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Haley Bennett, MPH

In observance of Public Health Week 2024, this review underscores the imperative need for equitable healthcare access across the United States. Especially in expansive rural landscapes, the demand for accessible and equitable healthcare is evident. We will explore the strategic integration of telehealth appointments conducted by lactation consultants and doulas, as well as shed light on the consequential challenges posed by the lack of telehealth coverage by insurance companies. Embark on a journey to explore how telehealth is breaking down barriers and providing a lifeline for rural communities facing the unique challenges of lactation support.

Unraveling the Rural Health Dilemma

Rural communities face unique challenges in accessing high-quality healthcare, highlighted by the 2022 findings from the March of Dimes Maternity Care Desert Report. While not explicitly addressing lactation concerns, the report underscores the overall inadequacy of maternal support nationwide. As featured in the CDC’s 2022 report, it is clear that there has been a substantial decline in breastfeeding during the initial six months of an infant’s life. This underscores the necessity for improved assistance to mothers on their breastfeeding journey, extending beyond the hospital setting well into the postpartum period.

Picture a small town where the nearest lactation consultant is hours away, posing a daunting challenge for new mothers. The lack of accessible support services leaves these women feeling isolated, navigating the intricacies of breastfeeding on their own. This rural health dilemma is not just a statistic; it’s the real narrative of people striving for the best possible start for their infants.

In this landscape with scarce connectivity and limited resources, traditional support falls short. Mothers yearn for expert advice, reassurance, and a sense of community beyond geographic boundaries. Here, telehealth emerges as a beacon of hope, crafting a new story of inclusivity, accessibility, and empowerment. 

Geographic Isolation:

Geographically isolated rural areas pose significant barriers for residents accessing healthcare, particularly expectant mothers. As explained in a 2023 Ballard Brief written by David Clove. Residents travel twice as far as their urban counterparts to access healthcare, encountering challenges such as further facility proximity, lack of transportation, and communication barriers. These issues, compounded by socioeconomic factors, emphasize the urgent need for comprehensive healthcare solutions, intensifying struggles, especially concerning lactation.

Scarce Resources:

Geographically isolated rural areas, characterized by extensive distances and low population density, present substantial challenges for expectant mothers accessing healthcare. The logistical hurdles, including limited facility proximity, transportation constraints, and communication barriers, underscore the need for urgent and accessible healthcare solutions, exacerbating difficulties, particularly in lactation support.

Shortage of Medical Professionals:

The shortage of medical professionals, particularly in breastfeeding and prenatal education, poses a critical challenge in rural areas, straining healthcare resources and limiting options for expectant mothers. A National Library of Medicine article reveals the impractical time demands for primary care physicians, which are typically the only available options in rural areas. This further contributes to adverse health outcomes and increased healthcare costs for both mothers and infants.The absence of telehealth and mandated nurse-to-patient ratios compounds the issue, potentially leaving some mothers without adequate support during labor. This substantial deficit in medical professionals, especially in preventative medicine, plays a pivotal role in the widespread healthcare challenge in rural areas.

Insurance Coverage for Telehealth Services:

Insufficient insurance coverage for telehealth services poses a significant barrier, particularly impacting expectant mothers in rural areas as they navigate healthcare challenges. The lack of comprehensive policies for telehealth, covering services like lactation consultants and doula care, creates a substantial obstacle, hindering access to vital virtual consultations. This limitation not only obstructs lactation and doula support but extends to various aspects of maternal care, encompassing routine virtual appointments and preventative measures. 

The Potential of Telehealth: Enhancing Maternal Care Access

In an era where Medicaid covers 42% of US births, telehealth lactation providers are adopting an equity-driven approach to enhance maternal care access. Serving as a catalyst, telehealth not only bridges geographical divides but also tackles healthcare disparities for expectant mothers in underserved regions. This innovative solution facilitates virtual consultations, connecting mothers with healthcare providers and delivering essential prenatal care, lactation consulting, and preventive services.

