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Colorado’s Looming Healthcare Crisis: 10,000 Nurses Needed by 2026

Healthcare statistics in Colorado continue to show a predicted shortfall of 10,000 registered nurses and 54,000 allied health professionals such as medical and nursing assistants by 2026.

This comes at a time when the population of Colorado continues to age and will need more healthcare services, and aging nurses are retiring or leaving the profession after COVID-19 pandemic stresses. The U.S. labor market study by consulting firm Mercer forecast Colorado will be the third-worst state in shortages of registered nurses behind Pennsylvania and North Carolina in 2026.

READ: Nurse Entrepreneurship — A Solution to Colorado’s Nursing Shortage and Healthcare Challenges 

“The healthcare workforce shortage is quite serious and something we’re devoting a lot of energy toward,” said Julie Denning with the Colorado Hospital Association. “In addition to the work every hospital and health system in the state is doing to retain their current workforce and grow the future workforce, CHA is partnering with the state on a number of healthcare workforce initiatives including offering education on workforce wellness, professional development and workforce pipeline growth.”  

Hospitals in the state have invested more than $1 billion since the pandemic to retain and recruit staff, according to the CHA. Hospitals are trying to build the pipeline of employees through tuition reimbursement, student loan assistance, training stipends and professional development programs. 

Increasing pay for existing nurses is happening through incentive bonuses, market and merit increases, and protected pay and emergency relief. After the pandemic, investments in caring for the healthcare workforce is even more important with programs aimed at fostering employee wellness, according to the CHA. 

“Health care workers are burned out from the pandemic and are experiencing increasing rates of violence from patients and their families, spurring many to leave the profession,” Denning said.  

Shortages of nurses is not a new problem due to such factors in recent years as economic downturns, waves of retiring nurses and increased health care demand, according to the American Nurses Association.  

“As the pandemic hit in March 2020, nurses, who represent the largest group of healthcare professionals in the country, already were under strain due to factors such as retirements outpacing new entrants to the field, increased demand for health care from aging and chronic disease populations, and inadequate workforce support,” according to the nurses’ association. 

Leaders at nursing programs such as Colorado Mountain College and Colorado Northwestern Community College say their students are offered jobs even before they graduate or pass their certification exams.

School of Nursing Dean Whitney Erickson at Colorado Mountain College said several key factors contribute to the state’s ongoing inability to graduate enough nurses to fill future needs, including a shortage of nursing instructors who are required to have a master’s degree in the field. Plus, most higher-level nurses make less money teaching than working at a hospital.  

“Most nursing schools are having a hard time hiring faculty,” Erickson said. 

READ: How the Pandemic Revived the Global Telehealth Industry

Smaller hospitals have limited spaces for nursing students to complete their required clinical nursing rotations. For the CMC nursing programs in Breckenridge, Steamboat Springs and Spring Valley near Glenwood Springs, the students may travel to the Front Range or Grand Junction to complete clinical rotation hours, which adds to education costs and inconvenience. 

“There is a real sense of burnout from working with a student all the time,” Erickson said of the challenge of hospital preceptors accepting nursing students. “Instead of just taking care of patients, you are trying to teach too.”  

Several nursing schools including CMC and Metropolitan State University of Denver are working to increase nursing student capacity by adding more or larger high-tech simulation labs where nursing students can earn up to half of their required clinical hours. 

READ: The Future of Colorado Dental Care Lies in Digital Transformation

Erickson points to a bright spot in funding through the Colorado Rural Health Care Initiative. The initiative works with 15 participating institutions to increase the number of healthcare graduates who serve in rural counties through measures ranging from housing assistance to scholarships to rural-oriented classroom curricula. 

State leaders approved funding in 2022 for the Care Forward Colorado program for zero-cost, short-term training programs at community and technical colleges. Students who enroll in cooperating programs in fields ranging from certified nursing assistant to phlebotomy technician have tuition, fees and course materials covered as funding allows. 

Ingrid Johnson, CEO at the nonprofit Colorado Center for Nursing Excellence, said “grow your own” programs are expanding, starting as early as high school with medical prep classes. For example, students at Cherry Creek Innovation Campus can learn to be certified nursing assistants while in high school. Colorado State University Pueblo recently was awarded $1.39 million to create a Partners Leading Advancement in Nursing Track, or PLANT, to grow pathways for southern Colorado students to earn a nursing degree. 

Hospital systems also are enticing health-care employees to attend nursing school if students promise to return to work for the hospital, in general for two years for every year of nursing school paid. 

Still, deans at multiple Colorado nursing schools say they do not have enough staff and infrastructure to accommodate all the interested nursing students. The deans say more targeted funding is needed to increase the number of nursing professors and to provide stipends for nursing preceptors in hospitals to accept students.  

