healthy mind healthy body - oxhpcardiovascular disease (cvd) is a broad all-encompassing term for a...
TRANSCRIPT
MS-06-137
healthy mindhealthy body
SPRING 2006 YOUR OXFORD® GUIDE TO LIVING WELL
What are allergies?Healthy Bonus® updateCocoa is hot!
Heart disease:
the good news
Did you know?Sometime in the future, functional fashion may take on a whole
new meaning. Researchers are exploring the use of ordinary-looking
“smart”clothing to deliver medications for some chronic
conditions. Based on technology similar to nicotine and contraceptive
patches, specially formulated fabric worn next to the skin will release
appropriate medications. Other possibilities include clothes equipped
with computer chips that monitor insulin levels, heart rate and other
vital signs. One promising application is infant sleepwear that sounds
an alarm when a baby’s altered heart rate or breathing signals a possible
crisis such as sudden infant death syndrome. O
As of October 1, 2005, 99.9 percent of primarycare physicians (PCPs) participating in Oxford’s network
in the tri-state service area (New York, New Jersey and Connecticut)
are either board certified or board eligible (85.4 percent board certified
and 14.5 percent board eligible). In addition, 99.8 percent ofspecialists in Oxford’s tri-state network are either board certified
or board eligible (82.5 percent board certified and 17.3 percent board
eligible). Board certification is the medical profession’s formal
recognition of a physician’s advanced expertise in a medical specialty
or subspecialty (e.g., pediatrics, neurology, dermatology, orthopedics).
To earn this certification, a physician must complete extensive additional training in an accredited, university-
affiliated postgraduate program and pass comprehensive examinations in his or her chosen specialty.
Board eligible physicians have five years in which to complete the board certification process. O
Gout, once thought to be the disease of kings and princes, is actually a
specialized form of inflammatory arthritis whose
incidence has doubled in the last 35 years. Gout causes inflammation
and pain in joints. In reality, gout shows little class distinction, although
it is more commonly found in men, especially those who are overweight,
eat lots of meat and fish and drink alcohol in excess — circumstances
once reserved for the wealthy that are more prevalent today. O
healthy mindhealthy body
SPRING 2006 YOUR OXFORD® GUIDE TO LIVING WELL
CEO, Northeast Region Mike TurpinChief Medical Officer and EVP Alan M. Muney, MD, MHAVice President, Marketing Chuck GreenVice President, Marketing Communications Rebecca MadsenMarketing Manager Tracy KerznerCopy Editor Starlet ColemanEditor Justin Colby
Healthy Mind Healthy Body® is published exclusively for Oxford Health Plans by:Onward Publishing, Inc.10 Lewis Road, Northport, NY 11768Phone 631-757-3030
Publisher Jeffrey BaraschCreative Director Melissa BaraschEditorial Director Wendy MurphyArt Director Bruce McGowinDesigner Lisanne SchnellAssociate Creative Director Tamyra ZieranProject Director Bret BaraschBusiness Manager Liz Lynch
Oxford Health Plans, LLC and Onward Publishing, Inc., are not responsible for typographical errors.
This magazine provides general health information and, as such, is neither intended to replace the advice of yourphysician nor to imply coverage of referenced treatments or medications. Please consult with your physician regarding any treatment or medication that could impactyour health before proceeding with it, and refer to your benefit documents for specific coverage information.
© 2006 Onward Publishing, Inc. All rights reserved.
C O V E R S T O R Y
Heart disease: the good news
O F V A L U E
New choices, new responsibilities
P A T H S T O W E L L N E S S
Is there ulcer relief?
P H Y S I C I A N P R O F I L E
Unraveling mysteries — one patient at a time
S P E C I A L T O P I C
What are allergies?
N E W S Y O U C A N U S E
Oxford benefits update
P R E V E N T I O N
Cold truths
L I V I N G W E L L
Keep your family safe from carbon monoxide
New Healthy Bonus® offers for 2006
W E B N E W S
Online health assessment: new tool for Oxford Members
W E L L N E S S
Cocoa is hot!
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C O N T E N T S
Healthy Mind Healthy Body, which is designed to give you the latest information on a wide range of
health topics and your plan benefits, is available on our web site. Simply log in to your personalized account page at
www.oxfordhealth.com. As always, we encourage you to e-mail your comments to us at [email protected],
or write to: Oxford Health Plans, c/o Member Publications, 55 Corporate Drive, Trumbull, CT 06611.
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COVER STORY 4
Heart disease:the good
news
5
Cardiovascular disease (CVD) is a broad all-encompassing term for a
collection of diseases and conditions of the heart (cardio) and blood vessels
(vascular), including angina, heart failure, hypertension, atherosclerosis,
arrhythmias, and stroke (see page 6). The good news is that startling
improvements have occurred in virtually every aspect of cardiovascular
care in the past few years. Not only has medical science made huge strides
in understanding many of the underlying causes of heart disease, but
conditions for which little remedy was available only a decade or two
ago are now increasingly treatable. And, we know now that with a few
lifestyle changes, many cardiovascular diseases may be preventable.
Getting a jump on CADImprovements in treatment for coronary artery disease (CAD), also known
as atherosclerosis, are prime examples of advances in management of CVD.
CAD is a condition in which the coronary arteries become narrowed and
rigid by the build-up of fatty deposits called plaque. These constricted
arteries increase blood pressure, making the heart and lungs work harder
to compensate for the decreased blood and oxygen levels. Doctors now
view rising blood pressure values and out-of-normal range cholesterol
and triglyceride levels as important indicators that CAD may lay ahead.
Doctors can work with their patients to improve these numbers through
diet, exercise and weight loss. If lifestyle changes aren’t enough, there is
a growing array of medications available that reduce plaque, increase
vascular elasticity or thin blood to enhance circulation.
Technology to the rescue Advanced imaging tools like MRIs and CT scans also take some of the
guesswork out of knowing which parts of the cardiovascular system are in
trouble. For example, partial blockage in an artery can be located and the
channel reopened through angioplasty before permanent damage is done.
Angioplasty is a minimally invasive procedure in which a thin tube called a
catheter is carefully threaded up an artery until it reaches the affected area.
The balloon tip of the catheter is then inflated to widen the artery and a
tiny mesh scaffold called a stent inserted to hold the area open permanently.
Since stented arteries may re-clog over time, the newest stents are coated
with a slow-release drug that reduces that risk substantially.
Sometimes, however, a heart problem requires more invasive surgery.
Coronary bypass may be required where arterial blockage is extreme.
This procedure involves taking a section of healthy vessel from another
part of the body and grafting it to bypass the blockage. Years ago, surgeons
had no choice but to stop the heart and use a heart-lung machine during
bypass surgery. Today, some bypass surgeries can be performed using
endoscopy, which involves smaller incisions, robotic surgical tools and
faster recoveries for patients. Endoscopy is also being used on some valve
repairs and replacements.
Your hardworking heartThe heart is an amazing work of nature.
Scarcely larger than your fist, this specialized
muscle contracts and relaxes some 100,000
times a day, over 35 million times a year. With
each beat it circulates about six quarts of
blood, moving oxygen, nutrients, disease-
fighting agents, wastes, and a host of other
materials through its four chambers and four
valves and on to the arteries and veins.
The healthy heart goes about its work with
exquisite precision. As the chambers pump,
tiny valves open and close with split-second
timing, directed by electrical impulses sent
from the heart’s natural pacemaker, the
sinoatrial node. Oxygen-depleted blood
enters the right upper atrium, travels to the
left lower ventricle, and goes on to the lungs.
