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Study: CT consumers not as satisfied with their health plans By John Stearns C onsumers in a Northeast region that includes Connecticut were among the least satisfied with their health plans, according to the J.D. Power 2017 Member Health Plan Survey. Other states in the region include Maine, New Hampshire, Vermont and Rhode Island. Satisfaction is highest among health plan members in five regions: Maryland (723); East South Central (722); California (716); Michigan (716); and Ohio (714). Satisfaction is lowest among members in the Colorado (676) and Northeast (682) regions. e study is based on responses from 33,624 commercial health plan members in the first quarter of 2017. Coordination of care among healthcare providers is the single most important criteria influencing member satisfaction with their health plan, the study says. Key findings of the study, according to a J.D. Power are that: • Close coordination is lacking among health plans and providers: e single most effective lever of health plan member satisfaction is helpful coordination of care among doctors and other healthcare providers. • Integrated delivery systems dominate rankings: Health plans that utilize an integrated delivery system (IDS) — a network of healthcare and health insurance organizations presented to members as a single delivery organization — outperform traditional health plans on every factor measured in the study. • Presenting low-cost narrow network options improves satisfaction: Although having access to a limited network of care providers can potentially become a friction point for members, health plans that have a narrow or tiered network also have the potential to reduce costs for commercial health plan members. Regardless of product choice, members who were presented with lower-cost narrow network options were significantly more satisfied with their health plan. • e effect of payer-provider alliances is mixed: Aetna, Cigna, Anthem and other insurers have begun to offer commercial products in collaboration with providers. Partnerships vary from less integrated contractual agreements to highly integrated health system purchases. J.D. Power found mixed results when it examined member satisfaction with the plans in instances when members are being served by providers that are part of a collaborative care model. { Q&A } Weighing the risks of youth concussions in sports Q&A talks with Dr. David Wang, director of Elite Sports Medicine at Connecticut Children's Medical Center, about youth sports and concussions, which occur aer a blow to the head causes a transient change of neurologic function without any structural brain abnormality. Concussion symptoms include headache, dizziness, light sensitivity and memory impairment, which can lead to more significant and prolonged symptoms and in some rare cases even death if not treated properly. Q: What do we know about concussion rates in youths? A: e exact numbers are not known but the Centers for Disease Control and Prevention estimates that between 1.6 and 3.8 million sports/recreation-related concussions occur each year. Concussion rates vary significantly between the different sports. Looking at high school data for all sports, over 10 percent of all sports-related injuries are reported to be concussions. Q: What are the most common causes of concussions you encounter in your practice? A: is is dependent upon the sport played but the majority of concussions are a result of a blow to the head from a collision or a fall where the head strikes the ground. Q: Reporting on the long-term effects of head injuries in the NFL have made some parents rethink allowing their children to play football, and also spurred efforts to educate coaches to recognize concussion signs. How would you advise a nervous parent? Research is currently underway as there is uncertainty surrounding the long-term cumulative injuries that can be associated with football. Because the evidence is not clear at this time, some argue that participation should be allowed until there is evidence suggesting otherwise. In these cases, it is believed that the benefits of sports outweigh the risks. Oen times lost in these discussions are the host of positive effects from sports participation. Others opt to stay away from risky activities as the long-term consequences are unclear. Personally, I would like to minimize head contact before the age of 14, so that the brain has time to mature. I would also like to see more time spent on skill development and overall conditioning rather than hitting. In fact, at the high school and college levels the amount of contact during practice is decreasing in an effort to decrease the cumulative blows to the head and body. It is also worth noting that due to the increased attention surrounding concussions we are now doing a better job of recognizing and treating them. is increased recognition comes not only from the parents and coaches but also the athletic trainers and other healthcare practitioners. Q: What might people not know about concussions? They don't just happen in contact sports, right? Concussions do not only occur exclusively from a blow to the head but also sudden acceleration and deceleration of the brain. is means in some cases that the head does not have to be struck to suffer a concussion. I have even studied the forces involved in figure skating spinning, as I have seen excessive spinning create a clinical picture very similar to that seen in concussions. I will not go so far as to call spinning injuries a concussion, but there appears to be some overlap. Many may not know that concussions are oen associated with eye and neck abnormalities. ese issues with the eyes and/or neck can lead to many of the symptoms seen in concussion. In fact, I oen see people in clinic with persistent concussion symptoms that are actually secondary to eye or neck issues. Q: You released a rap video on YouTube last year about concussions. Why? A: is idea came from the fact that I wanted to educate the youth in a way that they would be most likely to listen. e target audience is young people not likely to research the signs and symptoms of a concussion on their own. ey also are under a lot of peer/personal pressure to "suck it up" and continue to participate. It was my goal to start to change the culture surrounding the athlete and let them know that we understand the pressures yet still want to protect them not only in the short term but also the long term. I want them to know that they are not being weak to tell a coach/parent if they have concussion symptoms. I oen say 'there are pains to push through and pains to listen to; this is a pain to listen to.' H H 12 GREATER HARTFORD HEALTH • Summer 2017