As telehealth becomes more accessible, its potential to reduce healthcare costs and improve overall maternal care is increasingly evident. Engaging in virtual consultations with a doula has been shown to substantially lower C-section rates. A recent study indicates when mothers who have previously undergone a C-section, and engage in two or more doula visits virtually, their odds of having another cesarean are reduced by 60%. (Maven, 2023). 

This exciting discovery suggests that virtual consultations have the potential to yield similar positive impacts as in-person visits. We strongly encourage insurance companies to consider incorporating telehealth as a legitimate avenue for care, recognizing its ability to address maternal healthcare challenges and contribute to a more inclusive and cohesive approach.

Strategies for Policy Change: Advocating for Inclusive Telehealth Coverage

Recognizing the distinctive challenges faced by expectant mothers in rural America, this section emphasizes the importance of comprehensive insurance coverage for telehealth services and outlines actionable strategies for policy reform that address the multifaceted healthcare needs of rural communities. Engaging in crucial conversations, fostering community involvement, and forging collaborative partnerships emerge as pivotal strategies.

  1. Advocating for Evidence-Based Lactation and Doula Coverage via Telehealth:

  • Promote evidence-based maternal services that harness the transformative capabilities of telehealth
  • Highlight success stories of mothers who have obtained access to care through telehealth and have obtained tangible outcomes, resulting in reduced maternal healthcare costs. 
  • Collaborate with your community partners: healthcare professionals, researchers, and policymakers to develop telehealth guidelines tailored to the needs of expectant mothers in rural areas.           
  1.  Supporting Telehealth Reimbursement Approaches in Policies

  • Survey your healthcare providers and obtain feedback on what they feel an ideal policy would be.  (i.e provider type, reimbursement rates, cpt codes, etc.).
  • Review policies in neighboring states for barriers and/ or policy replication
  • Collaborate with policymakers to create financial incentives for insurance companies that adopt inclusive telehealth coverage.
  1. Expanding Specialized Providers in Maternal Care:

  • Advocate for the expansion of specialized telehealth providers focused on maternal care in rural regions (Doula, Lactation Consultants, Midwives, etc.)
  • Collaborate with board associations and doula certification organizations  to encourage the expansion of RN licensing and Doula certification recognition within their state.
  • Propose incentives or grants to attract specialized providers to underserved rural areas, ensuring a robust network of professionals offering comprehensive maternal care services both in person and via telehealth.

Implementation of these strategies actively contributes to reshaping policies that foster inclusive telehealth coverage. This initiative envisions a future where maternal care in rural America is more accessible and equitable, aligning with the goals and responsibilities of legislation and policy makers.

An Evolving Landscape of Unity and Accessible Care

As we conclude our exploration of the transformative landscape of telehealth in maternal care, a vision of unified and accessible healthcare, particularly in rural America, takes center stage. The collaborative efforts of dedicated advocates and individual initiatives have not only highlighted challenges in rural care deserts but have also charted a strategic path forward. Despite obstacles, the steadfast belief endures that every expectant individual deserves comprehensive and equitable healthcare, regardless of their location or financial circumstances.

If you would like more information regarding how you can advocate and build health equity for your members through telehealth, please email our Strategic Partnerships team at strategic.partnerships@aeroflowinc.com or schedule time with us below.

If you would like more information regarding how you can advocate and build health equity for your members through telehealth, please email our Strategic Partnerships team at strategic.partnerships@aeroflowinc.com or schedule time with us below.

