SUMMER 2016
WELL
INFORMED
IN THIS ISSUE
NEWS FOR US FAMILY
HEALTH PLAN PROVIDERS
From Our ManagementPAGE 1
Comprehensive Diabetes CarePAGE 2
Communicating with PatientsPAGE 3
FROM OUR MANAGEMENT
SUBMITTED BY CATONYA FLOWERS, MANAGER – PROVIDER RELATIONS
All of us at US Family Health Plan are grateful to our network providers for the care
you provide to our members.
In this issue we are highlighting Comprehensive Diabetes Care and Communicating with
Your Patient. We appreciate the time our providers take to talk with their patients and the steps
they take to help their patients to play a bigger role in their own care.
If you have any questions, please call a Provider Relations Representative or
Member Services at 1-800-678-7347 & 1-844-282-3100.
We thank you again for the care you provide our members
CaTonya Flowers
Manager – Provider Relations
PC16
COMPREHENSIVE DIABETES CARE
Diabetes is a common disease, yet every individual requires
unique care. Here are some of the most critical aspects to
Comprehensive Diabetes Care:
A Hemoglobin A1C Test (HbA1C) provides a 2-3 month average of your patients’ blood glucose. The results provide an idea
of how well a diabetes treatment plan is working.
Kidney Health
These are some of the ways the A1C test can help
manage a patient’s diabetes:
As with retinopathy, the key to keeping kidneys healthy is to
•
Confirm self-testing results or blood test results
with a doctor.
disease, also known as nephropathy, affects between 20
•
Judge whether a treatment plan is working.
the primary cause of end stage renal disease, in which the
•
Explain how healthy choices can make a
difference in diabetes control.
kidneys can no longer adequately clean blood and must be
According to the American Diabetes Association
(ADA) your diabetic patients’ HbA1C level should
be checked at least twice a year.
optimize blood glucose and blood pressure levels. Kidney
and 40 percent of people with diabetes. Nephropathy is
treated with dialysis or a kidney transplant.
When our bodies digest the protein we eat, the process
creates waste products. Our kidneys’ capillaries function
as filters, so as blood flows through the capillaries, small
molecules such as the waste products generated from our
Eye Health
Multiple studies have shown that maintaining blood glucose
diet squeeze through and become part of the urine. Useful
substances, including protein and red blood cells, are too
big to pass through the holes in the capillary filters and stay
and blood pressure control can protect the eyes from
in the blood.
damage to the retina. Long-term and uncontrolled diabetes
Diabetes can damage this system. High levels of blood
can cause retinopathy, which may not have any obvious
symptoms until it degenerates into vision-threatening
proliferative retinopathy or macular edema. For these
reasons, the ADA recommends annual dilated eye exams to
detect retinopathy early.
Please note USFHP does not require a referral for annual
sugar make our kidneys filter too much blood. All this extra
work is hard on the filters, and after many years, they start
to leak and useful protein is lost in the urine. Having small
amounts of protein in the urine is called microalbuminuria,
which is one predictor of nephropathy. Fortunately, when
microalbuminuria is diagnosed early, several treatments may
dilated eye exams by an INN eye care professional. Please
keep it from getting worse.
encourage your patients to take part in their diabetes care
The ADA recommends patients with diabetes get annual
and schedule an appointment with their ophthalmologist or
optometrist.
kidney function tests. Should kidney problems be
detected, treatment may include a special diet as well as
specific types of blood pressure medications known as
ACE inhibitors and ARBs.
Source: American Diabetes Association - www.diabetes.org
COMMUNICATING WITH PATIENTS
Patient education allows patients to play a bigger
role in their own care. It also aligns with the growing
movement toward patient- and family-centered care.
To be effective, patient education needs to be more than
•
Learn the patient’s perspective. Talk to the patient about
instructions and information. Health care providers need to be able
worries, fears, and possible misconceptions. The information
to assess patient needs and communicate clearly.
you receive can help guide your patient teaching.
The success of patient education depends largely on how well you
•
assess your patient’s:
just questions. Use open-ended questions that require the
patient to reveal more details. Listen carefully. The patient’s
Needs | Concerns | Readiness to learn | Preferences | Support
answers will help you learn the person’s core beliefs. This will
help you understand the patient’s motivation and let you plan
Barriers and limitations (such as physical and mental capacity, and
the best ways to teach.
low health literacy)
Often, the first step is to find out what the patient already knows.
•
•
•
volunteers to be involved in your patient’s care may not be the
person your patient prefers to be involved. Learn about the
Patient teaching based on incorrect assumptions may not be
support available to your patient.
very effective and may take more time.
Get to know your patient. Introduce yourself and explain your
•
such as low health literacy may be more subtle and harder to
basic get-to-know-you questions.
Establish a rapport. Make eye contact when appropriate and
help your patient feel comfortable with you. Pay attention to
the person’s concerns.
•
•
Identify barriers and limitations. You may perceive barriers to
education, and the patient may confirm them. Some factors,
role in your patient’s care. Review their medical record and ask
•
Involve others. Ask if the patient wants other people involved
with the care process. It is possible that the person who
Gather clues. Talk to the health care team members and
observe the patient. Be careful not to make assumptions.
•
Learn about the patient’s skills. Find out what your patient
already knows.
Use these guidelines to do a thorough assessment before starting
patient education:
Ask the right questions. Ask if the patient has concerns, not
recognize.
•
Take time to establish rapport. Do a comprehensive
assessment. It is worth it, because your patient education
efforts will be more effective.
Gain trust. Show respect and treat each person with
compassion and without judgment.
Source: National Library of Medicine- National Institutes of Health
Determine your patient’s readiness to learn. Ask your patients
https://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000456.htm
about their outlooks, attitudes, and motivations.
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TRICARE is a registered trademark of the Department of Defense, Defense Health Agency. All rights reserved.
Marcia Williams Cromer—Managing Editor
This publication in no way seeks to serve as a substitute for professional medical care. Consult your physician before undertaking any form of medical treatment or adopting any exercise program or dietary guidelines.
ASSOCIATE PROFILE - Jackie Bruning
Q: What is your role at USFHP? I am the network
account specialist for the Houston and surrounding
areas.
Q: Do you have a military background? My father
and brother were both in the Army. Being able to work
for a plan that supports our armed services is a personal
honor.
Q: Do you have a healthcare background?
I have been in the insurance business since 1988. For
ten years I worked at US Family Health Plan as a claim
adjuster before deciding to work with the provider
relations team.
Q: What do you like best about your job at
USFHP? I enjoy working for a great management
team and provider relations team. We all have the
same agenda when it comes to our network providers.
Ultimately, our goal is to provide our members with the
family doctors and specialists that they need to ensure
quality access to health care in a timely manner.
Q: How do you see your role impacting the
lives of USFHP providers? Making their work lives
easier by promptly addressing issues and providing
outstanding customer service. If our providers are
happy with our service then they become advocates
for our health plan and provide an integral part to the
system of care for our members.
Q: How do you see your role impacting the
lives of USFHP members? Keeping them happy by
listening to their concerns and taking quick action to
resolve any issues for the doctors who are members
have grown to trust as healthcare partners for
themselves and their families.
Q: What do you bring to this role that is unique?
Experience, attitude and personality
Q: What do you enjoy doing in your free time?
I enjoy spending time with my husband and our four
wonderful children as well as my extended family and
friends. I also enjoy volunteering with US Family Health
Plan community events such as their Freedom over
Texas 4th of July Celebration and the Veterans Day
Parade Celebration.