 

Suzie C. Romig is a freelance journalist who has lived in Colorado since 1991. Her byline has appeared in newspapers and magazines across the state on topics ranging from small businesses to raising children to energy efficiency. She can be reached at [email protected]

Colorado’s Mental Health Crisis: Innovative Services Poised to Improve Health Equity & Access

Colorado is facing a mounting mental health crisis made worse by the unprecedented staffing and economic pressures in the wake of the pandemic. The state currently ranks 45th nationally when it comes to access to behavioral healthcare. The state must start implementing different antidotes to the problem, including long-term behavioral home care for patients.

In Colorado Springs, more than 18 percent of adults reported having experienced a behavioral health disorder in the last year and 43 percent of patients who needed those mental health services reported not being able to receive the care they needed. If people cannot access treatment, they cycle in and out of emergency rooms or mental health facilities, which results in fractured care, frustrated healthcare workers, and high healthcare costs.

READ: Maximizing Your Mental Health Insurance Benefits — A Guide for Gen Z in 2023

Specialized behavioral healthcare needed

As a clinician for almost 30 years and the CEO of a behavioral home healthcare company for over two decades, I can tell you first-hand that without a system in place to support long-term behavioral health patients out of the hospital, people will not get better, and this crisis will continue. In far too many cases they are taking up hospital beds they don’t necessarily need, or worse, they aren’t receiving care at all. 

When we started our operation in Massachusetts, the same problem existed (albeit on a smaller scale). Our model provides in-home behavioral care to complex patients and currently conducts around 20,000 patient visits per week across the state. An example of a patient we serve is a 55-year-old male identifying and suffering from severe mental illness, such as schizophrenia. They also typically suffer from up to twenty comorbidities or complications. They are additionally among the highest-cost patients in the healthcare system who take up to 10-15 medications and often live in communities with less access to care.

Without home-based or community behavioral health services, these patients would utilize the hospital or emergency rooms as the primary care physicians-sometimes up to 15 times a year at an enormous cost. For example, a single hospitalization costs, on average, about $38,000, whereas an entire year of our in-home services costs $25,000. In most cases, hospitalization could be 98 percent preventable with the right home care infrastructure in place, e.g., using technology to assess patients in their homes, sharing cohesive electronic medical records to help treat them, and assigning a clinician to help administer their medication and take their vitals.

READ: Telehealth to Play Key Role as Geriatric Population Soars

Expanding to address Colorado’s mental health crisis

We recently expanded our services to Colorado Springs because we believe this innovative home healthcare model is filling a critical gap for this patient population, which in turn will have an immediate impact in treating underserved patients in Colorado. For example, in Colorado Springs, there is a higher prevalence of severe mental illness — 10 percent — compared to Colorado’s statewide average of 6 percent. 

It is also critical to have the right policies in place, and Colorado lawmakers have demonstrated a commitment to behavioral health reform plans by earmarking $547 million to ensure more access to the continuum of care that the highest cost drivers require. This strategy will ensure interconnectivity on quality, payment, accountability and provider standards that have population health at the center of the thought process. We are hopeful that health equity will remain at the core of Colorado’s vision and that state leaders will work together to implement innovative solutions for vulnerable patients who are disproportionately impacted by social, economic and environmental issues that have downstream clinical impacts. 

We have seen firsthand how home healthcare can remove the social barriers to continuing care and reduce the chances that untreated mental illness leads to other traumas like addiction, homelessness and even incarceration. Also, since multiple studies have shown home healthcare reduces readmissions to hospitals, behavioral home healthcare can help save the state of Colorado up to $200,000 a year per patient, improve patient outcomes, and take pressure off the healthcare system.

Home healthcare services can keep patients in their homes and in a more stable, compassionate environment. We look forward to working within the healthcare system to effectively reach and serve this patient population in Colorado that too often unfortunately goes without the care they need and deserve. 

 

Joseph Mcdonough 400x400Joseph McDonough is the CEO of Innovive Health, which recently expanded into Colorado with clinical operations out of Colorado Springs

Nurse Entrepreneurship: A Solution to Colorado’s Nursing Shortage and Healthcare Challenges

As the population ages, two major changes are happening simultaneously in the United States: The number of patients needing care and the number of nurses retiring from the profession are both growing. Additionally, many nurses leave the profession due to stress, and enrollments are not keeping pace with demand. This is causing some big problems for Colorado’s healthcare system, including an alarming nursing shortage.

Although the state needs 33,000 nursing graduates per year to meet demand, some years have only seen 24,000 nursing students graduate, creating a major shortfall of new talent. To ensure that patients can get the quality care they deserve while also helping to reduce stress on existing nursing staff, getting more nurses to graduate and enter the workforce in Colorado is critical. 

READ: Guest Column — Denver Physician Details 5 Common Medicare Mistakes

One important way to help address this problem is with nurse entrepreneurship. Advanced practice nurses, such as nurse practitioners, can start their own practices and provide a range of health services with autonomy in Colorado. 

Here’s why these businesses can help with the nursing shortage in the short and long term. 

The role of independent nursing practices 

Nurse practitioners have a lot of freedom to practice independently in Colorado, once they meet the requirements. NPs can diagnose and treat patients, and even prescribe medication once they’ve had enough hours under supervision and collaboration with a physician. 

