SMART LIVING

MAR/APR 2024

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Changes to ExpressCare Clinic Locations


Retail clinics in Wasilla and Midtown Anchorage close to ensure right mix of services to our communities.

With our patients and financial sustainability in mind, Providence regularly considers how we can best provide care in our communities. After thoughtful discernment, Providence Clinical Network leaders decided to close the ExpressCare clinics in Wasilla and the Midtown Mallin Anchorage at the start of the year. The last day of operations at both clinics was Dec. 31, 2023.

This change ensures we have the right mix of clinics and services in these areas as we redirect patients to other facilities in our network.

Caregivers who served at the Wasilla and Midtown ExpressCare clinics were retained by Providence and transitioned to other locations without any loss of employment due to the closures. We are also easing the way for patients who sought care at these clinics and reached out to them regarding the closures with information about other convenient, same-day care options, such as ExpressCare Virtual and Urgent Care. These alternatives provide patients with continued access to the care they need when they need it.

WHERE CAN PATIENTS OF THE WASILLA AND MIDTOWN CLINICS GO TO RECEIVE CARE?

Patients in Wasilla and the nearby area who need sameday care for common conditions can schedule an online visit with one of our board-certified providers from a Smartphone or computer. Providence ExpressCare Virtual services are available from 7 a.m. to 7 p.m., seven days a week, providing patients with accessible care whenever they need it. To access this service, patients can visit providence.virtual.org or download the Providence app.

Patients are also welcome to visit other ExpressCare clinics and Urgent Care in person at the following locations:

  • Urgent Care – Midtown 1200 W. Northern Lights Blvd., Suite B, Anchorage, AK 99503 (open 7 a.m. to 7 p.m., seven days a week)
  • ExpressCare – Huffman 1389 Huffman Park Drive, Suite 110, Anchorage, AK 99515
  • ExpressCare – Tikahtnu 1118 N. Muldoon Road, Suite 130, Anchorage, AK 99504
  • ExpressCare – Eagle River 17101 Snowmobile Lane, Suite 114, Eagle River, AK 99577

All ExpressCare retails clinics are open 8 a.m. to 8 p.m., seven days a week. For more information, patients can call Providence ExpressCare at (888) 227-3312 or visit providence.org/services/expresscare.

You Asked, We Listened: Direct Contract List Updates


When a national PPO contract does not meet the needs of providers, they have the option of negotiating a direct contract with the Trust for the benefit of its members. The following providers have responded to their patients’ requests and have completed an in-network contract negotiation directly with the Trust for the benefit of you and your family.

PEHT now has direct contracts with 85 providers to ensure you have access to high-quality, low-cost providers in network.

The following providers have responded to patients’ requests and have completed an in-network contract negotiation directly with the Trust for the benefit of you and your family.

