Here are three developments for 2019 that we think you’ll be interested in:
1. We’re covering diagnostic mammograms as preventive.
Diagnostic mammography is used to follow up when something is detected in a screening mammogram or when someone who has previously had breast cancer. Breast tomosynthesis, or 3D mammography, may be useful for women with dense breast tissue to get more accurate screening results.
These are valuable tools in detecting breast cancer and protecting a woman’s health. Check your plan for the all of the preventative benefits you receive as a ConnectiCare member.
2. We’re working to address the opioid epidemic.
The opioid crisis persists. More than 115 people die each day in the United States after overdosing on opioids. Connecticut residents are more likely to die from an unintentional drug overdose than a car accident. That’s why we’ve launched an advanced opioid management program.
The program goal is to help members safely treat their medical conditions while limiting the potential for drug misuse. It includes identifying potential abuse and reaching out to members, their health care prescribers and/or pharmacists when flags go up.
Some of the program measures include:
- Coverage reviews and provider notifications for members exceeding a total opioid dose of more than 200 Morphine milligram equivalents.
- Setting a seven-day supply limit for the first fill of short-acting opioids.
- Sending real-time alerts to dispensing pharmacists if there are concerns about a member’s clinical safety or medication use.
- Helping members bring all prescriptions under one treating provider, if needed, for better care management.
Some of your employees may receive letters from Express Scripts, our mail-order pharmacy service, about this program.
3. We’re providing more support for those with life-threatening illness.
Support can make a huge difference for someone facing a life-altering illness. That’s why we are working with Aspire Health to provide members with in-home palliative care during times of serious or advanced illnesses, such as COPD, heart failure and cancer.
The Aspire Health care team will visit members in their homes to help treat symptoms and effects of severe health concerns, including pain, nausea, difficulty breathing, trouble sleeping, emotional distress and more.
To reduce confusion, we will reach out to members who may benefit from these services and introduce them to Aspire Health. There is no additional charge for these palliative care services.
*Restrictions may apply based on plan type and location. This applies to fully insured groups only. ASO groups will have the option to pick and choose coverage. Note that 3D mammography is covered for Connecticut plans, but not for Massachusetts plans. Members should check their evidence of coverage for benefits and eligibility.