While many nurse practitioners choose to work at medical groups or hospitals, others start their own independent practices. This is helping to ease the nursing shortage that is making it more difficult for patients in Colorado to access care. 

With nurse practitioners able to diagnose, treat and prescribe, many patients can take care of their routine health needs at an independent nursing practice. This helps to reduce the number of patients in hospitals and decreases wait times for patients who need to see their primary care physician. Nurse practitioners offer patient-centered care, which can be more appealing for many patients who want a personalized healthcare experience. 

READ: 7 Tips for Choosing Your Health Insurance in 2023

Providing preventative care & telehealth services 

One key way that nurse entrepreneurs can help with the nursing shortage is to provide more preventative services in their practices. When people are more proactive with their health, they are less likely to need invasive treatments and other hospital procedures requiring inpatient care. This reduces the number of patients in the hospital and eases the workload for existing nurses who are already stretched thin. 

Telehealth is another great option that nursing practices can offer patients. It allows people who live in rural areas or do not have access to transportation to access preventative care and basic health advice without needing an appointment in person. Telehealth services make life easier for patients and providers alike. 

READ: Telehealth to Play Key Role as Geriatric Population Soars

Other types of nursing businesses 

The field of nursing is expanding, and there are lots of opportunities for nurses who want to make a difference in healthcare. Nurse entrepreneurs in Colorado who don’t want to open an independent practice can start businesses that provide services like travel nurse staffing or nursing informatics. 

These kinds of businesses help with staffing issues and can help make hospitals more efficient overall. They also provide more career choices for nursing students and might even encourage more young people to join the profession by offering different options for students with a range of talents and interests. 

Encouraging and inspiring the next generation of nurses

Starting an independent nursing practice is also a great way to encourage and inspire the next generation of nurses. Long-term, solving the nursing shortage will require increasing the enrollment levels at state nursing programs and improving working conditions for nurses who are already in the field. 

Encouraging the next generation of nurses in Colorado needs to start right now. As our nursing workforce continues to retire and patient numbers rise, the situation for nurses who are in the field now is only going to get worse. 

Nurse entrepreneurs create new job opportunities and show how it’s possible to practice independently as a nurse in Colorado. That example of success might just lead to more young people pursuing this challenging, yet rewarding career path. 

 

Andrew Deen HeadshotAndrew Deen has been a consultant for startups in a number of industries from retail to medical devices and everything in between. He implements lean methodology and is currently writing a book about scaling up business.

Maximizing Your Mental Health Insurance Benefits — A Guide for Gen Z in 2023

This past year, members of Generation Z began to turn 26, which, for many, meant leaving their families’ health insurance plans and picking their own for the very first time. As the generation reporting the highest rates of mental health issues, choosing an insurance plan and understanding the benefits associated is essential for maximizing your health, including your mental well-being.

READ: 7 Tips for Choosing Your Health Insurance in 2023

So, first things first, Gen Z: get familiar with health insurance lingo. Understanding common terms allow you to accurately evaluate your needs, understand and compare benefits and manage costs (check out this guide for a quick refresher on common insurance terms). 

Now that you have the lingo down, it’s time to grasp the benefits associated with your plan. Remember, mental health affects everyone differently, and treatment isn’t one-size-fits-all. To make sure you are maximizing your benefits, here are a few tips to consider when choosing a plan:

Check your mental health insurance benefits

Caring for your mental health is crucial in achieving overall wellness. Coverage for your mental health care services depends on the benefits of your plan. You can determine the services you are eligible for by signing into your health plan or calling the number on your ID card. Some health insurers give members access to phone and mobile app services with certain health plans to help people cope with stress, anxiety and depression as a complement to their health care coverage.

READ: The Top 5 Ways You Can Support Mental Health in the Workplace

Understand your prescription benefits

Understanding your plan’s prescription benefits may help you manage costs. You can view a list of medications and see how they’re covered through your plan’s Prescription Drug List (PDL). PDLs may change, so if you have a medication you take regularly, you should keep a close eye on your plan’s PDL to stay ahead of any potential changes in costs. You may also be able to fill your prescriptions at a participating network pharmacy or with home delivery via mail if it’s included in your benefits, which can also lower costs and save you money.

Review wellness and rewards programs

Remember, our physical health and mental health are intertwined. Many health plans offer incentives and rewards for everyday healthy living, such as completing a health survey, exercising or avoiding nicotine.  Plans may also offer gym memberships or wellness programs at no additional cost. 

Consider a plan with virtual visits

If you are someone who juggles work, school, kids, travel, or just prefers to connect with a doctor from the comfort of your own home, check if your plan includes 24/7 virtual care. Virtual care, sometimes called “telehealth,” may include in-network virtual visits for medical, mental health, physical therapy, occupational therapy, speech therapy, chiropractic, home health, vision, hearing and dental services. These visits are typically lower in cost and allow you to connect with doctors about any mental or physical health issues from the convenience of your own home using a smartphone, tablet, or computer.