References

Centers for Disease Control and Prevention. (2022, August 31). Breastfeeding report card. Centers for Disease Control and Prevention. https://www.cdc.gov/breastfeeding/data/reportcard.htm 

Clove, D. (2023, August 2). Healthcare access disparities among rural populations in the United States. Ballard Brief. https://ballardbrief.byu.edu/issue-briefs/healthcare-access-disparities-among-rural-populations-in-the-united-states 

March of Dimes. (n.d.). Medicaid Coverage of Births: United States, 2020. March of Dimes | PeriStats. https://www.marchofdimes.org/peristats/data?reg=99&top=11&stop=154&lev=1&slev=1&obj=18 

Maternity Care Deserts Report. March of Dimes. (n.d.). https://www.marchofdimes.org/maternity-care-deserts-report#:~:text=U.S.%20(2022%20REPORT)-,NOWHERE%20TO%20GO%3A%20MATERNITY%20CARE%20DESERTS%20ACROSS%20THE%20U.S.%20(2022,care%20and%20no%20obstetric%20providers 

Maven Clinic. (n.d.). Association Between Doula use on a Digital Health Platform… : Obstetrics & Gynecology. Obstetrics & Gynecology. https://journals.lww.com/greenjournal/fulltext/2024/02000/association_between_doula_use_on_a_digital_health.4.aspx 

Porter, J., Boyd, C., Skandari, M. R., & Laiteerapong, N. (2023, January). Revisiting the time needed to provide adult primary care. Journal of general internal medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9848034/

This content has been reviewed for accuracy by Mike Cantor, Chief Medical Advisor at Aeroflow Health.

Dive into our blog inspired by our webinar, “Data Driven Strategies: Harnessing The Unanticipated Power of Partnerships In Value-Based Care,” to discover the opportunities Aeroflow Health brings to health plan value-based care initiatives. From tailored strategic alignment and seamless data integration to quality measures, innovative solutions, and cost-effective strategies, we’re dedicated to exceeding expectations. For a deeper understanding and comprehensive insights, don’t miss the chance to watch the webinar playback.

Table of Contents

How can health plans effectively collaborate with their provider community, including DME providers, to ensure a seamless and coordinated approach to delivering value-based care?

Amanda: Immediately, I think of the phrase “building a care team,” and I think it’s essential to recognize that there are multiple providers that play a part in a patient’s care journey. In our experience, as a DME, we’ve seen patient journey mapping to be very helpful in the collaboration process. Understanding who the patient is engaging with and when they are doing so, helps us to pinpoint patient journeys that have gone well that we would want to try and duplicate and also those who haven’t had a positive journey, so that we can understand where gaps in care might be present. I believe many solutions are in place that ensure a seamless and coordinated care approach, and when health plans look at unlikely providers like DME, there are more significant resources that can be tapped into.

Ryan: Opening up lines of communication with health plans and DME suppliers is crucial. When health plans understand the touch points that we have with the patients as the medical equipment supplier, and vice versa, when we as the DME understand the journey from a health plan perspective, the patient is able to receive a holistic continuum of care. One way in particular that Aeroflow Health approaches this topic is by providing integrated solutions where and when the patient wants to be met. We also have seen this come into play regarding “notification of pregnancy.” In many cases, we are able to partner early with these moms in their maternal journey and provide resources like breast pumps and education. For example, I know that through our partnership with Sentara Health, we’ve been able to impact many mothers.

Could you share examples or success stories where health plans have successfully integrated DME providers into their value-based care initiatives, resulting in improved patient outcomes?

Kate: Sentara has had a very successful partnership with Aeroflow, specifically with our Mom & Baby program. One of the many advantages has been receiving member- level data, which has allowed us to reach out in a more timely manner and actively engage our members where they are. Receiving ongoing data like “notification of pregnancy” has been huge for us. This has helped us know when to reach out to members and engage them with our programs regarding breastfeeding and other additional educational resources. Aeroflow and Sentara’s goals align, and this has allowed us to utilize and leverage the information we receive. We want positive patient experiences for all of our members, so when we hear that our partnership with Aeroflow is closing gaps in care like breast pump utilization and education on breastfeeding that leads to moms being able to breastfeed in their desired timeframe, we’re thrilled. Being able to partner with Aeroflow in a member’s journey from conception to post-partum has allowed Sentara to offer programs of longevity.