Once there, the blood quickly exchanges
carbon dioxide for oxygen and is shunted
back to the heart’s left atrium and the ventricle
below. The left ventricle, the most muscular of
the four sections of the heart, then contracts
with maximum force to send refreshed blood
to every artery, organ and cell. It takes a lot
of power to keep the blood moving; laid end
to end, all the vessels of the adult circulatory
system would extend 60,000 miles.
The heart of an average adult at rest repeats
this entire sequence about 72 times per
minute, although 60 to 100 beats are
considered within normal range. A well-
conditioned athlete or an individual taking
heart medications may have a slower beat;
excitement, a high fever, vigorous exercise,
and anger can drive the numbers considerably
higher than 100 beats per minute. The rhythm
and strength of pulse are also good indicators
of the overall status of the heart.
Blood pressure (BP), another critical indicator
of heart health, is a measure of the physical
force exerted on the interior walls of your
arteries. As heart muscle contracts, it pushes
the volume of blood along producing a higher
pressure within the vessels; between beats,
when the heart muscle relaxes, the pressure
drops. A reading below 120/80 is considered
normal for a healthy adult, but age, hormonal
activity, stress, cholesterol levels, and a
co-existing disease can increase arterial
resistance causing BP to rise.
ds
COVER STORY 6
Other major advances are in the development of treatments
for arrhythmias. Medications continue to be the first line
of care. Also, artificial pacemakers can be inserted in the
upper chest to provide a normal heart-beat when the heart’s
own rhythm is either consistently too fast or too slow.
But pacemaker technology has recently expanded to include
the development of a device for people at risk for sudden
heart attack. A miniaturized defibrillator, not unlike the
defibrillators used on ambulances and in hospital emergency
rooms, can sense an attack before it begins and shock the
heart back into normal rhythm. Another new treatment is
radio-frequency ablation, a procedure that has proved to be
effective in treating some forms of atrial fibrillation. Using
high energy waves, a surgeon locates the tiny cluster of heart
cells (usually scar tissue) causing the arrhythmia and destroys
it to restore normal electrical activity.
Patients as partners As progress continues to be made in the management of
heart disease, the patient-physician partnership remains a
critical factor. Compliance with instructions from healthcare
providers is very important; this includes taking medications
as prescribed, carefully following any recommended changes
to diet and getting enough of the right kinds of exercise. If
cardiac rehabilitation is recommended, it means staying
the course. Rehabilitation usually begins in the hospital.
Nutrition counseling, smoking cessation and familiarization
with new medications are also common elements during
hospitalization. Later, on an outpatient basis, heart patients
are offered instruction in how to best manage their disease,
and are given supervised aerobic and resistance (strength)
exercise, as well as psychological counseling. Participation
in a rehabilitation program has been shown to play a key
role in recovery, but a surprisingly high percentage of
candidates underestimate its benefits to their long-term
health and drop out prematurely or fail to enroll entirely.
Patients who understand their condition and are diligent
in following all aspects of their treatment stand a much
better chance of living a nearly normal life. O
Principal vascular diseases Aneurysm is a bulge or weakness in the wall of an
artery or vein. A person may live with an aneurysm
for some time without acute problems, although
aneurysms tend to enlarge and become progressively
more vulnerable to rupture, particularly in people
with hypertension.
Arteriosclerosis is a condition in which arterial walls
become “hardened” or thick and inelastic, resulting in
smaller diameter channels and reduced blood flow.
Atherosclerosis is arteriosclerosis that is specifically
due to the accumulation of plaque (fatty deposits).
Coronary thrombosis is any obstruction of a coronary
artery by a blood clot.
High blood pressure (hypertension) describes higher
than optimum pressure within arterial blood vessels.
Stage I hypertension is 140/90 or slightly higher; Stage II
hypertension is 160/100 or higher. High blood pressure
can gradually — and often silently — do damage to the
entire cardiovascular system.
Low blood pressure (hypotension) is blood pressure
low enough to cause symptoms such as dizziness,
fainting and confusion. Dehydration, excessive urination
or sweating, heat exposure, decreased heart output,
anemia, hyperventilation, and significant blood loss due
to injury are all temporary causes of hypotension. Shock
is extreme low blood pressure; too low to sustain basic
life functions.
Peripheral arterial disease (PAD) occurs most often
in the legs (though arms may also be affected) and
involves obstruction or claudication of arteries serving
these areas. As PAD develops, pain and cramping
hamper exercise and walking; eventually symptoms
are felt even when at rest.
Stroke is a sudden disturbance of blood flow in the
brain. An ischemic stroke is one in which an artery
serving some part of the brain is blocked. During a
hemorrhagic stroke, the artery ruptures causing the
brain to bleed.
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Arrhythmia (abnormal heart rhythm) includes any pattern of
heartbeats that differ from the normal range. Heart rate that is
inappropriately fast is called tachycardia; extra slow heart rate
is bradycardia. A beat that flutters is said to be in fibrillation.
Angina is crushing chest pain or
discomfort that occurs when the heart
muscle does not get enough blood.
Stable angina typically comes on during
vigorous exercise and can usually be
relieved with rest and medication.
It may be a warning sign of a future
heart attack. Unstable angina does
not follow a pattern, comes on
unexpectedly and should be
treated as a probable heart
attack in progress.
Cardiomyopathy
describes all diseases
of the heart muscle,
including the
most common,
idiopathic dilated
cardiomyopathy, an
enlarged heart with
no known causes.
Congenital heart
disease is any heart
disease present at birth
that affects the formation
of the heart or its parts.
The defect may be apparent
during the fetal stage, but
some congenital errors are
detected only many years later.
Coronary artery disease (CAD)
is the most common type of heart
disease and the leading cause of
death in men and women. The condition
occurs when the heart’s arteries become hardened
and narrow, usually due to build up of fatty deposits
(plaque), a condition also known as atherosclerosis.
Coronary heart disease (CHD) is a term encompassing both
CAD and its resulting complications, including angina or chest
pain, heart attacks and scar tissue created by heart attacks.
Heart attack is a non-medical term for myocardial infarction (MI).
In an MI, part of the heart muscle is destroyed due to a sudden
cutoff of its blood supply, usually as a result of
a blood clot.
Heart failure (HF), sometimes referred to as
congestive heart failure, is a condition in
which the heart has diminished capacity
to pump blood, causing vital organs to
suffer. Typical symptoms are shortness
of breath, fatigue and fluid retention
(edema); often first visible in the legs
and feet. Heart failure may develop
suddenly, but more often it
is a progressive condition
lasting many years.
HF is typically
secondary to other
cardiovascular
problems such
as CAD.
Pericardial diseases involve
the sac or pericardium that
encases the heart, and include
pericarditis (inflammation),
pericardial effusion (fluid
accumulation) and constrictive
pericarditis (stiffening). Similarly,
endocarditis occurs in the
smooth interior lining of the
heart and typically develops
from a bacterial infection.
Valvular heart disease involves
the valves of the heart. A valve may
become narrowed (stenosis), it may
leak (regurgitation) or it may not close
properly, either because of a congenital defect
or because of damage caused by an infection
such as rheumatic fever.
Diseases of the heart at a glance
OF VALUE8
Today, with rising costs and
changing benefits packages,
selecting the right healthcare plan
can be difficult. At Oxford, we
want to help you simplify what
can seem like a complicated choice
and keep you informed about new
developments in health coverage.
In the coming months, you’ll be
hearing more about consumer-directed health plans
(CDHPs) — your employer may even offer healthcare
options that fall under the umbrella of CDHP.
Consumer-directed health plans give individuals
a larger stake in how their personal healthcare dollars
are spent, while offering the potential to save money in
the form of lower premiums. These plans are typically
high deductible health plans (HDHPs).