READ: Telehealth to Play Key Role as Geriatric Population Soars

If you need help understanding what benefits are right for you or want to explore speaking with a professional, some health insurers, like UnitedHealthcare, offer advocacy services and employee assistance programs to help you find the right type of care.

 

Dr. Donald TavakoliDr. Donald Tavakoli is the national medical director for behavioral health at UnitedHealthcare.

7 Tips for Choosing Your Health Insurance in 2023

Amid higher inflation, you may be looking at ways to adjust your lifestyle and spending habits. But when it comes to health care, it’s important to keep your well-being and budget in mind.

Annual and open enrollment season is here — a time when more than 5.7 million people in Colorado and across the country will have the opportunity to select, or switch, their health insurance plan for the coming year.

Open enrollment is a good chance to review how often you’re using health services and decide whether you’ll stick with the plan you’ve got or switch to another being offered. It’s also an opportunity to assess your overall care costs to ensure you’re choosing a plan that will work best for next year’s budget.

READ — A New twist on health insurance

Enrollment timing — For people with coverage from their employer, open enrollment typically happens for two weeks sometime between September and December. Medicare members can enroll or make changes to coverage from Oct. 15-Dec. 7. Most selections made will take effect on Jan. 1, 2023.

Here are seven things to consider when evaluating the next move in your health insurance journey:

1. Understand all your options

Take time to understand and compare the benefits, services and costs of each plan, so you can figure out which will work best for you. A good first step may be to watch a quick refresher video on health insurance lingo, including premiums, deductibles, copays, coinsurance and out-of-pocket maximums.

  • Medicare members: As you weigh your options, ensure you’re familiar with the difference between Original Medicare and Medicare Advantage. If you need a review, visit MedicareEducation.com — an online resource with answers to questions about eligibility, plan choices, cost basics, prescription coverage and more.

2. Check your prescription benefits

Knowing how to get the most out of your prescription benefits may help you manage costs. For example, check into discounts and lower-cost alternatives, including generics, which may be available. You may also be able to fill your prescriptions at a participating network pharmacy or with home delivery by mail — two more money-saving options. 

  • Medicare members: You may be surprised to learn Original Medicare doesn’t generally cover prescription drugs. Consider adding Part D or a Medicare Advantage plan with prescription drug coverage to help keep your medication costs in check.

3. Check for mental health coverage

In addition to in-person mental health care, you may have access to a large virtual network of therapists and psychiatrists. Some health insurers also offer advocacy services to help you find the right type of behavioral health care.

  • Medicare members: Some plans offer virtual mental health care with a $0.00 copay, including UnitedHealthcare Medicare Advantage.

4. Don’t forget about specialty benefits

Additional benefits, such as dental, vision, hearing or critical illness insurance, are often available and may contribute to overall well-being.

  • Medicare members: You may be surprised that Original Medicare doesn’t cover most dental, vision and hearing services, but many Medicare Advantage plans do.

5. Look into wellness programs

Many health plans offer incentives that reward you for taking healthier actions, such as completing a health survey, exercising or avoiding nicotine.

  • Medicare members: Many Medicare Advantage plans also offer gym memberships and wellness programs for members at no additional cost.

6. Anticipate next year’s health expenses

If you’re expecting a significant health event in the next year, such as surgery or the birth of a child, compare the differences in plan designs for that specific situation, including any out-of-pocket costs.

7. Consider a plan with virtual care services

If you’re busy or just prefer connecting with a doctor from the convenience of your home, consider choosing a plan that includes 24/7 virtual care. You may have access to virtual wellness visits, urgent care and chronic condition management.

  • Medicare members: Most Medicare Advantage plans provide access to virtual care, which can be an easier, more affordable way to talk with doctors about common health issues on a smartphone, tablet or computer.

For more helpful articles and videos about open enrollment, visit uhcopenenrollment.com.

 

George Young 1George Young is the CEO at UnitedHealthcare Medicare & Retirement, AZ, CO, MT, NM, WY.

 

Aco Summitt

Marc Neely is the President and CEO at UnitedHealthcare Employer and Individual, CO & WY.

 

The Future of Colorado Dental Care Lies in Digital Transformation

The dental benefits landscape stands to gain significantly from digital transformation, particularly in Colorado where access to dental healthcare is alarmingly low across certain patient populations.

Presently, 1.3 million Coloradans — that’s a little over one-fourth of the state’s population — lack access to dental insurance. These statistics can reasonably be classed as bleak.

This disparity must be addressed: affordable dental care significantly decreases the onset of harmful oral health conditions and can help increase the number of Coloradans with access to proper dental coverage. Implementing a consistent cadence of preventive care and clinical intervention in childhood is particularly important for establishing healthy habits and achieving early disease detection.

READ — The Success of Our Economy Depends on Accessible, Affordable Child Care

The implications of increasing access to dental care for patient populations are far-reaching. Improving patient access to dental care results in healthier Colorado residents, higher job retention for employers, and reduced healthcare costs overall.

