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Carlisle, Pa. • Saturday, March 1, 2014 • Day 2 of 3
HEALTH CARE
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Annual — Health Care
E2 • The Sentinel
Saturday, March 1, 2014
Sections E and F of today’s Annual • E4: What you don’t know about pain can hurt you. • E5: Expanding needs calls for more health system coverage. • E6: Word of mouth a key to success. • E7: Health care companies say mergers offer better options. • E8: The need for specialty health care keeps growing. • E9: There is a
race to sign up the young for health insurance. • E10: These tips can help you save on drug costs. • E11: Nutrition and aging go hand in hand. • F1: Some faces of health care in Cumberland County. • F2: Taking the fear out of a colonoscopy. • F2: Understanding the liver and how to
keep it healthy. • F4: Help take pain out of the stomach bug. • F4: Physical therapy can be key. • F5: Doctors pressured to partner up with health systems. • F6: Urgent care centers take root. • F9: What to expect at your annual physical.
Michael Bupp / The Sentinel
Norman “Tom” Stout of Boiling Springs, left, visits with Dr. Chad Jumper of Boiling Springs Family Medicine during a regular medical check-up.
Coming up in Sunday’s Annual Sunday’s Annual section looks at transportation in the Midstate, including a
breakdown of what the state’s transportation bill says and the arguments
against it, the future of Cumberland County, infrastructure and the Pennsylvania Turnpike.
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The Sentinel • E3
Annual — Health Care
E4 • The Sentinel
Saturday, March 1, 2014
What you don’t know about pain can hurt you It can become intolerable, impacting your quality of life; here’s what you need to know Brandpoint
feel after cutting your finger or breaking a bone. It hurts but eventually the pain goes away. When pain doesn’t subside and lasts for several months, it can be considered chronic. Unfortunately, acute pain — such as from surgery — can become chronic if it’s not treated correctly by physicians because the nerves may be injured or become hypersensitive to the stimuli causing the pain. Learn more about physicians who specialize in pain medicine and how they manage pain by visiting physician-paincare.com. • Chronic pain is common: About 100 million Americans suffer from chronic pain, which can seriously interfere with their quality of life, according to the Institute of Medicine. The most common sources of chronic pain are headaches, back pain and arthritis pain in the joints, such as knees and hips. • Pills are not always the right solution: If you are someone suffering from chronic pain, there are many alternatives beyond traditional oral pain medication to provide you with relief. Serious pain
You may not like it, but when you feel pain, your body is trying to tell you something. In most cases, it’s to stop what you’re doing. (“Ouch, that stove is hot!”) That’s why some pain is necessary and can prevent us from seriously injuring ourselves. But, at times, pain also can be intolerable, becoming constant and negatively impacting your quality of life. “Understandably people want to alleviate their pain,” said Dr. Jane C.K. Fitch, president of the American Society of Anesthesiologists. “Over-the-counter pain relievers can provide temporary relief from minor pain such as headaches and muscle aches. But in many cases, the reasons for and extent of pain are complex and there’s more to safe pain control than popping a pill.” If you or a loved one suffers from chronic pain, it’s important to learn the best way to treat it, according to ASA. Here are some things you should know about pain: • Address pain when you first feel it: Acute pain is the type you
sometimes may be alleviated or minimized by injections or appropriate use of medication(s). In addition, other non-medication methods can help alleviate pain, such as acupuncture, physical therapy, psychological therapy and electrical stimulation — which short circuits pain by stimulating nerve fibers either through the skin or, in some cases, via an implanted device in the spine (and no, it’s not painful).
• Anxiety equals more pain: People who feel anxious-before they have surgery are more likely to feel higher levels of pain afterward. That’s why before a procedure patients are evaluated. Questions regarding their care are answered and physician anesthesiologists often administer medications to help reduce a patient’s anxiety, in addition to performing blocks or administering medications to treat pain. • Pain medicine requires special-
ist care by a physician: Pain medications are strong, the spine and nerves that register pain are delicate and everyone’s anatomy and pain tolerance is different. Pain treatment is complex and it can cause more harm if it is not provided by a skilled pain medicine specialist such as a physician anesthesiologist, who has the training and expertise to diagnose and treat each individual patient safely and effectively. Care provided by a pain specialist is effective because it is individualized to each person. Therefore, it’s important that pain medication be taken only by the person to whom it was prescribed. If you are prescribed pain medications from a skilled pain medicine specialist, be sure to safely store and dispose of prescription medicines once you are finished with them to ensure they are not accessible to anyone else. The American Society of Anesthesiologists recently released a list of specific tests or procedures related to pain medicine that are commonly ordered but not always necessary as part of Choosing Wisely, an initiative of the ABIM Foundation. The list identifies five targeted, evidence-based recommendations that can support conversations between patients and physicians about appropriate pain care. To view the list, visit physician-paincare.com.
