Summer 2008


From the Chairman:

During stressful economic times like these, we become even more conscious of the old adage, “time is money.”   Originally attributed to Benjamin Franklin, the concept of evaluating what our time is worth and spending that time wisely is a key to success in business today.

Here at Primary PhysicianCare, we continually look for ways we can operate more resourcefully to save all of us time and money.  Toward that end, we recently invested in the technology for paperless faxes, which allows us to process claims more efficiently and to increase the accountability factor. 

In addition, we have just launched our new Provider Access Portal on www.primarypc.com, which will free up significant amounts of time for our call center representatives to handle inquiries from members.  Read more about it in this month’s Call Center Corner.

This edition of Care Management News also includes information on controlling costs through our case management and Step Therapy programs; details about our upcoming Corporate Health and Wellness Summit in Greenville, SC; and an announcement about an exciting new partnership between Wellness Coalition America—a wholly owned division of Primary PhysicianCare—and News 14 Carolina that will promote wellness through a new video series. 

Here’s what’s in this issue:

  • Call Center Corner:
    New Provider Access Portal Unveiled
  • Washington Watch:
    Preparing for GINA Compliance
  • In the News:
    U.S. Diabetes Rates Still Rising
    Weight-loss Program Success Tied to Intensity
  • Rx Trends:
    Step Therapy Helps to Manage Rising Drug Costs
  • On the Case:
    Case Management Effectively Controls Medical Costs
  • Workplace Wellness:
    Corporate Wellness Programs 101
    Summer 2008 Corporate Wellness Summit in Greenville, SC
    Wellness Coalition/News 14 Partnership Promotes Wellness

Please let us know how we can improve our service to you and to your employees.  We look forward to your feedback.

Sincerely,

David R. Tate
Chairman and CEO

 
Primary PhysicanCare Health Systems

Call Center Corner: New Provider Access Portal Unveiled

By: Ryan Stewart, Call Center Manager
and Lauren Staley, CSR Team Leader

 

In this month's Call Center Corner, we are pleased to announce a new online resource for our healthcare provider community.  We recently launched the Provider Access Portal on www.primarypc.com, which allows providers to register under their federal tax identification numbers and view basic eligibility information including policy effective dates, covered dependents, and lines of coverage.
 
Washington Watch 
Preparing for GINA Compliance
By: Kay Jones Lewis, Staff Writer

Just when you thought you had ADA, ERISA, and HIPAA figured out, the government hands you a whole new set of guidelines to learn called GINA—the Genetic Information Nondiscrimination Act of 2008—which President Bush signed into law in May.  GINA outlines rules for health insurers and employers to follow, which protect Americans from discrimination based on DNA that may affect their health. The good news is, we all have until next year to become familiar with GINA—health insurers until May 2009, employers until November 2009.
 
Healthcare Horizons

In the News:
U.S. Diabetes Rates Still Rising
By: Kay Jones Lewis, Staff Writer

New data from the Centers for Disease Control and Prevention revealed recently that diabetes rates in the United States are still on the rise.  As of 2007, 8 percent of the population had the disease—or about 24 million people.  That’s an increase of 3 million diagnosed cases of diabetes in two years.  The report also estimated that another 57 million people have pre-diabetes, meaning that they have an increased risk for developing the disease.

 

Weight-loss Program Success Tied to Intensity
By: Kay Jones Lewis, Staff Writer

Corporate wellness programs aimed at helping employees lose weight are effective—at least to some degree—according to research conducted at the University of Cincinnati College of Medicine.  But the success rate appears to be tied to intensity.  Michael Benedict, coauthor of the study, said he found programs that involved face-to-face contact more than once monthly seemed to be the most effective.  

 
Rx Trends

Step Therapy Helps to Manage Rising Drug Costs

By: Bryan Klazinga, Vice President, Pharmaceutical Services

 

Drug costs continue to rise, but over the past few years, we have seen some relief.  One of the key factors in controlling pharmaceutical costs has been the increase in generic drugs.  As brand name drug costs continue to go up, they are offset by the influx of generics to the market.  Generics are available for many different classes of drugs; and in some cases, multiple generics are available, making them the best value for members and plan sponsors.
On the Case

Case Management Effectively Controls Medical Costs
By: Linda Roochvarg, MD, Medical Director

Medical case management (CM) is a service provided by registered nurses in Primary PhysicianCare's medical department.  These nurses assist patients and the patients' families—as well as healthcare providers—in implementing and coordinating care and treatment.  Their goal is to achieve the best clinical outcomes and patient satisfaction in the most cost effective way. 

Workplace Wellness
Corporate Wellness Programs 101
By: Kay Jones Lewis, Staff Writer

Healthcare costs in the United States are through the roof and we have no one to blame but ourselves.  That’s because, statistically speaking, we’re sicker and heavier than we should be, and we’re often thoughtless about the way we consume healthcare services. Consider the following facts:
 

Summer Corporate Health and Wellness Summit in Greenville, SC
By: Kay Jones Lewis, Staff Writer

On August 20, 2008, Wellness Coalition America will host a Corporate Health and Wellness Summit and luncheon for executives in Greenville, SC.   It will be held from 11:45 a.m. to 1:30 p.m. at the Greenville Marriott, One Parkway East.  Here's an outline of the topics the program will cover.

 
Wellness Coalition/News 14 Partnership Promotes Wellness
By: Kay Jones Lewis, Staff Writer

Wellness Coalition America, a wholly owned division of Primary PhysicianCare, is pleased to announce a new partnership with News 14 Carolina that will promote wellness to people across North Carolina via television, as well as online.