By Amanda Case, LCSW, SAC

An estimated 58 million Americans experience a mental disorder in every year, yet many people avoid talking about this or getting treatment because of the stigma that is associated with mental illnesses.  Many of us who either have mental illness or are affected by a loved one with mental health issues, may feel ashamed or uncertain about sharing this with others.  By sharing our stories, our strengths, our challenges, and ability to cope, we can start to change the stigma around having a mental illness.

Stigma refers to a cluster of negative attitudes and beliefs that motivate the general public to fear, reject, avoid, and discriminate against people who have a mental illness. Self-stigma occurs when a person applies these negative beliefs to themselves.

• Stigma results in fear, mistrust, and violence against people living with mental illnesses.
• Stigma prevents people from receiving needed mental health services.
• Stigma is a barrier and discourages individuals and their families from getting the help they need due to fear of being discriminated against.

Source: SAMHSA

Here are some helpful resources to learn more about mental illness and how to educate yourself and others about mental health stigma.

NAMI (National Alliance on Mental Illness) 

WISE- End Stigma Together, One Story at a Time

Wisconsin United for Mental Health

What’s the difference between a preventive physical and an office visit, and can I be charged for both in the same visit?

At first glance, a physical and an office visit may seem like the same thing…

BUT, there is a difference. It is important to understand the differences between the two, because it may affect your costs.

Here are the main differences:

 A Preventive Physical is:

• A thorough review of your general health and well-being
• Your provider will complete a physical exam and make recommendations regarding your general health that usually focus around diet, exercise or disease screenings and well-being
• Typically, GHC covers preventive physicals at no charge. But you should refer to your Summary of Benefits or Certificate for exact benefit coverage.

 An Office Visit is:

• An appointment to discuss specific, new or existing health problems.
• Your provider may then prescribe medication, order additional tests like lab work or X-rays, refer you to a specialist or discuss other treatment options.
• Depending on your benefits, an office visit usually results in additional costs to you.

Based on the definitions above, you may be wondering if the same appointment can be considered both a physical and an office visit? The answer is, yes.

On occasion, one appointment can meet the requirements for both types of visits. If this is the case, your provider will submit a charge for both a preventive physical and an office visit. If your preventive physical includes consultation or treatment

for a specific condition, your provider is legally required to document additional medical services on your bill.

So, what does this mean for you?

While combining a preventive physical and an office visit will save you time by eliminating an extra appointment, it may also affect your costs. Providers must bill your visit based on both the reason you initially scheduled the appointment and what is done during the appointment. For this reason, it’s important to remember that when you see your provider for a physical, something more than a general evaluation may result in unanticipated out of pocket costs for you based on your benefit plan.

We hope this article has helped to clarify the difference between physicals and office visits. As always, if you have further questions about your insurance coverage or costs you can review your Summary of Benefits and Coverage by clicking here. You can also call our Member Services team Monday through Friday, 8 a.m. – 5 p.m. at (608) 828-4853.

Written By: GHC-SCW Chief Medical Officer, Chris Kastman, MD

You may have heard that all GHC-SCW primary care clinics recently earned PCMH Recognition from the National Committee of Quality Assurance (NCQA) but what does that exactly mean and why does it matter?

PCMH Recognition is an award from NCQA that providers and practices can earn when they exhibit evidence-based and patient-centered processes that focus on highly coordinated care and foster ongoing partnerships between patients and their providers. GHC-SCW’s long-standing commitment to improving the quality of care and patient experience while striving to reduce healthcare costs is foundational to PCMH Recognition. Since the organization’s inception, GHC-SCW clinics have employed patient-centered care and initiatives but this award allows us to solidify and celebrate all that we do!

