Are health insurance companies finally getting smart?
A sign of things to come?
I was busy at work when I received a phone call from my health insurance company, Aetna Blue Cross of California. The insurer, best known for attempting to raise premium rates into the stratosphere and a history of seeking to deny coverage to those often in the greatest need, was phoning to invite me to participate in a program they are offering to their customers with chronic health conditions – such as diabetes and heart disease.
Sadly, such a program very much includes me.
The offer included a weekly phone call from one of their health care aides along with 24/7 access to their nurses, pharmacists and nutrition experts. And…get this… all at no charge to me whatsoever.
While I tend to stay very much on top of my chronic conditions and have a pretty healthy knowledge and understanding of how to properly care for my “issues”, I decided to play along. After all, I’ve been arguing that this sort of program is precisely the sort of thing that will, in the long run, save health insurers a lot of money, improve the health of their customers and, as a result, bring down premium costs for payers everywhere.
I could hardly turn them down.
The conversation took awhile. After a preliminary discussion with the individual who made the initial contact, I was turned over to a health specialist who presented me with a long list of questions designed to work out where I could use a little help or motivation to keep the blood sugar under control and the coronary arteries from suffering any further damage.
The questions were relevant and on point. They knew what they were asking and why.
Based on my answers, the consultant suggested a few things that I was welcomed to accept or pass on. For example, I agreed to the weekly phone call from one of their nurses, mainly because I want to see how well the program functions. I passed on the opportunity to speak with the nutritionist, taking the opportunity to relay the tale of how I was forced to see a hospital nutritionist prior to being discharged from my triple bypass surgery adventure only to find that the nutritionist was a three hundred pound woman who clearly was not prepared to practice what she preached. Despite Aetna’s assurances that their nutritionists were all committed to healthy eating, I really do know enough to understand when I’m eating poorly so I decided to save their nutritionist’s time for someone who could better benefit from the service.
Kudos to Aetna Blue Cross of California.
While these programs may be baby steps in the direction of getting the cost curve under control, they are important steps just the same and should be encouraged.
I’ll report back on this subject after my first telephone conference with the insurance company’s nurse.
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There is parable in the Dhammapada (attributed of course to Gotama Buddha, but..???). The story tells of a scorpion on the bank of a fast flowing stream. A frog came by and the scorpion asked for a ride across the stream to the other shore (the ‘other shore’ is always a metaphor for enlightenment in Buddhist literature). The frog said “no way, you will sting me”. “No” responded the scorpion, “then I would not get to the other shore”. So the frog consented and halfway across to the other shore, the scorpion stung him on the back. The frog, as he was dying and drowning, asked the scorpion, “why did you do that, now you will die also”? The scorpion responded “I can’t help it, I’m a scorpion”. And as he himself drowned he was shrugging his shoulders.
(the shoulder shrugging is my personal adaptation for the sake of realism).
Um, how exactly does this parable relate to Rick’s post? (The “Um” is my personal adaptation for the sake of realism).
In response to another comment. See in context »[...] Are health insurance companies finally getting smart? – Rick Ungar … [...]
[...] Are health insurance companies finally getting smart? – Rick Ungar … [...]
An industry that consumes 15 % of our GDP is going to be unwieldy to change, but this could be the beginning. Aetna is our family insurance provider here in Virginia. I’ll be waiting to see how extensive this new approach is.
as a (retired) nurse, i have seen how hard it is for people to live with diabetes.
a consultation with a Registered Dietitian would benefit you.
anyone can call themselves a “nutritionist.” so IF you see someone who is a “nutritionist,” make sure the person has had the proper schooling. — eg, Nutritionist, Mr Smith, Registered Dietician. i would definitely recommend it. (just sayin’)
what’s the difference between an RD and a nutritionist?
from the government:
http://eclkc.ohs.acf.hhs.gov/hslc/ecdh/Health/Nutrition/Nutrition%20Program%20Staff/WhatAretheDiff.htm
from a Univ of Illinios:
http://fshn.illinois.edu/undergraduate/dietetics/dietitian
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