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PERSPECTIVE

Spring 2019

Untangling Healthcare — A conversation with John Servais, SVP of Benefits Policy and Design

Recently, Perspective spoke with John Servais, Senior Vice President, Benefits Policy and Design, to explore how members of The Episcopal Church Medical Trust (Medical Trust) can more easily navigate the healthcare system and better their long-term health through service enhancements included with their coverage:

As the healthcare system becomes increasingly complicated, how is the Medical Trust helping active members navigate it?

We have always offered support through various resources such as Health Advocate, but more recently we began offering truly robust care management programs for members in the Anthem and Cigna plans, through the new Anthem Health Guide and Cigna One Guide/Personal Health Teams. They can help active members coordinate care across multiple doctors, manage chronic conditions, confirm coverage of various services, understand authorizations required for certain treatments, and answer other questions that arise in critical health situations. Just one phone call provides access to multiple resources. All active members can use these programs to help ensure that they are getting the right care at the right time.

What member services are available via health plan apps on mobile devices?

Active Anthem and Cigna members, and both active and retired Kaiser members, can use the applicable vendor apps to find network providers and facilities, check claim status, verify cost shares and deductibles, access their ID cards, and much more. The Express Scripts and Eye Med apps are also available to all members, whether active or retired, as is the Cigna app for dental plan members. In addition, Medical Trust Medicare Supplement Health Plan members have access to UnitedHealthcare’s app.

Health Advocate, a service for both active and retired members that offers professional assistance with claims and other issues, is included with all our health plans. While an app is available, most members take advantage of this resource through phone calls.  

Telemedicine is another relatively new care option for Anthem, Cigna, and Kaiser plan members. How does it make plan services more accessible?

Telemedicine is a way for an active member to be diagnosed quickly and inexpensively for many common ailments by a board-certified physician, without having to make a trip to a doctor’s office. In Anthem, Cigna, and Kaiser plans, a member can use a computer or mobile device to schedule a virtual visit. Depending on the diagnosis, the doctor can recommend a course of treatment, refer the member to a provider or facility, and even call in prescriptions to the member’s pharmacy.

Finally, how is SilverSneakers® contributing to the health of members in our retiree plans?

The popular SilverSneakers® program gives retired members in the Medical Trust's Medicare Supplement Health Plans special access to thousands of gyms and fitness centers across the country. Studies show that being sedentary is almost as big a health risk as being a smoker. SilverSneakers® not only helps our retirees stay physically active, but it also has proven to be a great way for them to make new friends and remain social.

 

Untangling Healthcare