UPPER PENINSULA HEALTH PLAN

April 2002

A Publication for Members of UPHP-Medicaid

In This Issue....

Do I Need a Referral?                                                             You Like UPHP!
Watch Out for Scams!                                             Smoking Facts for Women
Controlling Asthma                                                             Safety Health Care Corner

Do I Need to Have a Referral?

As a member of Upper Peninsula Health Plan (UPHP), you are assigned a Primary Care Provider (PCP). Your PCP’s name and phone number are listed on your membership ID card. In most cases, this is the doctor you see first when you need medical care, although there are a few cases in which you may see a different doctor without seeing your PCP first. They are:

• When you see a Pediatrician.
• When you see an Obstetrician/Gynecologist (OB/GYN) for your annual exam or for routine care while you’re pregnant.
• For emergency or urgent care services.
• For routine eye exams.

In the above cases, you don’t need a referral if you see a participating provider. If the doctor doesn’t participate with UPHP, you must have approval before the visit. The only exception to this is for emergency or urgent care. Refer to your Member Handbook or call Customer Service for more information.

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You Like UPHP!

UPHP was one of 19 Medicaid health plans surveyed for member satisfaction in 2001. This survey is called Consumer Assessment of Health Plans Study (CAHPS). 47% of surveys sent to our members were completed and returned. This is a very high response rate. The results show how UPHP compares to other health plans in the state. UPHP ranks high in member satisfaction with the plan. The plan does a good job of providing its members with a personal physician or nurse. Our providers get high ratings from 81% of our members. 82% of our members feel that getting care is not a problem, and 87% say they get their care quickly. This is very high compared to other plans and is above the state average. Our members feel that the doctor communicates well and the office staff is courteous and helpful. With all experiences with the plan, 65% of our members rate UPHP highly. You rate UPHP above average on nearly all children’s health care satisfaction areas. Parents are satisfied with the plan, with 73% rating it highly. This compares to a 68% statewide plan average. 77% of out parents say they had no problem with UPHP customer service and only 4% called or wrote to UPHP with a complaint! This compares to the statewide plan averages of 70% and 6%. Thanks for your response to the survey!
UPHP has also received our 2001 Health Employer Data and Information Set (HEDIS) results. This study compares the plan’s care to state and national Medicaid plans. Some of the areas HEDIS looks at are childhood and adolescent immunizations; well-child visits; cervical cancer, breast cancer, and chlamydia screening; prenatal and postpartum care; diabetes care; asthma care; and advising smokers to quit.
If you would like more information on CAHPS or HEDIS results, call Customer Service. We’ll be glad to tell you more!

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Watch Out for SCAMS!!

From time to time Upper Peninsula Health Plan (UPHP) may need to send you mailings. This may be because we have to tell you some valuable news. we may also have to get some important facts from you. This information may be an essential part of your ability to access care. Unfortunately, in this day and age, we can’t always trust what we receive in the mail or who is calling us on the phone. UPHP doesn’t share its member information with any outside company. If you receive a request for information about your Medicaid coverage and aren’t sure if it is safe to provide it, call UPHP right away. We can check and see if you should have received anything from us. Never release any Medicaid information if you are unsure who you are giving it to or how it will be used.

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Facts for Women About Smoking!

Did you know that:
Nearly a quarter of Michigan women smoke, slightly less than the number or men that smoke.
Since 1963, more than twice as many men have quit smoking than women. (Ladies! Say it isn’t so!)
Each year more women die from lung cancer than breast cancer. (Yikes!)
Women who smoke during pregnancy are more at risk to have lower birth weight babies. People who smoke have more facial wrinkles than those who do not smoke. (Ugh!)
When one person smokes in the house, everyone in the house smokes. Women who live with a partner who smokes are also at increased risk of lung cancer.

Now here’s the clincher: tobacco is an addictive drug that affects the body just as heroin and cocaine do. But, in spite of the strength of this addiction, nearly half of Michigan women who have ever smoked cigarettes have quit!
Ladies, you can do this! If you want help, remember to cal your doctor to discuss a plan. He or she can help make quitting easier. You can do it!

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Are Your Asthma Symptoms Controlled?

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