tips for


delicious, healthy food can be easy and fun. If you're ready, .... participating behavioral health clinician. .... Screening helps find precancerous p...

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Stride

WINTER 2017

HMO

tips for

eating healthier

at home

ALSO INSIDE Taking the right dose ... the right way page [ 6 ]

Spotting signs of depression page [ 7 ]

Stride (HMO) SM

Medicare Advantage Plan

Dear Member,

I hope you enjoy the cover story about the benefits of eating healthy. This article is based on the healthy eating guide developed by the Harvard Pilgrim Foundation, Healthy, Delicious Food at Every Age. If you would like a copy, please email [email protected] harvardpilgrim.org. This spring, you may be receiving a survey from the Centers for Medicare & Medicaid Services asking you about your experience with your health care provider and your health care plan. If you receive it, please take a few moments to fill it out. Your answers will let us know how we’re doing and where we could improve. Thank you in advance for completing the survey. Wishing you the best of health. Sincerely,

Michael S. Sherman, MD, MBA, MS Senior Vice President, Chief Medical Officer

Tell us what you think! Email your comments and suggestions to [email protected] [ 2 ]

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tips for

eating

healthier

at home T 1 2 3

o get into the habit of eating healthy, it’s best to start at home. Cooking and eating delicious, healthy food can be easy and fun. If you’re ready, try making some of these small changes: Add color to your plate. Green is good, but green + red + yellow is even better. Add red or yellow peppers, orange carrots, purple eggplant and berries. Discover the wider world of protein. There’s fish, of course, but also beans, nuts, certain grains such as quinoa and oats, and protein-rich, low-fat yogurt. Try almond butter on apple slices or fast-cooking quinoa instead of rice. Double up on veggies. Look at your plate — chances are proteins and starches take up the most space. Downsize each of those foods to about a quarter of your plate and make more room to double up on vegetables (they should fill half your plate).

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Did you know… our bodies need salt, but most of us get way too much of it? The recommended daily sodium (salt) allowance is less than 2,300 mg.

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Join the whole-grain revolution. Buy whole wheat breads and pastas. If you bake, use a mix of whole wheat and white flours. Hold the mayo and the cream. Instead of mayo on your sandwich, use mustard or try smashed avocado mixed with a few drops of olive oil. Substitute Greek-style yogurt for sour cream or heavy cream. Roasted, yes! Fried, not so much. Roasting your foods (such as meats and vegetables) is both easier than frying and healthier. Brush a little olive oil on your chicken, fish or carrots, and pop them in the oven at 350–425 degrees. Try smaller portions. A portion is any amount of a specific food that you choose to put on your plate for a meal or snack. Portion control is important for managing your weight.

A serving is a recommended amount of that food based on health and nutrition guidelines. Understanding how much a serving size of food is and how many calories, carbohydrates and fat a serving contains is important in helping you control your portions. The best way to determine the amount of food in a serving is to look at the Nutrition Facts label. Packaged foods continued on next page

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continued from previous page always show the serving size information on these labels. You can use the labels to: • Compare products easily • Find out the nutritional value of foods • Better manage special diets, such as ones low in sodium or carbohydrates Here’s a cheat sheet on how to read Nutrition Facts labels:

}

START HERE

}

CHECK CALORIES

LIMIT THESE NUTRIENTS

GET ENOUGH OF THESE NUTRIENTS

}

FOOTNOTE

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Nutrition Facts Serving Size 1 cup (228g) Servings Per Container: 2

Amount Per Serving Calories 250 Calories from Fat 110 % Daily Value* Total Fat 12g 18% Saturated Fat 3g 15% Trans Fat 3g Cholesterol 30mg 10% Sodium 470mg 20% Total Carb 31g 10% Dietary Fiber 0g 0% Sugars 5g Protein 5g

Foods like meats and fresh produce may not have a Nutrition Facts label. Here are a few tips to keep in mind when it comes to the portion sizes of certain foods:

= 1 cup of salad greens = baseball

= 3 ounces of meat = a deck of cards

= 3 ounces of lean fish = checkbook

= Medium piece of fruit = size of a woman's fist

Vitamin A 4% Vitamin C 2% Calcium 20% To learn more, visit www.fda.gov/ Iron 4% *Percent Daily Values are based on a 2,000 calorie diet. Your daily values may be higher or lower depending on your calorie needs.

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food and click on “How to Understand and Use the Nutrition Facts Label.”

