Sunflower Electric Power Corporation August, 2005 Tom Zerfas at x357 or a member of the Committee
Also in this issue: Cost Cap Update An Ounce of Prevention. Determining PPO Heard It Through The Savvier Car Buyers Than Providers Grapevine Healthcare Consumers? A recent study performed by
• Wholesale prices for
What can we learn from Great-West Healthcare brand-name drugs network. The spouse of this? As we have advised, found that consumers de- increased by an av- vote more time researching a car or refrigerator pur- erage of 6.6% be-
company needed cancer provider of service is a chase than they do a doctor tween 2004 and treatments and contacted or health plan.
the Cancer Treatment It is important to ensure
2005, more than twice the inflation cated in the Southwest with the service or prod- Drug Marketing Tactics
• The Center for Dis-
OK. As he should, the PPO. This includes institu-
The FDA plans to announce a review of direct-to- ease Control recom- consumer prescription drug mends that children advertisements. Many phy- exercise one hour sicians and consumers
Blue Cross of Oklahoma. medical equipment provid-
over the course of think drug ads exaggerate each day. The exer- benefits and do not ade- quately disclose risks. The cise doesn’t have to review is typically the first be in one continu- step in setting new rules to ous block, though, govern advertising. as children are more
they received were from viders have the flexibility of
likely to be active in
the Center. During the using different profession-
Generic Available “fits and spurts.”
stay, the Cancer Center als or institutions for treat-
• The top five proce- Nexium (“the purple pill”) dures performed in cost our plan $109 per pre- scription and $40 per em- US hospitals in ployee co-pay. Omeprazole, 2003: cesarean sec-
write off the additional the generic equivalent, cost tion (C-section); up-
amounts that BCBSKS the plan just $39 and em- per GI endoscopy Medical Center is not a won’t pay, verify it and try ployees $10 per co-pay. (to diagnose ulcers, Be sure to ask if a generic is stomach cancer, right for you.it could save etc.); heart catheteri- you and the plan a lot of zations; respiratory intubation and artifi- cial respiration; and Got a HIPAA Concern? angioplasty. The answered correctly to the the network by going to the total charges for earlier question that it was your Privacy Officer these were $108 bil- Tom Zerfas (785) 623-3357 tzerfas@sunflower.net
H e a l th c a r e B e n e f i t C o st C o n tr o l Co m m i t te e
Q u e s t i on s ? C o n t a c t T o m Z e r f a s a t x 3 5 7
Cost Cap, Claims, & Utilization Update Cost Cap & Claims Utilization Analysis
The utilization analysis is a helpful tool to track us-
age and costs in certain areas. Below, we compare
the first six months of 2005 to the same time in 2004.
2004 Avg 2005 Avg % Inc/Dec Contract Contract Institutional Services # of Inpatient Admissions $168,908 $137,168 Inpatient Plan Paid Inpatient Average Plain Paid/ $156,213 $176,045 Admission # of Outpatient Claims Outpatient Plan Paid $154,248 $189,399 Outpt Avg Plan Paid/Claim # of ER Claims $479,369 $502,612 ER Plan Paid ER Avg Plan Paid/Claim Professional Services Performance Update # of Claims
For the first six months of the year, 64% of the claims were under $1,000 and 94% were under $5,000: this points out
Plan Paid
how the majority of claims usually are small, but a minority
Average Plan Paid/Claim
usually are larger-ticket items. We had an increase in the
Drug Services
amount paid for professional services (some of this is due to the new $10 co-pay). Once again, the number of prescrip-
# of Scripts
tions written for drugs has increased. A good sign is that we
Plan Paid
are selecting generic equivalents more of the time (51% this
Average Plan Paid/Script Generic Potential Generics Purchased Your Healthcare Committee Members Dental Services
If you have any questions regarding the performance of our
# of Services
plan, contact Bill Washburn, Chad Dockter, Robert Staats,
Plan Paid
Sandy Skipton, Chuck Fischer, Dale Livingston, Don Tull, or Del Kaps.
Average Plan Paid/Service Average Cost Per Contract 2005 (through July)
Pre-requisites before starting the CMAT Registration: We suggest you have the following ready before starting the CMAT registration process A Computer with good Internet connectivity so that there is no breakage of Internet during registration All your qualification details as you need to enter them while registering for CMAT exam You need to upload your scanned photo while registering, h
Clinical Endocrinology (2006) 64 , 423–428 Effects of growth reduction therapy using high-dose 17 β -estradiol in 26 constitutionally tall girls U. Radivojevic, E. Thibaud, D. Samara-Boustani, C. Duflos and M. Polak Department of Paediatric Endocrinology and Gynaecology, Necker-Enfants Malades Hospital, Paris, France Introduction The use of sex steroids to reduce final height in pat
Sunflower Electric Power Corporation