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New for large groups and KYP small groups: Geisinger knee pain treatment option

Geisinger, in partnership with AposHealth, announced that a new non-invasive, drug-free treatment for patients suffering knee pain from osteoarthritis will be available to Geisinger Health Plan’s commercial members in Pennsylvania starting on April 1, 2021. AposHealth treatment is available exclusively at Geisinger in Central and Northeast Pennsylvania. 

Developed by experts in orthopedics and sports medicine, the AposHealth device is approved by the U.S. Food and Drug Administration to help temporarily reduce knee pain and improve lower extremity function. 

The AposHealth program is a year-long, at-home treatment that requires patients to wear a personalized device for approximately one hour a day during normal daily activities. Supported by more than 60 clinical studies, including recent research published in The Journal of the American Medical Association (JAMA), patients using the AposHealth system have experienced significant improvements in temporary pain relief, function and gait patterns. 

“Providing personalized treatments for individual conditions is a tenet of Geisinger’s approach to musculoskeletal care,” said Michael Suk, MD, JD, Chief Physician Officer, System Services and Chair of the Musculoskeletal Institute at Geisinger. “AposHealth’s at-home treatment is perfectly aligned with our way of thinking of managing total health. Embracing new technologies and treatments allows us to reimagine the care pathway for knee osteoarthritis.”

“We are excited to be part of the innovative approach to treating knee pain taken by Geisinger, a Center of Excellence for Knee Replacements. This partnership brings a convenient, clinically proven knee osteoarthritis treatment option to patients and provides clinicians with an alternative non-invasive option,” added Cliff Bleustein, MD President and CEO of AposHealth®. 

The AposHealth treatment is currently available to Geisinger Health Plan’s commercial members in selected Geisinger locations in Danville, Wilkes-Barre and Scranton. Throughout 2021 Geisinger will be exploring opportunities to make this treatment available to more Geisinger patients across its footprint in Central Pennsylvania. Please call 800-275-6401 to schedule an appointment. 

How to know if your group is eligible: 
The following groups are covered if orthotic devices are included in the base benefit and/or the rider is purchased:

A note about New York state surcharges for self-funded groups

The New York Health Care Reform Act (NYHCRA) has been in effect since Jan. 1, 1997. It imposes certain surcharges and assessments on a variety of healthcare physician/other healthcare professional services received in New York State by a covered member. The surcharges and assessments collected are used to finance bad debt, graduate medical education and a variety of other healthcare initiatives. It applies to self-funded payors located in all states.

How does this affect groups?
All self-funded groups are impacted by the NYHCRA surcharges and assessments, regardless of where the group’s office or headquarters is located. If a covered member receives a healthcare service in the state of New York and the healthcare service is subject to the surcharge, then the surcharge is added to the claim cost. The actual surcharge percentage applied to affected claims depends on the group’s election status. In addition, electing customers also must pay a covered lives assessment for each covered member residing in the state of New York.

Once the group has been elected into the NYHCRA Public Goods Pool, the surcharges and covered lives assessment will be paid by Geisinger Health Plan (GHP) and billed to the group.

Here’s what’s changed
GIIC will expect the group to register with the state of New York before the implementation of the administrative service organization (ASO) financial arrangement. GIIC will pay applicable fees on the employer's behalf if requested and the amount will be billed as a claim on their monthly reporting. Except for the NY surcharge, any surcharge or fees will not accrue towards aggregate or specific losses or be considered a part of any financial settlements that are part of this plan.

Download the latest Geisinger Extra flier

The July edition of the monthly Geisinger Extra flier is now available in English and Spanish. As a reminder, this flier is updated monthly and is stored on the brokerHUB. Download them here:

How to quit smoking with our smoking cessation program

If you need help to quit smoking, a smoking cessation program is designed to do just that. One of the best things about a support group? It lets you see you aren’t alone. And even if you can’t find a local support group, virtual support groups abound online. 

Geisinger Health Plan members can join a smoking cessation program by logging into the member portal to complete a consent form. When they answer “yes” to the question about whether they smoke, it will give them the next steps.

Anyone who chooses ‘yes’ in the consent form will be directed to call our health and wellness team to speak with a health coach. They’ll then have the option to continue calls with the health coach or complete an online learning module.

Learn more.

Stay informed about COVID-19 

Geisinger.org/coronavirus is full of the most up-to-date information about the latest on COVID-19 including vaccine FAQs, our safety checklist, community resources and much more.

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Fast Facts:

This week’s fast facts are brought to you by the National Association of Healthcare Underwriters.