Public Employees' Benefit Board February 2010

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Public Employees' Benefit Board

February 2010

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Healthcare Quality in Oregon

Quality healthcare doesn’t just happen automatically. Unfortunately, there are big variations in care in Oregon. The good news is that when people are involved in their healthcare and work with their providers, they are more likely to get quality care – care that works, is safe, timely, and tailored to individual needs. A new Web site, www.PartnerForQualityCare.org, has easy-to-understand information that helps you work with your providers to get quality care. It includes tips on What questions to ask doctors Where to look for trustworthy healthcare information How to get care that works for you The site also has data to compare quality in Oregon hospitals. This spring, it will have data on quality of care in doctors’ offices. Screen shot: www.PartnerForQualityCare.org Produced by Partner for Quality Care: Information for a Healthy Oregon Dedicated to measuring and improving healthcare through collaboration Managed by the Oregon Health Care Quality Corporation. Contact: info@PartnerForQualityCare.org, (503) 241-3571

Important Member Health Survey

You may be one of 2,000 members to get a call soon about a survey for PEBB. Please take the time to participate. Your responses will help answer important questions about the PEBB group:

What is our overall health status?
What choices are we making on physical activity and eating habits?
What support for wellness do we get in the worksite?
What is our experience with the healthcare system?

The state’s office of public health leads Oregon’s participation in this state-by-state survey for the Centers for Disease Control and Prevention. They include a random sample of PEBB members in calls to thousands of Oregonians statewide.

You can schedule the 15-minute interview at your convenience — at work, if your job allows, or at home if you prefer. Responses are completely confidential. The survey firm uses member phone numbers for this survey only. Results are reported as a whole group, and no person can be identified through any reported information.

Rx Coverage in the Statewide Plan

Providence Pharmacy Services is working with members in the Statewide Plan on the transition to their new formulary. Many members received a letter from Pharmacy Services in January advising them on specifics. Here are some positive changes to be aware of.

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» Preferred retail pharmacies fill 90-day prescriptions at the mail-order co-pay

» The plan automatically coordinates coverage for dual-enrolled employees (submit evidence of co-pay only if one is in a non-Providence plan)

» More than 60 drugs for asthma, diabetes depression and heart disease have zero co-pay

» About 10,000 members automatically have lower prescription co-pays in 2010

» Members and providers can access the prior-authorization form online

Take the direct route for answers to questions on your prescription drug coverage – call Providence Pharmacy Services at (503) 574-7400.

Change Your Risk for Heart Disease

Certain habits or conditions, called risk factors, lead to poor heart health. For example, having a family history of heart disease, being a man over age 45 and being a woman over 55 are all risk factors for heart disease.

Obviously, these are risk factors that you can’t change. But, you can control many risk factors for heart disease, says Jodi dePinna, R.N., cardiac educator with Providence Health & Services.

Risk factors you can control include high cholesterol and high blood pressure, lack of exercise, being overweight, smoking and not dealing with stress.

"There is a lot you can do – and not do – to keep your heart healthy," says dePinna. "Certain lifestyle changes such as quitting smoking, increasing exercise and losing weight can have a dramatic impact on your risk for heart disease."

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Upcoming Policy Discussions

Your Benefit Board plans to address three long-standing policy issues during its March meeting Opting out of PEBB medical Weighting of premium tiers Implicit rural subsidy Staff is preparing background documents on each of the issues. See the documents (or references) on the Web site.