  • Alaska Family Health Center
  • Alaska Natural Health Solutions
  • Alaska Oncology and Hematology
  • Alaska Pain to Wellness Centre
  • Alaska Surgery Center
  • Alpine Chiropractic (Dr. Fuller)
  • Alyeska Vascular Surgery
  • Anchorage Neurosurgical Associates, Inc.
  • Arctic Chiropractic and Phys Med
    Eagle River DBA Chiro One
    Wellness Center of Eagle River LLC
  • Arctic Chiropractic East Anchorage
  • Arctic Chiropractic East
    Anchorage DBA Chiro
    One Wellness Center of Anchorage East LLC
  • Arctic Chiropractic Haines
    Arctic Chiropractic Huffman DBA
    Artic Huffman DBA Chiro
    One Wellness Center of Huffman LLC
  • Arctic Chiropractic South DBA
    Chiro One Wellness Center of Anchorage South LLC
  • Arctic Chiropractic West Mat-Su
  • Arctic Chiropractic Wrangell
  • Artic Medical Center Matsu
  • Arctic Rehabilitation & Physical Therapy
  • Back in Action Physical Therapy
  • Birds & Bees Midwifery
  • Bundle Konstantine, DR
  • Complete Chiropractic and Sports Therapy
  • DeMers Mary, DO
  • Dimond Chiropractic DBA Arctic
    Dimond DBA Chiro One
    Wellness Center of Dimond LLC
  • Express Care Clinic
  • Fireweed Counseling and Wellness
  • Free By the Sea
  • Healing Therapeutics-Mark Stiubhard
  • Hillstrand Mary Margaret, ANP
  • Hopkins Weston, DR
  • Horizon Chiropractic Center LLC
  • Hunt Jennie, AGNP
  • Ideal Family Medicine
  • Integrated Wellness and Center for Birth
  • Jaded Body Wellness and Spine Institute
  • Jennifer Aist Lactation Services LLC
  • Jorgensen Family Chiropractic
  • Kiernan Brendan, MD
  • Kilby Catherine, MD
  • Labor of Love Midwifery
  • Larson Chiropractic
  • Larson Logan
  • Last Frontier Eye Care
  • Litwin Sharon
  • Luminary Chiropractic Care
  • Makin S. Harbir, DR
  • Medevac Alaska
  • Midnight Sun Oncology
  • Mind, Body, Spirit Counseling and Consulting
  • Morris Leslie, DR
  • Morrison Madeline, DR
  • Neurobehavior North, Inc
  • Northstar Chiropractic
  • NorthStarr Cardiothoracic Surgery
  • Nutrition Partnership, LLC
  • Pemberton & Young Counseling
  • Pioneer Peak Orthopedics
  • Prism Optical of Alaska
  • Providence Alaska Medical Center
  • Rainforest Pediatric Care
  • Ramirez Chiropractic
  • Restoration Wellness
  • Schaefer Sharon, DR
  • Schroll Jennie, LCSW
  • Silver Moon Acupuncture
  • Smith Amy, LCSW, CDCI
  • Snow Blossom Acupuncture
  • Solomon’s Porch
  • Soma Wellness
  • Spine and Joint Rehabilitation Specialists
  • Spine and Sport Injury Center
    DBA Complete Family Care
  • Sports, Personal Injury and Chiropractic Consulting
  • Taylor Brent, DR
  • The Talking Place, Child & Adolescent Counseling
  • Transitions Counseling; Christina McGauthiar
  • True North TMS
  • Valley Allergy and Asthma Clinic
  • Wendi Compton-Karuna Counseling
  • Wickler Laurence, DR
  • Wild Iris Integrative Massage (Lawton)
  • Willow Medical and Wellness
  • Wisdom Traditions Counseling Services
  • Wolf Eye Center
  • Yelverton, Brian

You can view your health plan’s direct contract listing by visiting pehtak.com/preferred-providers.

ACCESS NON-EMERGENCY MEDICAL TRAVEL BENEFITS WITH PRE-APPROVAL


Benefits for non-emergency medical travel may be payable for transportation by commercial airline (coach class only, with at least a 14-day advanced fare) or ferry from the place where the illness or injury occurred to the nearest area where necessary professional treatment can be obtained, unless the plan administrator finds a longer trip is necessary.

For reimbursement consideration, commercial airline flights may only be scheduled for departure 1-2 days in advance of the first appointment or 1-2 days after the last appointment related to the condition being treated. Consideration for additional days may be given upon approval by the plan administrator.

All non-emergency commercial travel must be pre-approved by the plan administrator (or their designate) using the “Public Education Health Trust Non-Emergency Medical Travel Request Form” or no benefits will be provided. The form can be found at pehtak.com/forms.

Contact the Health Trust by phone. In Anchorage call (907) 274-7526; outside of Anchorage call (888) 685-7526. Business hours are Monday-Friday, 8 a.m.-4:30 p.m. (AKST).

TRANSPORTATION BENEFITS

Transportation benefits in any one calendar year will be limited to two round trips.

Transportation benefits apply only to the illness or conditions covered under this plan. They do not apply to dental care benefits, vision services, routine care or preventive care exams unless approved by the plan administrator.

A local physician must certify that needed services are not available locally. Transportation benefits for any foreign healthcare will not be covered, including Canadian healthcare.