[ Healthy planning ]

Help yourself to a smooth recovery after a hospital stay

A

fter a hospital stay, you may feel like you have been checked from head to toe. The last thing you want to do is see another doctor. But it’s important to see your primary care provider (PCP) within one to two weeks of coming home from the hospital. Here’s why:

Closing the loop Your PCP is your go-to person when it comes to making sure everyone is on the same page as far as your care is concerned. Meeting with your PCP soon after you come home from the hospital gives you a chance to bring him or her up to speed on your hospital stay. It also lets your PCP identify anything that could be standing in the way of your recovery. Minimizing medicine mix-ups While you were in the hospital, perhaps you started taking new medicines. You may also have temporarily stopped taking some of your regular medicines. In order to make sure that you are taking your medicines as prescribed, take a complete list of all your medicines to your appointment with your PCP. He or she can review dosages and do a “before and after” check, looking for duplicate or dropped medicines and potentially harmful medicine combinations.

Prevent readmissions One out of five Medicare patients go back to the hospital within a month of coming home, often due to avoidable complications. After you check out of the hospital, remember to check in with your primary care doctor. It is a simple step that can increase your chances for a speedy recovery.

FOR MORE INFORMATION on your medicines or health condition, visit harvardpilgrim.org/ stridewellness and click on “Health Topics A-Z.” To talk with a nurse care manager about your recent hospital visit, call 866-750-2068, Monday – Friday, 8 a.m. – 5 p.m. (TTY Service: 711).

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[ Healthy notes ]

A smart choice for staying healthy: Taking the right dose … the right way

M

ost of us take medicines every day as instructed. But did you know that taking medicines incorrectly (such as skipping doses or cutting a dose in half) may cause harm and could even lead to a hospital admission? Whether you are starting a new prescription or shopping for cold medicine, the details do matter. To get the most benefit from your medicines, it is important to follow your Can I take health care provider’s instructions and to half a tablet if understand how, why and when to take I feel well? your medicine. Here’s a checklist of questions to ask your health care provider: • What’s the name of the medicine? • How often should I take it, at what dosage and when? • For how long should I take it? • What side effects should I expect? What should I do if they occur? • What foods, drinks or other medicines (prescription and over-the-counter) should Should I take this I avoid while taking the new medicine with medicine? food or meals? • What should I do if I forget a dose? Write the answers down. When you pick up the prescription, check that it is the same as the one your health care provider prescribed.

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Is this new medicine safe to take with my old medicine or over-thecounter medicine?

[ Healthy notes ]

Questions & answers: Spotting signs of depression

A

s people age, they often shrug off their feelings if they feel gloomy and empty. Family and friends also may ignore these warning signs of depression, thinking they are “just part of aging.” Yet the signs of depression are too serious to ignore. Here is what you should know about depression to protect yourself or someone you love.

Q

What are the warning signs of depression? A. Someone who is depressed tends to lose interest in onceenjoyed activities and may stop taking care of himself or herself. He or she also may be irritable or anxious, have difficulties sleeping or sleeping too much, or experience unusual changes in appetite and weight. He or she may even think about death frequently. Because some of these symptoms can be signs of other medical problems, it makes

sense to call or see a health care provider.

Q

Maybe it is dementia, not depression. How can I tell the difference? A. Depression may come on very quickly, while signs of dementia appear over a longer period of time. While depressed people may have trouble concentrating, they usually can remember recent events. People with dementia often cannot.

Q

Is depression linked to other conditions? A. Sometimes depression goes hand-in-hand with other chronic illnesses, such as heart disease, diabetes, cancer, Alzheimer’s disease and Parkinson’s disease. However, depression can affect healthy adults, too, including those who never have had it before.

Q

What should I do if I suspect depression? A. Talk with your health care provider about your own concerns with depression. Encourage your friend or family member to speak with a trusted health care provider. You may want to seek help directly from a mental health professional. The sooner you recognize the symptoms of depression and seek help, the more effective treatment will be. Call United Behavioral Health/Optum (Harvard Pilgrim Health Care’s behavioral health partner) at 888-777-4742, Monday – Friday, 8 a.m. – 7 p.m. (TTY Service: 711), for the name of a participating behavioral health clinician.