High deductible health plans have deductibles that
range from $1,000 to $2,000 per year, and in many cases
offer lower monthly premiums than traditional insurance
plans. Because Oxford recognizes the value of preventive
care, Oxford’s CDHP products include in-network
coverage for annual physicals, well-woman exams and
children’s immunizations at 100 percent, even before
the deductible has been satisfied.
In this issue, we’ll look at the health savings account
(HSA). Paired with HDHPs, an HSA is a tax-advantaged
personal bank account similar to an individual retirement
account (IRA). Used only to pay eligible health-related
claims, the HSA may be funded by your employer. You
or a family member may also contribute. Employee
contributions to HSA accounts are made through pre-tax
payroll deductions. This means funds going into the
account are tax-free and remain tax free if used for
eligible medical expenses. Interest on
HSA money is also accumulated tax free.
Most Members will draw against the
HSA using a dedicated HSA credit card
or checkbook provided by the bank
every time they incur an eligible
medical charge until the balance is
used up. Money remaining in the HSA
account at the end of a year will roll over to the next year,
retaining its tax-favored status and remaining available
should you need it, either to fill the gap in your deductible
for expenses that exceed your savings account or to
undergo an eligible elective procedure that might not be
covered under a more traditional plan. HSAs have the fur-
ther advantage of being portable, an excellent benefit for a
Member who changes jobs, and money accumulated in an
HSA account can even be saved until retirement and used
to pay Medicare out-of-pocket expenses.
Oxford recognizes that having more control over your
healthcare dollars is easier when you have easy access
to excellent decision-making tools. That’s why we
provide an outstanding suite of services such as Subimo
Healthcare Advisor™, Subimo Hospital Advisor™ and
Oxford On-Call®, our 24-hour nurse line, to help you
make informed choices about your healthcare. These
tools enable you to obtain up-to-date information on
the cost of various services and medications, and make
choices about any recommended alternatives. That way,
you can decide with your doctor how best to proceed
with your care.
If your employer offers a consumer-directed health
plan, and you want increased choice, control and
responsibility when it comes to your healthcare,
a CDHP may be the right choice for you. O
choicesresponsibilitiesNEW
Choice is good; but as new options become available, making the best choice
can be challenging.
Alan M. Muney, MD, MHAis the Chief Medical Officer and an
Executive Vice President for OxfordHealth Plans. Dr. Muney received his
bachelor of science in biology andmedical degree from Brown University
in Providence, RI. He also received amaster’s in health administration fromthe University of La Verne, California.
James Dillard, MD, DC, CAcis the founding Medical Director of Oxford’s Complementary &Alternative Medicine Program and is Chairman of the OxfordChiropractic Advisory Board. He is a board certified medical doctor, a doctor of chiropractic and a certified medical acupuncturist.
PATHS TO WELLNESS 9
Usually, your digestive system goes about its work unnoticed, but
occasionally something causes the stomach to lose its protective lining
and become seriously irritated. That’s when peptic ulcers or sores develop. About one
in 10 people will suffer from peptic ulcers. If you experience burning, aching or soreness
in your stomach, late night pain similar to hunger pangs, black or bloody stool or vomit,
talk to your doctor immediately. Most ulcers heal with treatment.
A AConventional ResponseTests can diagnose ulcers and their underlying causes.
Using a flexible tube (endoscope) inserted down your throat
into your stomach, your physician will first try to get a look
at the ulcers and take a biopsy of the affected tissue. Barium
x-rays, gastric analysis and blood tests may also be used.
Diet and medicationsThe most frequently suspected culprit is the bacterium
Helicobacter pylori (H. pylori), which can cause a break-
down in the protective mucus lining. Antibiotics will
usually rid the system of this irritant. Other causes of
ulcers are alcohol consumption, smoking and reactions to
potentially corrosive drugs, any of which can cause excess
acidity and contribute to the erosion of this lining. Your
physician may prescribe an over-the-counter (OTC) antacid
or possibly a stronger ulcer-healing drug for short-term use.
A bland diet, once considered a primary weapon against all
peptic ulcers, is no longer regarded as a primary treatment.
Surgery — a last resortIn some instances, ulcers can develop potentially critical
complications requiring surgical intervention. These
include ulcers that perforate the stomach or penetrate a
solid organ, bleeding that becomes massive or persistent,
and scar tissue from chronic ulcers that creates an
obstruction in a digestive passage.
Complementary ResponseOnce conventional treatment of peptic ulcers has
begun, complementary remedies can help soothe
inflamed stomach tissue while healing takes place.
A classic remedy is a glass of raw cabbage juice taken
twice a day. Cabbage, which is high in vitamin C,
seems to inhibit H. pylori, so the juice may have
antibacterial effects, too. Yogurt containing the live
culture acidophilus also inhibits the growth of
H. pylori bacteria. Finally, deglycyrrhizinated licorice
(DLG), a chemically-modified form of licorice root,
may stimulate the production of protective mucus.
(Plain licorice is not recommended as it can raise
blood pressure.) As always, consult your physician
before beginning any alternative therapies.
Examine eating habitsGreasy foods, milk products, eating on the run, and a
diet low in fiber are all associated with stomach acidity,
so changing the way you eat may be helpful. And when
taking OTC pain relievers, consider acetaminophen.
Stress, no longer blamed as a cause of ulcers, can
inhibit good digestion. Meditation, controlled breath
work, yoga, guided imagery, massage, and regular
physical exercise are all antidotes to stress. O
QIs there ulcer relief?
PHYSICIAN PROFILE10
“Allergies, including asthma, are on
the rise, not just in the United States,
but everywhere in the developed
world,” Dr. Robert Biondi explains.
As an Oxford participating allergist
and immunologist, Dr. Biondi is able
to track this trend first hand. For
some 35 years, he has maintained a
multi-office practice in Connecticut.
In addition, Dr. Biondi holds a
Clinical Professorship in Pediatric
Allergies at Yale University Medical
School in New Haven, where he
oversees a Pediatric Allergy Clinic.
He credits his staff with helping him
to keep the practice and clinic
running smoothly.
Unraveling mysteries — one patient at a time
11
“We don’t know precisely why these hypersensitivities
are more prevalent today,” he continues, “but we are
definitely getting better and better at understanding
their cellular mechanisms. And that knowledge is
providing the tools for improved treatments, more
effective drugs and more consistent management of
symptoms. Unfortunately, once a patient develops an
allergy, there’s a good chance it will remain life-long,
but it doesn’t have to make the person miserable —
or in constant danger of a medical crisis — anymore.”
Detective work“When a new patient is referred to one of our offices,
their primary care physician or pediatrician has
already ruled out other likely diagnoses. So we start
by interviewing the patient (or parent in the case of
a young child), developing critical clues as we go.
We begin with a very detailed health history. First,
we identify the symptoms.” Allergic symptoms run
the gamut from occasional itchy eyes and sneezing
to chronic congestion, sinusitis, mild to severe difficulty
breathing, skin rashes, all the way to anaphylaxis.
The last of these is a potentially dangerous allergic
reaction that may include system-wide shock and
respiratory failure.
Dr. Biondi next establishes the time frame of allergic
incidents: At what age did they begin? Are they seasonal
or year-round? Are they more intense in the morning or
at night? “We ask patients to recall, if they can, other
activities that were going on prior to allergic incidents,”
he continues. “We ask whether any other member of
the family — a parent, a sibling, a grandparent — has
allergies, because there’s a strong genetic component
in this disease complex. We talk about the foods the
patient eats. A person can theoretically be allergic to
just about anything, but statistically more than 90
percent of food allergies can be traced to just eight
foods — milk, soy, wheat, eggs, tree nuts (walnuts,
pecans, pistachios, etc.), peanuts (a legume), fish, and
shellfish. We ask about pets, about the kind of heating
and air conditioning operating in the household, and
whether the patient lives in an apartment or perhaps an
old house with a damp basement. We inquire about the
kinds of vegetation surrounding the house, especially
substances that might become airborne like mown grass.
