Real World Health Care Blog

Tag Archives: Americans

Are Shorter Doctor’s Office Wait Times Just a Phone Call Away?

Nobody likes to wait, especially at the doctor’s office. No one knows for sure what will happen to wait times, which average from about 16 minutes to just over 24 minutes nationwide according to Vitals – as 30 million more Americans obtain health care coverage under the Affordable Care Act. But it stands to reason that wait times could increase. Couple that with the looming shortage of primary care physicians, and time spent in doctors’ waiting rooms may become an even more precious commodity.

Linda Barlow

Linda Barlow

Patients who lack, well, the patience to wait may have a solution – one that is showing great promise to eliminate doctor visit copays and is available even to those without medical insurance. The free Urgent Care app from GreatCall Inc. is designed to give people 24/7 access to health care information anytime, anywhere. Launched in January, the GreatCall app rose to the top of the Google Play and App Store medical categories by mid-May.

Urgent Care is the only app that provides users with round-the-clock access – for a price of $3.99 per call – to a live, registered nurse with LiveCare Clinic who can escalate inquiries to a board-certified doctor for health-related advice, diagnosis and even prescriptions without an appointment. It also provides a medical dictionary and medical symptom checker tool.

Urgent Care empowers patients to make choices about how and where they receive medical consultation. For example, many access the app’s Interactive Symptom Checker feature to pinpoint various symptoms of common ailments they might initially find uncomfortable to discuss in person. The app also helps identify:

  • Possible causes of symptoms
  • When to self-treat
  • When to contact a medical professional

“With the costs of medical care rising, people are looking for other options to get access to quality health care,” said Aaron Amerling, Manager of Mobile Apps at GreatCall. “Urgent Care fills a very real need by giving anyone access to medical resources, as well as the ability to quickly connect to a nurse or doctor for less than the cost of a typical Starbucks beverage.”

Amerling notes that Urgent Care is being used by a wide range of people – from those seeking a Spanish-speaking nurse or doctor to those who have health insurance and are frustrated by sitting on-hold or waiting long periods for returned calls from their health care providers.

When asked whether apps like this undermine the authority of health care providers by placing too much control in the hands of patients, Amerling said, “When people have the ability to look up ailments online, they may find a myriad of potential causes and are unable to self-diagnose safely. That’s why we made the ability to access registered nurses and board-certified physicians for expert opinions an important component of Urgent Care.”

According to Amerling, the app has been so successful that the company is looking to add even more resources for patients, including:

  • Access to health news and videos
  • Drug information forums
  • Expanded medical libraries
  • A Spanish-language version of the app

Have you ever used Urgent Care or another app to obtain medical advice? If yes, how did you feel about the quality of care you received? If not, do you think you would ever use an app like this?

Categories: Access to Care

This is Not Your Father’s Oldsmobile, Nor Your Child’s Social Network

David Sheon

David Sheon

Does social networking conjure images of teenagers who share seemingly worthless online videos of watermelons dropped from atop buildings? Well get this:

Americans OVER age 45 represent the largest percentage increase in social media usage in the past year, now up to 38 percent in 2012, compared to 31 percent in 2011 (Source: Edison Research).

What does this mean for improving health care outcomes?  At least one analysis finds a prolific growth in online patient communities, where peers help one another find solutions, determine the right time to go to the doctor, and essentially crowd source solutions to their problems.

Many social networks specifically for patients have launched using a number of different business models.  Here are just a few:

  • Inspire has social networks for patients with various diseases and health conditions, each sponsored by health organizations.
  • The Mayo Clinic has created a platform for patients with various diseases, not limited to the 500,000 patients treated at the Minnesota-based hospital system annually.
  • Patients Like Me is a web-based portal for patient-to-patient communication that was started by two brothers at MIT.  They pledge complete transparency in terms of funding sources.
Are social networks resulting in better outcomes or improved access? Any success
stories out there you’d like to share? What are some of the best sites for connecting with others who have similar health conditions?

Categories: Access to Care

Implementation of Health Care Law Expanding Coverage to More Young Adults

LJB head shot 03

Linda Barlow

For the first time in nearly a decade, the number of 19-25 year-olds gaining access to health insurance is on the rise, according to the Commonwealth Fund 2012 Biennial Health Insurance Survey. Researchers point to a provision in the 2010 Patient Protection and Affordable Care Act (PPACA or ACA), which allows young adults to stay on their parents’ health insurance until age 26, as a likely cause of this groundbreaking trend.