You can also visit harvardpilgrim.org/stridewellness and click on “Health Topics A-Z” where you can search “depression” for more information. [ 7 ]

[ Healthy notes ]

We heard you! W

e recently surveyed Harvard Pilgrim members to better understand how to effectively provide you with the support you may need to improve your health and well-being. Based on your responses, we thought

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that the following resources would be helpful to you: • Questions about plan benefits? Your StrideSM (HMO) membership includes many benefits, some of which have been expanded this year. If you have any questions about your medical or prescription drug

benefit, please call Member Services at 888-609-0692. • Health Topics A-Z. Visit harvardpilgrim.org/ stridewellness for up-todate health and wellness information. For example, go to “Health Topics A-Z” and search for “preventing falls” if you are

We Want Your

Opinion

Have something to say? Let’s hear it. Harvard Pilgrim LISTENS gives you an exciting and convenient way to connect with us and share what you think. As a member, you’re invited to join Harvard Pilgrim LISTENS, an online forum for sharing your thoughts, opinions and ideas. What’s important to you? What’s not? How can Harvard Pilgrim do a better job of giving you the information you need? We want to know! Each month, you’ll have the chance to participate in online surveys and discussions, and you can be entered to win one of our monthly prize drawings as well! Harvard Pilgrim is dedicated to improving the quality and value of health care for the people and communities we serve. And there’s no one better than our members to let us know how we’re doing. GET STARTED NOW! Visit harvardpilgrimlistens.org/stridewinter2017.

having problems with balance or falls. • Provider lookup. We have expanded our health care provider network to give you more choices, both for primary care providers (PCPs) and specialists. For a complete list of providers,

go to harvardpilgrim.org/ stridewellness and click on “Find a Doctor.” • Nurse care management. If you have a chronic condition such as diabetes or heart disease, Harvard Pilgrim’s nurse care managers will work with you, your PCP and other

health resources to help you coordinate and manage your care. If you would like to speak with a nurse care manager, please call 866-750-2068.

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5 [ Healthy planning ]

preventive screenings you should never skip Your health care provider is there for you when you’re sick, but it’s just as important to visit him or her when you’re well. During your annual wellness visit, ask which screenings you need. Health screenings check for signs of disease before you have any symptoms. The earlier you find problems, the easier they are to treat. Below are five screenings you should discuss with your health care provider at your next visit. Check with him or her to see if there are others that you should consider as well.

SCREENING

WHY

HOW OFTEN

BLOOD PRESSURE CHECK

High blood pressure can cause a heart attack, a stroke, eye problems and kidney problems — without you even knowing your blood pressure is high. That’s why it’s important to get your blood pressure checked, even if you don’t think you have a problem.

At every visit with your health care provider.

MAMMOGRAM

A mammogram can find breast cancer early, before any symptoms appear.

At least every two years for women ages 50-74 depending on risk factors. If over age 74, speak with your health care provider.

IMMUNIZATIONS

As you age, you need a few extra vaccines to help you stay healthy, including a flu, pneumonia and shingles vaccine.

• Flu shot — every year • Pneumonia vaccine — two doses after age 65 • Shingles vaccine — after age 60

COLORECTAL CANCER SCREENING

Colorectal cancer is the second leading cause of cancer in the U.S. But it can be prevented. Screening helps find precancerous polyps so they can be removed before they turn into cancer. Screening can also find colorectal cancer early, when treatment is most effective.

Screenings are recommended for adults starting at age 50 and continuing up to age 75. How often depends on the type of screening. Ask your health care provider which screening is best for you.

DIABETES CARE

If you have diabetes, it is recommended that you have a dilated eye exam, kidney testing and A1C testing to prevent diabetes complications such as eye, heart, nerve and kidney problems.

At least once every year for each test.

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[ Healthy lifestyle ]

Strong bones prevent falls

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o matter what your age, strength training can improve your bone health and your balance. As we age, we lose bone. This increases the chances for breaking a bone, even from a minor fall. Strength training is an exercise in which your muscles move against resistance (such as handheld weights or the weight of your own body). Strength exercises build muscle. Even small changes in muscle strength can make a real difference in your ability to perform everyday activities like carrying groceries, lifting a grandchild or getting up from a chair. It can also help improve your balance, thereby preventing falls. Strength training is good for your heart, too. It can lower your blood pressure and cholesterol, and it can help you lower or maintain your weight.

BONE HEALTH Ask your health care provider if you should have a bone density test. The lower your bone density, the greater your risk of breaking a bone. Early detection and treatment can reduce your chance of serious injury if a fall occurs.

