June Communication with your Doctor PAGE 2. Always Available to Our Members Quality Management Department: Measuring Success

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1 June 2013 Communication with your Doctor PAGE 2 Patient Safety Corner: Stand Up for your Safety PAGE 3 Preventive Health: Lose the Habit; Gain a Healthier, Longer Life Diabetes HbAlc Control PAGE 4 Always Available to Our Members Quality Management Department: Measuring Success PAGE 7 Colorectal Cancer Screenings Concierge Service Locations PAGE 8 Member Rights and Responsibilities PAGE 5 Preventive Health Standards: Prevention is Key! PAGE 6 Please refer to our website for updated information on plan providers at or contact Member Services at

2 C m n o o mu ica i T alking to your doctor can be overwhelming, but talking to your doctor and asking questions is actually expected. You should not feel like you are bothering him or her. Sometimes you may not know what to ask your doctor or he or she may use words that you do not understand. It is always important to ask questions or to say I m not sure what you just said. It may also be easy to forget what the doctor says, no matter your age. You can ask someone to be with you when you are speaking to your doctor; this can be someone coming with you to an appointment or being with you during your hospital stay and/ or discharge. They can listen to the doctor with you and provide support. They can ask questions you may forget. They may also remember something the doctor said that you don t remember. It is okay if you want to write things down, have someone else write things down for you or ask the doctor to write down the important words. It is important to try to ask all of your questions before you leave your appointment or the hospital. Make sure you also understand any instructions given before you leave. Repeat instructions you receive back to your doctor or nurse to make sure you understand them. You shouldn t be afraid to contact your doctor if any other questions or concerns come up after your conversation. h r n y ur t w it o As a patient, it is important to understand your health condition. Talk to your doctor about recognizing symptoms and make sure you understand how to check if your health condition is getting better or worse. Know what to do and when to call your doctor to report changes. It is also necessary to talk to your doctor about what medicines you are taking. This includes prescriptions, over-the-counter medicines, vitamins and other supplements such as herbal products. You can bring your pill bottles in for your appointments with your PCP or Specialist. It s a good idea to keep a medicine list especially if you see more than one doctor. The doctor can let you know of any possible problems with your medicine. You should know why taking your medicine is important and understand about any changes in your medicines. Talk about any side effects that you may have and make sure you know what to do if you think you are having side effects. Any instructions that your PCP or Specialist gives you to take care of your health is part of your treatment plan. If you don t understand something in your treatment plan, you need to ask. Ask for your treatment plan to be written down for you if it would be helpful for you to keep track of it. Treatment plans can always change, so it s helpful to discuss it at your doctor visits. Make sure you understand Docto 2 Freedom Health - Member Newsletter June 2013 It is essential to have good communication with your doctor. This is important to remember when talking to your Primary Care Provider (PCP) or Specialist, as well as doctors that may take care of you in a hospital setting. When you feel you are able to openly converse with your doctor, you can have better health results. Better health results improve your overall health and well-being. any changes made. Verify your treatment plan is always up to date. If you are being discharged from a hospital, there are additional things you may need to discuss with your doctor. Make sure you have the name and phone number of who you should get in touch with in