We get specifics on the kind of mattress and pillow
used, medicines taken and where the patient spends
substantial time each week — at work if an adult,
at school or daycare if a child.”
After a half hour or more of discussion, clues begin
to emerge as to the likely allergenic culprit. To
confirm or deny his suspicions, Dr. Biondi requires
some preliminary testing. Using a patch or scratch
test, he applies the suspected substance, as well as
a few other common allergens to a small area of the
skin. A rapid, mild reaction — usually a reddening
of the skin at the point of contact — indicates that
the patient has an allergy to that substance.
The investigation continues“Based on what we find,” Dr. Biondi says, “we may
follow up on the second visit with more extensive skin
and blood tests. If asthma is the diagnosis, we may also
do a pulmonary function test to determine the degree
of bronchial airway constriction. If the patient has
frequent ear infections, we may also do a tympanogram
to see if the eardrum and middle ear are affected.”
— one patient at a time
PHYSICIAN PROFILE12
“When we have all our information,” Dr. Biondi continues, “we meet for a
summary conference at which we discuss the recommended treatment plan.
I spend a considerable amount of time explaining the cellular mechanisms of
the allergy to my patients because I’m a firm believer that the more they know,
the better able they are to manage their condition and to work constructively
with me in adjusting treatment. This is a dynamic disease, so changes are
virtually assured.”
“I start by focusing on the things the patient and family can actively avoid —
dust, animal dander, mold in the house –– if these are implicated. We talk
about how to work around certain food allergies, if necessary. But you can’t
get away from every allergen. Pollen and spores, for example, are everywhere
during some seasons. So it is sometimes necessary for a treatment plan to
include medications.”
Drug treatment typically consists of a combination of therapeutic and
preventive medications. Antihistamines, the classic example of therapeutics,
go to work mopping up the irritating histaminic compounds released by the
body in response to allergens, but these drugs work only for a short time and
only in the aftermath of an active allergic response. For people with chronic
year-round allergies, preventive drugs such as nasal sprays and lung inhalents
are also used on a regular basis to block histamine release altogether.
About 25 percent of Dr. Biondi’s patients are also candidates for allergen
immunotherapy or allergy injections. “This procedure involves injecting the
allergen under the skin,” Dr. Biondi explains. “I start with a very weak dose
at the initial treatment and gradually increase dosage strength, as well as
the intervals between injections. The body reacts by gradually becoming
desensitized to what would ordinarily cause an allergic reaction. Because
the route of entry for the allergen is new — through the skin and blood rather
than through inhalation, for example — the body responds with a different
kind of antibody, one that is more tolerable, so the patient remains symptom
free. However, allergen immunotherapy must be continuous with maintenance
doses given roughly every 28 days for desensitization to continue.”
What’s next?Dr. Biondi predicts that major advances may alter allergy therapy when
genomics — the science of how genes interact — becomes a reality. Meanwhile,
one piece of advice he gives to parents concerned about the rising incidence of
food allergies in the very young is to delay introducing certain hard-to-handle
foods. “There’s been a tendency to expose kids to some very sophisticated foods —
before the body’s system for breaking down proteins has matured — and that’s
now thought to be a factor in the growth of hypersensitivities. Peanuts, tree nuts,
fish, and shellfish all carry high allergenic risks and should be avoided in the first
three years of life. It won’t guarantee that the children will stay allergy-free, but
it may help — and young children certainly aren’t going to complain.” O
S P E C I A L T O P I C 13
What areallergies?
Our bodies exist in a world full of harmful substances
that can cause irritation, inflammation, infection, and
disease. Fortunately, we have internal defense systems
designed to ward off most such attacks. Chief among
them is the immune system. At the first sign of invasion,
the immune system mobilizes a rapid and powerful
response that typically overwhelms the invader in the
early stages of attack. But for some people, the immune
system becomes abnormally sensitive and overreacts
to substances that are usually harmless to most people.
Triggered by microscopic agents known as allergens,
these reactions, or allergies, are caused by bits of protein
called antibodies or immunoglobulins, which float
around in the blood and lymph systems waiting to
release chemicals, such as histamines, when they
sense an unwanted substance in the body.
Types of allergies and allergic reactions
Common allergens are inhaled pollen, dust mites,
mold spores, and animal danders. Hay fever is one
example of a common minor allergy. Localized allergies,
although frustrating, are typically not dangerous.
Systemic allergies, by contrast, are potentially dangerous
and need to be monitored and controlled. Asthma, the best
known systemic allergy, involves the entire respiratory
system and is usually chronic. It can require medications,
as well as lifestyle and dietary modifications to manage.
Other systemic allergies include the extreme allergic
responses that some people have to substances to which
they have developed a hypersensitivity after multiple
exposures — bee stings, for example. People with a
history of severe, acute allergic reactions are at risk of
anaphylactic shock, during which breathing becomes
difficult, blood pressure drops rapidly and coma or even
death may occur. Because these kinds of allergic reactions
can take place when least expected, people who are
vulnerable typically carry an auto-injection kit containing
epinephrine. An instant antidote, epinephrine works by
reversing the symptoms of anaphylactic shock and slowing
its progression. The kinds of allergens that provoke severe
systemic reactions fall into four categories: injections,
such as penicillin; insect stings (honeybee, wasp,
yellow jacket, hornet); latex allergies (primarily among
healthcare workers); and certain foods (shellfish, eggs,
peanuts and other legumes).
Allergic reactions come in many forms and degrees
of seriousness. Among localized forms are:
• Allergic rhinitis, which is expressed as a runny nose,
irritation, swelling, sneezing, and/or eye irritation
• Skin reactions, including eczema, hives (urticaria)
and contact dermatitis
• Physical allergies, which are reactions to physical
stimuli including sunlight, heat, sweating, cold,
and friction
Allergies on the riseAn estimated 50 million Americans are allergic to
something, and many of them have multiple allergies.
(Most will be allergic throughout life, though children
do occasionally outgrow milder hypersensitivities).
Asthma alone currently affects some 15 million people,
a third of them children. The incidence of allergies is
growing sharply. Health experts have many theories
as to the reasons, ranging from degrading air quality
to the negative consequences of using antibiotics too
freely. Genetics also play a part; children of a parent
with allergies have a one-in-three chance of having
allergies themselves.
Whether simply irritating and inconvenient or
potentially more severe, it’s important to know that
the symptoms of most allergies can be alleviated once
the allergen has been identified. If you experience any
unusual reaction that you suspect might be an allergy,
call your primary care physician. After a preliminary
consultation, you may be referred to an allergist.
For more on diagnosing and treating allergies, see
the allergist and immunologist profile on page 10. O
NEWS YOU CAN USE14
OOXF OR D | BENEFITS UPDATE
Update to administration of out-of-network benefits1
Oxford Health Plans is committed to helping make
healthcare more affordable for our Members. One
way to do this is to provide more information to you
about the costs of medical services and your financial
liabilities when you see non-participating providers.
As part of this effort, we are making a change to the
way we direct claim payments for services rendered
by non-participating providers. Effective April 1, 2006,
if you choose to receive services from a facility or
physician who does not participate in the Oxford
Health Plans network of providers, Oxford may
make the claim payment directly to you instead
of to the non-participating provider.2
In such cases, the non-participating provider will
be instructed to bill you for services rendered. The
reimbursement check you receive from Oxford will
represent the benefit amount payable by Oxford for
this service, and will be attached to an Explanation of
Benefits. You will be responsible for making payment
to the non-participating provider for the full amount of
the check mailed to you, in addition to any applicable
copayment, deductible, coinsurance, or other cost share
allowances, according to your benefit plan. Please ensure
your mailing address is current with your employer
and with Oxford so that claim payments for services
from non-participating providers arrive at your home
without delay.