“The early provisions of the Affordable Care Act are helping young adults gain coverage and improving the affordability of health care during difficult economic times for American families,” said Sara Collins, Ph.D., a Commonwealth Fund vice president and lead author of the Biennial Survey’s report, Insuring the Future: Current Trends in Health Coverage and the Effects of Implementing the Affordable Care Act.

The improvements in young adult health coverage are significant, according to the Biennial Survey:

  • Nearly eight in 10 (79 percent) of Americans ages 19-25 reported that they were insured at the time of the survey in 2012, up from 69 percent in 2010, or a gain in health insurance coverage for an estimated 3.4 million young adults.
  • The share of young adults in this same age group who were uninsured for any time during the year prior to the survey fell from 48 percent in 2010 to 41 percent in 2012 – an estimated decline of 1.9 million, from 13.6 million uninsured young adults in 2010 to 11.7 million in 2012.

Of the estimated 3.1 million young adults who are now covered through the ACA, 60 percent are leveraging it for mental health, substance abuse, or pregnancy treatment, according to a study from the Employee Benefits Research Institute (EBRI). For one large, national employer profiled in the study, the newly-covered young adults used about $2 million in health care services in 2011 – about 0.2 percent of the employer’s total health spending.

Access is a major barrier to care for young adults, who were previously terminated from their parents’ plans when they turned 19. According to the Henry J. Kaiser Family Foundation (KFF), young adults typically face difficulties obtaining their own coverage because they work in entry-level, low-wage or temporary jobs that are less likely to provide health insurance. Lack of insurance makes it harder for young adults to receive adequate medical care –  a problem that plagued one in five young adults before the ACA began to take effect.

“Young adult women have additional health needs and are particularly vulnerable when they are uninsured, as they are at an age when they require reproductive health services,” noted Karyn Schwartz and Tanya Schwartz, authors of KFF’s Issue Paper, How Will Health Reform Impact Young Adults? “Having health insurance and consistent access to the medical system may increase the likelihood that they receive timely pre-natal care if they become pregnant.”

Meanwhile, some skeptics are expressing concerns about key aspects and implications of the Act, from objecting to young single males being required to purchase a plan including maternity benefits and well-baby coverage – to others saying that full implementation of the ACA in 2014 will mean much higher premiums for young adults. Many have challenged these assertions, however, noting that the ACA’s age-based pricing requirements are largely in line with premiums individuals are paying now.

Although the news for young adults is mostly good, the survey also found that 84 million people – nearly half of all working age U.S. adults – went without health insurance in 2012, or faced out-of-pocket costs that were so high relative to their income that they were considered “underinsured.”

The survey did indicate that 87 percent of the 55 million uninsured Americans in 2012 are eligible for subsidized health insurance through the insurance marketplaces or expanded Medicaid under the ACA. Up to 85 percent of the 30 million uninsured adults also might be eligible for either Medicaid or subsidized health insurance plans with reduced out-of-pocket costs.

Click here to learn more about pricing options for young adults seeking health insurance coverage.

Now it’s your turn. Does rollout of the ACA mean more accessible and affordable health insurance coverage, or will it drive up costs, particularly for younger Americans? Get the conversation started.

Categories: Access to Care

Heroes Needed: Apply Within

We’re taking a departure today from our coverage of what works in American health care to ask for your help.

Patients want us to re-open our Breast Cancer Fund at HealthWell, but we can’t successfully do that until we identify several key companies or organizations to partner with us in this effort.

When HealthWell’s Breast Cancer Fund was open, thousands of Americans battling breast cancer found new hope to live healthier lives. Nearly 17,000 insured breast cancer patients received the financial assistance they needed so that the surging cost of treatments was not a barrier to accessing critical care.

As HealthWell prepares to re-launch its massive Breast Cancer Fund, we are expanding our call to action. We are seeking partners to help us make a real, positive difference in the lives of insured patients who often struggle to afford critical treatment including medications.

By becoming a strategic partner with the HealthWell Foundation, your organization will help thousands of Americans who face medical bills they can’t afford.  Beyond the incredible satisfaction of knowing that you played a role in persuading your organization to help us re-open this fund, you’ll gain a cause marketing partner that will support your efforts to build and shape your brand to new audiences.

