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Published by Healthscient, LLC | © 2017-2018Published by Healthscient, LLC | © 2017-2018

© 2017-2018

Y O U R G U I D E T O TA K I N G C O N T R O L

O F Y O U R H E A LT H C A R E

Y O U R G U I D E T O TA K I N G C O N T R O L

O F Y O U R H E A LT H C A R E

5 ST E P STO B E T T E R

H E A L T H C A R EAT

L O W E R C O S T

5 ST E P STO B E T T E R

H E A L T H C A R EAT

L O W E R C O S T

“Own” can mean to acknowledge or take full responsibility for something. It can also mean to completely get the better of, or have the upper hand. In the case of making decisions about your healthcare, both apply. It’s on you. And, you can triumph!VISION YOUR (NOT TOO DISTANT) FUTURE SELF.Owning your healthcare really does start right there. Begin by asking some important questions about the years ahead.

• What do I want to be able to experience?• What do I want my life to be or to mean?• In what would I like to participate?• What would I like to be able to contribute to

the world? To my family?• What would I like to be rid of?• What do I want to look like?• What do I hope to feel like?• What would I like to be able to physically

accomplish?• What do I NOT want to worry about?

No kidding. See yourself as you would like to be in the next few years. Fix that image – that way of being – in your mind. Write it down somewhere. Tear out a picture from a magazine that represents your preferred future. Draw it. Do whatever … but make it continually visible. Start right where you are, but shoot towards that. What decisions do you need to make to get there?SET SMART, REALISTIC GOALS.Some people love goal setting. Some people hate it. If you are going to “own” your healthcare decisions (in every sense of the word), you’ll need to set some smart, realistic goals. Love it or hate it.

Author:David White

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page 1 of 18 FIVE STEPS to Better Healthcare at Lower Cost • Healthscient © 2017-2018

www.healthscient.com/fivestepstobetterhealthcare.pdf

There is no shortage of goal “categories.” The key is to remember that this is about you – your decisions – your vision for your future self. Weight, mobility, blood chemistry, chronic condition management, doctor / patient relationship, medication, financial outlay, physical fitness, sleep health, holistic or integrative approaches, and nutritional strategies are but a few. What goals do you need to set (first) to move you toward your preferred future?

FIVE STEPS to Better Healthcare at Lower Cost | Step One

Take Ownership of Your Healthcare Decisions.

Step

Take control of your health. Start by setting personal health goals and then develop a consumer mindset towards your healthcare. You HAVE options - physician partnerships, insurance coverage plans, preventive strategies … you are in charge!

Goals are dynamic in nature. Start where you are. Do what you can. Adjust as needed. Rinse and repeat.

Maybe you have a particular goal-setting method that works for you. Great. Use it. If you don’t, this S.M.A.R.T goal structure is not a bad place to start. We don’t know who originated it (or we’d give them credit) but variations of it are everywhere. Adjust as you see fit. Your goals should be:

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Specific – so it’s very clear what you’re aiming for. The more specific the better. “Eat better” or “exercise more” is not specific. “Have 3 servings of fresh fruit and fresh vegetables a day” is specific. “Walk 4 times a week for at least 30 minutes” is specific. “Consider changing my doctor” is not specific. “Research physicians in my area who will understand my health goals and proactively participate with me” is specific. “Control my blood sugar level with a proper diet and exercise rather than medication” is specific. “Reduce my healthcare costs by 10% without sacrificing quality of care” is specific. “Research insurance plan options available to me” is specific. Get the idea?

Measurable – so you will know without a doubt that you have achieved what you are striving for. There has to be tangible evidence that you’ve “owned” your goal. Tracking and assessing progress helps you stay focused and motivated. Your measurements should have real meaning.

Achievable – something that can be done and something specifically you are able to do. Can this goal actually be achieved? Is it really possible? Can you, given your circumstances and conditions, actually attain it? On the flip side, is it ambitious enough? Setting the bar too high or too low does you no good.

Relevant – something that actually moves you toward the vision of your preferred future self. There is no need to waste energy and effort on things that won’t matter much in the long run. Also, think in terms of results or outcomes rather than just activity.

Time-bound – so that you have a specific target date. That’s important. There should be a practical sense of urgency. A specific target date creates a “tension” between your current reality and the next step toward your preferred future. Without the tension – the sense of relative urgency – your goal is unlikely to produce a relevant outcome.

… something thatactually moves youtoward the visionof your preferredfuture self ...


FIVE STEPS to Better Healthcare at Lower Cost • Healthscient © 2017-2018


SET SMART, REALISTIC GOALS.

With the vision of your preferred future and your S.M.A.R.T. goals in mind, start researching options. Compare options for the best value relative to your goals. Ask some questions. Do some math. Do some comparison shopping. Do some negotiating. Make a choice.

But also remember this … if you make a choice that doesn’t quite work out the way you hoped or if your goals or circumstances change for any reason, just back up and do it all again. Make another choice.

You are in charge.

• Try this the next time you go to a pharmacy. Determine your copay for each prescription filled. Ask the pharmacist what each medicine would cost if you just paid for it out of your pocket. A recent study shows that around 23% of the time, the out of pocket cost will be LESS than your copay amount. Read a short blog about this little experiment here:

https://healthscient.com/try-this-to-save-money-on-prescription-drugs/

• Do you require somewhat frequent lab tests? Read about this woman’s experience (and surprising discovery!) and set up a similar experiment for yourself. You may be shocked at how much money you can save.

www.detroitnews.com/story/opinion/2018/03/14/insurance-direct-primany-care/32946709/.