If you choose to see a provider who participates in
Oxford’s network of providers, that physician or facility
will continue to be reimbursed directly by Oxford.
Remember that in most cases, it will be less expensive
for you to visit a participating network provider. Oxford’s
Freedom Network is one of the largest provider networks
in the tri-state area, with more than 69,000 physicians
and 230 hospitals.
If you have questions, please call Oxford Customer
Service at the number on your Oxford ID card, or
at 1-800-444-6222.
1 This applies to Oxford commercial Members who have out-of-network benefits (e.g., Point-of-Service and Freedom Plan® Members).
2 Non-participating providers will continue to be reimbursed directly for services rendered to New Jersey small group product Members and New Jersey Individual product Members.
15
How are we doing?We are committed to providing our Members with
access to quality healthcare, and we strive to bring
you a better healthcare experience, from your contact
with our Customer Service Department to your ongoing
encounters with the physicians and hospitals in our
provider network.
This past year, the National Committee for Quality
Assurance (NCQA), the most respected independent
rating organization in the healthcare industry, again
awarded Oxford ratings of “Excellent” — NCQA’s
highest level of accreditation, in New York, New Jersey
and Connecticut. To continue this trend of excellence,
we are seeking feedback from our Members on ways to
enhance specific details of their healthcare experience.
In 2006, we will continue to work toward
improvements in:
• Processing claims and appeals more efficiently
• Member education, both in our written materials
and on www.oxfordhealth.com, by putting
information regarding how your plan works and
how you can make the most of what is available
to you in language that is clearly understandable
• Contact with your physicians and the staff in their
offices — we’re working to improve patient-doctor
communication, all of which should help ensure that
you get the care you need at the right time and place
If you have a suggestion about how we can improve
your satisfaction with Oxford, please continue to let us
know how we can serve you better. Contact us via e-mail
at [email protected] or at the
address below. We’re listening!
Member Satisfaction — Oxford Health Plans
Quality Management Department
44 South Broadway
White Plains, NY 10601
Updated Member Handbooks for New York Members
If you are a New York Member and have coverage
through your employer or purchase individual coverage
directly from Oxford, we would like to inform you that
an updated electronic version of your Member Handbook
is available on www.oxfordhealth.com. Just log in,
and click on Tools and Resources, then Your Benefit
Coverage under Practical Resources.
The new Member Handbook may contain some
language that differs from the provisions in your current
Certificate of Coverage and Member Handbook (or your
individual contract) and replaces certain sections of your
Certificate of Coverage. To request a printed copy, please
call our Customer Service Department at the number on
your Oxford ID card. You can also contact us by mail at:
Oxford Health Plans
Managed Care Act Request
48 Monroe Turnpike
Trumbull, CT 06611
Privacy notice concerning financial information
At Oxford, protecting the privacy of the personal
information we have about our customers and
Members is of paramount importance, and we take
this responsibility very seriously. The following notice
describes our policy regarding the confidentiality and
disclosure of customer and Member personal financial
information that Oxford collects in the course of
conducting its business. Our policy applies to both
current and former customers and Members.
The information Oxford collects
We collect non-public, personal financial information
about Members from the following sources:
• Information we receive from you on applications
or other forms (e.g., name, address, Social Security
number, and date of birth)
NEWS YOU CAN USE16
• Information about your transactions with us, our
affiliates (companies under common ownership
with, controlled by, or owned by Oxford) or others
• Information we receive from consumer reporting
agencies concerning large group customers
The information Oxford discloses
We do not disclose any non-public, personal financial
information about our current and former customers
and Members to anyone except as permitted by law.
For example, we may disclose information to affiliates
and other third parties to service or process an insurance
transaction, or provide information to insurance
regulators or law enforcement authorities upon request.
Oxford security practices
We emphasize the importance of confidentiality
through employee training, the implementation of
procedures designed to protect the security of our records,
and our privacy policy. We restrict access to personal
financial information of our customers and Members to
those employees who need to know that information to
perform their job responsibilities. We maintain physical,
electronic and procedural safeguards that comply with
federal and state regulations to guard your non-public,
personal financial information.
This notice is being provided on behalf of the following
Oxford affiliates: Oxford Health Plans, LLC, Oxford
Health Plans (CT), Inc., Oxford Health Plans (NJ), Inc.,
Oxford Health Plans (NY), Inc., Oxford Health Insurance,
Inc., Investors Guaranty Life Insurance Company, and
Oxford Benefits Management,® Inc.
Please note: A copy of Oxford’s Notice of Privacy
Practices can be obtained by logging on to
www.oxfordhealth.com. To request a written
copy, please call our Customer Service Department
at the number on your Oxford ID card. You can
also contact us by mail at:
Oxford Health Plans
HIPAA Member Rights Unit
48 Monroe Turnpike
Trumbull, CT 06611
Oxford cares about quality Oxford Health Plans’ Quality Management (QM)
Program is focused, in part, on monitoring access to
quality healthcare. Our QM Program is led by an
Executive Quality Management Committee and consists
of various regional committees in which QM staff and
network providers participate. Functions include:
• Identifying the scope of care and services available
through Oxford
• Developing clinical practice guidelines (e.g.,
guidelines regarding treating heart disease) and
service standards (e.g., processing precertification
requests) to measure performance
• Verifying the medical qualifications of providers
who participate in Oxford’s network
• Monitoring and evaluating the quality and
appropriateness of the services and medical care
received by Oxford Members (e.g., via ongoing
Member satisfaction surveys)
• Pursuing opportunities to improve patient safety
and customer service
• Resolving identified quality issues or concerns
If you would like to request more information
about Oxford’s QM Program and goals, please call
our Customer Service Department at the number
on your Oxford ID card.
Promoting appropriate careThrough the media or your own research, you
may have become aware that some managed care
organizations offer rewards or bonuses to providers
who limit and/or deny care. Please note that
decisions about the care you receive are based
only on appropriateness of care, service and existence
of coverage. Oxford does not compensate providers
for denials of service, nor do we offer incentives
to encourage denials. We do encourage the use of
appropriate care and services to prevent and/or treat
illnesses. For details about your specific benefit
coverage, please refer to your Certificate of Coverage.
17
Commercial Member rights and responsibilities
As an Oxford Member, you have certain National
Committee for Quality Assurance (NCQA) rights and
responsibilities related to your coverage. The following
information is provided for your reference:
Oxford commercial Membershave the right to:
• Receive information about
Oxford, its services, its
practitioners and providers,
and Members’ rights and
responsibilities
• Be treated with respect and
recognition of their dignity
and right to privacy
• Participate with practitioners
in decision making regarding
their healthcare
• Have candid discussions about
appropriate or medically
necessary treatment options
for their conditions, regardless
of cost or benefit coverage
• Voice complaints or appeals about Oxford or the
care provided by participating providers
• Make recommendations regarding the organization’s
Member rights and responsibilities policies
Oxford commercial Members have the responsibility to:
• Provide, to the extent possible, information that
Oxford and its practitioners and providers need
in order to care for them
• Follow the plans and instructions for care that
they have agreed on with their practitioners
• Understand their health problems and participate
in developing mutually agreed upon treatment
goals to the degree possible
In addition to the previously noted information,
Members are also entitled to rights and responsibilities
subject to applicable state law. These rights and
responsibilities are outlined in your Certificate of
Coverage. If you have questions concerning your rights
and responsibilities, please call our Customer Service
Department at the number on your Oxford ID card.
Adopting the latest technologies New treatment methods are constantly being
developed for conditions ranging from asthma to
skin cancer. The following information will help you
understand how Oxford evaluates these new medical
technologies and how decisions are made regarding
their use.