When you work with us to empower patients, you will leverage a unique opportunity to win exclusivity, naming rights and more.

With one in eight women in the U.S. expected to develop breast cancer during her lifetime, the need for timely, life-sustaining care is outpacing our health system’s ability to assist patients. More and more Americans are in desperate need of immediate financial relief to afford deductibles, co-pays and premiums, yet many have few places, if any, to turn for assistance.

Women like Linda in Powell, Tenn., illustrate exactly why support for the Breast Cancer Fund at HealthWell is needed. When Linda realized just how expensive her breast cancer medication would be, she was scared. As a self-employed grandmother of two, she faced a $5,500 deductible for her insurance premium alone. Additional costs for mammograms, colonoscopy, endoscopy and lab work were all out-of-pocket and she wasn’t sure how she would make ends meet.

That is, until she discovered the Breast Cancer Fund at HealthWell, a lifeline that enabled her to afford the treatments she needed to remain cancer-free two years after her diagnosis.

“My patient advocate gave me a list of several foundations to contact which I did,” Linda said. “The first turned me down because they said we went $50 over our salary. The second turned me down because I had a deductible. Then I heard from HealthWell. We couldn’t believe we had found help. We just had to cry. I am so thankful. Every time I have my prescription filled it still amazes me. Not many good things have happened to us.”

The fund’s incredible track record of success in offering assistance to patients in need is exactly why we must reopen it now.

The HealthWell Foundation believes that no patient – adult or child – should go without health care because he or she cannot afford it. As demand for medical treatments increases while associated prices continue to spike, we want the Breast Cancer Fund at HealthWell to once again provide timely, critical copay and premium assistance and expanded services to breast cancer patients.

These services went far to ease the strain felt by patients covered under Medicare, Medicaid, private insurance and employer-sponsored plans with incomes up to 400% of the federal poverty level.

Strengthening the financial safety net for more patients begins with teamwork. Together we can be part of the solution, harnessing our resources to make access to quality medical treatment a reality for more Americans battling breast cancer. Please contact us if your company may be interested in partnering with us to re-open this vital fund.

The HealthWell Foundation sponsors this blog because we are innovators in finding solutions to overcome hurdles in the American health care system. The thousands of women at work right now trying to clear the hurdle of breast cancer deserve everything we have to give.  Join us.  We have so much yet to do.  And you could make a difference in so many lives.

Categories: Cost-Savings

It Takes a Community for Effective Disease Prevention and Management

To help stem the tide and high cost of persisting disparities in U.S. health care, providers are leveraging Community Health Workers (CHWs) as critical players in improving health outcomes by successfully linking “vulnerable” patient populations to better care. Living in the communities where they work, CHWs understand what is meaningful to those communities, communicate in the language of those they serve, and incorporate cultural buffers to help patients cope with stress and promote health outcomes.

As the CDC reports, growing evidence supports the involvement of CHWs as a critical link between providers and patients in the prevention and control of chronic disease:

  • They help high-risk populations, especially African-American men in urban areas, to control their hypertension.
  • They enable diabetic patients to reduce their A1C values, cholesterol triglycerides and diastolic blood pressure.
  • Their interventions improve knowledge about cancer screenings as well as screening outcomes.
  • Their interventions help patients reduce the severity of asthma.

Many Americans – especially those with low incomes, have no insurance or face other socio-economic barriers to primary care – often distrust the health care system, or lack the resources and awareness needed to take charge of their health. As a result, they wait until health issues and chronic disease escalate enough to drive them into the emergency department, where they receive short-term solutions that drive up the total cost of health care.

CHWs are changing that, community by community. Examples of CHW programs – both at home and abroad – abound. One is Penn Medicine’s IMPaCT Program.

IMPaCT (Individualized Management for Patient-Centered Targets) pairs patients in need of extra support with relatable neighbors and peers (people who have shared language, ethnic and geographic backgrounds) to assist them in navigating the medical system and identify the underlying causes of illness.

“Lower income patients tend to poorly manage chronic disease and have worse health outcomes than other patient populations,” explains Dr. Shreya Kangovi, Director of the Penn Center for Community Health Workers, which houses the IMPaCT program. “They are less likely to get preventive care and more likely to end up in the hospital. This scenario leaves health care practitioners frustrated, because they can’t move the needle on health outcomes. And it makes it difficult for the health system to meet its quality targets.”