23%

THINK LIKE THE CONSUMER YOU ARE. When you shop for a house, a car, a college for your children, a TV, a laptop, a new washer and dryer combo, or even order from a restaurant menu – you flex your consumer muscles. With your goals, your research, your options, the pros and cons and comparisons in mind, YOU decide. All the time. Nearly every day. Why should it be any different for health and healthcare decisions? It shouldn’t.

Though it may not always feel like it, YOU DO have options.

YOUget to choose your doctor.

YOU

get to choose and invest in preventive strategies.

YOU

get to determine a treatment plan when necessary.

YOU get to determine what kind of

insurance (comprehensive vs. catastrophic for example) you

will purchase.

YOUget to determine what you

are willing to spend.

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Continue to Step 2“Get Copies of Your Health Data”

of the time




TIPS FOR KICK STARTING Your Consumer Mindset!

No one knows more about you than you. But, trying to recall every test, every lab result, every medication or even every surgery one has had becomes impossible for most people. Yet, detailed medical history and health information is crucial to sound healthcare decision-making. Sometimes those good decisions – like avoiding needless, duplicate tests or scans – save you money.

Collecting and archiving your own personal health data is important, but what about your children? Or, more problematic for many of us, what about your parents? How much do you know about their doctor visits, chronic conditions, and medications? On an even more frightening note, how much do you think your parents know (and remember) about their health data?

UNDERSTAND WHY THIS IS IMPORTANT. It’s always good to start with “why” you should have copies of all your healthcare data.

• To ensure there is a complete record. -You simply cannot trust that your physician(s) and specialists have all of your most current health data. Neither can you fully expect that they have visibility to your full health history, which may be important when considering treatment plans. You simply cannot assume that everything is “in there”.

• To ensure there is an up-to-date, accurate record. -Sometimes information is entered into your clinical and other records incorrectly. Sometimes information is left out altogether. And sometimes things just fall through the cracks. Nobody’s perfect. Everyone is human.

Insist on gathering all of yourown records. Healthcare providers are not perfectwhen sharing records witheach other on your behalf.

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• To ensure constant visibility. -The only way to make sure you have access to ALL of your health data – all day, every day – is to have it in your hands and under your control.

• To ensure a doctor has the latest, relevant health information right at the time of a medical visit or appointment. -This is especially true in the case of an unexpected trip to a doctor when you’re out of town, an emergency room visit, or an urgent care visit.

• To ensure that a new doctor, new specialist, or second opinion doctor has all the data she needs. -Things change. Doctors change. A new doctor will request medical information from your previous doctor but that takes time. (And we’ve already established that the completeness and accuracy of the data might possibly be a little suspect anyway.)

• To ensure that you have the data you need to better understand a medical condition. –This is especially true for people with multiple chronic conditions. The status or “progression” of a condition often correlates with the results of blood tests or other types of tests. In other words, numbers mean something. Armed with your rich health data, you may decide to learn more about your condition through research. This often this leads to more actively monitoring and managing your health.

• To ensure that whoever you want to see your health data can do so at any time you decide. You own it. You paid for it. Show it to whomever you like for whatever reason.

2www.healthscient.com/fivestepstobetterhealthcare.pdf


You should grant access to your health data to whoever you wish, and whenever you want to. It’s Your Data!

Your personal health data is vital for good decisionmaking. As a consumer, insist that your primary care physician, specialists, and healthcare system give you constant visibility to your data. Archive it for sharing as you find appropriate. After all, you paid for it. You own it.

FIVE STEPS to Better Healthcare at Lower Cost | Step Two

Get Copies ofYour Health Data.

Step

KNOW WHAT KINDS OF HEALTH DATA TO KEEP TRACK OF.When it comes to getting copies and archiving your health data, more is better. But, you want to make sure you are at least keeping up with these kinds of things.

List of chronic conditions. This would include anything you are currently seeing a doctor for on a regular basis. Make a note of when you were diagnosed with the condition and any major related milestones.

Medication list. Be sure to list all prescribed medications as well as any over the counter medicine or supplements you may be taking. Make note of any new or recently prescribed medication. Make note of any medications you have stopped taking in the last 6 months. Make note of any medications to which you are allergic or that have been problematic for any reason.

Lab results. More specifically, the results from blood and urine testing are important. Having a chronological series of test results is helpful in identifying trends. These reports may be the most valuable of all. Be diligent. Ask the lab technician and/or your doctor for the actual report – not just a summary or readout. Numbers mean something. Know them.

Radiology and imaging results. This includes things like x-rays, ultrasounds, CT scans, or MRI’s. Get a copy of the test from the provider – don’t simply rely on it being uploaded to your Electronic Health Record, Electronic Medical Record, Personal Health Record, or patient portal. A big advantage of having copies of these tests is the ability to better prevent duplicate tests from being ordered.

Other medical diagnostic reports. This includes things like EKG’s, echocardiograms, or any other special heart imaging tests. Also be sure to have copies of coronary artery disease tests like the treadmill test and catheterization reports. Include things like pulmonary function tests, neuropsychology evaluations, and all biopsy or pathology reports. Any diagnostic report related to the management of a current chronic condition is important. So, pretty much the kitchen sink.