Increasing patient access to dental health insurance in Colorado must be a priority in the coming years to reduce health disparities and bolster the quality of life for all Coloradans.

Admittedly, people might be hesitant to visit the dentist. The hefty premiums, confusing benefit details, and uncertainty of what it might cost keep many Coloradans from routine dental appointments. But it’s an integral puzzle piece that completes the picture of a healthier life.

Better dental benefit options mean healthier Colorado residents and employees.

Dental insurance ranks as the third most important benefit to employees, and offering dental insurance to employees can both improve employee retention and employee health.

Having good dental hygiene reduces the chances of gum disease, which can be detrimental to an individual’s health, nutrition, and appearance.

Gum disease exacerbates a host of other chronic conditions, including diabetes and heart disease. It can also cause tooth loss over time, which impedes what a person can eat, how they speak, how they look, and how they feel about themselves.

While visiting the dentist with reasonable regularity may take some time and effort in the short term, it saves employees and companies a ton of time in the long term. One report from the Surgeon General found that employed adults miss more than 164 million hours of work each year due to dental disease or dental emergencies.

Offering dental benefits as part of employees’ benefits packages enables them to access vital preventative care and reduces the chances that dental emergencies will arise. By extension, access to dental insurance also decreases the number of productive hours employees lose each year due to oral health issues.

READ — Local Dental Office Addresses the Special Needs Community

The dental insurance status quo is dated.

The term “dental insurance”, while universally accepted, is a misnomer. Insurance generally denotes a buffer against steep financial expenses that patrons pay overtime to protect themselves against the high cost of unexpected crises.

But that’s not really what “dental insurance” is. Unlike medical insurance, dental insurance does not cover any serious problems or procedures. Today’s dental insurance is only meant to pay for routine maintenance procedures like cleanings and checkups – it does not offer protection against serious and costly oral health issues.

Typically, traditional dental insurance has an annual maximum of $1,000 to $2,000 in coverage, and also requires co-payments for all major services. But emerging tech-led dental platforms are changing the status quo.

With these next-gen dental benefit platforms, plans can be customized and upgraded based on each group’s needs. Additionally, there’s no added risk of emerging dental emergencies. These platforms empower employers to set limits and know their precise rate of utilization. And importantly, employers keep all unused benefit dollars.

This last perk is particularly important in light of a 2020 internal study, which found that only 9% of Americans use their entire annual maximum. This allows traditional insurance companies to retain unused benefit dollars.

Next-gen dental benefits platforms don’t work that way. They let employers keep the excess and save on State and ACA taxes, claims processing fees, and insurance capital reserves.

It’s time to change the status quo of dental insurance with modern technologies and innovation.

Colorado dental benefit options are transforming the oral care landscape.

Colorado is leading the charge for the digital transformation of the dental care industry. This digital transformation is taking place in the form of a SaaS solution that enables employers to build, launch, and administer their own dental plan without the need for traditional dental insurance companies.

Leveraging an end-to-end platform to build custom dental plans lowers the cost of plan administration and claims processing. It also offers members access to greater transparency and discounted rates.

With flexible customization options, companies of every size and budget can tailor their plan to meet their specific needs, with significant cost savings. As a result, employees can get better benefits at a lower cost.

Companies and individuals can choose plans designed to meet the needs of associates, part-time workers, and contracted workers.

Overall, self-insuring benefits through an innovative digital platform help companies deliver better benefits to employees for a lot less.

Digitizing the dental benefits process provides a better and more modern end-user experience for employees, translating to higher adoption rates and fewer frustrations.

Ram is a serial entrepreneur with nearly 30 years of experience in technology development, senior management, marketing and sales in the US, Canada, UK, France, Italy, Israel and India. Identifying the need for change, Ram founded Bento in an effort to create a better experience and provide affordable oral care for all Americans. Prior to building Bento, Ram successfully built multiple startups. Ram was the Founder and CEO of Cimaron (acquired by AMCC), Founder, CEO and Chairman of CHiL Semiconductor (Acquired by IR, IR then acquired by Infineon) and Chairman of the Board at Sanovi (Acquired by IBM). Ram has also served senior positions as Sr. VP, GM & CTO at AMCC, Sr. VP at IR, and Architect at AT&T Bell Labs.

Telehealth to Play Key Role as Geriatric Population Soars

Whether you’re looking for services for yourself or for an elderly family member, navigating the programs available for seniors is as important as it is complex. More seniors who need care face an industry with fewer medical specialists trained to meet their needs.

READ — Aging Smarter: Denver Doctor Gives Tips for Better Brain Health

The number of people age 60 and older will increase from 900 million in 2015 to 2 billion by 2050 — moving from 12% to 22% of the global population, according to the World Health Organization (WHO). 

But even though the population of older adults is rising, there’s no evidence that they’re in better health than previous generations, which means they need to prepare for getting the care they need as they age.  

The U.S. care services market is expected to reach $748.5 billion by 2030, expanding at a compound annual growth rate of 5.76%, according to a report from ResearchAndMarkets.com.   

