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Public Employees' Benefit Board

Managing Your Health
Take Care of Yourself
 
In these lean times, your Benefit Board wants to help you make the best use of your benefits and keep healthcare costs manageable. 
 
Healthy Budgets   Some PEBB members have written about how they’re saving money by changing to generic medications. Your Benefit Board changed the plan design to encourage use of generics in 2006. Since then, member use of generics has increased from 61 percent to more than 68 percent.
 Did you know? With every one percent change from brand to generic medications, the pool of PEBB members saves more than $1 million in annual medical costs.
 
Healthy Practices  The PEBB plan design covers a number of generics for chronic conditions at low or no cost. This brings down cost barriers to taking these critically important medications. You may want to talk with your provider about switching from a brand drug to a generic version to get the same quality at a savings.
 Did you know? Generic versions of Imitrex (for headaches) and Effexor (for depression) should be available later this year.
 
Healthy Weight   This year, the Board offers a weight management program. More than 5,000 employees have already signed up for the program. Many have written to share early and ongoing successes (see reverse).
 Did you know? Within just one year of losing weight, you save money on healthcare and have a better quality of life.
Healthy Habits  Do your part to stay healthy and keep costs down.
  • Take care to eat right and exercise
  • Move to generic medication when possible
  • Brush and floss every day
  • Use the healthcare system wisely
When times are difficult, it’s even more important to take good care of your health – your most valuable resource.

Here's to Your Health
PEBB members offer tips and resources to help you care for your health without breaking the bank

Prescriptions   Taking a brand drug? Ask your provider if a generic would work.  
"I tried to switch to the generic drug…but my stomach couldn’t take them. So, my doctor returned me to the brand name. The real story here is TRY the generic. If it works, you win. If it doesn’t you can go back. It’s a no-lose situation." – PEBB member
 
FDA search tool: www.accessdata.fda.gov/scripts/cder/drugsatfda/ 
Compliance   Compliance means following doctor’s orders – on lifestyle as well as medicine.   "I am down 140 pounds from when I started the process…My doctor has taken me off diabetes medication altogether…This summer I got to do things I have not done in years, like hiking, fishing and walking on the beach." – PEBB member
 
Weight Watchers: www.mypowwr.com/downloads/PEBB.pdf 
Gym discounts: www.oregon.gov/DAS/PEBB/Stories/FitnessDiscounts.shtml 
Prevention 
 

The sweetest savings may come from not having to pay the piper in the first place.   "I quit smoking in 2008 and I save about $600 a year just in cigarette costs – not including not going to the doctor for bronchitis twice a year." – PEBB member
 
Quit for Life: www.quitnow.net/PEBB
Screenings    Cancer screenings? Priceless.   "I went in for a routine check-up…If my PCP had not ordered the labs, the cancer would not have been detected until much later. By then it would have been much more advanced and difficult treat." – PEBB member
 
National screening guidelines: www.cancer.gov/cancertopics/screening 
The Value Equation   For consumers, Value equals Quality divided by Cost.   "For the last two years [my husband] received his …therapy at an infusion center monthly, at the cost of $15,000-$17,000 per treatment. This year, by changing infusion centers, he was able to access a different brand and it costs $5,000-$6,000 per treatment– a whopping savings!" – PEBB member
  Compare hospital quality: www.oregon.gov/OHPPR/HQ/detailed-summaries/main.shtml
 
Making your doctor visit count
family doc
Do you feel rushed, anxious or not listened to when you go to your doctor’s office? Most physicians allow about 10 to 20 minutes for an office visit. Consider the following tips to help you make the most of your visit with your physician.
 
  • Think about your main concern or issue and write it down.
  • Keep a symptom journal.
  • Compile and take with you a medical history that includes health problems, medications you are taking, allergies, lab reports, and vaccination record.
  • Be honest by answering your physician’s questions truthfully. It is hard to make a correct diagnosis with inaccurate or incomplete information.
  • Take notes of your conversation with your doctor. Ask for written instructions when appropriate.
  • Ask questions about anything that seems unclear to you. Keep asking questions until you fully understand.
 
