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We’re sending health and wellness reminders to members
August 16, 2019

To help our members maintain their health, we’re sending health and wellness reminders to certain members this September.

Who will receive letters?
We will send letters to approximately 85,000 members with asthma, coronary artery disease, and/or diabetes, to remind them about preventive services 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 data1).
  • Eligible members over 50 will also receive reminders about the importance of mammography (to members over age 52) and colon cancer screening (to members over age 51).
Members who have And are2 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 here.
Coronary artery disease
  • Males ages 21-75  
  • Female ages 40-75 
  • Statin use
Diabetes Ages 18+
  • Test to measure control of glucose over several weeks (HbA1C)
  • Eye exam
  • Urine test for kidney function
  • Statin use (age 40-75)

1 Measurement period January 1, 2019-June 30, 2019
2 As of December 31, 2019

Mammography and colon screening
Members without one of the conditions listed above, but who are eligible for routine mammography or colon screening, will get a call, email, or text telling them of the importance of these services. We will send this communication to about 200,000 members.

Members who did not have And are Will receive a message about
Either a flexible sigmoidoscopy, colonoscopy or FIT-DNA or fecal occult blood test during the measure period3
  • Age: 51-75 as of December 31, 2019
  • Without a total colectomy
The importance of screening for colorectal cancer
A mammogram during the measure period4
  • Age: 52-74 as of December 31, 2019
  • Without a unilateral or bilateral mastectomy
The importance of screening for breast cancer

3 For Colorectal Cancer, we identify members back to January 1, 2018 who have been continuously enrolled for two years, and look for lack of a screening claim in the following time frames:

  • No colon screening or colonoscopy between January 1, 2010-June 30, 2019, OR
  • No CT colon graph, flexible sigmoidoscopy between January 1, 2015-June 30, 2019
  • No FIT-DNA (Cologuard) test between January 1, 2017-June 30, 2019
  • No fecal occult blood test or FIT Kit screening between January 1, 2019-June 30, 2019

4 For Mammography, we identify members back to October 1, 2017 who have been continuously enrolled for two years, and look for lack of a screening claim in the following time frames: No mammogram between October 1, 2017-June 30, 2019

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, or who are eligible for screening services.

To review the guidelines we use for our recommendations, go to Treatment Resources and click on the appropriate condition and you’ll see links to nationally recognized treatment guidelines.

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.

MPC#022119-1F-1-ART

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