The growing geriatric population and rising incidences of diseases such as dementia, Alzheimer’s and orthopedic conditions are fueling the growth, while the increasing cost of treatment is one of the prime concerns for governments and health organizations.  

And it’s only going to become harder to care for older adults as the baby boom generation — those people born between 1946 and 1964 — ages and the number of geriatricians declines. 

However, the senior population of today has attained a level of comfort with technology that previous generations haven’t had.

READ — Robots Tapped as Companions for Seniors

“What’s challenging is this is a unique population,” said Dr. Wendee Gozansky, a geriatrician at Kaiser Permanente who also is chief quality officer. “They’re a bit more tech savvy, and we really need to use that to focus on the convenience needs they have.”

As the elderly population grows, telehealth technology offers practical ways to help seniors retain autonomy, stay safe and save money. Not many technologies can promise all that and convenience, too. Kaiser Permanente expects to use telehealth to meet the needs of aging seniors.

As people age, using telehealth technology and providing the health care and services they need all in one place is not only convenient, it also reduces the possibility the patient will suffer an injury from an accident. Technology can make it easier for seniors’ families to keep tabs on their loved one’s care and health status. Connected monitoring devices mean that elderly people can stay independent longer.

“When people are so old and frail, getting to pick up your medicine can be a risky sort of thing,” Gozansky said. “I had a patient who tripped in the parking lot and fractured her hip and couldn’t go home.”

A health-care provider like Kaiser Permanente provides seniors with one-stop shopping. They can get their hearing checked, glasses adjusted, pick up prescriptions and get a flu shot without having to drive all over town — a big plus for people who may be mobility challenged or have trouble parking or getting around in the snow.

“Kaiser is well-known for prevention,” Gozansky said. “We also have incredible specialty care.”

Kaiser’s goal is to help its older patients maintain as much function and independence as they can, said Dr. Tracy Lippard, a geriatrician at Kaiser Permanente and director of Complex Needs, Community Health & Government Programs.

One of Kaiser’s key strategies is to provide an annual total health assessment to its geriatric patients, who are asked to complete a survey that asks questions about physical activity and screens for depression and anxiety. The survey also covers hearing and vision, falling and balance, bladder issues and memory concerns. 

“We want to know if they have issues with food insecurity and what their caregiver status is,” Lippard said. “All of these things really allow us to individualize care on the issues that matter most to them as they get older.”

Kaiser provides financial assistance to members who need it to ensure they take their blood pressure medicine so they don’t end up in the hospital with a heart attack or stroke.

“One of the stressors with everything going on right now is financial stress,” Gozansky said. “We have heard that loud and clear as a nonprofit organization.”

One of the biggest challenges facing the industry is the lack of geriatricians to care for older adults. Even though geriatrics is among the most rewarding specialties for doctors — studies show they’re the happiest specialists — most people in medical school don’t go into the field because many of the things geriatricians do for their patients are not reimbursed.

“Geriatricians are thinkers,” Lippard said. “We have discussions about nutrition and family conferences — things that take a lot of time and don’t get reimbursed. People have student loans and want to go into professions that allow them to pay them off.” That’s why Kaiser is “geriatrisizing” all of its integrated delivery systems, Gozansky said.

“We have 10 geriatricians in different roles,” she said. “We’re training to make sure every primary care doctor knows how to solve problems like incontinence.”

Jody Gastfriend, principal with Health Management Associates who is a licensed clinical social worker and national expert in senior care, said that whether a senior is on Medicaid or Medicare, understanding what services are covered is essential. She recommends seeking an expert to navigate this tricky terrain and suggests several resources seniors can tap.

Good sources of information include:

  • The Area Agency on Aging (AAA), operated by the Denver Regional Council of Governments, which plans and provides comprehensive services to address the needs of the region’s older adults.
  • State Health Insurance Assistance Program (SHIP), which offers one-on-one assistance, counseling and education to Medicare beneficiaries, their families and caregivers to help them make informed decisions about their care and benefits.
  • Program of All-Inclusive Care for the Elderly (PACE), operated by Health First Colorado (the state’s Medicaid program) and Medicare, provides comprehensive medical and social services to certain frail people 55 years and older.

“Boomers are living longer — many are still working and many are caregivers,” Gastfriend said. “This generation of older adults, because life expectancy has increased, is still caring for parents and has adult children and grandchildren — it’s not just the sandwich generation, it’s the club sandwich generation between multiple generations.

“From a health-care perspective, there needs to be more understanding on lifestyle impact on health. There’s an emphasis on healthy aging and maintaining strength — both physical and mental — so a holistic approach to health care is ideal.”

6 strategies to reduce health care disparities among employees and tackle top cost drivers

A recent white paper by the Health Action Council (HAC) and UnitedHealthcare finds companies that implement deliberate strategies around their employees’ most common chronic health conditions may improve overall employee health and achieve cost-savings over the long-term.

The findings are based on a study of five chronic health conditions – hypertension, diabetes, back disorders, mental health and substance use, and asthma – across more than 280,000 HAC members insured with UnitedHealthcare.

