Healthline member newsletter

Exercise Is Medicine

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Karl Hempel, M.D. 

Medical schools are now teaching students to prescribe exercise as a powerful form of treatment for most of the diseases that are disabling and killing our society. I recently attended a conference at Stanford University on how technology is changing the practice of medicine. It was amazing how many of the presentations promoted health through regular exercise. 

Approximately 70% of the diseases we die of are preventable and caused by our own behavior, such as obesity, inactivity, smoking, alcoholism, diabetes and hypertension. Regular exercise alone reduces your chance of getting diabetes by 58%. So why is only 30% of the population exercising regularly? The answer may be because it is hard to motivate people to exercise, particularly when they first start. 

So what would it take to get more people to exercise? Several medical problems have persuaded my patients over the years to seriously take up exercise. They are mainly high cholesterol, diabetes, hypertension, having a heart attack or a stroke, gaining weight and anxiety. Exercise is the only thing that has been proven to reduce the onset of dementia. Personally, that bit of information is the only thing I need to know to continue exercising regularly.

I also wonder if we could completely overhaul the health care system by paying people to be healthy. Paying a little for prevention could reduce the health care cost dramatically. A longtime sponsor of the Turkey Trot and other healthy events in this community, Capital Health Plan actually pays a portion of a membership to a gym for their members. Diabetes alone costs more than $100 billion per year just for medical care. What if we reduced this number by 58% just by encouraging regular exercise?  

One of the keynote speakers at the Stanford conference was BJ Fogg, PhD, the director of the Persuasive Tech Lab at the university. He gave an example of how someone should approach a behavior change, such as regular exercise. He suggested it is better to set a goal with a short span of time such as one month as opposed to saying, “I’m going to walk everyday for the rest of my life.” If your goal is to walk everyday for one month, after two weeks you could say, “I am halfway through and another two weeks is easy!” Hopefully, after doing this for one month you would notice how much better you feel and want to set another goal. Behaviormodel.org discusses Fogg’s model of persuasion in more detail. 

Another great resource is the website exerciseismedicine.org. This site, started by the American College of Sports Medicine and the American Medical Association, promotes regular exercise as a treatment for disease.

After years of practice, I have concluded that one of the most important things I can do for my patients is to convince them to exercise regularly. I agree with Thomas Jefferson who once said, “Make time for exercise now or allow time for illness later.”

Managing Your Diabetes

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Do you have Diabetes? Actively participating in your care will help you control and possibly prevent complications associated with Diabetes. Most people with diabetes need to see their primary care physician (PCP) two to four times per year.

Here are some important topics to discuss with your doctor: 

  • Obtaining or maintaining a healthy weight
  • Quitting smoking (if you smoke)
  • Exercise appropriate for you
  • Laboratory tests: Discuss with your PCP the appropriate frequency for these tests:
    • Hemoglobin A1C:  your report card for blood sugar control over three months. A Hemoglobin A1C level less than 7% demonstrates good control. 
    • Lipid levels:  your risk for heart disease and stroke. Strive to achieve a level of <100mg/dl if you do not have heart disease and <70mg/dl if you do have heart disease.
    • Creatinine/BUN/eGFR:  to check your kidneys 
    • Microalbumin:  a urine test that can show early kidney damage
  • Blood Pressure: Maintain your blood pressure at 130/80 or below.
  • An eye exam, including having your eyes dilated to check your retinas
  • Feet and toenail health: You may need to visit a specialist for some issues.
  • Your medications (including all over-the-counter medications and supplements) 

Taking your medications as prescribed every day is one of the most important aspects of maintaining control of your Diabetes. Medications in the class of Angiotensin-converting enzyme inhibitors (ACE Inhibitors) or Angiotensin II Receptor Blockers (ARBs) have shown in studies to be the best at helping prevent kidney and heart complications in diabetics.  Generic formulations are available for both of these categories of medications. Ask your doctor to prescribe a 90-day supply when appropriate and in accordance with your pharmacy benefit (Medicare members with a CHP pharmacy benefit have access to 90-day supplies of both generic and brand medications [excluding Specialty drugs]. Commercial members with a CHP pharmacy benefit have access to a 90 day supply of generic drugs).  Less trips to the pharmacy means less opportunities to “forget” refilling your medications. Not taking your medications as prescribed increases your chances of complications from diabetes such as amputation, stroke, blindness and heart attack. 

For more information on the Diabetes Disease Management Program offered by CHP call (850) 523-7442- option 1.

Remember to get care from your doctor.  If you don’t have a scheduled appointment with your primary care physician in 2012, call today.  If you do not have a PCP assigned to you, call CHP Member Services at (850)383-3311.

Happy Birthday Capital Health Plan

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

In June of 2012, Capital Health Plan will celebrate 30 years of serving this community. In 1982, a handful of Tallahassee civic leaders came together with the common vision of creating a quality, affordable health care system that responded to the needs of the community. Now 30 years later, Capital Health Plan has not only met these goals but surpassed them by becoming a national leader in health care.