Hospital and emergency room reports. Do your best to get a copy of the narrative reports clinicians create when a person comes into the emergency room or is hospitalized. These reports are intended to be read by other doctors (not the same as patient discharge instructions – that’s pretty watered down.) You might have to file a medical records request to get a copy of these types of reports. Emergency room clinical notes, hospital admission history, physical notes done by the admitting doctor, and clinical hospital discharge summaries are particularly useful.

Clinical visit notes. These notes come from visits to your primary care doctor and other specialists. There is little need to keep the notes for longer than the last 5 visits.

List of involved clinicians. Keep an up-to-date list of the doctors and providers you regularly see. This list might include your primary care provider, specialists such as your cardiologist, pulmonologist, urologist, neurologist and so on, plus behavioral clinicians and medical therapists.

Advance directives. Not exactly in the realm of health data, but be sure to have a copy of any advance directives like a living will, pre-hospital DNR, or some type of physician orders for life-sustaining treatment (POLST).

Save the documents you need to read. And, keep related deep medical and science data available so other doctors can refer.



what to keep

FIVE STEPS to Better Healthcare at Lower Cost | Step Two

BE HABITUAL AND PERSISTENT ABOUT COLLECTING AND UPDATING THIS DATA.Begin with the understanding that the health data you might like to track and archive may not automatically appear or be made available to you. You will have to be habitual and persistent in collecting it.

• Get into the habit of asking, “How do I get a copy of the results for my personal records?” Next, “Will that be hard copy, electronic, or both?” Then finally, “When should I expect to receive it?” Ask before the test is administered. It may be that it becomes part of the “order” or may be noted on the paperwork. Regardless, get into the habit of asking. Every blood work lab. Every image. Every diagnostic test. Every hospital, emergency room, or urgent care visit. Every clinic visit. Every time. Ask. You may have to submit a request in writing, you may have to pay a fee in some cases, or you may have to sit with a physician so that he can explain the findings. You may have to follow up once or twice. Whatever it takes, get a copy.

• If applicable, access your patient portal provided by your doctor. Check the information for accuracy (remember, we’re all human). Most of them have “print” options available. Print a copy of your data just in case.

• Keep your medication, chronic conditions, and clinician lists current and up-to-date. Be sure to include as much information as possible – especially dates.

• Keep your advance directives information current and up-to-date. You may want to use one of the many free advance directive forms available online. AARP offers forms by state at https://www.aarp.org/caregiving/financial-legal/free-printable-advance-directives/

DETERMINE THE WAY TO ARCHIVE YOUR HEALTH DATA THAT SUITS YOU BEST.There is no right or wrong way to organize and archive your health data. Regardless of your method, ask yourself:

1. How easy is it to take the information to a doctor’s visit? This is especially important for people who see more than one doctor or healthcare provider.

2. How secure is the information? How much do you care about security of your personal health data? Encryption is common for online health information storage services, but encryption of data on your personal computer takes some effort.

3. How easy is it to access and update the data? If it’s not easy, it’s less likely to be done. Again, we’re all human.

4. How easy is it to share the information with others? There will be times when you need or want to share your data with healthcare providers, family members, or caregivers.

WITH ALL OF THAT SAID, YOU MAY WANT TO CONSIDER:

• A paper binder. The tried and true. Though it may seem overly simple, it meets the criteria. On the downside, it can be lost or destroyed and copies of the data (in the hands of family members for example) can’t be easily updated. And, of course, the data is not “sortable or searchable” the way digital tools may be.

• Home computer digital document storage tools. There are lots of ways to scan, file, and store documents on your home computer. These files are easily updated and easily shared with others. Remember to think about security.

• Online health record and health data tracking products. A quick Internet search will lead you to a number of options. Some are free. Most are not. Most allow for easy sharing and security is normally strong.

• Consider using a combination of tools.Something paper plus a digital backup – or vice versa.

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GET IN THE HABIT OF ASKING:

How do I get a copy of the results for my personal records?

Will that be hard copy, electronic, or both?

When should I expect to receive it?


www.healthscient.com/fivestepstobetterhealthcare.pdfFIVE STEPS to Better Healthcare at Lower Cost | Step Two

As a Slight Aside … Try Keeping a Health Journal.

The thought of journaling is exciting and engaging to many. To others, it sounds awful. But keeping a health journal is a good idea for several reasons. Here’s what you should aim to do with your personal health journal:

• List symptoms or events that worry you so you can remember to ask your doctor about them. A journal allows you to make note of these symptoms or events as they happen. Infrequent or irregular symptoms are often forgotten during doctor visits. Think about things like sleep problems, knots or bumps that appear and disappear, moles or skin irregularities you’ve noticed at some point, fatigue, pain, and the like.

• List questions or concerns you want to remember to ask your doctor about. It could be about some of the things above or you may have questions about things like nutrition or diagnostic tests or screenings you are considering.

• Take notes during your doctor’s visit. We’ve all gotten home and struggled to remember every detail of what our doctors say to us. Write it down and there will be no confusion.

Again, a combination of paper and digital tools is probably best for health journaling. The key is to make sure it’s portable or accessible.

To get the ball rolling, create and archive your current medication list. Remember to include any over the counter medications you are taking as well as any supplements on your list. Why is a current, up-to-date medication list important?

• This information is important because it’s critical for your doctor to have in order to help make the best treatment decisions for your symptoms or conditions.

• It could be that that your symptoms or conditions are actually being caused by your medications. This is especially true when there are multiple prescribers with little or no visibility to each other.