Following these tips can help you be an active and informed participant in your health care.
 

Do you need a check up?
Remember back in the day, when everyone thought they needed an annual "physical?"
 
Today, doctors target health exams based on your age, sex and risks. The U.S. Preventive Services Task Force recommends the following screenings for most adults.
  • Blood Pressure: at least every two years
  • Blood Glucose: clinical decision based on risks
  • Cancer Screenings:
    • Breast - every one to two years beginning at 40
    • Cervix - every one to three years no later than 21 and up to 65
    • Prostate - clinical decision based on risks
    • Colon - one to 10 years (based on type of test) beginning at 50
  • Cholesterol: routinely for men at 35; women at 45

 

 
Recommendations from the U.S. Preventive Services Task Force  

Talking with your healthcare provider
nurse
A prescription for good health
Did You Know?
 
Did you know that most people get just 13 minutes to talk with their doctor during a routine visit? Can you get all your questions answered in 13 minutes?  In the days of Marcus Welby, healthcare was simpler. Today, new technologies, innovative care models and cutting-edge research have created a more sophisticated and complex healthcare system. These days, you can’t simply leave your healthcare decisions to your doctor. Nor can you depend on short doctor visits to learn everything you need to know about your health. You need to educate yourself and become an active partner with your doctor. And you need to demand changes in the healthcare system that could make getting information – from doctors and others – simpler.
 
What can you do?
 
Take action to make the most of your doctor visit. A little planning can help you get the most of the time you have with your provider.
 
Be prepared.
  • Bring a list of your current symptoms and related questions.
  • Also bring a list of all the medications and supplements you take.
Participate.
  • Take notes and ask questions. If you don’t understand an answer, ask again until you do.
  • Ask your doctor to write down instructions or to give you printed material.
Get support.
  • Bring a family member with you to help with questions and remembering details.
  • If you still have questions at the end of the visit, ask to speak with a nurse. Or schedule another visit to get your questions answered.
  • If you’re getting medication, ask the pharmacist how you should take it and possible side-effects.
  • Ask your doctor if you can follow up with questions via phone or e-mail.
Take Charge.
  • If you’re not happy with how your doctor relates with you, say so. Even a busy doctor should listen with respect, clearly explain things, encourage you to ask questions and treat you as a partner in your care.
  • Many health plans don’t pay doctors for the time they spend answering patient e-mails.  Ask your plan if they do or if they would consider doing so.
  • “E-prescribing” can save time and make care safer. Ask your doctor about this technology.
 

I wish I had more time with my patients, but given the realities of my practice, I don’t often have the time I want. I ask my patients to be prepared for our appointments. I invite them to bring me a list of symptoms and a set of questions that we can go through together. I encourage them to tell me when they don’t understand what I’m saying or if they feel too rushed. And I often follow up with an e-mail summarizing our discussion and just stay in touch. We work together to help them get the best care and learn to take care of themselves as much as possible.”
Chuck Kilo, M.D.
 
 

How to Work with Your Doc
Rx changes get this member lower dose and lower cost

"I had my annual physical with my primary care doc today. As soon as she saw the Regence letter I had in my hand about alternatives to a medication I take [sent to PEBB members taking non-preferred brand medications], she reacted negatively. Apparently I was not the first patient to show up with such a letter.
 
"However after she looked at it she indicated that, with this particular medication, the alternatives recommended were good ones. So we agreed to make a switch to a less expensive one, which also requires a lower dose.
 
"So for me, thanks to PEBB for pointing out the alternatives that were available and getting me to discuss this with my doc. It has resulted in both a lower dose and a lower cost to me and my insurance provider."

Know your numbers
What you should know
Forget phone numbers; you can always look them up. Here are numbers you really need to know:
  • Your cholesterol levels (major predictors of future heart disease)
  • Your blood glucose level (lets you know if you’re at risk for diabetes and serious complications)
  • Your body mass index (indicates risks for diabetes, heart disease, arthritis and even cancer)
  • Your blood pressure rate (high numbers increase risk of stroke, heart disease and more)
Knowing your numbers helps you know your risks. Knowing your risks helps you take better care of yourself.
 

