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We’re sending health and wellness reminders to members
August 31, 2020

We understand that availability of routine care has been limited due to the COVID-19 pandemic. This September, we’re sending health and wellness reminders to certain members to help them maintain their health during these unprecedented times.

Who will receive letters?

All members with asthma, coronary artery disease, or diabetes will receive letters to remind them about preventive services that are important to managing their health.

  • This includes members who belong to our Medicare Advantage, commercial HMO and PPO, and Federal Employee Program (FEP) health plans.
  • The letters will tell members if they have not received critical health services (based on our claims data).
  • Eligible members will also receive reminders about the importance of mammography (to members over age 52) and colorectal cancer screening (to members over age 51).
Members who have And as of December 31, 2020 are   Will receive information about Sample letter
Asthma Ages 5+ Medication to control asthma:
  • Steroid inhaler or other controller medication
See samples of health and wellness reminders. Log on and find this article in News>Clinical and Pharmacy, and open links to the adult and pediatric reminder letters.
Coronary artery disease
  • Male ages 21-75  
  • Female ages 40-75 
  • Statin use
Diabetes Ages 18+
  • HbA1c
  • Eye exam
  • Urine test for kidney function
  • Statin use (age 40-75)

Mammography and colorectal cancer screening reminders

Members who do not have one of the conditions listed above but who are eligible for routine mammography or colorectal cancer screening will get a call, email, or text telling them of the importance of these services.

Members who did not have And as of December 31, 2020 are Will receive a message about
Either a flexible sigmoidoscopy, colonoscopy, FIT-DNA, or fecal occult blood test during the measure period1
  • Ages 51-75 
The importance of screening for colorectal cancer
A mammogram during the measure period2
  • Ages 52-74
  • Without a unilateral or bilateral mastectomy
The importance of screening for breast cancer

1For colorectal cancer screenings, we identify members back to January 1, 2019 who have been continuously enrolled for two years, and review for a screening claim in the following time frames:

  • Colon cancer screening or colonoscopy between January 1, 2011 - June 30, 2020, OR
  • CT colon graph, flexible sigmoidoscopy between January 1, 2016 – June 30, 2020
  • FIT-DNA (Cologuard) test between January 1, 2018 – June 30, 2020
  • Fecal occult blood test or FIT Kit screening between January 1, 2020 – June 30, 2020

2For mammography, we identify members back to October 1, 2018 who have been continuously enrolled for two years and look for a screening mammogram claim between October 1, 2018 – June 30, 2020

As always, we urge our members to discuss any tests or treatments with their doctors. Please help reinforce these messages to your patients with these conditions and those who are due for screening services.
To review the guidelines we use for our recommendations, log on and go to Clinical Resources>Clinical Programs & Information>Treatment Resources. Click on the appropriate condition and you’ll see links to nationally recognized treatment guidelines.