• Medication lists maintained by doctors’ offices are quite often incomplete or out-of-date. There is a reason they ask you to bring your current medication list to every single appointment (annoying though it may be)!

The goal is to create and archive a list that is easy to update and easy to share with those who need to see it. You may choose to use a simple Microsoft Word document or spreadsheet. You may choose to use one of the many medication apps for smartphones and tablets. Or, you may choose to use good old pen and paper (believe it or not, the pen and paper route is often the most difficult to keep neatly updated). Regardless of your chosen methodology, just do it. Take the first step to having a copy of your health data.

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Continue to Step 3“Partner with a Doctor Who Cares About You”

To get the ball rolling, create and archive your current medications.

List questions and/or concerns

you want to remember to ask

your doctor about.


www.healthscient.com/fivestepstobetterhealthcare.pdfFIVE STEPS to Better Healthcare at Lower Cost | Step Two

TIPS FOR KICK STARTING Your Health Data Tracking!

The operative words are Partner and You! Together, you and your primary care physician should work proactively and collaboratively for your optimum health and wellness in order to avoid medical issues. Improved health and wellness means reduced need for healthcare and considerable cost savings over time.

START BY REMEMBERING YOUR VISION OF YOUR FUTURE SELF AND YOUR REALISTIC HEALTH GOALS.It’s worth revisiting. Remember, as a healthcare consumer, this is about YOU.

• What do YOU want to be able to experience?• What do YOU want your life to be or to mean?• In what would YOU like to be able to

participate?• What would YOU like to be able to contribute

to the world? To YOUR family?• What would YOU like to be rid of?• What do YOU want to look like?• What do YOU hope to feel like?• What would YOU like to be able to physically

accomplish?• What do YOU NOT want to worry about?

And perhaps most importantly• What smart, realistic goals have YOU set –

what decisions about YOUR health have YOU made – to get YOU there?

UNDERSTAND THE REALITIES FACING A TYPICAL PRIMARY CARE PHYSICIAN.While it remains true that this journey is (mostly) about you and your healthcare decisions, you need a primary care physician

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with the expertise to assist you with any medical problems that arise. To make informed choices about the right doctor for you, it’s important to have a little insight into the reality of a typical primary care physician navigating the US healthcare universe.

3


www.healthscient.com/fivestepstobetterhealthcare.pdfFIVE STEPS to Better Healthcare at Lower Cost | Step Three

Partner with a DoctorWho Cares About You.

Find a physician whose mission is to help you stay healthy and avoid medical issues rather than to merely medicate you. Your physician should be willing to spend time with you and be accessible to you whenever you need her. Your best bet?Find a Direct Primary Care or Concierge physician.

Step

To make informed choices about the right doctor for you,

it’s important to have a little insight into the reality

of a typical primary care physician navigating the US healthcare universe.

• They often carry hundreds of thousands of dollars of medical school debt into their 40’s or 50’s.

• They have to carry a patient load of between 2000-3000 clients to simply make the economics of their practice work.

• As such, they have to see between 20 and 30 patients per day in about 10 minute increments.

• It takes about 13 minutes per patient to simply complete the insurance billing and administrative paperwork. That costs real money.

• On average, 30 percent of appointments are no-shows.

• On top of it all, as high as 50 percent of patients with at least one chronic illness do not adhere to prescribed treatment plans.

It’s no wonder that primary care physicians are experiencing burnout in record numbers, that fewer and fewer medical school graduates are opting for careers in primary care, that there is real concern about the emerging primary care physician shortage, and that a growing number of them are looking for a way out. Not to mention, physicians have families and interests outside of work just like we all do. They are altogether human.

PRIORITIZE THE THINGS THAT ARE IMPORTANT TO YOU IN A PRIMARY CARE PHYSICIAN.Remember your health goals. Keep the realities of the US healthcare system in mind. Think back on both the satisfactory and the frustrating experiences you’ve had. Consider your current health and any chronic conditions from which you suffer. Think about your bank account.

What’s important to you? Consider things like:

• Access – How long does it take to get an appointment? How often do you speak directly to your doctor? What about after hours?

• Face time – How much time do you actually spend with your doctor during appointments?

• Proximity – How convenient is their office location? Will your doctor come to you?

• Money – Does your doctor work with you to lower your costs? Does their practice model make financial sense to you?

• Technology – Does your doctor utilize technology to augment access? Does your doctor use telehealth tools – like live chat e-visits or remote patient monitoring – to help keep you from having to come in to the clinic?

• Care coordination – Does your doctor work on your behalf to organize the care of specialists?

• Communication – Does your doctor communicate well with you? Is the communication timely? Is there consistent follow-up?

• Familiarity – Does your doctor know you and know what you are trying to accomplish?

Do you feel like a number? An inconvenience? A name on a chart?

• Proactivity – Does your doctor proactively work with you to help you avoid medical issues? How involved is your doctor in helping you make good, day-to-day health decisions and lifestyle choices? How about nutritionists or fitness experts?

• Approach – Does your doctor include holistic, integrative or functional medical practices? Is your doctor willing to think outside the box?

• Insurance – Does your doctor handle the insurance hassle for you? Is there a way

to escape the hassle (and expense) and lower your overall costs?

• Medical expertise – How confident are you that your doctor is managing your chronic conditions in the best possible ways?



Physicians have families and interests outside of work just like we all do.

You owe it to yourself to look into it. Remember, regardless of how you vision your (not too distant) future self, your health is your most important asset.