Quick Quiz:
What’s your fasting glucose level? Blood pressure? Total, “good” and “bad” cholesterol levels? Body mass index? 
If you can’t answer, you need to find out.
 
These numbers are indicators for chronic conditions such as heart and vascular disease and diabetes. If your numbers aren’t in line, there are things you can do now to reduce the likelihood of developing these conditions - but you have to know your numbers first.
 
The next time you see your doctor, ask about each of these numbers. Work with your provider to make sure you know your health risks and what you can do to maintain and improve your health.

Lowering Cholesterol
IT'S IMPORTANT TO EVERYONE

 
 What is cholesterol, and why does it matter?
 
Cholesterol is a fat-like substance in your blood. Over time, it builds up on the walls of your arteries. This can narrow the arteries, slowing down blood flow to the heart. This can cause chest pain. If part of the blood supply is completely blocked, you can have a heart attack.
 
Who should pay attention to cholesterol?
 
High cholesterol is a major risk factor for heart disease. And heart disease is the number one killer of women and men in the U.S.
 
The National Heart, Lung and Blood Institute (NHLBI) says, "Cholesterol lowering is important for everyone – younger, middle age and older adults; women and men; and people with or without heart disease."
 
How do I know my cholesterol levels?
 
Many PEBB members who attended worksite health screening clinics this summer and fall had a blood test called a "lipoprotein profile." This fasting test measures:
  • Total cholesterol
  • Low-density lipoprotein (LDL) cholesterol
  • High-density lipoprotein (HDL) cholesterol
  • Triglycerides – another type of fat in your blood.
The NHLBI says "everyone age 20 and older should have their cholesterol measured at least once every five years." If you’re due for a cholesterol check, go to the PEBB Web site to view a schedule of worksite health screenings or contact your medical provider.
 
 What can I do about my cholesterol levels?
  • Diet. Reduce the amount of saturated fat and cholesterol in the foods you eat.
 
  • Weight. Losing weight can lower your "bad" and total cholesterol levels, along with triglycerides, and increase your "good" cholesterol levels.
 
  • Physical Activity. Try to be physically active for 30 minutes or more on most days. It helps lower bad cholesterol and raise good cholesterol levels.
 
  • Treatment. If your doctor prescribes medication to lower your cholesterol levels, be sure to take it as recommended.

Type of Cholesterol Fasting Values Values if Not Fasting
Total: Total HDL and LDL in bloodstream
Desirable200 or lowerNormal200 or lower
Borderline200-239
High240 or higher
LDL “Bad”: Clogs vessels; may cause heart attack or stroke (lower is better)
Ideal100 or lowerNot valid if not fasting
HDL “Good”: Helps remove bad cholesterol (higher is better)
Low40 or lowerLow40 or lower
High60 or higherHigh60 or higher
Triglyceride: Fat in blood and fat tissue (lower is better)
Ideal150 or lowerNot valid if not fasting
Normal200 or lower
High200-499
Very High500 or higher
 
Online Resources
  
The American Heart Association’s Cholesterol Web section also offers support for keeping your cholesterol numbers where they should be.
 
Resources from Your Medical Plan
  • Kaiser Permanente has a complete self-study packet. Call (503) 286-6816, option 1.

Did You Know? Over weight leads to chronic disease
scale
Did you know that too much body weight is a leading cause of many chronic diseases? By managing your weight, you may be able to reverse your risks for some of these diseases – and even the disease state itself.   The national Centers for Disease Control says overweight increases risks for:
  • Heart disease
  • Type 2 diabetes
  • Stroke
  • Gallbladder disease
  • Sleep apnea and breathing problems
  • Some types of cancer.
The most recent public health survey reports that 60 percent of adult Oregonians are overweight.   Health experts agree that our man-made environment contributes to the increase in the number of children and adults with unhealthy weight. For most of us, too much food with too many calories is too available. Add the fact that physical activity has been almost engineered out of daily life, and it’s no surprise that much of the population is at risk.   If you think you’re outside a healthy weight range, find out your risks. Bring it up with your healthcare provider. Ask how your weight may be affecting your health; discuss it as a medical – not cosmetic – issue. Learn what resources are available in your community and health plan to help you gain balance in nutrition and physical activity to decrease your risks.  
 