Dr. Kangovi notes that many patients served by IMPaCT didn’t have a relationship with a primary care physician prior to joining the program.

“There is a lot of focus today on reducing hospital re-admissions,” she says. “But before we can reduce re-admissions, we need to make sure patients have a substitute for the emergency department.”

She shared the story of “Ben,” a young man with a bad case of lupus and no insurance. Ben had been visiting Penn’s Emergency Department regularly for lupus flare-ups. There, he received steroids and pain medications before being sent along his way. Thanks to IMPaCT, Ben was set up with a primary care doctor who understands his health problems, and placed Ben on a better medication regimen. Not only does Ben now feel better, he has more trust in the health care system that he sees as an ally, she says.

IMPaCT currently serves about 500 patients via two programs – one for hospitalized inpatients and one for primary care outpatients. The program’s CHWs meet with patients upon admission to the hospital to set short-term goals and identify pathways to solving their clinical and socioeconomic hurdles. They advocate for patients during their hospitalization, then work with them during discharge and beyond to get them connected to resources in their community. On the primary care side, patients work with their IMPaCT partner over six months to break long-term health goals down into smaller, achievable steps.

“Once patients leave the hospital, real-life issues intervene,” Dr. Kangovi says. “IMPaCT’s community health workers address these health and life issues on the ground, and do so much better and at a much lower cost than clinically trained personnel.”

Are CHWs making a difference where you live? How are they helping to reduce costs and improve access to health care?

Categories: Access to Care

Making Life Easier for Patients and Loved Ones: Meet MyHealthTeams

Talk to anyone impacted by a chronic condition – autism, multiple sclerosis, breast cancer – whatever disease or condition, they will all tell you it’s not easy. It’s not easy finding the support that best suits them. It’s not easy finding providers. It’s not easy period. At MyHealthTeams we create social networks for chronic condition communities. We believe that when you or a loved one are diagnosed with a disease, it should be easy to connect with people just like you, who can share their daily experiences, and help you discover the best people around to help you.

Since we founded MyHealthTeams in 2010, we’ve launched three social networks – MyAutismTeam, for parents of children with autism; MyBCTeam, for women facing breast cancer; and MyMSTeam, for those living with multiple sclerosis.

Each of the social networks we’ve built has been fully embraced by the communities we’ve addressed. Our flagship community, MyAutismTeam, has in less then 24 months, grown from 30 parents to more than 40,000 parents across the US.

Emily Ybarra, mother of a 4-year old boy with autism, was having difficulty finding a dentist capable of handling her child’s sensory processing disorder – a common challenge associated with autism.  After joining MyAutismTeam she connected with other parents near her in Orem, Utah and asked if anyone could recommend a dentist capable of “working with a special-needs child who recoils from human contact.”

Within a few days she had a referral to the autism-friendly dentist she still uses today.  More important, she had established friendships with many other parents of children on the autism spectrum.  Parents nearby reached out to her, but so did parents from all across the country who could empathize with the challenges of having a child with sensory processing disorder.   She wasn’t alone and she didn’t need to reinvent the wheel.

MyBCTeam already has roughly 4,000 women on the site since our launch in September 2012 and the majority of those women are actively engaged on the site or the MyBCTeam mobile apps every month.

This past week we launched MyMSTeam and as of this writing we are already closing in on 500 registered members.

Users of all three of these social networks share recommendations of local providers, openly discuss daily triumphs and issues, share tips and advice, and gain access to local services.  Thousands of posts, comments and updates are shared every day across these three sites and that number climbs each week as the networks expand.

Three major drivers behind the growth of our sites:

  1. People crave connection with other people just like them – they just need a safe and reliable environment to do so.
  2. The simplicity of our technology – our communities reflect aspects of social networks that our users are already familiar with (i.e. Facebook, Twitter, etc.) which provides for high user engagement.
  3. The rapid word-of-mouth among these communities.

One in two Americans live with a chronic condition[i] and they are seeking support from not only their medical providers, but also from people like them. In fact, for women with breast cancer, recent studies show that having strong social support improves outcomes[ii]. Sharing with people who are in your shoes offers a sense of community that can’t be found elsewhere – these are people who know the language of your condition; they understand the daily frustrations and the small triumphs that can mean so much.