TIPS FOR KICK STARTING Your Primary Care Physician Assessment.

• With your prioritized list of things that are important to you in a primary care physician in hand, assess your current doctor objectively and honestly. Review each item in your list and give each a thumbs up or thumbs down. How can your current doctor be better?

• Regardless of how your current physician stacks up against your priorities, research Direct Primary Care and Concierge physicians in your area. Ask your friends. Do a Google search. Peruse their websites. Pick at least one that piques your interest and contact them. Schedule a time for a consult. Be honest with them that you are simply researching possibilities (unless you’ve decided by this point to make a move!) and would like to learn more. Give it a shot. There is nothing to lose and potentially quite a lot to gain.

Do some research onDirect Primary Care and Concierge physicians in your area today!

Continue to Step 4“Understand Your Health and Make Improvements.”

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STRONGLY CONSIDER PARTNERING WITH A DIRECT PRIMARY CARE OR CONCIERGE PHYSICIAN FOR YOUR PRIMARY CARE.In all likelihood, you already have a primary care physician and the thought of changing doctors is a little terrifying. There is no need to change a winning game plan, but are you really winning when it comes to your healthcare? Are you sure? How do you know? Of course, Direct Primary Care and Concierge practices vary, but let’s consider the above list again. In most cases, you can expect:

• Access – Same day or next day appointments. 24/7 access via cell phone. Both carry patient loads in the 300-600 per doctor range instead of the 2000-3000 patients per doctor typical of traditional primary care models.

• Face time – Average face time is 30-45 minutes per appointment. No rush. More time if you need it.

• Proximity – There are fewer of them, but their numbers are growing rapidly. Many make house calls.

• Money – Both are subscription or membership-based. Direct Primary Care is intently focused on lowering costs. Concierge tends to focus on exclusive service. Neither sacrifices excellent medical attention.

• Technology – Both strive to keep you well and out of the clinic. Both often use technology to expand and enable care outside their walls.

• Care coordination – Excellent care coordination is typically a hallmark of DPC and Concierge practices.

• Communication – Fewer patients and lesser administrative requirements usually results in more complete and timely communication.

• Familiarity – Direct Primary Care and Concierge doctors know you well and how best to care for you (all things considered).

• Proactivity – Both will customarily be as involved as you will allow them to be.

• Approach – Many tend to be more holistic and integrative in nature. They like solving medical problems – it’s why they got into medicine to begin with.

• Insurance – Some take insurance (usually Concierge) and some don’t (usually DPC). Don’t let that throw you. It may be that you don’t need as much insurance as you think.

• Medical expertise – It’s a given.

NOTE: Make sure you understand the financial model. Ask questions about what

to do with your current insurance plan. Should it change? What would the doctor suggest? For most of us, the money is an emotional trigger and a fiscal reality.



4The healthcare consumer marketplace is swelling with ever-evolving and continually improving devices, wearables, and sensors. Health screening and diagnostic testing is becoming more and more accessible and affordable. Trackers and monitors are becoming smarter, more accurate, and dependable. Even genetic sequencing and biomarker tracing (biomarkers are either traceable substances introduced into the body to examine organ function or a substance in the body whose detection indicates something may be wrong) are now within reach of the healthcare consumer. Prevention, detection, monitoring, and control are more readily available than ever before. Take advantage!BEGIN WITH THESE THINGS IN MIND. THEY’RE IMPORTANT.

• Your health goals – by this time, you have them firmly in mind. Don’t lose sight of them.

• Your chronic conditions – fully understand all you can about your chronic conditions. These may include things like diabetes, high blood pressure, cholesterol, depression, or obesity. They may also include things such as heart disease, COPD, or cancer.

• Your family health history – you’ve had to provide that information on form after form. It’s important data because it offers insight into potential trouble spots. Some conditions are hereditary. Other diseases or illnesses in your family history may be attributable to environmental factors, such as where you lived or what you ate and drank. • Your age-related likelihoods – as you grow older, the likelihood of certain diseases,

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illnesses, or conditions may increase. These may include things like heart disease, weight gain, immune system degeneration, various cancers, and bone health to name a few. You can’t stay young forever but you CAN extend your more youthful health!DEVELOP A STRATEGY. CHART A PATH.With these things in mind, make a list of the things you think you should keep track of and the things you should keep an eye out for. Talk with your doctor about your list. Ask about what you can do – behaviorally, nutritionally, and habitually – in terms of prevention or condition control. Ask about the types of tests, screens, and diagnostics available to monitor the things you have listed. Ask about the recommended frequency of testing.



Understand Your Healthand Make Improvements.

Wearables like fitness trackers and sensors are improving every day. Diagnostic testing is becoming more accessible and affordable by the minute. Don’t be afraid to leverage these new developments to improve your health! The way to improve your health is to know it. Knowledge is power.

Step

FIVE STEPS to Better Healthcare at Lower Cost | Step Four

The importance of this cannot be overstated. Research and understand your options. Remember that your doctor (unless you have a Direct Primary Care or Concierge physician) is often entrapped by a payer-driven system where the payer determines what, when, and how often they will reimburse. Health insurance may not pay for newer tests and sometimes paying cash for tests can be cheaper than copays. The point: don’t let the system (necessarily) make your decisions regarding diagnostic tests and screens for you. Service providers frequently have self-pay/cash up-front prices that are affordable - especially with a little pre-planning.

So, develop a strategy. Chart a path. Keep track.