What is new medical technology?
New medical technology is defined as a newly approved
drug or medication, a new surgical procedure or new
medical equipment. Oxford continually assesses new
medical technologies. Two examples of new medical
technologies that were recently approved for coverage by
Oxford are intranasal influenza vaccine (FluMist™) and
the Wearable Cardioverter Defibrillator (WCD®).
Pacemaker
NEWS YOU CAN USE18
What is the evaluation process?
Oxford’s Healthcare Services Department, led
by experienced physicians representing multiple
specialties, is responsible for evaluating new medical
technology. The process begins with a review of
the medical literature and other technical research.
The clinical staff also seeks opinions from leading
physicians and specialists in the community —
providers who have knowledge and expertise
regarding how new medical technology will be
used on a day-to-day basis. Once a thorough review
of the available information has been conducted,
Oxford’s senior medical staff meets to decide
whether or not to cover the new medical technology.
They base their decision on the strength of the
scientific evidence published in medical journals.
Representatives from all department areas then
meet to create a policy that outlines the conditions
for which the technology will be covered. Once
the policy is finalized, front-line Oxford employees
are trained regarding precertification, review, benefit
application, and claims payment. When a new policy
is implemented, Oxford notifies physicians through
a quarterly publication called the Provider Program
and Policy Update (PPU) and on our web site,
www.oxfordhealth.com. As a Member, you are
notified of important new policies through this
News You Can Use section in Healthy Mind Healthy
Body® magazine. All policies are reevaluated on a
periodic basis.
New Jersey primary care physician (PCP) and OB/GYN disenrollment process
If you are a New Jersey Member and your Oxford
PCP or OB/GYN disenrolls from Oxford’s provider
network, we will provide you with a 30-day advanced
written notification. The notification will inform
you of the disenrollment date and advise you of the
procedures for selecting a new participating PCP
or OB/GYN.
Please note: Advance notice is not required if your
PCP or OB/GYN is terminated due to quality of care
concerns, fraud or breach of the Oxford participating
provider agreement.
New Jersey IndependentConsumer Satisfaction Survey results
If you are a New Jersey Member and would like
to request New Jersey Independent Consumer
Satisfaction Survey results and an analysis of
quality outcomes of healthcare services of managed
care plans in the State you may contact:
Office of Health Care Quality Assessment
New Jersey Department of Health and
Senior Services
P.O. Box 360
Trenton, NJ 08625-0360
1-800-418-1397
Access to care We recognize that timely access to medical
services is important — whether you need a physical,
a colonoscopy or an appointment to be treated for
an unexpected illness. That’s why we’ve developed
provider service standards and regularly monitor
our provider network for compliance with these
standards. As an Oxford Member, you can expect
to see a provider for urgent care within 24 hours,
routine symptomatic care (non-urgent, but in need
of attention) within 72 hours or a regular physical
exam within six weeks. Your wait in a provider’s
office should be no more than 30 minutes. We
also set standards for the maximum number of
appointments a primary care physician should have
scheduled per hour, and how many patients he or
she can care for in the practice. Measures like
these are designed to help promote quality care.
19
2006 Prescription Drug List UpdateThe following is an update to the Prescription Drug List (PDL) for Oxford’s three-tier prescription drug benefit.
The complete PDL is available online at www.oxfordhealth.com. The PDL Management Committee reviews
new medications approved by the Food and Drug Administration (FDA), as well as current medications when new
information becomes available. When a brand name medication becomes available as a generic, that brand name
medication may move to a higher tier. These changes may occur without prior notice and may not be reflected below.
Coverage for the listed medications may be limited or excluded based on a Member’s eligibility or plan design.
Please note: Diabetic supplies that are available through the Member’s base medical benefit will be subject to
the applicable copayment noted on the Member’s Summary of Benefits.
Changes:
The following medications have been moved to Tier 3 (highest cost option) of the PDL. This means that Members
with a three-tier prescription drug plan may pay a higher copayment as a result of the change in tier status. A listing
of Tier 1 (lowest cost option) and Tier 2 (midrange cost option) alternatives is provided.
Drug Therapeutic Use Tier 1 and Tier 2 AlternativesAllegra Allergic rhinitis fexofenadine (generic)
Amaryl Diabetes therapy glimepiride (generic)
DDAVP tablet Misc. agent desmopressin acetate tablet (generic)
Migralam Headache therapy isometheptene/apap/caffeine (generic)
NEWS YOU CAN USE20
Oxford On-Call®
At Oxford, we realize that questions about your
health can come up at any time. That’s why we
offer you flexible choices in healthcare guidance
through our Oxford On-Call program.
With Oxford On-Call you can:
• Speak with a registered nurse who can offer
suggestions and guide you to the most appropriate
source of care
• Chat online with a nurse about your general health
questions or listen to recorded messages on over
1,100 health topics — 24 hours a day, seven days
a week
• Learn how to make the most of your doctor visits;
call Oxford On-Call before you go to your
appointment, and a nurse can help you make
a list of questions to ask your doctor
If you are an Oxford Member and you need to reach
Oxford On-Call, please call 1-800-201-4911. To access
the Health Information library, call the Oxford On-Call
phone number and choose the option for Health
Information Library. Enter PIN number 123. You may
then dial 1000 for a sample directory of topics.
It’s your health — don’t be afraid to ask
Having a clear understanding of your health
information is important to help you make the most
of your doctor visit. It is important to tell your
healthcare providers when you do not understand
the information they give you. The next time you
visit your doctor, these tips may help you to better
understand your treatment:
1. Don’t be afraid to ask questions Make a list
of questions to bring with you to your doctor.
The “Ask Me 3” program, set up by a team of
national healthcare groups, suggests three simple
but important questions people can ask their
healthcare providers:
• What is my main problem?
• What do I need to do?
• Why is it important for me to do this?
If you think of more questions after your visit, write
them down, and call the doctor’s office later in the day.
2. Bring a family member or friend This person may
be able to help you take notes and hear the provider’s
instructions — in case you miss something.
3. Speak up Tell your healthcare provider if you do
not understand the information he or she has given
you. Ask him or her to repeat the instructions until
you know what you need to do.
4. Repeat instructions After the healthcare provider
gives you instructions, repeat them back to him
or her to make sure you’ve got them right.
5. Ask for more information If your provider says you
have a health problem, ask for extra information
such as a hotline number, brochure or web site.
Work closely with your healthcare providers. They
can advise you on ways to lead a healthy, active life.
For more information, visit the Partnership for Clear
Health Communication web site at www.AskMe3.org.
The site features information on the “Ask Me 3”
program and how it can help you. It also has a
checklist that can help you get ready for your next
healthcare visit. O
P R E V E N T I O N 21
Cold truths
The common cold is indeed common, with an estimated one billioncases erupting each year in the United States; that’s six to 10 sets of
sniffles for the typical child and two to four runny noses for an adult.The prevalence of the common cold has led to an abundance
of remedies and advice — some sound, some silly. Here are a few cold hard facts about colds.
200 or more different viruses are known to cause
the common cold.
Winter is high season for colds, not because of cold
weather but because we spend more time close to
one another in hot, dry indoor environments where
colds thrive.
By the time you experience symptoms, you’ve probably
had your cold for two to three days, often time enough
for you to have passed it along to the next person.
It’s not so much the actual attack of the cold virus but
the body’s response that causes most of a cold’s misery:
sneezing is an early indication of nasal irritation; the runny
nose and cough are efforts to carry away the virus before
it does more harm; the stuffiness and pressure are the
results of swollen mucus membranes and sinus passages.