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Annual — Health Care
Saturday, March 1, 2014
The Sentinel • E5
Hospitals: Competing with care Expanding need calls for more health system coverage in Midstate area By Samantha Madison The Sentinel When it comes to competing and creating an image in the hospital market, officials from five health systems agree that providing the best possible care for patients is the only thing that matters. Bill Pugh, chief financial officer at PinnacleHealth System, said the best thing about the Midstate hospital market is people have the opportunity to choose which facility and care best suits them. “I think we have a great story, and we like to differentiate in the market from the standpoint of our quality, access to well-trained physicians and our low costs,” he said. “So the combination of accessibility to services and the value that we have, I think, really does differentiate us in this market. I think a primary focus of getting the word out is the high-quality expertise of our physicians because the physicians are, after all, the point of care.” At Holy Spirit Health System, the focus is on offering patients access to quality care at a price they can afford, said Rick LaVanture, senior vice president and chief strategic officer with the hospital. He said every health system is likely to follow that same model because health-care reform has shifted the focus to providing patients with the best experience possible. “Hospitals in the area do compete, but we also collaborate, so it’s a two-way street,” LaVanture said. “All of the hospitals in the area offer some things that are similar, but some things that are different. And we all provide care in very distinctive ways. We’re really engaging people in their care in the medical home and avoiding unnecessary hospitalizations at a higher rate. We’re really trying to put an emphasis on this outpatient network and services and trying to do all this at a lower cost.” Harold Paz, CEO of Penn State Hershey Medical Center, said he believes people deserve access to care, so the hospital puts more emphasis on the patient. The hospital wants to be able to provide top health care to the people of the Midstate so they don’t have to drive out of the region. “We take a unique view of the region because we are the only academic health center that is a teaching hospital and college of medicine together in the entire region,” Paz said. “So our focus is on making sure that people who live in Central Pennsylvania have access to cutting-edge care.” R i c h Newe l l , C EO o f Carlisle Regional Medical Center, said in order to compete in the Midstate hospital market, the individual health systems need to take
on the future; we’ve been focusing on providing great, quality care for the patients of our community and being part of the community. We want to be the premiere hospital for this community.”
The market
LaVanture said the Midstate market is expanding because of baby boomers. The aging population places higher demand on doctors and increases the need for more outpatient care. He said Holy Spirit has expanded to a five-county coverage area, which allows the health system to help more people and compete with other systems in the Midstate. He said as the population ages, the amount of diseases that need to be treated is going to increase, and the health systems will need to pay attention to those changing needs. “Because of the aging of the population, the baby boom phenomenon, we’re finding that we have a very rapid onset of (diabetes, cancer, heart disease, stroke),” LaVanture said. “The first of the boomers are now Medicare age, and so for the next five to seven years, we’ll move into the belly of the baby boomers, and so this will accelerate. There’s a substantial number of people 65 years and older that have two or three of these prominent, significant medical disorders simultaneously — it’s really becoming a problem in our country.” Likewise, PinnacleHealth has expanded to eight counties now, including a new center in Newport, Perry County. Chris Markley, the senior vice president of strategic services and general counsel for the health system, said the coverage area has grown. He said the idea is to provide people with the opportunity to get quality health care they can afford from the organization. PinnacleHealth also has outpatient facilities, family practices, lab centers, home care, a hospice center, and is collaborating with the Pennsylvania Psychiatric Institute and more organizations throughout that eight-county coverage area. “I think one of the other focuses and one of our other strategies is really having integrated care between physician services and hospital services,” Markley said. “Traditionally hospitals were hospitals, and they did hospital things, and doctors were all independent and did their thing. And now, as the environment changes, the payers and the insurance companies and the government are looking for From the top: Carlisle Regional Medical Center, Holy Spirit Hospital and PinnacleHealth System. results and performancebased measures. It’s more care of their patients first tors think looking forward is the future,” he said. “Our vices. The past is just that, important for hospitals and and let them do the adver- more important. image is built by those pa- the past. Since I’ve been the tising for the hospitals. He “We have a long tradition tients that utilize our ser- CEO, we’ve been focusing See Care, E6 said despite CRMC’s past is- of taking care of this comsues with the state Depart- munity, and we’ll continue ment of Health, administra- that as we move forward into
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Annual —Health Care
E6 • The Sentinel
Saturday, March 1, 2014