Transportation benefits will not be given for diagnostic or second-opinion diagnosis unless diagnostic services cannot be provided locally and are deemed medically necessary by the plan administrator. The physician must provide written certification or detailed medical documentation of the existing condition in advance of the trip.

Non-emergency transportation charges will only be allowed for a patient who is a covered person, except for the following circumstances:

  • If the patient is a covered person under 18 years of age,then the transportation charges of a parent or legal guardian accompanying the child will also be allowed.
  • If the patient is a covered person over age 18 and has a mental disorder or physical disability that requires the assistance of a caretaker post-procedurally or during travel, the transportation charges of a parent, legal guardian or assigned caretaker accompanying the patient will also be allowed.
  • After the travel has occurred, a completed “Public Education Health Trust Non-Emergency Medical Travel Request Form” must be submitted with the boarding passes and the receipts of the travel, signed off by the attending physician, or no benefits will be provided. All information must be sent to EBMS.

Maintenance Program Reminder


Public Education Health Trust provides a mandatory 90-day maintenance program designed to save you time and help you better manage your medication(s) that you take regularly.

The program allows up to two 30-day fills of your maintenance medication and then you must switch to a 90-day supply before your third fill, or you prescription won’t be covered.

YOU HAVE TWO OPTIONS TO FILL YOUR 90-DAY PRESCRIPTION(S):

  1. Sign up for home delivery by going to optumrx.com or call (855) 395-2022, TTY 711
  2. Keep filling 90-day supplies at your local retail pharmacy
  3. If you are currently taking a maintenance medication, call your doctor today for a new 90-day prescription.

Staying Safe In The Cold: An Alaskan’s Guide


In Alaska, we’re no strangers to cold weather, which might make you think we're more prepared than most. But did you know that according to the National Institutes of Health (NIH), the rate of hypothermia death is ten times higher here than the rest of the United States? So, as the temperatures drop and the snow continues to pile up, it’s crucial to not underestimate the risks associated with prolonged exposure to the cold.

HYPOTHERMIA

Hypothermia can be the result of prolonged exposure to the cold and causes the body to lose heat faster than it’s produced, depleting stored energy and leading to lower body temperature. This will often impair cognitive function and mobility, making it especially dangerous as individuals may not even be aware it’s happening. So, recognizing the warning signs of hypothermia is key. In adults, symptoms include shivering, confusion, memory loss and exhaustion. Infants may display red, cold skin and very low energy. If any of these signs are observed, check the person's temperature. Seek emergency medical attention immediately if it’s below 95°F.

Mild hypothermia can occur in relatively mild conditions, especially if a person is wet or not adequately dressed. Symptoms may start to appear after prolonged exposure in temperatures around 50°F (10°C) or lower.

Moderate to severe hypothermia would happen in colder conditions, such as freezing temperatures or below, and sets in more quickly, especially if a person is exposed to wind and wet conditions. It may take 30 minutes to an hour or even less for severe hypothermia to develop.

WHAT IS FROSTBITE?

Frostbite is a serious cold-related injury that occurs when the skin and underlying tissues freeze due to exposure to extremely colt temperatures. Commonly affected areas include the face, ears, wrists, hands, and feet. In temperatures around 0F (-18C) with a wind chill, frostbite can occur on exposed skin in as little as 30 minutes or less — that’s fast! You'll know it’s happening when your affected skin turns whitish, becomes still anf eels numb rather than painful.

ARE YOU FROSTBIT?

Take immediate action! Gradually warm the affected part of the body in warm – not hot – water. The water temperature should be comfortable to the touch to unaffected parts of the body. Alternatively, use blankets, sweathers, coats or even your body to cover the frostbitten area. And remember that frostbitten areas are numb and susceptible to burns so never use direct heat sources like heat lamps, stoves, fireplaces, etc.

Spring is on its way, but in the meantime stay warm, stay informed and stay safe!

Mark Your Calendars: Open Enrollment Starts On May 6


Open enrollment is quickly approaching! Every year, you have the opportunity to carefully review your benefits and make changes you’d like to see for the coming plan year (July 1, 2024 – June 30, 2025).