We started small. We began with a network of 75 doctors and proudly served 5,000 members. Now CHP serves more than 125,000 members and provides a network of more than 550 doctors and specialists in the Capital City area. 

You are the reason we’re still going strong. Everything we do at Capital Health Plan is driven by our commitment to focus on the health of the community, improve the patient experience and reduce the cost of health care. That means that with each decision we make, we keep our members in mind. We thank you for your membership and look forward to 30 more years! 

Celebrate with us. 

We invite you to join us in celebrating this important milestone by visiting www.happybirthdaychp.com.

This special site is an online community where CHP members can share stories about what CHP has meant to them.  You can read testimonials from members like you who have played a part in Capital Health Plan’s 30-year history, and then share your own story. 

I’m a CHP Baby

We want to hear from babies born under Capital Health Plan. Whether you have a newborn, or you are a grown up CHP baby yourself, visit the “I’m a CHP Baby” page on the anniversary website to submit a story and a photo.

Member Services Message: Log on to CHPConnect

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Connect to Your Health Care with CHPConnect. 

Capital Health Plan Member Services Department is pleased to announce that we will offer CHPConnect training classes so that you can get the most out of this helpful, online, secure, health resource. 

Using CHPConnect, you can:

  • Maintain a personal history of your doctor visits, procedures, and diagnoses
  • Track claims, referrals, and medications (for members with CHP prescription drug benefits)
  • View some lab results
  • Manage children’s immunizations and visit dates 
  • Review your benefits, including copays
  • Learn about allergies and common health issues in the HealthWise reference library
  • Request ID cards 
  • Change your primary care physician and demographic information

And, you have access to CHPConnect 24 hours a day, right at home. Register online at capitalhealth.com.

The CHPConnect training will help you register, and introduce you to all the elements of the system. 

Trainings will be held on: 

  • Wednesday, May 9, 2012 at 10:00 a.m.
  • Wednesday, September 5, 2012 at 3:30 p.m. 

At the Capital Health Plan Administrative Office:1545 Raymond Diehl Rd, Suite 300, Tallahassee, FL 32317

Please call Member Services to reserve a space at one of these training sessions. Space is limited. We look forward getting you connected with CHPConnect. 

Member Services - Five days a week 8 a.m. -7 p.m.850-383-3311 or 1-877-247-6512

Medicare Member Services - Five days a week 8 a.m. - 8 p.m. 850-523-7441 or 877-247-6512

TTY - 850-383-3534 or 1-877-870-8943

Where does my CHP dollar go?

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

At Capital Health Plan, we aim to keep coverage affordable and focused on hospital, physician, drug and other health care services.  

Administrative costs represent less than 4% of our total revenues, one of the lowest levels in the nation. CHP’s overhead has been below 5% of revenues for the past 25 years. 

This means that over $0.96 of your dollar goes directly toward providing the health care services you need.

Taking Your Medications the Way They Are Prescribed

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Poor medication adherence accounts for 125,000 deaths per year in the United States, 23% of nursing home admissions, and 10% of hospital admissions.

Medication adherence is a measure of how well you take your medication exactly as prescribed by your doctor. The World Health Organization (WHO) states that more than 50% of patients do not take their medicines as prescribed. This is concerning because not taking your medications as intended can interfere with the ability of the drug to do its job and increase your risk for serious complications.  

Below are some common medications with possible consequences of not taking them as prescribed:

  • Blood pressure medications: non-adherence can increase your risk for heart failure, stroke, kidney problems, and other health problems.  
  • Cholesterol medications: non-adherence can increase your risk for heart disease, which is the number one leading cause of death in the United States.
  • Diabetes medications: non-adherence can lead to uncontrolled diabetes, which can increase your risk for heart disease and stroke, kidney disease, blindness, amputations, nervous system disease (such as neuropathy), and other health problems.
  • How can you avoid these health complications? Work with your doctor to ensure that you are on a medication regimen that works for your medical condition AND for you. Two factors that most often lead to poor adherence are (1) medication cost and (2) regimen complexity. If the cost of your medicine is keeping you from taking it, or if the schedule you are asked to follow is too complex, talk to your doctor about possible alternatives.  

Here are a few ways to make taking your medications easier: 

  • Use generic drugs when possible to help keep your costs low. 
  • Ask your doctor to prescribe a 90-day supply when appropriate and in accordance with your pharmacy benefit (Medicare members with a CHP pharmacy benefit have access to 90 day supplies of both generic and brand medications [excluding Specialty drugs]. Commercial members with a CHP pharmacy benefit have access to a 90 day supply of generic drugs).  Less trips to the pharmacy means less opportunities to “forget” refilling your medication.
  • If your medication requires you to take it more than 2 to 3 times per day, ask your doctor if there is a once daily alternative that is right for you  – less doses per day decreases the chances  of  forgetting a dose.
  • Stay informed about the medications you are prescribed, why you are taking them, and the consequences of not taking them – a more informed patient is a more adherent patient.