Word of mouth key to success Advertising also plays a role in getting word out By Samantha Madison The Sentinel Health systems in the Midstate said they advertise in a number of ways, but they also see word of mouth from satisfied patients as an important way to gain and keep patients. R i c h Newe l l , C EO o f Carlisle Regional Medical Center, said despite past image problems, the patients the health system deals with today have provided good feedback. He said that doesn’t mean they don’t advertise, but the patients do a good bit of advertising for them. “What we found to be very beneficial, like a lot of other places, is utilizing the Internet,” Newell said. “We provide a lot of important information to local journals in order to reach out to those areas that we serve. It always comes back to quality care that’s convenient for the patient to use, so they don’t have to drive 15-20 minutes away.” Jessica Walter, director of marketing and public relations for Summit Health, said her department uses a variety of advertising tools
“Obviously it’s very important to get the people in different ways, because they all have different resources and they all have different ways in which they capture and process information.” Rick LaVanture, senior vice president and chief strategic officer at Holy Spirit to reach its audience. Some of those include billboards, Internet advertisements, social media, advertisements in newspapers and magazines, and commercials on radio and TV, she said. Other health systems in the Midstate — Holy Spirit Health System and PinnacleHealth System — follow the same type of advertising model, using media outlets available to them. Penn State Milton S. Hershey Medical Center did not return calls about the way it
Jason Malmont / The Sentinel
Dr. Elie Azar, right, and Craig Goss, RN, left, prepare the interventional radiology suite for a patient recently at Holy Spirit Hospital. uses advertising. Holy Spirit and PinnacleHealth said they believe providing people with information is the most important marketing tool they can use. “Obviously it’s very im-
portant to get the people in different ways, because they all have different resources and they all have different ways in which they capture and process information,” said Rick LaVanture,
senior vice president and chief strategic officer at Holy Spirit. “All we’re really trying to do is inform the general public about what is available and keep them informed and educated. So
what we’re trying to do (on social media) is make sure that residents of the community know that we’re a source of information and that they’ll return to us for information.”
Care Continued from E5 physicians to get together and jointly coordinate the care of patients.” Chambersburg Hospital, which is owned by Summit Health, went from being a small, two-ward hospital in 1895 to having two buildings with more than 400 beds today, said Patrick O’Donnell, CEO of Summit Health. “Our starting point is to understand the health needs and concerns of the populations in our service area through numerous avenues, including, but not limited to, community health needs assessments, patient feedback, and provider input,” he said in an email. “As a nonprofit organization, we continuously reinvest in our employees, physicians, facilities and equipment to offer a comprehensive array of services based on the needs of our community.” Newell said CRMC’s system, which is nearing its 100-year anniversary, not only serves Carlisle, but also now covers a fourcounty area that includes Adams, Dauphin, Cumberland and Perry counties. He said the expansion has allowed other people to experience the care the hospital can provide. The increased presence in those counties includes sleep services, lab services, wound care, outpatient centers, imaging and radiology outside of the main campus in Carlisle. “We’re always looking at service lines that will serve our community,” Newell said. “The outpatient ser-
vices that expanded us up into Perry County and Dauphin County ... it’s really looking at service and development in those areas so that the patients can stay local to get their health care. With the face of health care changing, I think you see more consolidation of health services. I think (people in) Central Pennsylvania (are) extremely lucky to have the choices that they do.”
A changing market The overall attitude toward health care has changed in the last decade, with more emphasis on preventative care and keeping people out of the hospital. O’Donnell said health care professionals view it as their responsibility to keep patients healthy, which means unraveling a century’s worth of thinking. “ T h e c u r re n t m a rke t changes, such as health care reform, Medicare reimbursement and health care exchanges, present some unique challenges, but also keep us on our toes,” he said.
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Top: Chambersburg Hospital. Above: Penn State Hershey Medical Center. “The market is extremely complex and changes rapidly. However, our focus is to continue to provide patients and families with the compassion and care they have come to expect 365 days a year, seven days a week, 24 hours a day.” PinnacleHealth, CRMC, Holy Spirit and Penn State Hershey officials all agree with O’Donnell, saying the change in the way health care officials think mixed with the changing responsibilities make it a completely new market.
Markley said it’s not necessarily about competing with each other but rather it’s more about how the health systems can provide the best care. If that means they work with another system to take care of a patient having a stroke or who has been diagnosed with cancer, then they are willing to do that. Another shift in the role of health systems and hospitals is that they provide more and more educational programs for people. Both PinnacleHealth and Holy
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Spirit use their Twitter accounts to share facts that are educational, instead of just promoting themselves.