Many of us will suffer at least one of these conditions during our lifetime, with a real impact on health care costs.

The study also revealed a number of important disparities in care, which can be improved through a combination of lifestyle modifications and targeted wellness programs.

Care Disparities Revealed

  • Among HAC members, African Americans are 63% more likely to have hypertension than other races or ethnicities. Also, the study found women are sub-optimally treated across all age groups versus men, who were typically administered more prescription drug treatments.
  • Men over 50 in lower income groups have the highest prevalence of diabetes, while those of Asian ethnicity have a 43% higher than average prevalence of the condition, largely driven by genetics and diet.
  • Typically, employees with back disorders skew older and are in lower income brackets, with factory work identified as one of the top jobs linked to back pain. Despite a strong case that physical therapy or chiropractic care helps reduce reliance on muscle relaxants and other drugs, our study found 6 out of 10 obese employees with a back disorder are foregoing or not being offered physical therapy or chiropractic care.
  • Those with mental health and substance use challenges tend to be female, younger and in lower-income Caucasian groups. Rural areas are often unable to meet mental health care needs due to inadequate services, leading to a higher than average number of emergency room visits and hospitalizations.
  • African Americans have a 20% higher prevalence of asthma than other races and are more likely to experience a flare-up that requires treatment, yet they are less likely to have been prescribed asthma steroids.

Tips for Tackling Health Care Disparities in Your Workforce

To address care disparities and ensure all employees have access to proper care, we recommend employers consider their population’s demographic and geographic profile and then create simple, targeted wellness programs to address the most prevalent common conditions.

Here are several suggestions:

  • Evaluate your current benefit plan design for opportunities to implement a care program that evolves with the patient over time – for example, making chiropractic care or physical therapy mandatory for back disorders before moving to more aggressive treatments.
  • Cover medications as preventive care for specific chronic conditions or promote the use of patient assistance programs for specific types of medications. The latter may require exclusion of some medicines from your benefit plan design.
  • Institute an exercise, stretch or meditation program at the beginning of work shifts to improve safety and decrease injuries. These types of practices are preventive and may decrease the severity of an injury if one occurs.
  • Create targeted communications for specific regions and demographics. Consider sharing success stories or appointing a program champion from the target audience. Understand and reflect on cultural differences when developing each communication.
  • Promote virtual care to improve access to treatment for specific conditions – for example, mental health support in rural areas.
  • Work with your third-party administrator or medical expert(s) to identify opportunities for provider outreach and education on best-in-class approaches.

You can reach and help those who may be at greatest risk of these common conditions and yet least likely to take action on their own.

To learn more, please read our white paper in full: Finding the uncommon: revealing disparities in care and prescribing for common conditions.  

Patty Starr is the President and CEO of Health Action Council and Craig Kurtzweil is the Vice President of UnitedHealthcare Center for Advanced Analytics. Health Action Council is a not-for-profit organization representing large employers to enhance human and economic health through thought-leadership, innovative services and collaboration. UnitedHealthcare is dedicated to helping people nationwide live healthier lives by simplifying the health care experience.

Tips to help make the most of your health plan in 2021

Last year was a difficult year as the COVID-19 pandemic swept through our country, impacting families and communities nationwide. The health challenges of the pandemic also provided a crucial reminder about the importance of health care.

For many Colorado residents, new health plan benefits began in January. If this is your situation, now is the perfect time to learn how to maximize this year’s health benefits, which may help improve your health and possibly save money.

Consider the following tips to help you take charge of your health and get the most out of your plan in 2021.  

  • Understand health insurance concepts. Review common health insurance terms like premium, deductible and copay. This may help you better understand your plan and how your costs are calculated. Insurance plans differ depending on the providers you see and how much you pay for services. Remember, in-network providers are contracted with your health insurer to provide services at a lower cost, so consider checking whether your current health care providers are in your network before making an appointment. Out-of-network providers may cost more and lead to higher out-of-pocket costs for you.
  • Schedule preventive services. Be proactive by taking advantage of preventive services that are often covered by your insurance, like an annual physical, mental health screening or flu shot. Scheduling these appointments with your primary care doctor may help prevent health problems before they arise.
  • Check your behavioral health coverage. Some insurers, such as UnitedHealthcare, offer behavioral health care programs that can range from treatment for substance use, eating disorders, anxiety and stress, with a goal of helping to improve your overall well-being. For example, an on-demand emotional support mobile app called Sanvello® is available to help you cope with stress, anxiety and depression.
  • Take advantage of telehealth visits. A popular health care choice, especially during the COVID-19 pandemic, has been telehealth or virtual visits, which enable people to connect 24/7 with a health care provider via a smartphone, tablet or personal computer. They may be an easier, more affordable way to talk to a doctor about common health issues. Log in to your health plan’s member portal to check availability.
  • Explore your options for wellness programs. Many health plans now offer discounts and other incentives for working out, walking, signing up for an online health coaching program, lowering your cholesterol, or avoiding nicotine. Incentive-based wellness programs are designed to reward people for making healthier choices. Check with your insurer or employer to see what programs are available to you.
  • Review your prescription coverage. Check to see what’s covered under your prescription drug plan by logging into your health plan’s member portal or by calling the phone number on your ID card. Your plan will show medication costs and coverage and help you locate a network pharmacy. It also helps to ask about generic medication options. In many cases, generic medications contain the same active ingredients as their brand-name counterparts, and they may save you money.
  • Apply for a child medical grant. Some charitable organizations, such as the UnitedHealthcare Children’s Foundation (UHCCF), provide child medical grants to middle- and low-income families who don’t qualify for Medicaid. Families can receive up to $5,000 annually per child ($10,000 lifetime maximum per child) and do not need to have insurance through UnitedHealthcare to be eligible.

