Health plan update [Vol. 5, no. 2 (Nov. 3, 2004)]

Health Plan Update
A Publication of the Board of Regents of the University System of Georgia
November 3, 2004 Volume 5, No. 2

The health plans offered by the Board of Regents provide University System of Georgia employees and their families with a variety of health education offerings that address the multiple needs of plan members who have chronic health problems such as diabetes, asthma and congestive heart failure. Called Disease State Management (DSM) programs, they are designed to help the afflicted individual understand the chronic condition and learn how to participate in improving his or her health and quality of life.
Along with a registered nurse "health coach," the plan member works with his or her own team of health professionals dieticians, respiratory therapists, exercise physiologists, etc. to develop strategies for managing the chronic condition. The member works with this team to set goals for improving health behaviors tailored to his or her individual lifestyle.
Unicare, which provides the University System's PPO and indemnity plan DSM programs, will identify plan members who may be appropriate candidates for participation in these programs through the person's medical records and claims history, a referral, or the member's inquiries regarding participation. Contact information is provided on p. 2.
New Program Added! Get Help Living with CVD
In 2005, the Board of Regents will add a new DSM program for participants in the Preferred Provider Organization (PPO) and indemnity plans who suffer from cardiovascular disease (CVD). This is an umbrella term for several heart-related conditions such as coronary artery disease, hypertension (otherwise known as high blood pressure), hyperlipidemia and stroke.
CVD was the number-one cause of hospitalization in the United States in 1999. By 2001, it was the number-one cause of death in the U.S. Four of the top 10 prescription drugs used by USG members in the PPO and indemnity plans between April and June 2004 are taken for high cholesterol, high blood pressure and/or heart disease all major contributors to CVD.
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MedCall
Free Medical Advice 24/7
With a quick call to MedCall (dial 1-800785-0006), members of the University System's Preferred Provider Organization (PPO) and indemnity plans can get free expert advice and even physician referrals from specially trained registered nurses at any hour of the day or night.
Medcall's Health Information Line is more than just a handy resource using it saves University System employees money if they are referred to a hospital emergency room for treatment.
MedCall nurses are equipped to refer callers to doctors, self-help groups and community agencies, and can answer questions about medical procedures, illnesses and the potential side effects of medications. In addition, they can advise callers
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CVD Program Added
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The "CVD with Stroke Overlay" DSM program has been added to the PPO and indemnity plans to prevent or delay disease progression. Over the past decade, the focus of CVD management has shifted from offering support AFTER acute episodic events have occurred to intervention designed to prevent these events from occurring. Research has revealed that enhancing a CVD patient's self-management skills is essential in positively impacting these chronic diseases. Early intervention helps minimize serious damage to the heart, as well as frequent or lengthy hospitalization. This, in turn, will help the University System and its plan members save money on health-care costs.
Available Disease State Management Programs:
PPO/Indemnity Plans Asthma, cardiovascular disease with stroke overlay, congestive heart failure, diabetes and oncology (for members diagnosed with breast, colorectal and lung cancer).
For additional information or to inquire about participation in any of the PPO/indemnity plan programs, please call 1-800-790-2507.
BlueChoice HMO Plan Asthma, cholesterol management (for members with cardiac disease), congestive heart failure and high-risk maternity.
For additional information about the BlueChoice HMO programs, please call 1-800-638-4754.
Kaiser Permanente HMO Plan (both premium and standard plan) asthma, congestive heart failure, coronary artery disease and depression.
For additional information about the Kaiser Permanente HMO programs, please call 404-261-2590.

MedCall
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of any pre-certification requirements that may govern the treatment options being discussed and will transfer a caller to the utilization-review team when appropriate.
This service is intended to offer information and support, not to diagnose illnesses. While nurses will help callers to assess their symptoms and suggest the options available, the final decision on whether to seek treatment or administer self-care rests with the caller.
MedCall also provides an audio library called the Healthwise Knowledge Base. The library contains helpful information on more than 200 complex medical problems, 135 symptom assessments, 500 health topics, 600 medical tests and procedures, 5,000 selfhelp or support groups, 257 cancer topics and 5,000 drug treatments.

Open enrollment in various options offered as part of your benefits for 2005 ends on Nov. 12. Have you made the necessary changes to your health benefits yet? If not, go to
www.usg.edu/admin/humres/benefits/ health/enroll05.phtml

To access the library, call 1-800-785-0006 or go to www.usg.edu/admin/ humres/benefits/health/ and click on the Healthwise Knowledge Base link.

for all the information needed to make intelligence choices in filling out the health-plan election form included in your benefits information packet.

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