Chambersburg’s Facebook page links to stories about topics ranging from trends in health care to scholarship opportunities. And each of the Midstate health systems feature educational programs. The market in the Midstate has grown to cover more than just emergency care and the typical health issues. People are turning to the health systems for education, preventative care measures, as well as support going through a difficult disease or diagnosis. Email Samantha Madison at smadison@cumberlink. com or follow her on Twitter @SentinelMadison
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The Sentinel • E7
Mergers offer better options? Health officials say patients shouldn’t be skeptical of all the deals By Samantha Madison The Sentinel The Midstate health systems market has seen its share of mergers and affiliations over the past few years. Each time the health systems involved tout the advantages the deal will bring to its patients, while some patients are skeptical of the reasons behind the merger. “At first, a merger may have a negative connotation, although I don’t believe that is necessarily the case,” said Patrick O’Donnell, president and CEO of Summit Health. “It is still early in the game to see the long-term impact of many of the mergers taking place. A number of other industries have gone through the ‘merger mania’ phase years ago, so I guess everyone can draw their own conclusions from these experiences.” Health systems often make decisions based on what is going to be in the best interest of their patients, O’Donnell said. Sometimes those decisions may include a merger or affiliation, which could benefit patients by allowing the health systems to share proven methods of providing the best care for patients in a much larger area, O’Donnell said. “This can also help to improve the quality of care for more patients,” he said. “Merging might also help the health systems look for and hire more new providers.” O’Donnell, of Summit Health, which owns Chambersburg Hospital, said he has spoken with all of the CEOs of the major health systems in the Midstate and they are all facing the same challenges. He said those challenges include declining volumes, regulatory changes and payment reductions from Medicare and other payers, more patients opting to skip care because of money concerns, new competitors coming into town with cheaper prices for services such as lab and imaging, unknown effects of health-care reform, lowering the cost to make it more affordable for patients and employers, and making tough decisions about merging with other systems or remaining independent.
Core values Bill Pugh, chief financial officer of PinnacleHealth System, agreed that mergers and affiliations are one of a number of changes that is happening in health care at this time. He said on one hand, mergers create new values for the community the system serves, but on the other hand, it can mean a loss of control in the local area. He said there are a number of things to think about be-
Recent mergers Here are some of the mergers and affiliations Midstate health systems have made: • Penn State Hershey and PinnacleHealth are exploring an “enhanced relationship” • Penn State Hershey partnered with Mount Nittany Health for cancer care • Carlisle Regional Medical Center paired with Penn State Hershey on its cancer center • Geisinger Health System and Holy Spirit announced an intent to explore an affiliation • Carlisle Regional Medical Center and Penn State Hershey paired for stroke care • Penn State Hershey has paired with eight different hospitals for stroke care • PinnacleHealth and Reproductive Medicine Associates • Penn State Hershey and Holy Spirit paired on cardiovascular health • Chambersburg Hospital’s parent company paired with WellSpan Health on stroke care • Good Samaritan Hospital in Lebanon and WellSpan Health in York announced plans to merge • Carlisle Regional Medical Center pairs with the burn center in Lehigh Valley fore a health system agrees to a merger or affiliation. “Mergers are just sort of one form of the changes that are going on in this industry — you can have partnerships and collaborations and affiliations and mergers,” Pugh said. “There’s usually a pretty rational explanation as to why two organizations would come together. But one size doesn’t fit all, and if you’ve seen one, you’ve seen one, and if you look at the next one, it’s going to be structured a little differently.” Rick LaVanture, senior vice president and chief strategic officer of Holy Spirit Health System, said while he can’t speak to other mergers or affiliations, the exploration between Holy Spirit and Geisinger Health System has been going well so far. He said he doesn’t see anything negative at this time, but it is important for health systems to match up their beliefs before moving forward. “Health systems need to be able to grow and adapt in order to survive,” LaVanture said. “For us, the reason that Geisinger and Holy Spirit have chosen to explore this together is that we share a lot of the same core
Dr. Mubashir Mumtaz and Dr. Brijeshwar Maini of the PinnacleHealth CardioVascular Institute at Harrisburg Hospital.
“If we can reach out and establish business relationships with other health-care providers when it benefits our patients, then we are adding value.” Patrick O’Donnell, president and CEO of Summit Health
The Holy Spirit interventional radiology suite. values in our mission and we both have that emphasis on patient care and community service. You want to pay close attention to culture. It’s very important that as cultures come together that they come together in a good way. As organizations affiliate, there (needs to be) a good communication plan. I think it’s very important for the organizations that combine or affiliate to keep both informed on what’s happening.”