Transmission of colds is easy: cold viruses, which
can survive in the open for hours, are either handed
off or blown about by people with active colds or
picked up when we touch doorknobs, telephones,
toys, and other virus-coated objects, and then rub our
hands on the two places where cold viruses thrive —
our eyes and noses.
Hot chicken soup does help provide some comfort
because steamy fluids replace fluid lost.
A single sneeze is capable of sending as many as 4,500
droplets of infected mucus up to 12 feet at a speed
of 100 mph.
Regular hand washing combined with keeping yourself
physically fit and relatively stress free are the best
preventive measures.
Antibiotics, which specifically attack bacteria, do
nothing to shorten a cold’s duration and should not
be used unless your doctor determines that a secondary
infection such as bronchitis has developed.
Echinacea, a dietary supplement, was once touted as
effective in shortening a cold but research conducted
recently by National Institutes of Health finds no
evidence to support this claim. Similarly, no full
scale study of vitamin C has shown it to be of value
as a preventive measure.
A person with a positive attitude, according to one
recent study, is less likely to catch a cold than a depressed,
nervous or angry person; a tense or sad person may
complain of cold symptoms even without a cold.
Influenza (flu) is sometimes mistaken for a particularly
nasty cold, but the fever, muscle aches, coughing,
and deep respiratory trouble that often accompany
flu make it potentially more serious. O
LIVING WELL22
CO poisoning prevention checklist• Have at least one CO alarm with an audible warning signal
installed on every level of your home and in sleeping areas
• Ensure that fossil fuel-burning devices are properly installed and working
• Have your home heating system and chimney inspected andcleaned by a qualified technician every year
• Do not burn charcoal inside your house; even in the fireplace
• Do not use gas grills in confined areas; even in your basement or garage
• Have gas fireplaces inspected each autumn to ensure the pilot light burns safely
• Keep chimneys clear of bird and squirrel nests, leaves andresidue to ensure proper venting
• Do not operate gasoline powered engines (e.g. generators) in confined areas such as garages or basements; and never leave your vehicle, mower or other gasoline-powered equipmentrunning in an attached garage — even with the door open
• Do not block or seal shut exhaust flues or ducts for appliances such as water heaters, ranges and clothes dryers
• Do not use ovens, household appliances or alternative energy sources that run on fossil fuel for heating purposes
* Original dated cash register receipt and original proofs of purchase accepted, no facsimiles. Offer good only in USA, void where prohibited, taxed or restricted by law. Mail-inoffer only, not for store redemption. Offer is limited to one response per family, group or mailing address. P.O. Boxes without street addresses will not qualify as mailingaddresses. Multiple submissions will not be acknowledged or returned. Requests must be postmarked by 12/31/06. Allow 6-8 weeks for shipment of gift card. Offer valid for purchases made between 1/01/06 and 12/31/06. Kidde shall not be responsible for lost, late, misdirected, damaged, illegible or postage-due mail or requests.
Carbon monoxide (CO), a
colorless, odorless gas, is a
by-product of incomplete
burning of fuel materials such
as oil, gas and wood. A tiny
molecule, carbon monoxide
can be very dangerous —
carbon monoxide is the leading
cause of accidential poisoning deaths in America.
CO enters the body primarily through the lungs
while breathing. When CO enters the bloodstream,
it takes the place of oxygen, preventing it from
reaching the heart, brain and all of the other systems
in the body that depend on oxygen to carry out their
functions. Depending on the concentration of CO,
reactions to exposure can vary, from minor headaches
to dizziness, nausea, even convulsions.
How does carbon monoxide find its way into our
homes? CO is commonly released from poorly
maintained, incorrectly installed or faulty appliances
such as boilers, oil burners, gas stoves, and water heaters.
While these may be more common in older homes,
this dangerous gas is often found in new homes as well.
Safeguarding your homeThere are steps that you can take
to help protect your family from
the dangers of carbon monoxide
poisoning. Install an inexpensive
and widely available carbon
monoxide alarm on every floor
of your home and in sleeping areas.
Make sure that your appliances, especially water heaters,
furnaces and gas stoves are installed properly, and have
them inspected by a qualified technician annually. See the
box below for more tips on keeping your household safe.
Don’t forget about fire safetyWhile inspecting your home, take an extra moment
to make sure that there is a working smoke alarm on each
floor and in sleeping areas, and that fire extinguishers are
available throughout the house, ideally within 40 feet from
any location in the house. Many local
fire departments offer annual fire safety
inspections at no charge. Finally, make
sure your family has a fire escape plan.
For more information about protecting
your home from fire and
developing an escape plan,
visit www.nfpa.org. O
OOXFORD INFOOxford wants to help to give you a head start on protecting yourfamily. Through the Healthy Bonus® program, you can receive a $10 Home Depot® Gift Card when you purchase $80 in Kidde Fire Safety Equipment from The Home Depot.*
Simply send a dated cash register receipt, (circling the purchase prices of the Kidde products) and enclose one proof of purchase for each product found on all packages of Kidde products, and include your name, address, and Oxford I.D. number to: Cindy Rogers, Kidde/THD Promotion,1394 South Third Street, Mebane, NC 27302.
To view a full-range of Kidde Fire Safety products and equipment visit www.kiddeus.com/ProductCatalogUS.shtml.
Keep your family safe fromcarbon monoxide
23
At Oxford, we understand that rising healthcare
costs impact our Members. We strive to contain these
trends, developing programs that aim to help reduce
healthcare costs and improve quality of care. We also
believe that there are other ways we can help Members
to reduce out-of-pocket costs, and we believe in the
power of prevention — that by taking a little extra time
to eat better, exercise and reduce stress, individuals can
remain on the path of wellness.
Our Healthy Bonus program offers access to discounts
and special offers on products that can help you make
the best kind of investment: a healthy lifestyle. Below
are some of the new discounts available to our Members.
For more information on the discounts and special offers
available, visit www.oxfordhealth.com and click on
Tools and Resources and then click Member discounts
under Manage Your Health.
MotherNature.com MotherNature.com is a leading online retailer of
vitamins, supplements, herbs, and other natural
and certified-organic healthy living products.
Oxford Members save 15 percent off the complete
selection of products, plus, no extra charge for shipping
on orders over $49! To get your 15 percent discount,
go to www.MotherNature.com and enter coupon
code OXFORD during checkout. Or call toll free at
1-800-439-5506 and mention the same code.
ShopNaturalShopNatural offers a
wide selection of natural
and organic products, including:
• Natural and organic groceries
• Vitamins and supplements
• Health and beauty products
• Gifts
Oxford Members receive
a 10 percent discount off all
products at ShopNatural. To receive this special savings,
visit www.ShopNatural.com, and enter coupon code
OXFHB6 when you place your order.
Today’s CaregiverMagazine
Today’s Caregiver magazine
is the first national publication
providing information
specifically addressing the
needs of family caregivers.
Published since 1995, the
magazine contains timely
advice from leading experts,
caregiver stories and interviews with celebrity
caregivers, such as Clay Aiken, Debbie Reynolds,
Rob Lowe, First Lady Rosalynn Carter, and Barbara Eden.
Oxford Members receive a special discount of 40
percent off of Today’s Caregiver magazine’s cover price
(Oxford Member rate is just $14.50). To order, just call
1-800-829-2734 and mention that you are an Oxford
Member, or visit www.caregiver.com/oxford.
Pilates Style™ MagazinePilates Style is the first magazine dedicated
exclusively to Pilates. Pilates Style includes articles
on nutrition, health and beauty, fashion, food, home
and travel, as well as comprehensive information on
Pilates conferences, retreats and certification programs.
Oxford Members can subscribe to a one-year
(6 issues) subscription of Pilates Style for $9.95.