case there is a problem during your transfer. You also need to be able to understand what is expected of you and what type of support you will need, such as home health visits or a walker, once you leave. Ask about any task you may need to perform when discharged (cleaning wounds, changing bandages, etc.), including how to do them. Let the doctor know if you do not feel you would be able to perform these tasks on your own and if you think you will need help. If you are leaving a hospital, you will receive a discharge plan. You need to be able to correctly follow the plan. Make sure you understand the discharge plan and ask questions if needed. As part of your discharge plan, make sure to schedule a follow-up appointment with your PCP or Specialist. It s also important to take any discharge paperwork with you to these followup appointments to facilitate communication. You can do things to help prepare for effective communication with your doctors, whether a

3 PCP, Specialist or hospital doctor. Make sure your doctor knows all of the medicines that you take. We suggest that you also make a medicine list. This list can make a big difference in how well your doctors and other health care staff can help keep you safe. Making your own medicine list is easy. Think about all of the medicine you take including over-the-counter medicine, vitamins and other supplements such as herbal products. You don t need to have a special list; you could use a notebook or a piece of paper. If you already have a list, take some time looking over it each year and make any needed updates. Also, consider keeping a folder of any labs or test results. This information helps you stay well-informed about your health. It also can save you and your doctor time if you have a folder with these reports readily available. You can look at this folder when talking to your doctor. It may help you answer questions that he or she may have. By understanding your health and communicating effectively with your doctor, you become an active partner in your own health. Patient Safety Corner - Stand Up for your Safety Falls are the most common cause of injury in senior citizens. In fact, the CDC states that one out of every three adults 65 years or older fall each year, resulting in a great deal of preventable injuries and hospitalizations. However, there are many precautions you can take to prevent falling.,_lyjpzlyln\shys`[vpujylhzl`v\yz[ylun[ohuk improve your balance. ;HSR[V`V\YKVJ[VYHIV\[WYLZJYPW[PVUZ`V\[HRL[OH[ may have side effects such as dizziness or drowsiness. /H]L`V\Y]PZPVUJOLJRLKH[SLHZ[VUJLH`LHYHUK make sure your eyeglasses or contacts match your most updated prescription. *VUZPKLY\ZPUNZVTLVM[OLMVSSV^PUNOLSWM\S products that can make your life easier, more enjoyable and safer: *HULZHUK^HSRLYZ^P[OWYVWLYY\IILY[PWZ )H[OZLH[ZHUKOHUKOLSKZOV^LYOLHKZ 9HPZLK[VPSL[ZLH[Z.YHIIHYZHUKWVSLZTV\U[LKWYVWLYS` throughout the home 5VUZRPKIH[OTH[ZHUKUVUZSPWZ\YMHJLZPU the shower or bathtub 9LHJOLYZ^P[OZ\J[PVUJ\WZNYPWZVYTHNUL[Z on the end Don t take the risk of falling and injuring yourself. Take precautions to stay strong and stay on your feet. TTY/TDD

4 Preventive Health: Lose the Habit; Gain a Healthier, Longer Life PE ven if you do not smoke JPNHYL[[LZ IYLH[OPUN PU ZVTLVUL»Z secondhand smoke can lead to serious health problems too. If you do smoke, please be respectful of others around you who do not ZTVRL -VY L_HTWSL NV V\[KVVYZ [VZTVRLKVU»[ZTVRLPUHJHY^P[O nonsmokers, and most importantly, JVUZPKLY X\P[[PUN family members will appreciate your efforts to keep them and yourself safe and healthy. ;OLYLHYLPTTLKPH[LHUKSVUN[LYT ILULÄ[ZMVYIV[O`V\HUK`V\YSV]LK VULZ ^OLU `V\ X\P[ ZTVRPUN;OL Online resources to help you quit smoking: WYVJLZZVMX\P[[PUNZTVRPUNJHUIL KPMÄJ\S[I\[[OLYLHYLTHU`[OPUNZ you can do to make the process LHZPLY ;OLYL HYL TLKPJH[PVUZ VY nicotine replacement products to relieve withdrawal symptoms. Counseling or different types of therapies are often helpful. Helplines offer free personalized help from specialists. 