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Blue Cross Indiana and Heart Disease

Blue Cross Indiana is pushing for additional coverage for treatment of heart disease. These treatments are a change from the traditional high-tech approach of modern medicine that attempts to treat every health problem as a disease that can be medicated or zapped.

The cutting edge is actually supplied by Medicare, which recently approved use of behavioral therapies to help people deal with chronic heart disease and obesity. Traditionally, the medical profession has prescribed diet and exercise to combat these health problems. And, combat them they do, if the patient follows the doctors’ advice. In fact, Blue Cross Indiana has policies that give discounts on your insurance if you participate in certain health programs or gyms. However, some people don’t follow their doctor’s recommendations. Typically, this is seen as a fault on the part of the patient. While this may be true in some cases, in other situations the patient may need additional guidance and education.

Enter Dr. Dean Ornish’s program for reversing heart disease, which has made a big splash in the medical community. Participants follow a plan incorporating a healthy diet and meditation, with yoga as exercise. A significant number of chronic heart patients have shown remarkable recovery due to participation in the program.

In fact, the Ornish program has been successful in treating several of the factors that contribute to heart disease, including high blood pressure, cholesterol issues, and a high body mass index. Doing so has significantly reduced the need for invasive procedures, saving money for the patient and for the insurance companies. The results have also reduced the need for more powerful drugs that often have negative side effects. The overall effect of this type of behavioral therapy is reduction of health care costs and improved health of patients – both lofty and previously elusive goals.

There are many hospitals, clinics, and health care professionals who have become certified in the Ornish program on their own, and many more have expressed interest in becoming certified. Right now, there are just a handful of hospitals that participate in the Medicare certification, though the number is expected to grow. The program was first covered by Medicare in spring of 2011.

Traditional rehab for cardiac patients is covered up to 36 hours by Medicare. However, this new behavioral therapy is covered for 72 hours – twice what Medicare usually allows. The Ornish program involves a physician supervisor, a case manager who is typically a nurse, a dietitian, an exercise physiologist, a mental health professional, and a yoga instructor. This team works with patients one-on-one and in group therapy sessions to teach stress management techniques that have historically generated lasting results. The team approach to treating chronic disease has proven quite successful, as it involves many fields of expertise and treatment for the whole patient.

To participate in the program, you must have a BMI of at least 30. To continue participation for a year, you have to lose a minimum of 6.6 lbs. Blue Cross Indiana will continue to pursue this form of treatment for all of our clients.

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