To receive this special offer please make checks
payable to Pilates Style and send to: Pilate Style,
PO Box 1926 Marion, OH 43306-2026. Or, subscribe
online at www.pilatestyle.com and enter key code
A6OHP to get this special price.
Offers are valid through December 31, 2006. These discounts are offered inaddition to, and separate from, your benefit coverage through Oxford HealthPlans. These arrangements have been made for the benefit of Members, and do not represent an endorsement or guarantee on the part of Oxford.Discounts may change from time to time without notice and are applicable to the items referenced only. Oxford Health Plans cannot assume any responsibility for the products or services provided by vendors or the failure of vendors referenced to make available discounts negotiated withOxford; however, any failure to receive discounts should be reported toOxford Customer Service by calling the number on your Member ID card.
New Healthy Bonus® offers for 2006
WEB NEWS24
Online health assessment:
a new tool for Oxford Members
In January 2006, Oxford launched a new health assessment tool on our web
site. You can access this tool by logging on to www.oxfordhealth.com,
and clicking on Health Assessment under Tools & Resources > Manage
Your Health. After you enter the Oxford HealthForums site, click on the
Health Assessment icon in the right column. This tool, offered by Optum,
a UnitedHealthcare Company, incorporates risk assessment tools, including
those developed by the Centers for Disease Control and Prevention (CDC)
and The University of Michigan Health Management Research Center.
25
Completing the entire Health Assessment takes about
10-20 minutes. You will then receive a personalized
health report that addresses 18 key health areas.
These areas are:
• Fitness
• Alcohol
• Smoking and tobacco
• Safety: driving, home safety — includes fire safety
checklists and tips on creating a disaster plan
• Nutrition: full analysis of a user’s diet
• Body image: includes user’s body mass index (BMI),
along with an interactive graph that shows how
BMI relates to diabetes, high blood pressure and
overall health risks
• Back pain
• High blood pressure
• Cholesterol
• Stress
• Depression
• Family planning
• Pregnancy
• Family health history
• Recommended prevention measures, such as
examinations, tests and immunizations
• Cancer risks
• Diabetes
• Heart disease and heart failure
Get the most from your assessment Before you begin
your assessment, gather relevant information. If you’ve
had a health screening recently — for example, a blood
pressure reading or cholesterol check — have those
numbers on hand. Also be prepared to enter data about
your health-related behaviors. Examples are how often
you exercise and how many servings of fruits and
vegetables you eat every day.
Celebrate your strengths One of the main reasons for
taking a health assessment is to celebrate what you’re
already doing well. Perhaps you’re exercising regularly,
managing stress and taking other concrete steps to
maintain your health. If so, the results of your
assessment will confirm these wise choices.
Tell the truth without self-judgment The more candid
your responses to a health assessment, the more useful
the results.
Build your commitment to change Consider what you
stand to gain by changing key health behaviors. Visualize
positive results such as a leaner body, a higher level of
energy and a more positive mood.
Set concrete goals Based on your assessment results,
list the specific health behaviors you intend to change.
Translate broad goals into actions you can take
immediately. For example, you could:
• Eat a fresh fruit or vegetable with every meal
• Skip a half-hour TV program each day and take a
brisk walk instead
• Skip dessert or second helpings at dinner
• Reduce stress by crossing activities that create little
value off your to-do list
Take the assessment more than once Your health may
change in subtle ways from year to year or even month
to month. Taking the assessment again can help you stay
on top of these changes.
Share the results Talk to loved ones and friends about
the changes you’re making. Also share assessment results
with your doctor. The most effective use of an online
health assessment is to complement — not replace —
professional medical care.
Be patient Many attempts at behavior change fail the
first time around. Relapse is often part of the change
process. This is especially true for deep-seated habits such
as smoking. If you become discouraged, remember that
every failure teaches you about what works — and what
doesn’t work — in changing your behavior. The next
attempt you make could be the one that succeeds.
Move into action Moving into action is how you create
the most value from any assessment. By adopting new
behaviors, you create new results in your life. Taking an
online assessment allows you to measure those results
and stay in charge of your health.
Please note: Health Assessments are not a substitute
for medical care and should not be used to diagnose
health problems. Consult your physician before
making decisions about medical care. Oxford
abides by all privacy and confidential information
regulations in regards to data collected through this
Health Assessment. O
WELLNESS26
Cacao beans naturally contain high levels of the
chemicals known as flavonoids. Flavonoids, also
found in abundance in red wine, green tea, apples,
and some other fruits and vegetables, are plant
compounds with potent antioxidant properties.
Antioxidants provide the body with some protection
from substances thought to damage the heart and
blood vessels as well as precursors to certain cancers.
But don’t rush out and buy your favorite candy bar;
the flavonoid content of cocoa is highly variable, so
check the label. The darker the chocolate the better —
unsweetened or baking chocolate contains up to
75 percent cocoa solids. Bittersweet chocolate, while
still dark, has a small amount of sugar, cocoa butter (fat)
and vanilla added. Look for chocolate or cocoa powder
made with untreated cocoa rather than dutch-processed
cocoa, which has been processed with alkali, drastically
reducing the beneficial flavonoid content while adding
sweeteners and other unhealthful additives. European
and Mexican brands of chocolate are a bit more expensive
than American varieties but are more likely to be
untreated and, as a result, high in flavonoid content.
Try the recipes at right for some ways to incorporate
cocoa into a wholesome meal or special treat. O
For many of us, chocolate is one of life’s little treasures.
An ancient culinary treat, cocoa was once considered so
valuable by the Mayans and Aztecs of Central America
that they used cacao beans — the source of cocoa —
as a form of currency. Now, according to preliminary
research, cocoa may be a source of valuable nutrients.
Cocoa is hot!
27A little cocoa adds a touch of authenticMexican flavor to this chicken recipe.
Chicken Yucatan2 lbs. boneless, skinlesschicken breast, cut into 1 inch cubes
2 tablespoons flour
2 tablespoons canola oil
1 clove garlic, minced
1 medium onion, chopped
1 red pepper, chopped
1 sweet potato, cut into 1⁄2 inch cubes
11⁄2 cups low-salt chicken broth
1 tablespoon chili powder
1 ounce square unsweetened chocolate, cut into small pieces
Salt to taste
4 cups cooked rice
Low-fat/fat free sour cream
Chopped cilantro
Directions:
1. Lightly flour chicken.
2. Cook chicken in hot oil over medium heat until brown on all sides. Remove from skillet.
3. In the same skillet, sauté garlic, onion, red pepper, andsweet potato until onion and red pepper are soft and potato begins to brown.
4. Add chicken broth, chili powder, chocolate, and salt. Cook over medium heat, stirring until chocolate melts.
5. Return chicken to the skillet.
6. Cover and simmer over low heat 15-20 minutes until potatoes and chicken are cooked.
Serve over rice. Garnish with sour cream and chopped cilantro.
Serves 6-8
Here’s a basic homemade mix for delicious hot cocoa. Prepare this mixand store in an airtight container in acool dark place for an occasional treat.
Hot Cocoa1 cup nonfat dry milk3⁄4 cup light brown sugar1⁄2 cup unprocessed cocoa powder or shaved dark chocolate
Ground cinnamon, nutmeg, cloves, or allspice to taste
To make one cup, stir in 2-3 tablespoons in a cup of skim or 1% milk. Mix well and microwave on high to heat 60 seconds to just below boiling. Whisk well to blend ingredients and to raise a froth. Pour the steamingdrink into your favorite mug, and then settle down in a comfortable chair to sip, relax and restore your spirit.
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transactions such as checking claims’ status, selecting a primary care physician and ordering materials and Member ID cards
• Learn more about Oxford’s various wellness resources, such as our Healthy Bonus® program and Self-Help LibrarySM by logging in to our Member web site
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