Since 2007, UHCCF has awarded more than 25,000 grants valued at over $54 million to children and their families across the United States. Families can read eligibility criteria and complete an online application at www.uhccf.org.

Becoming familiar with your new health plan — especially at the start of a new year — is one way to help you be proactive when it comes to your health. For more health and wellness information, visit UHC.com.

Dr. David Severance Dr. David Severance is the Chief Medical Officer of UnitedHealthcare of Colorado.

Four ways COVID-19 is changing health care–now and in the future

As Colorado and the nation continue to navigate the deep impacts of COVID-19, one thing seems certain—the pandemic has changed the way many of us have traditionally viewed and engaged with the health care system.

Many times, crises create an urgency to speed up innovations to meet consumers’ demands and provide convenience. COVID-19 has led to a few emerging trends that may usher in permanent changes to the ways we access health care.

1. Telehealth is here to stay.

Telehealth wasn’t new prior to COVID-19, but fewer people were using it before the pandemic. Now many health insurance plans have encouraged the use of virtual visits as an alternative to visiting health care facilities in person, and we’re seeing adoption accelerate.

Even specialty care is leveraging telehealth through prenatal visits, and more recently UnitedHealthcare has made physical, occupational and speech therapies available.

The push toward contactless care is likely to continue through virtual appointments in primary care, urgent care, disease management and behavioral health.

2. More people will receive care at home.

Similar to how telehealth enables efficient and accessible care at home, the response to the pandemic has created momentum around the concept of a patient’s home as a site for medical services. This idea relies heavily on the adoption of technology and advanced digital tools. Some areas where home-health is advancing are chronic disease management and infusion services.

For example, diabetes and congestive heart failure are two chronic conditions that can currently be monitored with the help of digital remote-monitoring tools like continuous glucose monitors (CGM) and activity trackers. Members can sync their devices to track progress, check their health data in real time, send and receive messages from a nurse care coach and share progress with their doctor. This helps address long periods of ongoing care.

And for patients who need certain medications, home infusion services may be a dependable way to reduce public exposure risk, especially during COVID-19. Typically, a nurse will come to the home and train the patient or caregiver on how to administer the drug. When infusion services are performed in the home, it may help patients receive the critical therapies they need without having to manage the travel and logistical concerns associated with leaving home to visit a clinic or hospital.

Moving the site of care to the home may also be an opportunity to save money by avoiding the overhead costs of an in-patient hospital setting. By improving continuity of care, patients may be able to avoid adverse events that may lead to readmissions to the hospital. We could also see more oncology care being moved to the comfort of the home. This would be especially important for patients who are immunocompromised and still need treatment.

3. The role of a pharmacist is changing.

Pharmacists play an important role beyond medication management in a care team. When doctor’s offices were closed or not available, some pharmacists could fill a gap in care.

Even before the crisis, some states had expanded the scope of practice for pharmacists. A few states have given pharmacists limited prescribing authority, and more than 800 pharmacists in the United States are board-certified in infectious diseases.

Pharmacists are also integrating more with behavioral health. We’re starting to look at a few things, including how we can help individuals with medication adherence and screening for depression through some of our pharmacies. But similar to the momentum around telehealth and home-based care, there’s an evolving definition of what being a pharmacist can mean.

4. Americans may live healthier lifestyles.

COVID-19 represents a convergence of current and long-term threats to the health of individuals and their families. Several chronic conditions — many of which are preventable and can be treated — are risk factors for falling severely ill to COVID-19. In addition, maintaining a strong immune system is seemingly more important than ever to avoid contracting or overcoming the coronavirus.

In addition, there’s a heightened awareness that cleanliness and hygiene practices can keep people healthier and avoid the spread of disease — expanding the notion of good health to include cleanliness of the things people interact with each day.

If the momentum continues to shift toward greater health ownership, the pandemic has brought forth advances that could support this renewed focus on health and well-being.

Looking ahead

COVID-19 has changed several aspects of health care, some for the better. These trends can help increase flexibility, convenience and access and may help more people get the care they need to live healthier lives.

Dr. David Severance is the Chief Medical Officer, UnitedHealthcare of Colorado and Wyoming.