Better technology Carlisle Regional Medical Center pairs with Penn State Hershey to provide better and quicker care for stroke patients, CEO Rich Newell said. He said the technology involves a computer robot that allows a patient displaying stroke symptoms to be brought to CRMC’s emergency room and still receive the kind of care they would get at Penn State Hershey. CRMC also partnered with Hershey on its cancer center. “It puts us right in touch with a neurosurgeon or neurologist at Hershey Medical Center instantly, and they help our emergency room physicians treat the patient
and get them the highest quality of care, quickly,” he said. “We’re always looking to expand our care and what we’re able to provide our patients. That’s part of the reason we (also) partnered with Penn State Hershey with our cancer center, because it allows our patients to participate in clinical trials that otherwise they wouldn’t be able to, which can open up new lines of treatment.” Penn State Hershey has eight partnerships just with the telestroke technology, said Harold Paz, the CEO of the health system. He said they have a total of 17 hospital affiliations throughout the region, some as far out as Reading and Lancaster. “We want to have that,” Paz said. “What we do ... is very different from what other hospitals are doing across Pennsylvania and what we’re trying to do is create these partnerships to add value to the care that can be delivered to these communities, and we think that is very important.” O’Donnell said Summit Health’s goal is to stay an independent unit, so even though it has looked into other options, the health system decided not to merge
with another. It does, however, have a partnership with WellSpan Health in York for a telestroke program, much like the one Hershey has with CRMC. “If we can reach out and establish business relationships with other health care providers when it benefits our patients, then we are adding value,” O’Donnell said. “Fortunately, Summit Health has remained financially stable over the years, and we have continued to do well with patient volumes. This will allow us to focus our attention at being better
at what we already do well.” Pugh said the most important reason that hospitals entertain an opportunity to either partner or merge with another health system is to help provide better care for the patients they serve. He said when it gets down to it, the competition isn’t as important as being able to help their patients. “Remaining independent and unaffiliated with a larger organization is becoming more and more difficult,” Pugh said. “We are constantly thinking about how we can improve the health status of the population and how do we do that. We think we have a good story to tell, but we know we can do better. And part of doing better is working with others and collaborating on things.” Email Samantha Madison at smadison@cumberlink. com or follow her on Twitter @SentinelMadison
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Annual —Health Care
E8 • The Sentinel
Saturday, March 1, 2014
Need for specialties keeps growing Cancer, cardiovascular, stroke care among services that need to be provided By Samantha Madison The Sentinel The Midstate follows the same trends as the rest of the country when it comes to the growing need for specialty care from hospitals and health systems. People need more attention for cancer, heart, stroke and obesity now than they did previously, officials said. Niki Showe, senior vice president of physician services at Summit Health, said a 2012 Community Health Needs Assessment survey showed that about 36.5 percent of respondents had a body mass index in the obese range, which can lead to the development of diseases such as diabetes and heart disease. That study is just one bit of information that helps hospitals determine they need weight management and heart care specialties. Summit Health, which owns Chambersburg Hospital, hired Paul Klink, a family doctor who now specializes in bariatric medicine, to lead Summit Weight Management Services. His role is to treat and support patients who may or may not have been diagnosed with a disease but are considered to be overweight or obese, Showe said. “We have also expanded our cardiology services by adding two full-time physicians, as well as collaborating with Keystone Health, who also hired a cardiologist last summer,” she said in an email. “Patients with Summit Cardiology can now schedule appointments within two days of when they call to schedule.”
Specialty care Summit Health is not the only health system in the Midstate seeing the need for these areas of care. PinnacleHealth Systems has responded to the increase in heart disease and obesity, as well as diabetes, cancer and stroke, by increasing its educational information through on-site classes and Twitter, as well as by increasing the staff in those specialties, said Bill Pugh, chief financial officer for PinnacleHealth. He said there is more of a need for the care of those people diagnosed with chronic illnesses. “The whole notion of managing chronic disease, intervening earlier, doing preventative work, identifying patients that are already high-risk and those rising-risk patients based on their likelihood of entering into a chronic disease state (is a big growth area),” he said. “The growth for us has been starting programs and changing the way we do things to help identify those patients and work with patients before they need to come to a hospital and hopefully keep them out of the hospital. While it doesn’t sound like a growth business, it is really where we’re spending a lot of our time and money.” With the baby boomers starting to reach Medicare age, Rick LaVanture, senior vice president and chief strategic officer at Holy Spirit Health System, said they have started to see the
need for ramped-up specialty care. He agreed there is a lot of focus on cancer, cardiovascular, diabetes and obesity, but he also said there is also an increase in minimally invasive surgeries being performed when possible. “Holy Spirit is a community hospital and a community health system, so as a community health system, we need to pay special attention to the changing health-care needs,” LaVanture said. “So, Holy Spirit, at least for its part, has put a special emphasis on (diabetes, cancer, cardiac disease and stroke). We put special effort into becoming a national certified stroke center. And for diabetes, we have the Holy Spirit Endocrinology Center and Diabetic Education Center, so we’ve really developed a center of excellence around metabolic disorders.”
