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Medicare (Dis)Advantage

I am sure many of you over 65 have seen advertisements for Medicare Advantage plans, which offer a privatized managed version of Medicare often touted as less expensive with a wider array of benefits. Enrollment in these plans have doubled over the past decade for these purported reasons. Many of you have called us asking us our opinion about joining one. The Office of the Inspector General within the Health & Human Services Department recently issued a report detailing how these plans have denied medically necessary tests, treatments and services. The report states that 13% of all denied requests would have been covered under traditional Medicare. Given the fact that government pays a fixed fee per patient to the Medicare Advantage plan, there are clearly incentives to deny claims or requests to maximize profits. We firmly stand behind traditional Medicare as the best form of heath insurance for those of you Medicare-eligible. Moreover, many of the Advantage plans require your PCP to be a “gatekeeper” for tests and referrals which would exclude us from being able to serve as your physician since we opt out of Medicare. Please feel free to contact us if you have any questions regarding these issues.

 

Lung Cancer Screening

As I am sure you have experienced, we make it a priority in our practice to screen for cancer—colon, cervical/breast, prostate, skin to name a few. We also make it a priority to screen for other cancers on an individualized basis given risk factors—genetics or behaviors. Lung cancer is the leading cause of cancer-related death in the United States, with smoking being the overwhelming risk factor for its development. Obviously, stopping smoking is the best preventative measure to decrease risk and mortality. But what about those who are unwilling or unable to stop, or those who have recently stopped? While studies looking at annual chest x-rays failed to reduce cancer incidence or mortality, recent well-done studies using annual low-dose CT scanning clearly demonstrate a reduction in lung cancer deaths and an additional improvement in all-cause mortality. We are recommending for those 50-80 years of age, with at least a 20 pack-year history of smoking (1 pack per day for 20 years) or having stopped within 15 years, to undergo annual chest CT scanning for lung cancer. Though we will often discuss this at your annual physical, if you would like to discuss sooner please feel free to call us. And remember, stopping smoking is the best preventative measure for preventing lung cancer mortality!


 

COVID Update

COVID cases are up substantially in our practice in the last 2 weeks. The virus is wide spread in Missouri and in the U.S. The new variants are substantially more contagious than omicron. Hospital rates, while relatively low comparatively, have risen 18% in the last week. Here are some take-aways:

  • Wear a high quality mask-- such as N95/KN95/KF94-- when indoors in public, particularly in crowded, poorly-ventilated spaces.

  • Try to socialize outdoors to reduce your risk, particularly for meals.

  • Rapid COVID testing often takes 3-5 days to test positive after symptom onset. A negative rapid test does not mean that you do not have COVID.

  • PCR tests are available in our office as a drive-through, these are important to do if you have 2-3 days of symptoms and a negative rapid test.

  • Treatments for COVID are widely available. They must be started within 5 days of symptom onset and work best the earlier you begin them. If you develop symptoms, call our office so we can help you get started on a treatment.


 

Mr. Golden Sun Jane Kozlowski, RN

The weather’s finally warming up, and with that, comes a reminder to wear your sunscreen. As the temperature rises, so does the strength of the sun’s UV rays. When purchasing and applying sunscreen here’s what we recommend:

  • For general everyday use, you want a sunscreen with SPF 15 or higher. But on those days you know you’ll be in the sun for an extended period, look for a sunscreen that provides SPF 30-50.

  • The sunscreen should say “broad-spectrum,” meaning it blocks both UVA and UVB rays.

  • If you’re planning on swimming, you should apply a sunscreen that says it’s “water-resistant.” Pay attention to the amount of time it’s water-resistant and don’t forget to reapply according to the label’s directions.

  • In general, you should reapply to all exposed areas of your body every 2 hours – make sure to include those often-forgotten areas such as the top of ears, hair part, tops of feet and back of knees.

  • Avoid sunscreens with oxybenzone - this ingredient has been shown to cause allergic reactions and can behave as an endocrine disruptor. Ideally, reach for ones that contain some titanium dioxide and/or zinc oxide.

As an alternative to applying sunscreen, another option is wearing sun protective clothing. Wearing long pants/skirts, long sleeves and a wide-brimmed hat can help lower your body’s absorption of the sun's harmful UV rays. However, keep in mind not all clothing material offers the same protection. For instance, a white t-shirt provides an SPF of 7 (and only SPF 3 when wet) whereas a denim, long-sleeve shirt provides complete sun protection with an SPF of over 1000. Many apparel companies now offer sun-protective lines of clothing – labeled with UPF ratings. A simple Google search will bring up many options. Also consider wearing swim shirts when hitting the water – these offer high levels of SPF and can keep those easily-burned shoulders covered as well. For more information, check out the Skin Cancer Foundation’s website.

 

Payments

If you elected for your invoices to be emailed, you should have received Dr. DeLaney's annual invoices and Dr. Katzman's quarterly invoices on May 1 from our third-party vendor, Bill.com. The invoice may go to your junk/spam folder if you have not yet saved their address to your contacts. If you prefer to receive a paper invoice mailed to you, please either contact our office at 314-993-1200 or Tonya.


 

New Insurance, Address or Email?

Please let us know at your next point of care if your insurance, address, email, or any other demographics have changed. It's important to keep your chart up to date as we utilize this information for office tasks such as placing outside orders/labs and making referrals. Thank you!

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