A medical home ensures that the patient is well supported throughout their healthcare journey. This helps diminish fragmentation in care delivery to improve outcomes. GHC-SCW Primary Care Teams which are composed of primary care providers (PCP) and nursing staff who work together to close gaps and coordinate patient care. These teams are further strengthened by Primary Care Behavioral Health experts, Clinical Pharmacists, Nurse Triage, Community Care, Reception and Call Center staff and many others who rally around members who need them. For example, when a patient gets discharged from the hospital, GHC-SCW Care Teams proactively call patients to ensure that they understand the instructions related to their care. They also remind each patient that they are available for ongoing support and are a resource if questions or concerns arise.

Other examples of patient-centered medical home processes at GHC-SCW include:

• A monitoring report was developed to help ensure that high-risk patients who have a consult visit scheduled with a specialist have been seen in an appropriate timeframe. If the patient has not been seen at the time that their consult was scheduled for, Case Managers and Care Teams can conduct follow-up with a patient to assess if there are barriers to care (such as transportation issues) or concerns that can be addressed.
• An Asthma Action Plan is a self-management tool that can help patients with asthma stay well. GHC-SCW’s Asthma Educator works with patients to develop plans which show what kinds of medicine to take and when. An action plan also helps patients understand how to handle worsening symptoms, including what to do if they have an asthma attack.

Because of efforts to help patients better manage their conditions and improved coordination during transitions of care, health outcomes improve while simultaneously reducing costs. In fact, research has shown that patient centered medical homes can help reduce emergency room visits and hospital admissions¹. Additional research has shown that patients who experience the PCMH model of care value the increased access to healthcare and ease of communication with their provider².

References:

1)            Harbrecht, M, Latts, L. (2012). Colorado’s Patient-Centered Medical Home Pilot Met Numerous Obstacles, Yet Saw Results Such as Reduced Hospital Admissions. Health Affairs.

http://content.healthaffairs.org/content/31/9/2010.abstract

2)            Lydie A. Lebrun-Harris, Leiyu Shi, Jinsheng Zhu, Matthew T. Burke, Alek Sripipatana, and Quyen Ngo-Metzger. (2013). Effects of Patient-Centered Medical Home Attributes on Patients’ Perceptions of Quality in Federally Supported Health Centers. Annals of Family Medicine.  www.annfammed.org/content/11/6/508.full

 

Did you know that 7 out of 10 smokers want to quit and approximately 55% of smokers try to quit each year? It may never feel like the perfect time to quit smoking, as behavior change can be difficult. But, if one thing is for sure, you will not regret it.  

At GHC-SCW, we are proud to offer support to anyone who wants assistance quitting smoking. Here is how you get started:  

To get started: 

1. Determine a target quit date no further than 30 days away  
2. Research suggests using one of following two smoking cessation medication options, paired with a form of counseling is most effective in helping a person quit smoking: Chantix + counseling  or using the Nicotine patch and Nicorette mini-lozenges together + counseling  
3. It is important to create a clean, fresh, and non-smoking environment for yourself. Remove all tobacco products such as cigarettes, ash trays, lighters, etc. from all areas of your home and car the day before your quit date.  
4. Remain open minded and positive: there is a chance quitting will not work out exactly as planned the first time around. Rather than viewing this as a failure, think of it as discovering one way that didn’t work. You’re one step closer to finding what works for you. You WILL be successful!  

Quitting smoking is the single most important thing you can do for your health. Here are a few things you can look forward to if you decide to quit:  

Within: 

• 8hrs: CO2 levels drop & O2 levels increase in the blood 

• 2 days: Ability to taste and smell is enhanced 

• 2-3 weeks: Lung function increases 30% 

• 1 year: Risk of Heart Disease decreases by half of a smoker 

• 10 years: Lung Cancer rate is that of a non-smoker 

 

BONUS:  think of all the money you’re going to save! For example, if you’re smoking 1 pack per day, this totals to $3,219 saved per year.  

Group Health Cooperative of South Central Wisconsin is dedicated to helping you achieve your wellness goals. Reach out to your Primary Care Provider today. They will connect you with all smoking cessation resources GHC-SCW has to offer! 

