pressure is on. Costs are rising, the economy is stagnating, and reliable predictions of when better times will arrive are hard to come by. These pressures heighten employers' concerns about their ability to pay for employee health benefits.
A new Alliance reference piece takes a fresh look at a proven alternative - self-funding - during tough economic times. Read it today and pass it on to a colleague.
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| QualityCounts for Employees |
- In Hard Times It's Important to Stay Healthy: During these bad economic times it seems people have been searching for ways to cut costs on health care. Help employees make wise choices.
Did you know you can find past issues of QualityCounts for Employees in the Employer Resource Center? After you log in, select "Consumer Newsletters" from the Employee Health and Education tab. Your employees can access them too at http://www.the-alliance.org/health_wellness.aspx.
You can also connect with this direct link to the Employer Resource Center but you will need to log in first. If you don't know your password, call Jen Linden, 800.223.4139, x 6635, and she will be happy to assist you.
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| News You Can Use |
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.
- Increasing Health Care Costs- Read more about Towers Perrin's survey on the major trends in U.S. employee and retiree health care costs.
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| About the 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 message with your name and agency to the Sales and Member Services Department. Read past issues of this newsletter on-line at www.the-alliance.org/agentresources.aspx.
Cathy Lanser, Editor
Melanie Cannon, Designer | |
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The Alliance encourages employers to distribute the 
The Alliance encourages employers to distribute the