TRICARE for the South Region - Decreasing ER related costs

(Recent news from 12/2011) A friend shared the following information with us.

Did you hear that the TRICARE South department has decided to put on a demonstration for all of the AD CG members and their dependents with respect to decreasing ER costs? If you are in the South Region, chances are, you received this in a letter. For those of you who haven't here's the info:

The objective of this demonstration is to decrease Emergency Room (ER) costs, increase access to care, and improve patient satisfaction. What does this mean for you? If you are unable to get an appointment to see your Primary Care Manager (PCM) for acute/urgent care, you may utilize, with no out of pocket costs, a TRICARE South Network Urgent Care Center (UCC) for each member of your family. Each Active Duty (AD) service member and AD family member will be allowed up to four visits for acute minor illness and/or minor injuries in each period.

The first period begins January 1, 2012 and ends on September 30, 2012.
Your clock will restart for another four visits in the second period which begins October 1, 2012and ends on May 1, 2013.

WE NEED YOUR HELP! If this pilot program is successful, it may be extended to all servicebeneficiaries on a permanent basis. This program should significantly reduce the costs of healthcare for the Coast Guard and the U.S. Government and improve services to members and their dependents. Please utilize this opportunity and save yourself unnecessary wait times in ERs. Important Information: Active Duty members must schedule a follow-up appointment with their PCM following any UCC utilization and AD family members are encouraged to schedule a follow-up appointment with their PCM. Participating UCCs may be found by visiting Humana Military’s website (http://www.humanamilitary.com/) and additional information on the project is available at the following website link (www.humana-military/urgentcaredemo). General information, including governing documentation, about this demonstration may be found by visiting the TRICARE Regional Office-South website (http://www.tricare.mil/trosouth/).

Coast Guard Health Safety Work Life points of contact are:LCDR Leah Preston at (703) 681-8716 or Leah.Preston@tma.osd.mil.LT William Chew at (210) 292-3277 or William.Chew@tros.tma.osd.milLT Cory McCollow at (510) 326-4032 or Cory.J.McCollow@uscg.mil.Following your visits to an urgent care center, please give us your feedback at the followingwebsite: https://surveys.uscg.mil/Community/

Standing Up for Military Families Struggling with Autism

Senator Gillibrand's (NY-Dem) proposed Amendment address cites a Coast Guard family.

Please support Taylor's family and all our other military families struggling with Autism by writing to your Senator to show your support and ask them to oppose budget cuts related to the Autism Budget.

Thank you USCG

Thank you for being a fairly family-friendly service. Thank you for giving me my husband when I need him. I know that doesn't always happen, and I've had my share of gripes when you took precedence over some things in my life, but lately, well lately you rock.

That's right folks. I said it. I'm grateful, like so many of you, for what the Coast Guard allows and provides for my family. A lot of you have given thanks lately, so I wanted to chime in too.

I started a new job a couple of months ago. As such I am on your typical probationary period. So, they tend to frown upon you asking for things, like days off, times to leave early etc. Still, with children, sometimes a mother has no choice. Things come up. Children get sick, schools close for a day, and what have you. I have been very fortunate though. While it could be due the man in blue's current position, I must still say I'm so thankful. He has been able to take off for illnesses, doctor's appointments and closed school days. Had he not been able to, I might have lost my job by now. Heck, with three kids, a lot can happen even in just a week's time.

So, I'm rambling. I know. What I am getting at is that I'm just a really happy gal right now. I can only hope this continues for awhile so I can continue to see the CG in a brilliantly positive light. ;)

BMI Criticism

According to the Center for Disease Control (CDC), "Body Mass Index (BMI) is a number calculated from a person's weight and height. BMI provides a reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems."

Note the "most" people, not all people. Of course, I would even argue that "most" is too generous.

The CDC also explains that, "BMI does not measure body fat directly, but research has shown that BMI correlates to direct measures of body fat, such as underwater weighing and dual energy x-ray absorptiometry (DXA).1, 2 BMI can be considered an alternative for direct measures of body fat. Additionally, BMI is an inexpensive and easy-to-perform method of screening for weight categories that may lead to health problems." To me, I see "cheap" and "lazy". Isn't the use of BMI doing a disservice to servicemembers. What say you? Look, if the CG and/or other services are going to really focus on health and fitness and treat it with extremely high importance than why not do it right?

The CDC, thank goodness, also mentions the following on their website:

"How reliable is BMI as an indicator of body fatness? The correlation between the BMI number and body fatness is fairly strong; however the correlation varies by sex, race, and age. These variations include the following examples:

• At the same BMI, women tend to have more body fat than men.
• At the same BMI, older people, on average, tend to have more body fat than younger adults.
• Highly trained athletes may have a high BMI because of increased muscularity rather than increased body fatness."

So, you are screwed if you are an older athletic female. There will be bells going off all over the place and red flags heralding attention for the fat-police. Again, ridiculous.

Perhaps I am exaggerating a bit. Still, this topic is one that is ever-present today as the Coast Guard recently announced that as of October 2009, it will be modifying the health and fitness program by adopting maximum allowable weight (MAW) and BMI.

ALCOAST 469/08 (internet release authorized) spells it all out. Outside of MAW and BMI, members should note that maximum body fat standards are also being reduced, no matter how old you are or if you are male or female. The CG submits that the use of BMI as it may help screen for health problems. Additionally, the ALCOAST referenced how the DOD adopted the BMI, but so what. Why jump on the bandwagon with something that doesn't make any sense?

Now, surely, a health and fitness program is vital. However, it should be realistic as well.

From Northwestern Health and Sciences University:

"Important Limitations of BMI:
BMI does not distinguish between fat mass and fat free mass. This is important because ACSM defines obesity as a percent of body fat at which disease increases. People with large amounts of lean tissue may have a high BMI while having their body fat percentage in a healthy range. In addition, a healthy BMI does not necessarily mean that body fat is within a healthy range.
BMI does not give any information on the location of the body fat which is important in determining obesity-related risk for disease." (Citing ACSM’s Guidelines for Exercise Testing and Prescription, 6th Ed., 2000 and ACSM’s Resource Manual for Guidelines for Exercise Testing and Prescription, 4th Ed., 2001).

Let's back up, ALCOAST 469/08 referenced above states, "BMI is a number calculated from a person's weight and height. It provides a reliable indicator of body fatness..."

It doesn't though.

Here's something else I'd like to point out. The Coast Guard obviously supports the Mayo Clinic teachings (see the Tobacco Cessation Program). So, I went ahead and did a bit of research on BMI as put forth by the Mayo Clinic. In a web article titled, "A Body Mass Index Puzzle", the Mayo Clinic states, in part, "The study results are not an invitation for heart patients to put on weight, researchers said. Instead they highlight some shortcomings in BMI (a ratio of height to weight) as a measuring tool — especially because it fails to distinguish between excess body fat and muscle mass."

Please read the article. It's brief, but interesting and well-worth the read. CLICK HERE

Seriously, read it!

Alright, so what of the folks who are over BMI. They will be body fat tested, the same way they were before, except that the allowable body fat is now at a lower percentage. Okay, that's a little more understandable than the absurd usage of BMI. So, why even waste the time with anything BMI related. What is the point? Members are currently required to have a physical conducted every five (5) years. If there is that much concern over health problems that may be related to BMI, then why not increase the frequency of physicals. Why not every two years or every year?

I am all ears. What are your thoughts on this program and the changes on the horizon?