 

Written By: Noah Fulton

Sugar is everywhere. Seemingly harmless foods like breakfast cereals are coated with it, our fruit filled yogurt needs added sugar to enhance flavor, and we put it in our morning coffee. After dinner we grab a piece of chocolate or a cookie from the jar. Let’s not forget about that can of soda that got you through the afternoon! So, what is the big deal about sugar anyways? Recent research suggests we may be harming ourselves more than we know with our excessive sugar intake.

Sugar is a chronic toxin. One can of soda or one piece of candy is not going to cause you immediate issues, as we typically do not experience acute symptoms in response to sugar intake. However, daily intake over time can wear down our metabolic system and lead to chronic, low-grade inflammation. Chronic, low-grade inflammation is associated with several serious health conditions, such as:

• Heart Disease
• Type 2 Diabetes
• Cancer
• Obesity
• Inflammatory Bowel Disease
• Osteoarthritis

The good news is, we have options to satiate our sweet tooth. Eating natural sugars, those derived from whole fruits and vegetables, does not have an association to inflammation! Fruits and vegetables are also high in dietary fiber, vitamins, and minerals. Building good dietary habits into our daily routine can make such a huge difference in inflammatory conditions and health in general. Look to avoid added sugars in your food selections and try to use a piece of fruit as your afternoon pick me up!

 

Written By: David Kwon, DO

What’s that? Appointments for Urgent Care???? Calling first???

Yes, we understand that at first, the idea of urgent care by appointment may sound like a strange idea to some, especially considering that many healthcare organizations offering urgent care services do not offer appointments and rather patients are seen on a walk-in basis.

Group Health Cooperative of South Central Wisconsin offers scheduled urgent care appointments in order to reduce the wait time spent in the waiting area for patients and to improve efficiency in caring for the patients who require urgent care.

In addition, we highly recommend calling prior to arriving at the clinic, as this will likely reduce wait time and ensure that patients are given the most appropriate advice regarding their concerns.

Typically, patients are called from the waiting area at or within a few minutes of their scheduled appointment time. Given that not infrequently, there are unforeseen and urgent circumstances that arise in caring for patients in the setting of an urgent care, there may be delays in the time that patients are actually called from the waiting room as well as possibly some waiting time in the room before the provider can arrive.

Please be assured that our urgent care team constantly strives to provide every patient with excellent, appropriate care in the most efficient manner possible. It is an expectation that our team members keep patients regularly informed of any time delays. We welcome and encourage feedback as to how we are doing with respect to communicating estimated wait time frames as well as patients’ overall experience of care.

Written by: Dr. Stephen Lo

As warmer weather settles into Wisconsin, many of us are spending more time in outdoor activities and sports. This means that we can also see more ankle injuries.  One of the most common injuries is a sprain of the ankle.  An ankle sprain is a stretching or tearing injury to the ligaments around the ankle joint.

Another common ankle injury is a fracture in one or both bones in the leg near the ankle.  A fracture is an actual break in the bone.  These can range from very mild fractures with just a tiny crack to more severe fractures with complete breaks in both bones.

Signs of an ankle sprains can include:

• Swelling around the ankle
• Bruising around the ankle
• Pain with movement of the ankle or when walking
• No pain when pushing on the ankle bones or on the shin

Signs of an ankle fracture include the above plus:

• Pain when pushing on the ankle bones or shin
• Severe pain that prevents walking or bearing weight

Ankle sprains and fractures can occur from the same types of injuries, and they can look very similar. It is important to see your medical provider for any moderate or severe ankle injury.

Treatment:

Depending on the severity of the ankle sprain, treatment may include:

• Icing
• Elevation
• ACE bandages or splints
• Crutches
• Rest from physical activities
• Physical therapy

Treatment for ankle fractures can include the above plus splinting or casting to allow for protection and proper healing.

Call your doctor if you have persistent swelling that doesn’t improve after two to five days of home treatment or have persistent pain that doesn’t improve after several weeks.

 

Group Health Cooperative is happy to be partnering with the Madison Mallards in 2018! With our sponsorship comes many exciting things not only for Group Health Cooperative, but for the entire Madison Community!