0[TH`ILHKPMÄJ\S[WYVJLZZI\[P[ could save your life and your family TLTILYZ» SP]LZ 9LTLTILY `V\ HYL UV[ HSVUL `V\Y WYV]PKLYZ ^PSS be more than happy to discuss your VW[PVUZMVYX\P[[PUN ^^^S\UNVYNZ[VWZTVRPUN;OL(TLYPJHU3\UN(ZZVJPH[PVU»Z-YLLKVT from Smoking Program ^^^ZTVRLMYLLNV]7YV]PKLZZ\WWVY[[VWLVWSL[Y`PUN[VX\P[ZTVRPUN ^^^X\P[UL[JVT ^^^JKJNV][VIHJJVX\P[FZTVRPUN ^^^)LJVTLHU,_VYN!(MYLLWSHU[VOLSW`V\X\P[ZTVRPUN Cigarette smoking puts you at risk for many different health problems and harms nearly every organ in your body. Smoking can lead to heart disease, doubles a person s risk for a stroke, and leads to many forms of cancer. Smoking is the leading cause of preventable death in the United States. TELEPHONE QUIT LINES Call for free one-on-one help from information specialists. *HUJLY0UMVYTH[PVU:LY]PJL8\P[3PUL *(5*,9 (TLYPJHU3\UN(ZZVJPH[PVU-YLLKVT -YVT:TVRPUN8\P[3PUL LUNG-USA Center for Disease Control QUIT-NOW " ;;@! Diabetes HbAlc Control I f you have Diabetes, you should be checking your blood glucose at home on a daily basis. But this daily testing does not show your sugar levels over a longer period of time. That is what the HbA1c test shows you. HbA1c is short for hemoglobin A1C, or glycosylated hemoglobin. This test measures your average blood glucose control over the past 2 to 3 months. If it is under control, your HbA1c should be less than 7%. If it is higher than 7%, you are at an increased risk of developing eye, kidney, or nerve disease. With these test results, you and your doctor can get a better idea of how well your treatment plan is working, and adjust it accordingly. The American Diabetes Association says the A1C test can help manage your diabetes by: s 3HOWING HOW ACCURATE YOUR DAILY SELFTESTING has been s $ETERMINING WHETHER YOUR TREATMENT PLAN IS working s 3HOWING YOU HOW HEALTHY CHOICES INmUENCE your blood sugar levels It is recommended for people with diabetes to get this test at least twice a year. If you are not meeting your blood glucose targets, you should be tested four times a year. Remember, while this test is an important tool for checking your blood glucose over time, it is not a replacement for your daily self-checks. 4 Freedom Health - Member Newsletter June 2013

5 You have certain rights while you are getting medical care. You also have certain responsibilities as a patient. The following is a summary of your rights and responsibilities. MEMBER RIGHTS As a member of a Freedom Health plan you have the right to: s "E TREATED WITH COURTESY AND RESPECT WITH APPRECIATION OF YOUR dignity, and protection of your need for privacy s! PROMPT AND REASONABLE RESPONSE TO QUESTIONS AND REQUESTS s +NOW WHO IS PROVIDING MEDICAL SERVICES AND WHO IS RESPONSIBLE for your care s +NOW WHAT PATIENT SUPPORT SERVICES YOU CAN GET AND IF AN interpreter is available if you do not speak English s +NOW WHAT RULES AND LAWS APPLY TO THE CONDUCT OF THE STAFF OF THE Plan and contracted providers s "E PROVIDED INFORMATION ABOUT DIAGNOSIS PLANNED COURSE of treatment, alternatives, risks, and prognosis by the Plan s providers s 2EFUSE ANY TREATMENT EXCEPT AS PROVIDED BY LAW s )F ELIGIBLE FOR -EDICARE KNOW UPON REQUEST AND IN ADVANCE of treatment, if the health care provider or health care facility accepts the Medicare assignment rate s 2ECEIVE BEFORE TREATMENT A REASONABLE ESTIMATE OF CHARGES FOR medical care s 2ECEIVE A COPY OF A REASONABLE CLEAR AND UNDERSTANDABLE detailed bill and, upon request, to have the charges explained s!ccess TO MEDICAL TREATMENT OR ACCOMMODATIONS REGARDLESS OF race, national origin, religion, physical handicap, or source of payment s 4REATMENT FOR ANY EMERGENCY MEDICAL CONDITION THAT WILL GET worse from failure to provide treatment s +NOW IF MEDICAL TREATMENT IS FOR EXPERIMENTAL RESEARCH AND to grant consent or refusal to take part in such experimental research s 0RIVATE HANDLING OF MEDICAL RECORDS AND EXCEPT WHEN REQUIRED by law, be given the chance to approve or refuse their release s 6OICE COMPLAINTS OR APPEALS ABOUT THE ORGANIZATION OR THE CARE IT provides s %XPRESS GRIEVANCES ABOUT ANY VIOLATION OF YOUR RIGHTS AS STATED in Florida law, through the Plan s grievance and appeals system, MEMBER Rights AND Responsibilities and to appeal to a state grievance