Strength exercises to try at home To do any of these exercises, stand up straight and use a counter or sturdy chair for support. Start by doing each exercise a few times, and work your way up to eight to 12 times for each exercise. • Heel raises. Rise up onto your toes. Hold for a few seconds. Slowly lower your heels to the floor. • Leg lifts. Hold onto the back of Check out videos on your chair. Keeping your legs how to get started with straight, lift one leg a strength exercises. Visit: few inches to the side. • growingstronger. Hold for a few seconds. nutrition.tufts.edu Slowly lower your leg. • nihseniorhealth.gov Repeat on the other side. and search for • Sit-to-stand. Sit “Exercises to Try” in your chair, with the chair against a wall. Stand up without using your hands. If this is too hard, start by using a pillow on the chair until you get stronger.

Strength-training tips • Talk with your health care provider before starting an exercise program. • Warm up with a five-minute walk. • Strength-train two or three times a week. • Skip a day between sessions to let your muscles recover. • Start out using as little as 1 or 2 pounds of weight or no weight at all. • For each exercise, aim for 10-15 repetitions to improve your strength; over time you can work up to 15-20 repetitions to improve muscular endurance. • Cool down and stretch after each workout. • Try something new. Boost your activity level with exercise that increases strength and balance. Try tai chi or barre. [ 11 ]

Stride (HMO) Medicare Advantage Plan SM

NONPROFIT ORG U.S. POSTAGE PAID HARVARD PILGRIM HEALTH CARE

Volume 2, No. 1 | Winter 2017

Harvard Pilgrim Health Care 1600 Crown Colony Drive Quincy, MA 02169 Clinical Advisors Colleen Harwood, RN Tami Ireland, MPH Jennifer Rollo, RPH, CDE Michael Sherman, MD, Chief Medical Officer Editors Lydia Bernstein, MPH Karen Salvato Matt Tousignant Harvard Pilgrim Member Services Phone: 888-609-0692 (TTY Service: 711) Oct. 1 – Feb. 14, 8 a.m. – 8 p.m., 7 days a week; Feb. 15 – Sept. 30, 8 a.m. – 8 p.m., Monday – Friday Developed by StayWell 11030M Please Recycle

1600 Crown Colony Drive Quincy, MA 02169

harvardpilgrim.org/stridewellness

Information in this newsletter is designed to complement, not replace, the care you receive from health professionals. Harvard Pilgrim does not assume any responsibility for the accuracy, completeness or clinical efficacy of information contained in the Internet Web sites referenced in Stride HMO. Harvard Pilgrim is an HMO plan with a Medicare contract. Enrollment in StrideSM (HMO) depends on contract renewal. Copyright © 2017 by Harvard Pilgrim Health Care. All rights reserved. Reproduction in whole or in part of any text, photograph or illustration without prior written consent from the publisher is strictly prohibited.

 L ANGUAGE ASSISTANCE SERVICES Español (Spanish) ATENCIÓN: Si usted habla español, servicios de asistencia lingüística, de forma gratuita, están a su disposición. Llame al 888-609-0692 (TTY: 711). Português (Portuguese) ATENÇÃO: Se você fala português, encontram-se disponíveis serviços linguísticos gratuitos. Ligue para 888-609-0692 (TTY: 711). Nondiscrimination statement Harvard Pilgrim Health Care and its affiliates (“HPHC”) comply with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex.

Roasted winter squash soup Ingredients 2 acorn squash 2 garlic cloves 3 sprigs fresh thyme 1 tbsp. olive oil 2 small raw onions ½ cup white wine 8 cups low-sodium vegetable broth ¼ tsp. bay leaf, crumbled pepper 1 ⁄3 cup cider vinegar

Directions 1. Preheat oven to 350 degrees. Cut squash in half, remove seeds and roast cut side down with garlic and thyme inside. 2. Roast squash for about 60 minutes or until soft. 3. Scoop out flesh and set aside, along with the garlic and thyme. Add olive oil to a pot set over medium-high heat; add onions and roasted

garlic and sauté until soft. Add scooped squash to pot and stir, then add wine to deglaze. 4. Reduce heat slightly and add broth and bay leaf, then simmer for 10 minutes. 5. Remove bay leaf and purée in a food processor; season with pepper and cider vinegar to taste. Serve immediately.

Serves four. Each serving contains about 220 calories, 7 g fat, 1 g saturated fat, 0 g trans fat, 0 mg cholesterol, 280 mg sodium, 34 g carbohydrates, 6 g fiber, 6 g sugar and 2 g protein.

TIP: Microwave squash for three to five minutes to soften skin before cutting.