Health Plan Web Resources  
 
Kaiser Permanente’s Web site   includes a Weight Management Section with advice on healthy eating, staying active, eating and emotions, and tips for parents. Kaiser also distributes a quarterly catalogue to members that describes all its wellness offerings, including weight management.  
 
  The Providence Choice Web site   lists classes and services available for weight management. For example, through Providence Nutrition Services, registered and licensed dietitians help you manage your individual nutrition needs. They specialize in medical nutrition therapy for weight management and other medical conditions.  
 
The Regence MyEngineWeb site   offers tools to help you develop an individualized weight management plan, set achievable goals, learn about and practice nutritional eating, get and stay motivated, and track your progress over time.  
 
Samaritan Select’s Web site   lets members sign up for weight reduction classes conducted by Samaritan providers. Participants learn how to develop healthy food and activity choices that will become part of their overall lifestyle.

The Eyes Have It
Did you know there is scientific evidence for eye care as well as other aspects of health care? In general, evidence suggests the following schedule for eye exams.
 

 Age Frequency
 Before 5 At least once
 6-39 Every 3-5 years
 40-64 Every 2-4 years
 65 or older Every 1-2 years
People with special risks, such as diabetes, previous eye trauma or surgery, family history of glaucoma, and certain racial backgrounds, may need more frequent eye exams.
 
If you are healthy but your vision has changed to the point where you don’t see as well as you think you should, make an appointment for an exam. You may need corrective lenses or an adjustment to your lens prescription. Let your vision be your guide.
 
Note: Before you make an appointment, review your routine vision care coverage in your medical plan member handbook.
 

 Emergencies Happen See a doctor immediately if you:
  • Injure an eye
  • Have sudden eye pain
  • Experience any loss of vision.
 
Eye Exam Checklist –  Be Prepared
  • When you make an appointment, ask if you will be able to drive yourself home; your eyes may be dilated during the exam.
  • Before the exam, make a list of any eye or vision problems, eye injuries or surgeries, prescription and over-the-counter drugs you are taking, and family history of such eye problems as glaucoma or cataracts.
  • During the exam, ask if there are any changes since your last exam and when you should return for the next one.


 Who's Who in Eye Care
 Ophthalmologists. Physicians with special training in the care of the eyes to prevent and treat disease and injury.
 Optometrists. Professionals who provide eye exams; diagnose and treat eye and vision disorders; and prescribe glasses, contact lenses and other treatments.
 Opticians. People licensed to design, finish, fit and dispense eyeglasses and contact lenses, based on an eye doctor’s prescription.
 
 
Diabetes and Eye Care

 People with diabetes are 25 times more likely to go blind than people without the disease. It is the leading cause of blindness among adults in the U.S.
 
Diabetes harms the body’s blood vessels – including those in the eye. Over time, lack of blood to the eye can cause blurred vision and blindness.
Diabetes can also result in cataracts, which also reduce vision. Cataracts can be a result of age, but they happen more often and earlier in people who have diabetes.
 
If you have diabetes, make sure you have your eyes examined regularly. It could save your sight.
 

 Play Hard But Protect Your Eyes  
More than 40,000 people a year suffer eye injuries while playing sports. Yet almost all sports-related eye injuries can be prevented. Whatever your game, whatever your age, you need to protect your eyes.
 
Regular glasses don’t provide enough protection. So take the following steps to avoid sports eye injuries:
  • Wear proper safety goggles (lensed polycarbonate protectors) for racquet sports and basketball.
  • Use batting helmets with polycarbonate face shields for youth baseball.
  • Use helmets and face shields approved by the U.S. Amateur Hockey Association when playing hockey.