and appeal oversight entity; or for Medicare members, through the CMS established appeal process s 0ARTICIPATE WITH PRACTITIONERS IN MAKING decisions about your health care, and provide input into your proposed treatment plan s 2ECEIVE INFORMATION ABOUT THE 0LAN ITS services, practitioners and providers, and members rights and responsibilities s 0ARTICIPATE WITH PRACTITIONERS IN MAKING decisions about your health care s (AVE A CANDID DISCUSSION OF APPROPRIATE OR MEDICALLY NECESSARY treatment options for your conditions, regardless of cost or benefit coverage s -AKE RECOMMENDATIONS REGARDING THE 0LANS MEMBER RIGHTS AND responsibilities policies MEMBER RESPONSIBILITIES As a member of the Plan, your provider expects you to: s 0ROVIDE YOUR HEALTH CARE PROVIDER TO THE BEST OF YOUR KNOWLEDGE correct and complete information about present complaints, past illnesses, hospital stays, medicines and other health matters s 2EPORT UNEXPECTED CHANGES IN YOUR CONDITION TO YOUR HEALTH CARE provider s 5NDERSTAND YOUR HEALTH PROBLEMS AND PARTICIPATE IN DEVELOPING mutually agreed-upon treatment goals, to the degree possible s $ISCUSS WITH YOUR HEALTH CARE PROVIDER IF YOU DO NOT COMPREHEND a course of treatment or what is expected of you s &OLLOW THE TREATMENT PLAN SUGGESTED BY YOUR HEALTH CARE PROVIDER and agreed upon by you s +EEP APPOINTMENTS AND WHEN YOU ARE UNABLE TO DO SO FOR ANY reason, notify your health care provider or health care facility s!nswer FOR YOUR ACTIONS IF YOU REFUSE TREATMENT OR DO NOT FOLLOW the health care provider s instructions s!ssure THAT THE lnancial OBLIGATIONS OF YOUR HEALTH CARE ARE fulfilled as promptly as possible s &OLLOW HEALTH CARE FACILITY RULES AND LAWS THAT AFFECT PATIENT CARE and conduct TTY/TDD

6 P re reventive health tests can give you information about your health. These tests can find health problems early, before they become serious. Freedom Health adopts preventive health standards for our members. These standards are based on nationally recognized standards of care. We provide these guidelines to our members to help you stay current with preventive health screenings and tests. Every year we review the standards and update them as needed. Our Quality Committee approves the changes to our recommendations. Throughout the year, we send information to our members about various preventive screenings that are recommended. Recommendations may be based on age and gender. They can also be based on other risk factors and health conditions. We let our network doctors know what preventive health standards we have adopted on a regular basis. Preventive Health Standards - Prevention is Key! +HUHDUHÀYHVWHSV\RXFDQIROORZWRNHHSXS ZLWK\RXUSUHYHQWLYHKHDOWKVFUHHQLQJV Look at preventive health recommendations. Which ones do you need based on your age, sex, and risk factors? Make a preventive health plan. Write it down. Talk with your doctor about your preventive health plan. Agree on what tests you should have and how often. Schedule your screenings. Put your screenings on a calendar or where you can keep track of them. Talk to your doctor about the results of your preventive screening tests. Write down and keep track of the results. Find out what you can do to reduce your risk factors for chronic illnesses or other health problems. Talk with your doctor about changes in your life style based on the results of your preventive health tests. For additional information regarding preventive health standards, please visit our website at: &REEDOM 5TILIZATION 1UALITY 1UALITY Management-> The Guide to Clinical Preventive Services You can also visit the following helpful websites to learn more about preventive health practices: s United States Preventive Services Task Force s Center for Disease Control - s Agency for Healthcare Research and Quality s National Prevention Strategy 6 reedom ealth - emer ewletter June 2013