With The Affordable Care Act on the horizon, implementing and expanding wellness programs has taken on a new importance for companies.  Organizations are seeking resources that not only help improve the quality of life for their employees, but also help control health care spending. Social networks, like the ones created by MyHealthTeams, allow employers to offer unique resources to their employees allowing them to create the support networks they need to get through to the next day.

For more information on the social networks created by MyHealthTeams, visit http://www.myhealthteams.com.


[i]An Unhealthy America: The Economic Burden of Chronic Disease, Charting a New Course to Save Lives and Increase Productivity and Economic Growth, Milken Institute, By Ross DeVol and Armen Dedroussian, Oct 2007 (free download http://www.milkeninstitute.org/publications/publications.taf?function=detail&ID=38801018&cat=resrep)

[ii] Journal of Clinical Oncology, Social Networks, Social Support, and Survival After Breast Cancer Diagnosis, Candyce H. Kroenke, et al., March 1, 2006

Categories: Access to Care

Three Pillars of Health Care Success: Cost Savings, Prevention/Patient-Centered Care, and Access to Care

Welcome to www.RealWorldHealthCare.org, a blog dedicated to showing what’s working to  improve health care in the U.S.

Why are we talking about improving access to good medical care? Rising costs could bankrupt us, and most people need to do a better job of preventing illness. But digging deeper, you may be surprised to learn that almost 10 percent of the U.S. population (that’s 29 million Americans) can’t afford the health insurance copayments, coinsurances and deductibles required to cover out-of-pocket costs for necessary treatments of certain chronic and life-altering medical conditions. The situation is so dire that about 60 percent of the personal bankruptcies filed in the U.S. are due to medical expenses.

As we see every day in the news, patients are facing more obstacles in accessing affordable, quality care. As across-the-board cuts to health care programs are now taking effect with implementation of the sequester – along with projected layoffs to health providers across fields – available funds to cover the rising cost of care will be strained even further. Staying abreast of the latest proven solutions to the increasingly complex challenges of our health care system is more important than ever, for patients and providers alike.

We want our blog to be the go-to source for demonstrating what’s working in our health care system by focusing on three important pillars of health care success:  Cost Savings, Prevention/Patient-Centered Care, and Access to Care.

Cost Savings: No patient – adult or child – should go without health care because he or she cannot afford it. The first step to finding solutions to the increasing cost of care is enabling health care systems and health care professionals to share their practical knowledge with one another as well as the patients who often have to choose between paying their medical bills and putting food on the table. From paying for prescription drug copayments and deductibles to affording health insurance premiums, our Cost Savings posts will explore proven strategies to help patients and families reduce the financial strain associated with the rising price of care.

Prevention/Patient-Centered Care: What’s the first thing you think of when given the words “health care?” Most people think “trip to the doctor,” or “medication.” Our attention has to shift more aggressively to find ways to help people stay healthy. Seeing a dietitian could be vital for millions of Americans hoping to live healthier and longer. Annual lab work can find vitamin deficiencies. Sometimes very simple things, like removing carpeting from the home, can contribute to better cardiovascular health, resulting in increased life expectancy. It takes a village to care for a patient. Partnerships among practitioners, payers, patients and their families are crucial for ensuring that health care decisions are made in a way that respects patients’ needs and that patients have the knowledge and support they need to make reasoned decisions and participate in their own care. In our Prevention/Patient-Centered Care blog posts, we’ll focus on the many strategies available for staying healthy and recognize ways that patients are taking an active role in decision-making about treatment options.

Access to Care: We are so fortunate to live in a world where scientists are developing novel, breakthrough therapies. But those therapies can’t result in positive health outcomes if the patients who so desperately need them can’t access them. The evidence is clear: Proper medication compliance and adherence – consistently the right medication, at the right dosage, for the right patient – is essential to mitigating chronic disease. Continued and properly managed care and staying on treatment will be the focus of our Access to Care blog posts.

We’ll be sharing real-life examples of positive health outcomes in this space, and we encourage you to join in the dialogue. How would you tackle the problem of unaffordable health care? How can business and philanthropy work together to reduce the financial burden on patients? Have you or someone you know received help paying for needed therapies? Let us know in the comments section.

Categories: General