Salute to Madison Night at the Madison Mallards – July 11^th, 2018

On July 11^th, the Madison Mallards players will be wearing one-of-a-kind jerseys that focus on the great city we live in, Madison. After the game, these jerseys will be auctioned off and all the money raised will be donated to Project Home.

Project Home is a Madison based non-profit that’s mission is to improve the quality and affordability of housing for low-to-moderate income residents in Dane and Green County, WI. They perform home repairs, accessibility modifications and energy improvements to make homes healthier, safer and to ease the financial burden of high energy bills for people who are struggling financially.

There will also be an opportunity for children and adults to pay $1 for a coloring page to draw what “Home Means to Them”. The money raised from this will also be donated to Project Home, and the individual will be entered into a drawing to win a special prize!

So come out and join us on July 11^th to salute the great city of Madison and all the hard work Project Home does to make it a better place to live.

Goat Yoga at the Madison Mallards – July 17^th, 2018 starting at 5:30

Have you ever heard of Goat Yoga?! Well now is your chance to find out what it is all about:

GHC-SCW will be sponsoring Goat Yoga in the outfield of the Mallard’s stadium on July 17^th before the game! Participants will have the chance to do yoga alongside live goats, and the goats may even jump up on your back! How cool is that?!

Stay tuned if you would like to sign-up for this unique experience. There is only room for 100 participants!

GHC-SCW Project Home-Run

All season long, every time a Madison Mallards player hits a homerun, GHC-SCW will donate $100 to Project Home! Just another reason to cheer for your hometown team this summer!

 

Written By: Dr. Stephen Lo

Spring is finally here, and everyone is eager to get outside to enjoy the nicer weather.  Unfortunately, this is also the time of year when many of us start to have seasonal allergies.  Seasonal allergies often occur in the spring months when many plants and trees are blooming and releasing pollen.  However, seasonal allergies can also occur during the summer or fall months, depending on which specific plants you are allergic to.

Typical seasonal allergy symptoms include:

• Sneezing
• Stuffy nose or runny nose
• Itchy and watery eyes
• Scratchy throat
• Cough from nasal drainage

Treatment:

• Try to avoid the specific plants that you are allergic to – for example, keep windows and doors closed in your house.
• Over-the-counter antihistamines (such as loratadine or cetirizine or fexofenadine) can help to control and prevent allergy symptoms – it is best to take these medications every day during your allergy season.
• Nasal steroid sprays can help reduce runny nose and sneezing.
• Anti-histamine eye drops can to help control itchy and watery eyes.

If you have asthma, it is important to remember that seasonal allergies can trigger an asthma attack.  It is best to keep both your seasonal allergies and your asthma under good control during allergy season. 

Talk with your medical provider if you have any questions, or if your symptoms are not improving with the above.

 

 

 

Written By: Dr. Mark Huth, Chief Executive Officer at GHC

Welcome to GHC-SCW’s new blog! Our blog will give us a unique opportunity to share news, updates and healthy living content, while also offering a place for us to interact with our members and the community. If you’re wondering what you can expect from the content you find on our blog, and how the information here differs from the information you may find on our website, read on.

Our blog will allow us to leverage social technologies to engage in two-way communication with our community and to take your feedback into consideration as we move through the ever-changing health care and insurance landscape. Here you’ll find patient stories, resources for members, local event updates as well as details on opportunities to engage with GHC-SCW. In addition, we’ll use the blog to share multimedia, such as videos, photo albums and more.

You’ll also find news articles penned by our very own providers and staff. The posts will cover a range of topics from “Screen Time and Your Child” to “5 Ways to Protect Your Skin from the Sun” – all designed to give you and your family the tools and tips you need to lead healthy lives.

As we continue to build our blog, we’ll also create health care and insurance-specific content so you can learn more about the latest news and research.

We look forward to growing with you as we embark on this new journey. Thanks for stopping by!