7 Always Available to Our Members Freedom Health offers a lot of information for our members on our website, including resources and programs available to members. Please check out our website at: Once you are on our homepage, click on the links below for more information on the following topics: ae Deae aaemet roram (IV\[-YLLKVT%<[PSPaH[PVU8\HSP[` lcal ealth dele *SPUPJHS/LHS[O.\PKLSPULZ reace eal 8\PJR3PURZ%.YPL]HUJL(WWLHSZ ealth ad elle formato ;VVSZ9LZV\YJLZ%/LHS[O>LSSULZZ 9LZV\YJLZ edcal ecord tadard 4LKPJHS9LJVYK:[HUKHYKZ ewletter ;VVSZ9LZV\YJLZ%-YLLKVT9PUNZ atet afet roram Quality Management reete ealth dele 8\HSP[`4HUHNLTLU[%;OL.\PKL[V Clinical Preventive Services rac 8\PJR3PUR%7YP]HJ`7VSPJ`3LNHS% Privacy Policies alt aaemet aemet roram Quality Management alt aaemet erformace 8\HSP[`4HUHNLTLU[%/,+0:9LZ\S[Z tlato aaemet roram <[PSPaH[PVU4HUHNLTLU[ Deco <[PSPaH[PVU4HUHNLTLU[ Quality Health Management: Measuring Success O ur goal at Freedom Health is to help our members improve their health by providing the best care and service options. In order to do this, we rely on our Quality Management (QM) program. This program defines how we monitor the quality of care and services our members receive. The QM Program helps us look for areas that need to be improved in medical and preventive services. We also perform outreach and health education activities to our members. Each year, we evaluate the Quality Management program. We also assess progress toward meeting our goals. One of the tools we use to evaluate the QM program is HEDIS (Healthcare Effectiveness Data and Information Set). HEDIS is the most widely used rating system in the health care industry. HEDIS is used like a report card. Health plans receive a score on certain services, tests and procedures. This spring, Freedom Health is going through its annual HEDIS review. We will use our overall HEDIS scores to create new goals and to develop improvement plans for the coming year. TTY/TDD

8 P.O. Box , Tampa, FL June 2013 Member Newsletter /LHS[O>LSSULZZ0UMVYTH[PVU Colorectal Cancer Screenings Colorectal cancer is a cancer that forms in your colon or rectum. It usually develops from polyps, or abnormal growths, in the colon or rectum. These polyps can be detected early by routine colorectal cancer screenings. Treatment is most effective when you catch it early. If you are between the ages of 50 and 75, you should get colorectal cancer screenings on a regular basis. If you are older than 75, talk to your doctor about whether or not you should be screened. There are three types of colorectal screenings recommended for adults ages s (IGH 3ENSITIVITY &ECAL /CCULT "LOOD 4EST &/"4 This test is done by your Primary Care Provider and detects the presence of blood in your stool. Blood in your stool can be a symptom of polyps or cancerous growths. It is recommended to get this screening once a year. s &LEXIBLE 3IGMOIDOSCOPY Your Primary Care Provider must refer you to a specialist to receive this screening. This test detects polyps or cancers in your rectum. This screening is recommended every 5 years. s #OLONOSCOPY You must get a referral from your Primary Care Provider in order to receive a colonoscopy. This test is similar to a Flexible Sigmoidoscopy. The difference is that this test screens your entire colon. Your specialist may be able to find and remove polyps or cancers during this test. It is recommended to get this screening at least every 10 years. This test can also be prescribed as a follow-up to one of the other screening tests. If you have not seen your doctor for a colorectal screening, make sure to make an appointment today. Discuss with your doctor about which screening test is right for you. Sources: US Preventive Services Task Force- uspreventiveservicestaskforce.org/uspstf/uspscolo.htm; Centers for Disease Control and Prevention - cdc.gov/cancer/colorectal/basic_info/index.htm Concierge Hillsborough/Pinellas/Polk &KXUFK $YH, Tampa, FL PKoQH HxW. 1 Hernando/Pasco/Citrus oUWKFOLIIH BOYG., 6pULQJ +LOO, FL 3466 PKoQH Orange/Osceola/Seminole/Brevard 5 6. :LQWHU PaUN 'U., 6WH.34, &avvhoehuu\, FL 377 PKoQH Marion/Lake/Sumter/Volusia 1 6: WK POaFH, BXLOGLQJ, 6XLWH 1, OFaOa, FL PKoQH Sarasota/Manatee/Charlotte/Desoto 3874 ( , BUaGHQWoQ, FL 348 PKoQH Lee/Collier 6831 PaOLVaGHV PaUN &W., 6WH. 1, FW. 0\HUV, FL. 331 PKoQH Indian River/St. Lucie/Martin Z\. 1, 9HUo BHaFK, FL 36 PKoQH