Help us to keep you healthy by taking your medications as prescribed!

Learn more about Medication Adherence

Download the Savvy Senior podcast of Dr. Dennis William’s presentation: Taking Medications the Way They are Prescribed. The program provides in-depth evidence about the risks associated with poor medication adherence, and ways to help you stay on track with your medications. Go to the “Savvy Senior Podcasts” page

Understanding Your 2012 Prescription Drug Benefit

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Medicare Members

Prescription drug benefit changes for all Medicare members: 

  • New 90-day supply benefit for Tier 1 generic prescriptions at network pharmacies
  • New 90-day mail order benefit. To learn how to start using the 90-day mail order process, contact Member Services at 383-3311
  • The list of covered drugs (the formulary) and the copayment/coinsurance for drugs is updated each year. This can affect what you pay for a drug.  To locate the most current version of our formulary, visit capitalhealth.com/Medicare-2012. Then, select your plan and view Prescription Drug Coverage.  
  • Catastrophic Coverage Limit increased from $4550 to $4700. Catastrophic Coverage applies to all Medicare Advantage members. This means if your yearly out-of-pocket expenses reach $4700, you pay the greater of 5% coinsurance or a $2.60 copayment for generic (including brand drugs treated as generic) and a $6.50 copayment for all other drugs for the remainder of the plan year.

Changes for specific plans:

  • State of Florida Retiree Advantage Members
    • The prescription benefit continues to be  administered by CVS/Caremark.  (Other State of Florida members now have Medco for their prescription drug benefit)
  • Advantage Plus Members
    • Initial Coverage Limit increased from $2840 to $2930
    • Generic drug costs during the coverage gap went down from 93% to 86%
  • Preferred Advantage Members
    • Initial Coverage Limit increased from $2840 to $2930
    • Non Tier 1 Generic drug costs during coverage gap went down from 93% to 86%

Commercial Members*:

Prescription drug benefit changes for Commercial Members*:

  • New 90-day supply benefit for Tier 1 generic prescriptions at network pharmacies.
  • The list of covered drugs (the formulary) and the copayment/coinsurance for drugs is updated each year. This can affect what you pay for a drug.  To locate the most current version of our formulary, visit capitalhealth.com, and under the section titled Popular Links and Documents, click Prescription Drug Benefit. Then click the green button labeled “2012 Commercial Formulary”.  

*State of Florida members not enrolled in Capital Health Plan Retiree Advantage have Medco for their prescription drug benefit effective January 1, 2012.  These State of Florida Members should check with Medco, at 1-877-531-4793, for any prescription related benefit questions.

Capital Health Plan Receives Excellent Accreditation from NCQA

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

February 29, 2012 – Once again, the National Committee for Quality Assurance (NCQA) awarded Capital Health Plan its highest accreditation status of Excellent for service and clinical quality. Capital Health Plan was awarded the Excellent status for both its Commercial HMO and Medicare HMO plans. This means that Capital Health Plan met or exceeded NCQA's rigorous requirements for consumer protection and quality improvement.  CHP has held the Excellent accreditation status for 11 years.

The National Committee for Quality Assurance (NCQA) conducted an on-site survey at Capital Health Plan on February 13-14th, 2012. The results of the on-site survey show that CHP achieved a score 100% out of 100%.  This on-site survey score is combined together with the most recent HEDIS clinical measures and CAHPS member satisfaction scores to calculate the new accreditation rating score for 2012.

Capital Health Plan was also awarded Medicare Advantage Deemed Status in accordance with the requirements set forth by the Centers for Medicare & Medicaid Services.

NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance.

According to NCQA: “NCQA’s Excellent Accreditation status is reserved for the best health plans in the nation.  It is only awarded to those plans that meet or exceed NCQA’s rigorous requirements for consumer protection and quality improvement and deliver excellent clinical care.

“Earning Excellent Accreditation reflects a health plan's ability to work with its members’ physicians to improve the quality of clinical care. It shows that the plan is building the kinds of partnerships that are critical to delivering great care and great service.”

National Health Care Decision Day - April 16

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

April 16, 2012 is designated as National Health Care Decision Day. The goal of celebrating National Health Care Decision Day is to encourage everyone to communicate their health care wishes to family and medical providers before the need to make decisions arises. Capital Health Plan’s Advance Directive of choice is Five Wishes.

Current statistics reveal that only 15-20 percent of the population has completed an Advance Directive. The end of life is often treated as a medical moment rather than a process that completes the circle of life. If asked, most will tell you that they want to be allowed to die a natural death.  Almost everyone has a “horror story” of a loved one dying in pain or isolation. This can all be avoided by completing an Advance Directive now before you become ill or incapacitated.

Life can change in an instant. Please give your family the gift of having completed an Advance Directive today.  To have a copy of Five Wishes mailed to you, call CHP Health Promotions at 850-523-7422 option 3.  Visit the Advance Directives and Living Wills page for more info.