Page 1B • The Leader • June 8, 2013 • www.theleadernews.com
Blue Cross could end coverage at Memorial Hermann by Jonathan McElvy jonathan@theleadernews.com It may just be a game of posturing, but as of press time, Blue Cross and Blue Shield of Texas says its will end coverage at all Memorial Hermann hospitals in the Houston market, including Memorial Hermann Northwest, effective July 1. Both Memorial Hermann and BCBSTX are clear about the issue: Reimbursement. The insurance company is looking to obtain reimbursement levels as low as possible. The hospital wants to be paid more. “BCBSTX monitors our contracts closely to ensure we offer competitive rates to health care providers that also
help keep premiums affordable for our members,” said a release distributed to impacted business owners in Texas. “We have offered Memorial Hermann a fair and reasonable reimbursement rate.”
James T. Campbell, who works in the external affairs office for the Memorial Herman Health System, countered that negotiations are ongoing because the level of care at their facilities has improved, and those improvements must be factored into reimbursements. “Memorial Hermann has worked very hard over the past years to create high quality, cost effective care for our patients,” Campbell said in a written response. “We are a recognized national leader in clinically integrated care. Therefore, any agreement with BCBSTX must embrace our clinically integrated care structure and provide appropriate reimbursement for our services.”
Many of the questions looming over such a separation are still unanswered. From what happens to BCBSTX patients admitted into the hospitals who may still be there on July 1, to if there is an ability to extend the current contract, cannot be answered yet. What seems clear, among both parties, is that negotiations are still being held and both sides want to find a solution. “Memorial Hermann is hopeful that we will be able to come to terms with BCBSTX,” Campbell said. “However, if we are unsuccessful in reaching a mutually acceptable agreement over the next few weeks, Memorial Hermann... will no longer be included in the BCBSTX network,
Avoid the ER this summer
effective July 1.” Campbell did say access to Memorial Hermann Emergency Centers will remain available to BCBSTX members. And Blue Cross also said it wants to find a solution. “We are disappointed that our longstanding relationship with Memorial Hermann may soon end,” the written statement said. “It remains our desire to keep the health system as part of the BCBSTX provider network.” Among health facilities that would continue to accept BCBSTX patients in The Leader’s coverage area are Doctors Hospital-Tidwell and St. Joseph Hospital in the Heights.
Preventive Medicine
Health begins in the grocery aisles by Betsy Denson betsy@theleadernews.com
Water, sun and heat are all factors that can turn summer fun into a health emergency. (Photo from Houston Arboretum & Nature Center)
Follow tips to keep you and your family safe during outings by Cynthia Lescalleet For The Leader Ah, summer. Beaches and barbecues. Pools and playgrounds. Road trips and picnics. And quite possibly a visit to the emergency room. Part of the shift to summer’s pursuits is mental, as we remember how to safely enjoy the season’s activities. To help area residents gear up for a safer summer, the Emergency department at Memorial Hermann Northwest Hospital has a few reminders – including that the trained staff is there and ready if you slip up and need their care. Simple awareness helps hinder accidents and injuries, says Harparminder Chadha, M.D., the Emergency department’s medical director. ”We have to be vigilant about our surroundings. When we go out to enjoy our interests, we tend to forget common sense.” Such as: Wear insect repellent and long-sleeved shirts if you can. Bug bites and stings send a lot of victims to the ER waiting room – as can insect repellent sprayed in your face or eyes. While you’re at it, empty outdoor containers with standing water where mosquitoes can quickly breed. Learn what poison ivy looks like and
avoid it if you encounter it. Skin reactions to it can be quite severe. Note how a more crowded playground means more chaos. Watch the swings, for example. Make sure your youngsters don’t walk in front of them when they’re in use. Pick a playground with soft surfaces by the equipment in case your child falls. Check the sizzle of the slides. They can get scorching hot in the Texas sun. Drink water and electrolyte-replenishing liquids to avoid dehydration, particularly if you are working – or working out – outdoors. Signs of dehydration include fatigue and confusion, then cramping, dizziness and nausea. Refrain from leaving your children or pets unattended in the car. A hot car can kill them in minutes. Use a grill mindfully. If at a park, keep at least 10 feet between fire pits. If children are present, don’t leave the grill unattended. And never use a grill inside your home or garage. Storing the propane tank in the garage is unwise. So is using gasoline to get your coals burning. Be on the lookout at cookouts. They’re notorious sources of food-borne illnesses. Perishable food quickly goes bad. “It might not taste bad, but the bacteria are forming even though you can’t taste them,” says Dr. Chadha. Another picnic tip: Preheat the
see Safety• Page 2B
At top, a day at the beach requires planning for sun protection, hydration and careful attention to water conditions. (Photo from state of Texas) Above, with plant life in full bloom in summer months, learning how to identify problematic growth, such as poison ivy, is essential. (Photo from Houston Arboretum & Nature Center)
Historic Community. Legendary Care.
If you ever want to see your grocery store with new eyes, just tag along with Melissa Hawthorne. A registered dietitian and wellness coach, Hawthorne is on the staff of Advice for Eating, a group of registered dietitians who help people eat — and be — healthier. Formerly at The Houstonian Hotel, Club & Spa for six years, Hawthorne started with Advice for Eating in January of this year. The company was founded by Catherine Kruppa, who served as a dietitian for the 2004 and 2008 US Olympic Diving Teams and also worked with former President George H. W. Bush. Advice for Eating conducts grocery tours for interested parties every other month. People can also schedule a private tour anytime up to 10 people at your grocery store of choice. Hawthorne visits Kroger stores around the Houston area, including the one on 43rd Street, for her tours as well as H-E-B, Central Market, Whole Foods and Rice Epicurean. “Many Houstonians rush in and out of the grocery store and buy the same products every week,” she said. “My clients rave about the tours and enjoy spending the time in the store to find out about new products and meal ideas.” While Hawthorne enjoys the group tours, a larger portion of her work is one-on-one consultations with individuals. Nutrition is always a part of the discussion, but Hawthorne says she also focuses a lot on a person’s overall lifestyle and eating habits. Her clients are a di“When people are in the verse group who come hospital, they’re often not for a variety of reasons: in the right frame of mind weight loss, food alto work on their nutrition. lergies, Celiac disease, sports nutrition, heart What I do helps prevent disease, diabetes, and pepeople from being in the diatrics, among others. hospital to begin with.” “I like helping the community in a wellness setting,” she said. “When people are in the hospital, they’re often not in the right frame of mind to work on their nutrition. What I do helps prevent people from being in the hospital to begin with.” From an early age, Hawthorne was interested in nutrition. She grew up in the Sharpstown area and was a gymnast before making the switch to cheerleading. “I had a pretty healthy upbringing,” she said, “and an open palate for most foods.” After a summer internship with a private practice, Hawthorne graduated from Texas A&M in 2004 with a bachelor of science degree in nutritional science. She then earned her master of science in nutrition from Texas Woman’s University. During her master’s work, she completed an internship of 1,200 hours and passed a national exam to become a registered dietitian. As part of her job, Hawthorne says it is important to stay abreast of nutritional fads and trends, in order to put them in context for her clients. “There will be a nutrition topic mentioned on a television show one day and I get questions about it the very next day,” she said. Advice for Eating is located at 1911 West Alabama,
see Hawthorne • Page 2B