The Pulse MEMBER NEWSLETTER Fall/Winter 2015 WHAT'S INSIDE PAGE 4 HERE TO HELP Understanding Care Coordination and Utilization Management PAGE 5 STAY UP ON FALL HEALTH! Tips for staying well PAGE 6 EVERGREEN IS EVER-GROWING New physicians, network additions Members: Amanda and Ashley
TABLE OF CONTENTS Welcome...3 Important Contact Information If you have questions, comments, or concerns, we want to hear from you! Here to Help...4 Fall Health...5 Expanding our Network...6 MEMBER SERVICES (855) 978-3282 PRIOR AUTHORIZATION (855) 530-1212 PHARMACY BENEFITS (855) 577-6516 CONNECT WITH US: EvergreenHealthCooperative @evergreenmdcoop EvergreenHealthCoop The Pulse is published twice a year. Evergreen Health Care Primary Care Offices Email Us: members@evergreenmd.org Visit Us Online: www.evergreenmd.org The Pulse Fall/Winter 2015 2 Baltimore (Rotunda) (443) 451-4993 Columbia (301) 575-8080 White Marsh (410) 344-2558 Greenbelt (240) 542-0170
A Message from the CEO WELCOME TO EVERGREEN HEALTH What Keeps Evergreen Health Competitive? You. A MESSAGE FROM CEO DR. PETER BEILENSON It s one of the toughest health care decisions anyone faces, and millions of Americans face it every year: Who to trust when choosing coverage? For many Maryland residents, this year s choice comes with the added anxiety of significant rate increases in some cases up to 25 or 30 percent. For decades, Marylanders options have been limited. That s exactly why Evergreen Health exists. At Evergreen Health, we believe everyone has a right to affordable, high-quality health care regardless of income or status. But that can only happen in a competitive marketplace, where insurance companies thrive by offering the high quality service that consumers deserve. As the state s only member-governed, nonprofit insurance cooperative, Evergreen Health puts your wellbeing ahead of all else including profits. Your input plays an integral role in helping Evergreen Health create products and services that meet the needs of individuals and families throughout Maryland. Your involvement is why we remain competitive in a market long-dominated by corporate giants. It s why we listen and take your health personally. We intend to be here for years to come, and with your help, we will be. Peter Beilenson, MD, MPH Founder & CEO, Evergreen Health The Pulse Fall/Winter 2015 3
CARE COORDINATORS Here to Help. Have you been diagnosed with diabetes, hypertension or other chronic conditions? Do you need help navigating the health care system in order to get the care you need to manage that condition? Evergreen Health s care coordinators all experienced nurses are here to help through our Disease Management and Case Management programs. Available Monday through Friday, from 8:30 a.m. until 5:00 p.m., our care coordinators can help you understand your condition and make the most of your benefits, so that you get the appropriate care. They also provide education, resources and strategies designed to help you maintain a healthy lifestyle. To contact an Evergreen Health care coordinator, call 410-600-3376 or email MyCarePlan@evergreenmd.org. Language assistance is also available. TDD/TTY services for the hearing-impaired can be accessed by calling 800-735-2258 or 711. The Pulse Fall/Winter 2015 4
Stay Up on Your Fall Health! With fall here, make sure your family is up-to-date on their recommended health care. Here are some things to keep in mind for a healthy fall: Flu Season Though the timing varies around the country, flu season generally kicks off around October and peaks between December and May. The Centers for Disease Control and Prevention (CDC) recommends flu vaccinations for anyone older than 6 months. Certain individuals face particular risk of flu complications including children younger than 2 years, adults over age 65, pregnant women and people with certain medical conditions. If you or someone you know falls into one of these categories, vaccinations are particularly important. For those with conditions making them vulnerable to other illnesses, ask your doctor if you need a pneumonia vaccine, and make sure your condition is wellmanaged. Back to School For most people, the start of the fall season means back to school time as well and schools are breeding grounds for germs. If you have a school-aged child or work in a school system, make sure your family is up-to-date on all necessary immunizations, including hepatitis B, MMR (measles, mumps, rubella), varicella (chickenpox) and other preventable illnesses. If you have a toddler, try to get all recommended shots before his or her second birthday. Get Your Physical If you or your children have not had physical examinations, there s no better time than now to schedule them. Many of the required or recommended screenings and lab tests can be knocked out in one visit. Regular examinations are also a great way to ensure any existing medical conditions are well-managed and under control. Taking care of yourself and your family now can lead to a healthier, happier future. If you have high blood pressure or diabetes and would like help managing these conditions, call our Care Coordinators at 410-600-3376 or email MyCarePlan@evergreenmd.org. For other