TAKE ADVANTAGE OF DIAGNOSTIC TESTS AND SCREENS AVAILABLE TO YOUR COMMUNITY.Various community partners will frequently offer an assortment of tests, screens, or assessments to members of the community. These will range from simple to more in-depth and sophisticated, and from free to low-cost. They may be offered by a municipality, a community doctor or hospital, or a charitable or faith-based group. Some examples are:

• A community hospital that offers a free blood sugar or cholesterol testing event to promote community health.

• A municipality or faith-based-organization-sponsored-health fair with various tests, screens, or assessments offered.

• A local doctor offering a specific test or screen, such as thermography to detect pre-cancerous conditions in the breast.

Simply put, pay attention. If the offer is pertinent to one of the things on your list – or pertinent to something that you’ve become a little concerned about - take advantage.

EMBRACE THE TRACKERS AND SENSORS BOOM.

A major component of good health resulting in lower costs is prevention. Prevention is mostly a function of discipline. Pay attention to physical activity and common sense nutrition and consistently monitor chronic condition indicators. Trackers help enable good diet and exercise habits. Various sensors now appearing in the healthcare consumer marketplace are making it easier than ever to monitor chronic conditions or areas of concern.

Fitness Trackers: More and more trackers with increasingly advanced functionality are bursting on the scene. We’ve come a long way since the days of mere steps counting – though counting steps remains an excellent place to start! Tracker features like heart rate monitoring and GPS capabilities are becoming quite common. Become familiar with the tracking capability of what you already own. All smart phones and smart watches (Apple Watch, LG Watch Style, Samsung Gear Sport, Fitbit Ionic to name a few) have robust fitness tracking features. Some common, well-regarded tracker manufacturers include: Moov Now, Samsung, Huawei Band, TomTom, Amazfit, Garmin, Fitbit and Polar.

Food and Nutrition Tracker Apps: Just like with fitness trackers, there are many options for food and nutrition tracking apps. Some of the more popular ones seem to be: Weight Watchers, MyFitnessPal, LoseIt, SparkPeople, CRON-O-Meter, FatSecret, MyNetDiary, FoodVisor, Fooducate, and Noom.

Sensors and Monitors: While current capabilities and product offerings in the sensors and monitors market are robust, they may pale in comparison to what’s coming! There are numerous heart rate monitoring devices on the market – from those you wear on your wrist to those you strap around your chest. EKG sensors for your smartphone are available and affordable. Glucose monitoring smart watches and bands abound. Keep an eye out for skin patch sensors, contact lens sensors, tooth sensors, and even sensors that you swallow. They are all developing fast and will be incredibly helpful in monitoring – thus, controlling – chronic conditions and areas of concern.

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Don’t stop with your doctor though.

Research by other means as well. Use the

Internet. Ask your friends. Consider

integrative, holistic, or functional medicine

possibilities. Be an informed consumer.


www.healthscient.com/fivestepstobetterhealthcare.pdfFIVE STEPS to Better Healthcare at Lower Cost | Step Four

Tracking your health will give you a view into how things are going - beyond your symptoms and moods. Plus, you may find yourself more encouraged to keep up with your healthy habits and actions.

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CONSIDER GENETIC TESTING.Like so many things in the healthcare consumer marketplace, genetic testing is becoming increasingly common and affordable. More notably (and predictably), the bank of knowledge of how to interpret and use the test results to a patient’s benefit has developed remarkably. That’s a big deal. What once seemed like science fiction – or at least out of reach – is now quite conventional. As humans, we have 46 chromosomes which contain around 20,000 genes inherited from our parents. Genes are made up of DNA. The structure of our genes (genetic coding) determines how our bodies regulate, grow, and react. When genes are normal, everything is fine. Abnormal or damaged genes (mutated), however, can lead to disease or can increase one’s susceptibility of disease. Some mutations are hereditary, but a greater percentage happens by chance. Our genetic code also determines how our bodies respond (or don’t respond) to medications. Genetic testing looks at your genes to determine if any mutations or abnormalities exist and to discern what may be done about it. The test is done using blood, saliva, or body tissue.

You may want to consider genetic testing:• To diagnose a disease or a type of disease.• To determine the cause of a disease.• To determine the best treatment options for a disease or condition.• To determine the risk of getting a certain disease that could possibly

be prevented.• To determine how best to minimize the impact of a disease.• To determine the risk of passing a disease to your children.

It is important to remember that a positive test (abnormalities or mutations detected) means that you have an increased risk for a particular disease but it does not guarantee you will actually develop the disease. It does mean, however, that you could pass the mutation to your children. Conversely, a negative test (no abnormality or mutation detected) means that you have a low risk for a particular disease but does not fully guarantee that the disease will not develop.

As with most things, there are pros and cons to genetic testing. On the plus side:

• You might be less worried about getting a certain disease.• You might be able to change your lifestyle to reduce your risk.• You might know how to move forward with family planning.• You might be able to get treatment to prevent the disease – or

greatly diminish its impact.• You might be able to determine which medications will be most

effective in controlling a disease.

The minuses tend to be mostly emotional. These may include:

• You may worry more than normal about getting a particular disease.• You may experience feelings of anger, bitterness, guilt, or depression.

Only you can decide what’s right for you but – on paper at least – the pros outweigh the cons.



TIPS FOR KICK STARTING Understanding and Improving Your Health.

Get serious about prevention if you’re not already.

