National Health
Awareness Calendar |
January
Cervical Health Awareness Month
National Birth Defects Prevention Month
March of Dimes Birth Defects Foundation
February
American Heart Month
American Heart Association
www.americanheart.org
March
National Colorectal Cancer Awareness Month
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Our Products
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24 Hour Utilization Management
24 Hour Nurse HelpLine
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Maternity Management
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Disease Management
Wellness/Health Coaching
Disability Management
Claims Cost Management
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| President's Message |
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 I hope everyone had a really wonderful holiday season and will be bringing renewed energy and enthusiasm to 2008. If you are like me, many of your New Year resolutions are health related. So whether you're dwelling on how to get rid of the extra pounds you packed on over the holidays as I am, or stopping smoking or just taking better control of your health, keep in mind that our Getting Well, Staying Well programs are designed to help with those efforts.
For those of us involved in health cost management, the overutilization of MRIs and CT scans is no surprise. However, recent studies reveal that this trend is not only expensive but also risky. In this issue, Dr. Lewin is going to tell you more about a recent study that suggests that having too many scans is unhealthy.
As we enter into the height of flu season, scroll down to view a link we've included in this edition to FluTrack, a tool for you and your employees to help you stay aware of how the flu is affecting your area.
I'm really proud to announce that Alicare Medical Management has received full reaccreditation by URAC for Case Management effective November 2007. Earlier this year, we also went through the reaccreditation process for Health Utilization Management, Independent Review and Health Call Center, which covers our Nurse HelpLine and Network Referral products and received full accreditation for all three of those products. We've been URAC accredited since 1994, shortly after we began to market our services commercially, and in 1996 we were one of the first two companies to be accredited as a Health Call Center.
Why do we put so much effort into URAC accreditation? It's voluntary - not every company chooses to submit to the accreditation process. It's an expense, not just the actual cost but the effort involved to create and maintain the necessary documentation. It's time consuming - we have an employee whose job is to monitor compliance and report to URAC. So, why bother?
Very simply, we believe that URAC promotes quality and accountability in medical management. By defining the industry's benchmark standards and ensuring that accredited companies conduct their businesses to meet those standards, URAC accreditation tells our clients that we care about quality. It helps us be certain that we are keeping up with changes in the industry so that the products we deliver are cutting edge.
Stay warm this winter!
Claire Levitt | |
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Medical Director's Update |
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Overview of CT Scans:
Impact of Rising Use
CT scanning has transformed much of medical imaging by providing three-dimensional views of the organ or body region of interest. In a recent review in the New England Journal of Medicine it was stated that, "The use of CT has increased rapidly, both in the United States and elsewhere, notably in Japan. According to a survey conducted in 1996, the number of CT scanners per 1 million population was 26 in the United States and 64 in Japan. It is estimated that more than 62 million CT scans are currently obtained each year in the United States, as compared with about 3 million in 1980. This sharp increase has been driven largely by advances in CT technology that make it extremely user-friendly, for both the patient and the physician."
The largest increases in use of CT scans have been screening exams in adults and use in children. Some scans take only a second or so, making it possible to perform them on children without any need to sedate or anesthetize the child. Projected increased use is also expected to come from CT screening for lung cancer in former and current smokers; virtual colonscopy; cardiac CT screening and total-body screening.
There is concern, however, over the increased use of CT scanning because of increased exposure to total radiation during each scan. For example, an abdominal CT scan may entail as much as 50 times as much radiation exposure as would be incurred by the performance of a single standard abdominal x-ray study.
Increased exposure to ionizing radiation can damage DNA and other biological structures, and can contribute to the development of cancer later in life. With younger patients being exposed earlier to CT's, their relative risk is greater, especially for children who are more radiosensitive. The population's higher life expectancy also means the number of possible exposures to CT scans may rise over time. Estimates are that the percentage of cancers arising out of the use of CT scanning have risen in recent years from 0.4% of the total to 1.5-2.0%, roughly a 500% increase.
There are several ways to reduce the risk to the population as a whole from the use of CT scanning. Considering the rise in use and the increase in attributable cancers, some of the ways to help reduce risk to the population include:
· Modify the equipment to use less radiation. Automatic controls to accomplish this are already available on some machines.
· Replace CT with other modalities which don't require ionizing radiation such as magnetic resonance imaging (MRI) or ultrasound. It's not always possible to replace CT with a different test, but in some cases it's possible and advisable.
· One of the most effective and sensible ways is to make certain that CT scanning is employed only when essential and when the outcome of the scan will clearly and directly influence the course of care.
