We recently sat down with David Stuart, senior vice president and chief operations officer at Community Health Options, to talk about why it’s important for companies to find health insurance partners that can facilitate access to health and wellness resources to help their employees thrive. Here’s what he had to say.
Q: What should a Maine-based company look for in a health insurance carrier?
A: Employers need health and wellness benefits that help employees and their families through each stage of life so they can get the care they need when and where they need it. The best partner shares a dedication to well-being and removes barriers to care, particularly for complex issues. Employers should expect that an insurer always has their best interest in mind, providing flexible, nimble world-class service, alongside specialized care teams who excel at finding providers and resources to help overcome the challenges of getting care throughout Maine, especially in rural areas.
Q: How should an employer evaluate the trade-off between the cost of premiums and coverage benefits?
A: It's important to provide high-quality benefits backed with excellent service as part of a total compensation package for current and future employees. Attracting and retaining talented people is a challenge felt everywhere, and it often means foregoing the lowest-cost, bargain benefits. Employees can thrive when they have access to wellness resources, along with caring and meaningful help through life's challenges from people who are right here in Maine. That's where Community Health Options comes in—as a long-term partner committed to managing the overall costs of benefits and lowering out-of-pocket costs for Members.
Q: Why are collaborative insurer-provider relationships important? Isn’t it most important that insurers just make sure claims are paid?
A: Providers are truly our partners as we seek to lower our Members’ healthcare costs without creating hurdles that make it harder to deliver the best patient care experience and improved health outcomes. Our care managers, for instance, can help ease a mother’s mind by finding behavioral health resources for a teenage son in crisis, or work with a cancer patient’s provider to coordinate chemotherapy treatments, often saving thousands on medications. And sometimes our teams find ways to provide more care—not less. We know how important this is because we're Members and patients, too.
Q: What’s the value in forming a long-term partnership with a health insurer?
A: A long-term partnership with an insurer that is invested in the well-being of a company’s employees and understands the resources available in their neighborhoods gives employers the opportunity to truly support their employees through life's journey. That begins with wellness, along with preventive and routine care, and continues with easy access to urgent care options when "life happens," and ongoing care to manage chronic conditions. Community Health Options offers great examples of that value through its infusion therapy support and Chronic Illness Support Program, along with a top-tier wellness platform.
Q: Why should a company consider working with Community Health Options?
A: Simply put, we put our Members at the center of everything we do. That’s a fundamental tenet of our business as a nonprofit. All our effort is focused on making things better for our business clients and Members. We truly are a Maine company—100 percent of our service team lives here—and when businesses partner with us, they are investing in Maine just like we do every day.
David Stuart, vice president and chief operations officer, has more than two decades of experience in the healthcare industry, holding roles in payer and provider organizations across Northern New England. His operations experience spans across enrollment and eligibility, quality audit, claims and configuration, service centers (Member, provider, broker, group administrator), payer and patient billing, and practice management, all with a strong focus on developing and leading teams. He holds an MBA and a Master of Science in Organizational Leadership from Southern New Hampshire University, and a BS in Business Administration from the University of Maine at Augusta.
*This article also appeared as sponsored content in Mainebiz on Oct. 30.
If you’ve been diagnosed with Type 2 diabetes, you likely already know the risks that come with high blood sugar levels—heart or kidney disease, blindness, nerve damage or stroke. Low levels can pose problems, too, like blurred vision, nightmares, headaches, confusion or lightheadedness.
Diabetes has become a national epidemic—there are at least 37 million people diagnosed with the disease, according to the Centers for Disease Control and Prevention. In Maine, more than 113,000 people—or about 10% of the state’s adults—have been diagnosed with diabetes, with an estimated 32,000 who likely have diabetes, but don’t know it.
It takes more than an occasional A1c blood test, a measure of average blood sugar over three months, to effectively manage Type 2 diabetes and prevent the serious complications that can go with it. Even so, there’s a good chance that for many with diabetes, daily glucose monitoring can be hit or miss. Let’s face it: It can be a hassle to keep track with frequent finger sticks.
Daily monitoring empowers you to take control of your diabetes, whether measuring a few times a day with a glucose meter or using a continuous glucose monitoring system (CGM) that tracks patterns 24/7. Daily monitoring can also provide real-time information and reveal patterns, like whether sugar spikes after a meal or drops to dangerous levels overnight. It can also show you how your body responds in real time to specific food, exercise or the medications you take.