• Download a diet and nutrition app (choose a free one or a free version of one) and commit to tracking your diet and consumption for one week. See how it goes and determine where you want to go from there. Remember your health goals. So much of your health is impacted (positively and negatively!) by diet.Remember that an ounce of prevention is worth a pound of cure. An ounce of prevention not only leads to a healthier you, it also leads to real cost savings. While you’re at it, exercise appropriately and regularly.

• Research the genetic testing options in your area. Costs will vary widely – between $200 and $2000. Check several options. Understand the comprehensiveness of the test (23andMe or Ancestry.com, for example, is not what we’re talking about here!). Determine if your insurance plan covers the test. But as always, also ask the provider what your upfront, out of pocket cost would be in order to compare. It may be less expensive than your copay. Doesn’t hurt to ask, right?

page 14 of 18

Continue to Step 4“Spend on Care. Not on Coverage.”

A WORD ABOUT PRECISION OR PERSONALIZED MEDICINE.

Precision medicine, sometimes called personalized medicine, tailors medical treatments, decisions, interventions, and products to a specific individual based on his or her particular biology. Both genetics and environmental factors are considered when tailoring care. Precision medicine is the polar opposite of the common practice of “standardized care,” which is determined by averaging treatment responses across large cohorts of people. Precision medicine seems to be an organically growing and developing philosophy of care made possible by the vast increase in knowledge of the human genome and significant technologocal improvement in the ability to gather and share genome data. That’s good news for the healthcare consumer.

An ounce of prevention not only leads to a healthier you, it also leads to real cost savings.



5

page 15 of 18

• Health insurance companies are middlemen. Simply stated, you pay them and they pay your doctor. But their revenue model requires them to collect more money than it costs them to reimburse providers. Administrative costs are mind-boggling. Health insurance companies have overhead like any other business. And, many of the largest insurance companies are for-profit entities, meaning they exist to make a profit.

• Everyone who can access and afford it should have some major medical or catastrophic medical insurance at least. Everyone.

• Your personal circumstances, financial picture, health conditions, and health goals should drive your decisions. One size does not fit all. You are a consumer with options and choices.

• Realism and pragmatism are important. Being overly optimistic serves no purpose, but neither does medical paranoia nor an overactive fear of what could possibly happen.

• Math is involved. Math is more important than fear.

• The pathway toward aligning your health insurance (or the shedding of it) with your personal needs can be long and winding. It takes effort and, perhaps, a little time. Hang in there. Do the work.

This is where the rubber meets the road for many of us. We fear finding ourselves in the middle of a serious health issue without the means to get the treatment we need. That fear is real. It causes us to often over-insure or to live with a constant, low-grade anxiety. Many of us are more anxious about healthcare costs than we are about being sick. Money is the emotional trigger in healthcare. Our goals should be better health, lowest possible costs, and peace of mind. Remember, not all returns are immediate. Better health means lower costs over the long arc. You may or may not need to spend a little more now to save a lot later.START BY REMINDING YOURSELF OF SOME IMPORTANT TRUTHS. THINK MINDSET.

• Health insurance is NOT healthcare. Healthcare can make and keep you well. Health insurance cannot.



Spend on Care. Not on Coverage.

Health insurance isn’t healthcare. Be sure to spend your money on care that will improve your health. Embrace preventive care to avoid expensive healthcare occurrences. Consider replacing your comprehensive insurance plan with hospitalization and catastrophic coverage (or a medical cost sharing plan). Insurance is to cover major medical issues - not allergies, the flu, and your annual physical.

Step

FIVE STEPS to Better Healthcare at Lower Cost | Step Five

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• Things change. Insurance plans and offerings change. Other products – like medical cost sharing plans – come and go on the market. Different medical practice models emerge (like Direct Primary Care). Financial circumstances change. People age. Health conditions change and some conditions become chronic. What you decide is best for today doesn’t mean you’ve decided for the rest of time. You can (and should) adjust periodically. Nothing is stopping you from that.

Conduct an assessment to better understand

your needs and possibilities.• How many times do you (and the people

whose healthcare expenses you are responsible for) actually go to a doctor on an annual basis? And for what reasons?

• What chronic conditions are you managing? What do they cost you annually?

• What medications are an ongoing must?• Do you need the amount of health insurance

coverage you currently have and are paying for?• What kind of options do you have available to

you? (Examples include Bronze, Silver, Gold Exchange plans, medical cost sharing plans, or employer subsidized coverage options)

• Is it possible to lessen your coverage (perhaps major medical or catastrophic only) and do something else with the savings? Could you put the cost savings (or some portion of it) in a personal medical savings account to fund out of pocket medical expenses or to fund a Direct Primary Care or Concierge membership?

• How old are you? What does your family medical history reveal? If you have done genetic testing, what did the test reveal? Is genetic testing something you should consider? How faithful are you at monitoring your overall health? Do you have an annual physical? What does all that tell you about what you can realistically expect health-wise in the immediate or not too distant future?

• How willing, able, and disciplined are you to take preventive measures such as regular exercise and nutrition control?

• What about your primary care physician? (How did the assessment in Step Three come out?) Are you willing to make a change? Are there Direct Primary Care or Concierge membership practices in your area?

WHICH APPLIES TO YOU? When thinking about how to spend on care

rather than on coverage, remember that there is no “right answer” that can be universally applied. There is a “most reasonably right answer” for YOU. At least, for right now. The best advice may simply be to get in the habit of assessing your needs, understanding your options, and then making informed, consumer-centric decisions. Fair warning, it takes effort. Start where you are and go from there.