Amanda: To piggyback off Kate, Aeroflow has been able to do more than just provide a data feed; we’re able to extend trust by notifying patients that they are going to be receiving outreach from their health plan partner. This warm handoff encourages and facilitates better engagement and provides a sense of empowerment for patients. The secondary piece is collaboration. Early on, we discussed with Sentara the pieces of communication that they wanted their members to be aware of, and Aeroflow was able to provide that wraparound service for them.

How can health plans leverage data and analytics to gain insights into the patient journey and identify opportunities for collaboration with DME providers to enhance the overall quality of care?

Amanda: I think notifications of pregnancy are just the start. When we map out the patient journey, the points of follow-up are made clear, and health plans and DMEs are able to see the gaps in care where we as a team can collaborate to intervene. Health literacy, in particular, is a huge opportunity for collaboration. Most people don’t understand insurance at a fundamental level, and Aeroflow has really been able to step in the gap to help educate patients and provide resources that make the often stressful circumstances less uncomfortable.

Lauren: Not only has Aeroflow Health been dedicated to providing patients with the supplies they need, like breast pumps and CPAP devices, but we’ve also been a partner in education through transparency that has built trust. We do the heavy lifting for patients as far as working with their insurance plan provider and determining the services and supplies that they are eligible for through their insurance. We’re able to lay out in a clear, concise manner what benefits are available and then provide any counseling or education they need along the way in their choices. We’ve also been able to learn what modality of communication is best for patients which we are able to relay to health plans to assist in their engagement strategies. We help health plans meet their members where and how they would prefer.

What do health plans have to gain by partnering with DME providers?

Amanda: DME vendors are definitely the unexpected partner. This is unfortunate as DME’s are one of the most engaged partners in care for patients. There is a great opportunity for health plans to build bridges of trust between the patient, health plan and medical equipment provider.

Ryan: Trust in healthcare is very important when it comes to the continuum of care for patients. When health plans choose to collaborate and open lines of communication with the DME provider, the DME provider can help drive the health plans’ overarching engagement goals. DME providers often have valuable data such as social determinants of health, mental health assessments and more.

What are some challenges or barriers that health plans face when trying to align with the provider community, including the DME providers? What is being done to address these challenges?

Amanda: A couple of barriers come to mind. Often, we put so much emphasis on the financial model of value-based care models and so you’ll see like capitation or sole sourcing, which is of course the goal that we’re all marching after. We all want to have some financial gain and achievement that generates a lower cost to the patient and satisfies the providers and health plan partners, but where I believe we potentially hit some failures is when this becomes the key driver. When we don’t ask questions like, “what is the patient actually doing and how is the patient actually navigating through this?” it becomes a more substantial burden on our health plan partners. I think if we can look at who’s already in the markets, get an assessment of how they’re actually performing in those markets, what the perception by the provider, health plan and patient communities is and how they are all engaging together, I think that’ll give us a good indicator of who we should be pursuing a value-based partnership with. We spend a lot of time looking into complaints and overall satisfaction levels instead of looking deeper into data like Net Promoter Scores and other reports of patient satisfaction. I also think there has to be some sort of reward mechanism that incentivizes a positive experience. It takes a team being aligned on goals to achieve well-rounded care.

Kate: I think some of the obvious challenges and barriers include communication, collaboration and goal alignment. As a health plan, we want to see increased patient engagement and member experience but we also want more positive health outcomes.
A part of this is increasing access for the members to get what they need and that’s where a DME plays a crucial part. If a patient doesn’t have access to the products and supplies they need, they are unable to meet their care goals. Years ago, when Sentara was researching providers that could supply products and coinciding programs that had a wraparound care approach, we found Aeroflow. This really led to our decision of partnership.