questions, call Member Services at 855-475-0990. UTILIZATION MANAGEMENT The Right Services, at the Right Time, in the Right Setting When it comes to medical care, knowing that you re receiving the right services, at the right time, in the right setting is important, not only for your physical health, but also for your peace of mind. At Evergreen Health, we understand that the best care is the care that s most appropriate for your needs. No one wants to waste time or money on overpriced services or unnecessary treatments. That s why our Utilization Management team strives to ensure you receive care that maximizes your benefits and meets your needs. If you have questions about the utilization review process, please call Member Services at 855-475-0990. Our professionals are available to answer questions from 8 a.m. until 7 p.m., Monday through Friday. After business hours, leave a message and your call will be returned as soon as possible. In addition, language assistance is also available. TDD/TTY services for the hearing impaired can be accessed by calling 800-735-2258 or 711. The Pulse Fall/Winter 2015 5
Evergreen Health, Ever-Expanding Network Including three new physicians in our affiliated primary care offices As a member or as a patient you want to know that when the time comes to find care, you ll have high-quality options from which to choose. Evergreen Health understands that choice matters, and we re doing all we can to offer you the comprehensive provider network you deserve. That s why, this summer, we added more than 500 providers to our network all with the goal of giving our members the options they want. It s not just our network that s growing: recently, our affiliated primary care offices welcomed three new primary care providers (PCPs), each of whom is accepting new patients. Don t forget: When you choose Evergreen Health Care for your PCP, you also have access to free care coordination and health coaching. For a complete listing, visit www.evergreenmd.org and click Find a Doctor. Evergreen Health Care Primary Care Offices BALTIMORE The Rotunda 733 W. 40th St., Suite 200 Baltimore, MD 21211 (443) 451-4993 WHITE MARSH Across from White Marsh Mall 7939 Honeygo Blvd. Building 3, Suite 127 (410) 344-2558 COLUMBIA Corner of Broken Land and Snowden River Parkways 9710 Patuxent Woods Dr. Suite 200 (301) 575-8080 GREENBELT Maryland Trade Center Building 3 7501 Greenway Center Dr. Suite 600 (240) 542-0170 The Pulse Fall/Winter 2015 6
Evergreen Health Care Welcomes Three New Providers Name: Aaron Greenblatt, M.D. Where he s from: Berkeley, Calif. Education: Attended University of Pennsylvania School of Medicine Residency: Family Medicine, Santa Rosa Family Medicine Residency Program, a UCSF-affiliated community hospital program; Addiction Medicine fellowship at University of Maryland Medical Center. You might be interested to know: In addition to English, Dr. Greenblatt speaks French, Spanish and Bambara, a language native to Mali. What he says: I'm a very inquisitive person, and, as a result, I ask a lot of questions, both of my patients and of the medical literature. Using the information that I glean along the way, I try to provide evidence-based care that is individually tailored to my patients' preferences and priorities. Name: Melissa DeLong, M.D. Where she s from: Baltimore, Md. Education: Attended medical school at the University of Maryland Residency: Primary care at Beth Israel Deaconess Medical Center in Boston, Mass; Fellowship in general medicine at Johns Hopkins University You might be interested to know: Dr. DeLong is a Baltimore native who enjoys jogging and skiing and loves city life. What she says: One of the most rewarding aspects of primary care for me is working in collaboration with patients to determine the best plan of care. I love educating and sharing with patients the information I have about their health concerns and discussing treatment options and determining the best care plan. Working with patients over time to make meaningful lifestyle changes that can have significant impact is the most rewarding aspect of my work. Name: Adanma Ndubuizu Where she s from: Though she was born in Washington D.C., Dr. Ndubuizu s family hails from Nigeria. Education: Attended University of Maryland Baltimore County, where she majored in biochemistry and molecular biology, with a minor in psychology. For medical school, Dr. Ndubuizu attended Duke University. She also has a Master s degree in public health from University of North Carolina, Chapel Hill. Residency: Family Medicine at Palmetto Health in South Carolina. You might be interested to know: Dr. Ndubuizu speaks Spanish and hopes to participate in medical mission work in the future. What she says: I am inspired by the patient-centered model that embodies Evergreen Health, because it allows us to provide multifaceted holistic care to our patients. Making sure my patients receive the best care possible is my highest priority, and I am dedicated to achieving this goal on a daily basis. The Pulse Fall/Winter 2015 7
The Pulse MEMBER NEWSLETTER Fall/Winter 2015 Members: Hats In the Belfry EHAMN20150930 3000 Falls Road, Suite 1 Baltimore, MD 21211 www.evergreenmd.org