At AMM, we have a clinical review staff that employ clinical guidelines when reviewing requests for CT scans. The reviewer's role is to make certain that any CT study we approve for a client's member is medically necessary and that no other modality can be substituted. This is an integral approach to care management that contributes to the clinically effective and safe practice of medicine.
 Dr. Seth Lewin
Medical Director
Alicare Medical Management
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| FluTrack |
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| Know What's Going On This
Flu Season
AMM is pleased to fill you in on a valuable tool that you can offer your employees right on your worksite's website. It's called FluTrack, and it provides employees an internet resource for influenza, an increasingly important health and political issue. MedWorks Consulting is working with SDI, the website developer, to offer organizations this worthwhile and informational tool.
FluTrack is a link that provides employees with important information about influenza: what it is and what it is not, how it spreads and how to keep it from spreading, where it has appeared in the US during the current flu season, and treatment options.
Planning and managing the flu is essential, as we all know how disruptive and costly a flu outbreak can be to an organization. When your employees have information in hand on how to avoid influenza, or at least to reduce the spread of the virus, you can minimize the effect of influenza on both their health and productivity, on a company's operations and on the community at large.
With FluTrack, you have the opportunity to help prepare your employees for the upcoming flu season. They have access to accurate, easy to use, up-to-date information. By logging on to the FluTrack website, employees are assisted in understanding, preventing and dealing with influenza.
FluTrack website information includes:
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Near real time, geographic information on flu outbreaks.
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Employee educational information such as key facts about influenza, interactive cold vs. flu education, how to prevent the spread of influenza, reasons for getting vaccinated against flu, flu treatment strategies, and healthy habits to reduce influenza infection risk.
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An employer pandemic planning tool that summarizes the US Department of Health and Human Services and CDC recommendations for employer pandemic influenza preparation.
To help you decide if FluTrack is a tool for your organization, you can visit www.flutrack.com. Enter username AMM, and password flutrack, for a complimentary visit to FluTrack. Further information about creating the link for your employees is available on that site as well.
We would be interested to know what you think of FluTrack. Feel free to send one of us an email (scroll down to see our contact information) with your comments or for more details. |
| Important Facts You Should Know About Colorectal Cancer |
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March is National Colorectal Cancer Awareness Month.
Did you know...
- Colorectal cancer can be prevented.
- Screening for colorectal cancer can identify polyps - grape size growths in the colon and/or rectum. These can be removed to prevent cancer from ever occurring.
- Starting at age 50, men and women who are at average risk for colorectal cancer should get screened. Men and women who have a higher risk of the disease may need to be tested earlier and should talk to their health care professional about when.
- No matter what your age, know the risk factors, know the symptoms, know your family history.
- Colorectal cancer is treatable.
More information and materials are available at www.preventcancer.org/colorectal. |
| Topical Topics from the Health Information Library |
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If you're a customer of our Health Information Library, you know how vast a resource it is. With a newly published, easy to follow directory for your staff, finding practical background information through a friendly voice, is just a phone call away.
In recognition of Heart Health Month in February, we wanted to share an excerpt from "Preventing Heart Disease" as an example of the information your member will hear upon calling that topic. Each topic is about two minutes long, identifies the issue, and offers tangible examples to support recommendations.
Excerpted Script:
Heart disease affects the quality of life of millions of Americans and is the leading cause of death. The development of most heart disease is related to the way we live. Changing to a healthier lifestyle will help prevent both new and repeat heart problems.
A family history of heart disease is an important risk factor. If members of your family have had heart disease, it is especially important for you to try to reduce other risks.
Try to control medical conditions that increase your risk of heart disease.
Diabetes, high blood pressure, and high cholesterol are major risk factors for heart disease. The same measures that help prevent or control these conditions will also reduce your risk for heart disease. For example, medicines for high blood pressure such as ACE inhibitors also reduce the workload of the heart and other organs.
Get regular exercise.
Many people get very little exercise. You should get regular exercise because it:
- Helps blood circulation.
- Helps keep blood pressure and blood cholesterol
within normal limits.
- Keeps muscles in tone.
Script continues.
Stop smoking.
Smoking is a major risk for heart disease. It causes narrowing of the arteries (vessels that carry blood around the body). Script continues.
Maintain a healthy weight.
Extra weight increases blood pressure, causes strain on the heart, and increases the risk for heart disease. Script continues.
To learn more about the 24 Hour Nurse HelpLine and Health Information Library, contact Janice Blattenberger, Director of Business Development, at 603-328-6602.
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