Lauren: Over the course of healthcare history, it’s not been common for patients to have a lot of choice as it relates to healthcare. Aeroflow understands this sore spot and has built out experiences for patients where they can feel in control of their health journey. For example, for those who choose to breastfeed, selecting a breast pump is an incredibly personal decision, and we understand the value of giving moms the choice of which breast pump suits their individual needs. Another piece of this is the additional piece of being able to provide lactation support and education via telehealth. Aeroflow is able to bridge the gap here. The convenience of utilizing these services leads to more moms needing the education they need to start breastfeeding or to continue even when difficulties arise.

Can you provide insights into the role of technology in facilitating communication and collaboration between health plans and their provider community, especially DME providers, to deliver more patient-centric and value-based care?

Lauren: Technology has made our processes more efficient for both our patients and customer service teams. It has also allowed us the time and flexibility to provide more of a white-glove solution for our patients that aren’t as comfortable with technology. We’ve been able to put more intentional time and care towards that more at-risk patient base and make sure they aren’t lost in the process.

To learn more about how Aeroflow partners with health plans to provide value-based care solutions, subscribe to our email communications here.
Picture of Michael Cantor, M.D.

Michael Cantor, M.D.

Dr. Mike Cantor is a geriatrician and attorney who has extensive experience designing and implementing value-based care, quality improvement, and care management programs for healthcare providers and health plans. He works as a fractional (part-time) Chief Medical Advisor for Aeroflow Healthcare, Uber Health, and other technology-enabled health services companies, value-based care organizations and digital health companies. Previous roles include: CMO for Bright Health Plan, an innovative health
insurer; CMO for CareCentrix, a leading outsourced home health, durable medical equipment, and post- acute care benefits manager recently acquired by Walgreens; and CMO for the New England Quality Care Alliance (NEQCA), the physician network affiliated with Tufts Medical Center, where he implemented network-wide quality improvement and care management programs for 150,000 managed care lives. He trained in internal medicine at Beth Israel Hospital in Boston and did his geriatrics fellowship at Harvard Medical School. He has degrees in law and medicine from the University of Illinois.

Picture of Ryan Bullock

Ryan Bullock

Ryan serves as Chief Strategy Officer at Aeroflow Health, a premier nationwide provider of durable medical equipment. In his current position, Ryan oversees strategic operations, corporate development and government relations. For over 14 years, Ryan has provided exceptional leadership, management and vision to Aeroflow, resulting in incredible growth and profitability for the company. Ryan holds a Bachelors of Science degree in Electronic Engineering from Western Carolina University and resides with his family in the beautiful mountains of Asheville, North Carolina.

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Amanda Minimi

Amanda is the Director of Corporate Development at Aeroflow Healthcare, the largest provider of breastfeeding equipment and services in the nation. Amanda has led Aeroflow Healthcare's health plan partnership initiatives where there collaboration-based solutions have led to better outcomes through high patient engagement and increased instances and duration of breastfeeding. Amanda also serves as the co-chair of AAHomeCare's Breastfeeding Coalition, a team that works with states and health plans to advocate to reduce barriers in access to breastfeeding.

Picture of Kate Maas

Kate Maas

Kate Maas has focused her nearly 20-year career specializing in Medicaid populations. She is the Manager of Marketing, Development and Outreach at Sentara Health Plans–Virginia’s largest Medicaid plan. She has held health plan and managed care leadership roles for the past 12 years. With a Master of Public Health (MPH) from the joint Eastern Virginia Medical School and Old Dominion University program, Kate is an expert in maternal and child health, as well as program development for member and community engagement.