Preventative care Penn State Hershey Medical Center is also seeing an increase i n e x t ra corporeal membrane oxygenation (EMCO) technology, sa i d H a rold Paz, the Harold Paz CEO of the health system. Another big growth area is the personalized medicine institute, where the doctors learn to better understand genetic code to discover how to treat a specific patient. “The greatest need we have in this country is primary care,” Paz said. “We see tremendous demand on our ECMO facilities, which are in our heart and vascular institute. With influenza this winter — the severity of it — many patients have been transferred in and put on a heart-lung bypass to allow them to get through their illness, so we’re seeing real growth in a lot of the high-tech (care areas).” He said because Penn State Hershey is a teaching hospital, the facilities tend to get the cutting-edge technology ahead of the rest of the health systems in the Midstate. He said catering to the new specialties in the field is important because people deserve access to care and they are training the next generation of doctors. Carlisle Regional Medical Center paired with Penn State Hershey about eight months ago to offer people more advanced stroke care, CEO Rich Newell said. He said stroke care is important because if a person can be taken to their home hospital and receive top care, it eliminates the drive time to someplace like Penn State Hershey and the loss of crucial moments to save the brain. CRMC also has boosted its cancer care as diagnosed cases are increasing and the baby boomers are starting to age. CRMC also has the wound center, which can address lower extremity wounds that won’t heal as well in patients who have diabetes. Newell also said, while it’s not a specialty per se, outpatient care has started to
The Ortenzio Heart Center is located at Holy Spirit.
Chambersburg Hospital’s new cardiac catheterization lab allows its cardiology team to treat patients in a larger space with state-of-the-art catheterization technology. become more popular with patients and hospitals alike because it makes everything run more smoothly. “(We aim to) provide as many outpatient services as possible,” he said. “If you make it convenient for the patient, it’s hard for them not to go there. Telemedicine services (are) a very big line that’s going to continue to expand in the future.” The five health systems agreed that while the specialty fields, such as cancer, diabetes, obesity, stroke and cardiovascular, have grown fairly steadily, it’s areas such as preventative care and outpatient care that seem to have seen the most growth. Showe said Summit Health is waiting to see what effect the new health care law is going to have, but she expects that it will be focused on preventative care. “With the anticipated expansion of health care coverage, we expect to see an increase in the number of people who have access
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to coverage for preventive care, including physicals,” Showe said. “In addition, we continue to have a growing elderly population. As a result, we are expanding several of our primary care practices in order to accommodate the needs of our local residents. This will allow residents to seek care closer to home and at times most convenient to them.” Email Samantha Madison at smadison@cumberlink. com or follow her on Twitter The Carlisle Regional Cancer Center opened in @SentinelMadison 1999.
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Annual — Health Care
Saturday, March 1, 2014
The Sentinel • E9
Race to enroll young and healthy for new insurance By Julie Pace Associated Press WASHINGTON — “Do you guys have health insurance?” David Bransfield asks each time a group of college students passes by. Some nod yes. A few promise to stop back after class. Others don’t bother removing their headphones. Nearly every day, Bransfield comes to a satellite campus of the University of the District of Columbia in the shadow of the Capitol, sitting for hours behind a table in the lobby of a classroom building. With an Apple laptop and lots of fliers, he’s part of the army of workers and volunteers trying to enroll young, and probably healthy, people in health insurance available through President Barack Obama’s law. Run largely by groups with close ties to the White House, the recruiting effort is based in part on lessons learned from Obama’s presidential races, which revolutionized the way campaigns tracked and targeted voters. “On the campaign, you want to be able to find an Obama voter and you want to get them to vote,” said Matt Saniie, who worked on the 2012 campaign’s data team and is now analytics director at the organization Enroll America. “In the enrollment world, you want to find someone who is uninsured and you want to get them to enroll.” More than any other group, participation from among the “young invincibles” — those ages 18 to 34 — will be crucial to the law’s success. The Kaiser Family Foundation estimates that about 40 percent of those who enroll need to be young and healthy, to balance out the higher costs of insuring older, sicker people.
Associated Press
David Bransfield, a state outreach coordinator for Young Invincibles, a group which supports President Barack Obama’s health care law, talks with student Philippe Komongnan, 27, who is in the process of signing up for health care, at the University of the District of Columbia in Washington on Jan. 30. An army of workers and volunteers has fanned out around the country trying to enroll young and healthy people in health insurance now available through Obama’s signature law. But less than two months before the March 31 sign-up deadline, the administration is lagging behind its goal. Young adults made up about one-fourth of the 2.2 million people who enrolled
in the exchanges through December, the last time the administration released demographic data. Officials announced in mid-January that 3 million people had enrolled in in-
surance plans, but officials didn’t update the demographic details. Critics of the law say young people were most likely to be turned off by the technical problems that
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man, her laptop and spiral notebook spread out before her as she worked in the Guilford Technical Community College cafeteria in Jamestown, N.C. “I’m unemployed. I can’t pay a whole lot of money. So that will definitely be a major factor.” As Chapman studied, a volunteer from Enroll America was going from table to table in the cafeteria, encouraging uninsured students to sign up. The volunteer, retired dentist Benjamin Williams, 75, didn’t persuade Chapman to enroll, but he did get her to sign a card setting her up for a follow-up call to answer her health care questions. With Chapman’s personal information now in Enroll America’s system, volunteers almost certainly will keep tabs on her enrollment status through March 31, mirroring the way the Obama campaign tracked likely Democratic voters. Unlike the political campaign, in which staffers relied on voting records to track possible supporters, there’s no ready-made list of the uninsured. So outside See Young, E10
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Annual — Health Care
E10 • The Sentinel
Saturday, March 1, 2014
These tips can help you save on prescription drug costs Metro Creative Connection
Associated Press
David Bransfield, a state outreach coordinator for Young Invincibles, works on his computer at a table set up to sign people up for health care at the University of the District of Columbia in Washington on Jan. 30.