IF YOU ARE:Covered by Medicare – It’s probably best to change

nothing at the moment. If you are a Medicare patient considering Direct Primary Care or Concierge practices (which we strongly encourage you to do), ask the practice how Medicare comes in to play. It varies from practice to practice. Stay informed on changes to Medicare. Things are always changing.

Covered by Employer Provided Health Insurance(Completely or Highly Subsidized) - If you pay

nothing to very little for health insurance provided by your employer, it’s probably best to change nothing at the moment. Simply make sure you understand your coverage relative to your health conditions and goals. You may still consider engaging Direct Primary Care or Concierge practices. More personalized, attentive care often results in better health overall. Ask them – and fully understand – how the money works.

Covered by Employer Provided Health Insurance (Not Highly Subsidized) – If you have an employer

provided plan with a high deductible (high deductibles serve to make the plans more affordable) for which you pay a good chunk of your earnings, do some research (and some math!). With what you’ve learned from the needs and possibilities assessment, do you need this plan? Do you have options? Is it possible that a high deductible, catastrophic, or major medical plan (usually less expensive) will work for you and your family? Would being under the care of a Direct Primary Care physician – even with the monthly fee – make a difference? All things considered, would it make sense to opt out of your employer-provided health insurance and shop for something in the private sector? Are you able to purchase a plan to cover catastrophic occurrences while putting a little money aside each month to cover any out of pocket medical expenses? What is financially possible, provides the best chance of good health and well-being, and gives you peace of mind?


www.healthscient.com/fivestepstobetterhealthcare.pdfFIVE STEPS to Better Healthcare at Lower Cost | Step Five

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Medicaid Recipients – Qualifications and available funding varies by state. You will have to do some digging here. Are you eligible? Are your children? Will this funding help you achieve better health at lower cost? The Centers for Medicare and Medicaid Services (CMS) is the federal government agency that oversees Medicaid in conjunction with your state. Be ready for the bureaucracy.

Self-insured, Pay Your Own Way (Government) – If you are in this category, you are likely already aware of the Affordable Care Act / Obamacare and the HealthCare.gov website. We often hear the horror stories of people trying to interact with the site in order to purchase health insurance. But, the website is actually quite thorough and helpful. The enrollment period is when chaos breaks out and systems crash!

• Do your homework ahead of time. Don’t wait until enrollment period. Take advantage of the resources there. Plan ahead.

• Do not automatically gravitate to the highest “metal level” you can afford. It very well may be that the Bronze Plan, all things considered, makes more sense for you than the Gold Plan even though you may be able to afford the Gold. Keep the results of your needs and possibilities assessment at the forefront of your decision-making.

• Remember that health insurance is NOT healthcare. What are you willing to do in

order to improve and maintain the best health possible? What habits will you establish?

Can a Direct Primary Care practice model help you? Likely so.

Self-insured, Pay Your Own Way (Cost Sharing Plans) – While NOT health insurance, a medical cost sharing plan may be an option for you. Many, but not all, are faith-based. Members contribute monthly. The money collected from members is escrowed, managed, and dispersed when members access various medical or healthcare services. The popularity of these plans is on the rise and worthy of consideration. Do an internet search. Make some calls. Be a consumer.

Uninsured - Whether by choice or by necessity, being uninsured makes it all the more necessary to commit to better health. In every way possible, be preventive. It may be that health insurance is out of your reach (or that you opt NOT to reach for it) but a Direct Primary Care monthly fee is within reach. Good health is not dependent on health insurance.

Your employer is not responsible for your healthcare. You are.



A SIDE NOTE ABOUT EMPLOYER-PROVIDED HEALTH INSURANCE

To be clear, your employer is not

your enemy. But they are also

not responsible for your health

and healthcare. You are. Your

employer is a business whose

goal is to stay solvent, or to

operate profitably. Health

insurance is a quagmire for them

as well. As a result, employers

seek to offer the least amount of

health insurance possible that

will allow them to attract and

retain employees at the lowest

possible cost to the organization.

Keep this in mind.


TIPS FOR KICK STARTING

Your Spending Plan

• Commit this year to preparing for your health insurance enrollment period well ahead of time. Do the research and know your options. An Open Enrollment Survey conducted by Aflac (2016 report) shows

that 80% of employees spend less than one hour researching their plan options, with 57% spending less than 30 minutes. 93% of employees simply choose the same benefits year after year with little or no

research. Commit this year to being an informed consumer.

• Start with an internet search using “tips for comparing health insurance options” or “tips for choosing the right health insurance plan” as the search terms. Have your plan documents in front of you and read them carefully. Make a list of questions you need to have answered. Access any available resources offered by your insurance company. Check their website. Call them. If you purchase health insurance through an employer, speak with the Human Resource person to see how she can help you prepare.

• Researching and understanding your plan options and coverage can be daunting. Be diligent, but don’t be discouraged! Remember why you're doing this. "Pay for care, not coverage." Don't settle for the status quo. Challenge the norm. In your current stage of life - and at your current health - what coverage do you actually need?

Even if you don’t make a change, we believe you’ll find comfort in understanding more about your options.



Visit Our Website:

Healthscient.com Keep yourself up-to-date on the most

important changes and trends in healthcare by visiting our website, www.healthscient.com

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SUMMARY CONSIDERATIONS

80%spend less than

an hour

93%choose same

benefits


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