The upcoming May/June newsletter will provide more information on how to enroll. If you have questions in the meantime, reach out to the Trust office or your Human Resources department.

OPEN ENROLLMENT RUNS MAY 6 THROUGH MAY 31, 2024

Transcarent

TRANSCARENT LAUNCHES NATIONAL INDEPENDENT PROVIDER ECOSYSTEM


Transcarent recently announced the first National Independent Provider Ecosystem with ten of the most innovative and highest-quality health systems across America as a key part of our efforts to make it easy for people to access high-quality, affordable care. This ecosystem will provide national employers and their employees with a health and care experience they value, faster access to verified high-quality digital or in-person care and guaranteed, affordable and predictable costs with full transparency.

“Everyone agrees that healthcare in America is too confusing,complex, and costly. Our goal is to make it easy to access high-quality care and to do that, we’ve partnered with the people who deliver that care . . . the best health systems across the country” said Glen Tullman, Transcarent Chief Executive Officer.

“Our close collaboration with these ten leading health systems will allow us to better design care pathways, provide higher-quality care, and faster access. By aligning with health systems who can guarantee both quality of care and competitive pricing, we can reduce administrative burden, and just as important,demonstrate true measurable value for the people who pay for care – employers and their employees. We’ll also more closely integrate the digital experience with the hands-on care that we know only health professionals can provide. It’s not an either/or, it’s both,” said Tullman.

For the first time at a national level, Members can access seamless virtual care that works in tandem with complex care services that are best delivered locally.

We’re beginning with 10 of the most respected, highest-quality and innovative health systems across the US:

  • Advocate Health
  • Atrium Health
  • Baylor Scott & White Health
  • Corewell Health
  • Hackensack Meridian Health
  • Intermountain Health
  • Mass General Brigham
  • Memorial Hermann Health System
  • Mount Sinai Health System
  • Virginia Mason Franciscan Health

Transcarent’s Comprehensive Care Model will offer employers and their employees:

  • One Connected “Concierge Level” Member Experience: Members get preferred access to care through a fully-connected journey, across digital and in-person care. Each Member will have a coordinated and personalized experience from the Transcarent platform directly through the care pathway of each health system, including scheduling and pre/post care. Members will also have transparent information and reduced overall costs through innovative employer benefit programs.
  • Trusted, Highest Quality Outcomes: Combining industry-leading quality information from CareJourney, additional quality reference sources and our health systems’ collective clinical experience, Transcarent Members can have confidence that they are receiving care of the highest-quality. When paired with Transcarent’s integrated wraparound support — like expert opinions, virtual physical therapy, orthopedic consultations, our pharmacy marketplace and access to immediate care in 60 seconds or even in-home — Members get more appropriate care and recover faster. Driving value into health and care is a must if cost and quality outcomes are to improve in the United States.
  • Predictable, Lower Cost of Care: By directly contracting for rates upfront with our health systems and guaranteeing same-day payment, which no one else does, we can also guarantee our employer clients very cost-effective outcomes.

To be clear, we’re not talking about the lowest costs, we’re talking about the highest quality of care enabled by better processes. High-quality care drives down the overall cost of care. Through early intervention, process design and second opinions, we identify what care is necessary and then ensure it is performed by quality organizations at the appropriate site of care. We share the benefits with both our employer clients and our health system partners, creating a win-win,” said Randy Hawkins, M.D., Transcarent Chief Medical Officer.

The Transcarent model simplifies the healthcare experience for employers, providers, and health consumers. Our direct-to-employer platform regularly pays providers on the same day the service is delivered and includes value-based incentives. Employers will receive competitive pricing previously reserved only for narrow networks while maintaining access and choice for Members. Employees and their families benefit from perks like waived co-pays and co-insurance for making better decisions about their care (where allowed by law and depending on their plans).

By offering a national comprehensive solution that combines innovative technology, top-quality care and reduces the cost of care, Transcarent’s National Independent Provider Ecosystem, along with our foundational health systems, is poised to reshape the future of health and care for Members and self-insured employers.