Young Continued from E9 groups are compiling their own databases through contacts their volunteers make while they’re promoting the health law at colleges, bars, church youth group events, and even laundromats. Marlon Marshall, another veteran of Obama’s presidential campaigns, now oversees health care outreach efforts for the White House. He said the strategy for signing up young people it to “meet them where they’re at.” The approach worked for Philippe Komongnan, 27, a student at the University of the District of Columbia.
Komongnan thought he had health insurance, but when a bad ear infection brought him to the emergency room last year, he was told he no longer had coverage. Because his school requires students to have insurance, he had to sign up for coverage through the college that costs nearly $700 per semester. Then Komongnan started noticing a health care display in the lobby of his classroom building, the one where Bransfield works most days. After a couple of conversations, Bransfield plugged Komongnan’s information into Washington’s health care website and discovered
that he qualified for Medicaid, which has been expanded under the new law. While Komongnan’s costs will drop dramatically, he doesn’t count toward the pool of young and healthy people the White House is courting because he’s getting coverage through Medicaid, not the new private marketplace. Bransfield, who works for the aptly named organization Young Invincibles, said signing up young people takes patience, given that most are buying insurance on their own for the first time. The process can sometimes take weeks, he said.
Prescription drugs can be quite expensive, and even those who have health insurance often pay more than they need to. According to a 2012 Consumer Reports “Best Drugs” poll on prescription drugs, Americans routinely take an average of four medications per day, spending nearly $800 on drug costs each year. Those who do not have health insurance may have to pay much more out of pocket. As expensive as prescription medications can be, there are ways to save money on drug costs.
medical bills as you would any other bill and verify that the charges are correct. If you have any doubts, check the drug name with your doctor and then consult with the pharmacy to see if an error was made.
Preferred pharmacy Certain insurance companies have negotiated discounts with mail-order pharmacies and pass on the savings to their members. Medicare and other government-sponsored plans may offer the same type of deal, and consumers can save a substantial amount of money by opting for mailorder service.
Comparison shop
Consider wholesalers
Believe it or not, drug prices vary depending on the time of the year and even the pharmacy. A person can shop around for the most affordable medication just like they would when buying another product. Prescription drug apps enable you to search for discounts in your neighborhood.
You may think of Costco or Sam’s Club as your goto place to buy 30-packs of toilet tissue, but these retailers offer discounts on prescription drugs. Even nonmembers are allowed to use these warehouses for prescription drug needs. Big wholesalers could give you the best deal on your pills.
Read your bill
Skip insurance?
Medical coding and billing is not always accurate. Employees entering codes may put in the wrong information, inadvertently charging a person for the wrong medication. Treat your
Consumer Reports says hundreds of commonly used generic medications can be purchased for around $10 for a three-month supply at various major chains. Program details vary, but
consumers might be able to save a lot of money by using these programs and leaving their insurance cards in their wallets.
Generic medications
Generic versions of hundreds of brand name prescription drugs are available and typically cost a lot less money. With a generic medicine you are not paying for marketing and advertising costs. These drugs are routinely tested for efficacy and safety. There is really no reason to select a namebrand medicine over the generic alternative, even when it comes to over-the-counter drugs. Ask your doctor on your script to check the box for the generic option.
Opt for OTC
In many cases, an overthe-counter medication may be just as effective as a prescription drug. Talk to your doctor about trying an OTC remedy before a prescription is written. Ibuprofen may relieve arthritis pain, and diphenhydramine could alleviate insomnia, all at a much lower cost than prescription drugs. Prescription drug costs can add up. But there are a number of strategies consumers can employ to reduce the out-of-pocket expenditures on medications.
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Annual —Health Care
Saturday, March 1, 2014
The Sentinel • E11
Nutrition and aging go hand-in-hand Metro Creative Connection Nutrition is important for people of all ages, but it’s especially important for men and women older than age 50, who can dramatically improve their quality of life by eating a well-balanced diet filled with vitamins and nutrients. Though that may seem like common sense, research has shown that men and women in this age group, who are often referred to as “baby boomers,” are not necessarily as healthy as they may seem. While the baby boomer generation, which is generally regarded as those people born between 1946 and 1964, boasts longer life expectancies than any generation that came before them, some of that likely can be chalked up to advancements in medical care, including a booming pharmaceutical industry that seemingly has an antidote to every ailment. But a 2013 study from researchers at the West Virginia University School of Medicine found that baby boomers are less healthy than the generation that immediately preceded them, tending to be more likely to have higher levels of hypertension, diabetes and high cholesterol. While that news might be sobering, it’s never too late for men and women older than 50 to start eating healthier diets, which can reduce their risk of a wide range of ailments, including heart disease, stroke and osteoporosis. The following are a few ways men and women older than 50 can alter their diets so their bodies are getting what they need to live long and healthy lives well into their golden years. As is always the case, men and women should discuss any potential changes to their
Nutrition is especially important for men and women older than age 50. diets with their physicians to ensure the changes will be both effective and healthy. • Balance your diet. Kids hear of the benefits of a balanced diet seemingly from the moment they enter a classroom for the first time, but many adults fail to heed that basic advice as they get further and further away from kindergarten. When changing your diet, be sure to include plenty of protein and carbohydrates. Protein maintains and rebuilds muscles, which is especially important for aging men and women who might find themselves unable to
keep up with the physical demands of everyday life as well as they used to. Including ample low-fat protein, which can be found in fish, eggs and low-fat dairy among other foods, will aid in muscle recovery, benefitting aging athletes as well as those men and women older than 50 who recently started exercising as a means to regaining their physical fitness. A diet lacking in sufficient protein can contribute to muscle deterioration, arthritis and even organ failure, so it’s important for men and women to prioritize including protein in
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their diets. Carbohydrates are also an important part of a balanced diet, as they are a great source of energy that can help men and women stay active well past the age of 50. Carbohydrates found in fruits, grains and vegetables are the most beneficial, as these contain valuable vitamins, minerals and nutrients. • Don’t denounce dairy. Dairy is a great source of calcium, which promotes strong bones and teeth. Men and women older than age 50 want their bones to be as strong as possible because aging is one of the strongest risk factors for osteoporosis, a potentially debilitating medical condition in which loss of tissue causes bones to become brittle and fragile. Vitamin D is necessary to effectively absorb calcium, and vitamin D can be found in certain dairy products, including pasture-raised eggs and grass-fed cow’s milk, and can be generated when men and women get enough sunlight. Other healthy sources of vitamin D include salmon, light tuna packed in oil, sardines, and sun-grown mushrooms. • Cut back on sodium intake. Cutting back on sodium intake can be very beneficial, especially for men and women older than age
ONE TEAM
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30+ YEARS OF DELIVERING BARGAINS
OTHER PROGRAMS OFFERED IN FIELDS LIKE: BUSINESS, LEGAL, MASSAGE, NETWORKING, AND MORE.
FIND OUT MORE AT OR CALL
McCann.edu
866-471-4760
A LWAY S A B A R G A I N . . . A LWAY S I N S T Y L E From local retail locations, to our distribution centers, to buying offices in New York, Los Angeles, Boston and our corporate headquarters, Ross Stores, Inc. offers tremendous career opportunities. So bring us your talent, your passion and sound thinking. We’ll give you a career, a challenge, a team and a place to call home. Are you ready to join us? Explore our website to learn more about Ross Dress for Less and dd’s DISCOUNTS jobs to find the career that fits.
Changing Futures. Changing Lives.®
Distribution Center and Local Ross Stores: Colonial Commons
346 YORK ROAD • CARLISLE, PA 17013
5100-C Jonestown Road, Harrisburg 717-671-649
For more information about our graduation rates, the median debt of students who completed these programs, and other important information, please visit our website at: disclosure.mccann.edu. McC.CAR.07708.C.101 • ©DCE 2014
Ross/dd’s Distribution Center 1707 Shearer Drive, Carlisle 717-249-3111
West Manchester
•
1275 Carlisle Road, West Manchester 717-848-4002
Mechanicsburg
• 6416 Carlisle Pike, Suite 2600, Mechanicsburg 717-790-9454
York
•
2855 Concond Road, Suite 350, York 717-840-4794
Hanover
•
71 Wilson Ave., Hanover 717-630-2288
Apply online at www.rossstores.com
E12 • The Sentinel
Saturday, March 1, 2014
CARLISLE REGIONAL MEDICAL CENTER
In the heart of Carlisle, we are committed to providing high quality healthcare for exceptional healing. • State-of-the-art emergency department • The latest in diagnostic imaging capabilities • The most advanced surgical technologies • A beautiful women’s center • Physicians, nurses, auxiliary and leadership dedicated to your health and recovery • Comprehensive cancer center affiliated with Penn State Hershey Medical Center • UHMS accredited wound healing center • Advanced surgical technologies, including MAKOplasty®robotic-assisted surgery
Convenient one-call scheduling: 717-245-5244
361 Alexander Spring Road | Carlisle, PA 17015 717-249-1212 | CarlisleRMC.com