Picture of Lauren Bennett

Lauren Bennett

Lauren Bennett is Chief Operating Officer for Aeroflow Health, where she leads national operational performance and experience. Lauren joined Aeroflow Health in 2014 and has held a variety of leadership roles within the company in strategy, experience, innovation, data analytics and growth. In her current role, Lauren oversees more than 200 operations employees and leaders across multiple business areas at Aeroflow Health. Lauren's priority is improving the experience for patients, health plans, providers and employees. Previously, Lauren was Vice President of Aeroflow Sleep and Director of Sales Operations for Aeroflow Breastpumps. She is known for driving innovation and efficiency through implementing state of the art automation with a goal of delivering a seamless patient experience

Written by Kristin Polson

Senior Marketing Manager

This content has been reviewed for accuracy by  Ryan Bullock, Chief Strategy Officer

Centers for Medicare & Medicaid Services (CMS) made significant changes to the ordering process for positive airway pressure (PAP) and respiratory assist device (RAD) supplies. These changes, outlined in a Dear Physician Letter from the Durable Medical Equipment Medicare Administrative Contractor (DME MAC) Medical Directors, aim to simplify the Standard Written Order (SWO) for supplies. This landmark change underscores the dedication CMS has towards reducing administrative barriers that prevent access to care. 

The update encourages physicians to use general descriptions like “CPAP Mask” or “Mask – Fit to Comfort” to accommodate mask variations without requiring a new SWO for each change. This flexibility not only reduces administrative burdens by ordering providers and DME suppliers but also ensures patients receive the most suitable masks and supplies without delays.

Flexibility for Physicians:

  • Physicians are now freed from the previous obligation to specify the mask type (e.g., full-face mask, nasal mask, nasal cushions, etc.) when prescribing items such as PAP devices and their associated components. This change allows physicians to issue a more general prescription, reducing the need for extensive communication with DME suppliers as patients explore different mask options.

Impact on Patient Adherence:

  • Aligning the SWO with more generic terms fosters a patient-centric approach, guaranteeing convenient access to the most suitable mask without delays caused by providers seeking updated documentation.

Addressing Supplier Concerns:

  • The SWO requires all items that will be billed must be separately listed on the prescription. It states, “For supplies – In addition to the description of the base item, the DMEPOS order/prescription may include all concurrently ordered supplies that are separately billed (list each separately)” Both the mask and the interface must be listed separately. However, the interface can/should be listed as “Mask Interface” instead of “Mask Cushions.” Mask interface allows suppliers to bill either pillow or cushion whereas “Mask Cushions” limits suppliers to providing cushions only.

These updates from CMS represent a significant step forward in streamlining the ordering process for PAP and RAD supplies. Aeroflow Health remains committed to championing the broader adoption of these updated policies across more health plans. These changes, aimed at reducing administrative burdens and promoting patient adherence, align with the goals and objectives shared by our health plan partners.We are excited to see the positive impact these updates will have on patient care and look forward to continuing to work together to improve health outcomes for all.

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Written by Sophie Lauver, MS, RD, LDN, NBC-HWC

Registered Dietitian for Aeroflow Health

Nutrition plays a significant role in health and Americans are becoming increasingly aware of its importance. The prevalence of chronic disease is forcing a shift in focus towards nutrition, giving rise to the ‘Food Is Medicine’ movement, into the spotlight as Americans look to avoid medications and take their health into their own hands. What we eat is directly tied to our health outcomes. However, there seems to be a lack of understanding about what foods in our diet are detrimental to our health.

The Standard American Diet is high in:

  • Saturated fat
  • Excess calories
  • Red meat
  • Sodium
  • Processed foods
  • Refined grains
  • Added sugars

The calorie-dense and nutritionally depleted nature of the Standard American Diet is a significant contributing factor to the over two-thirds of Americans who are overweight or obese. This diet also plays a significant role in the increase in chronic diseases like type 2 diabetes, heart disease, cancer, and stroke. Looking at the top ten leading causes of death in the US, heart disease and cancer are the top two. Type 2 diabetes, also on the list, is not far behind.

This dietary pattern is illustrated in a 2010 report from the National Cancer Institute showing that nearly the entire US consumes a diet that does not adhere to the current dietary recommendations. Over 75% of men and women of all ages were estimated to be eating a diet below the recommended intake of fruit and almost 90% of men and women were below the recommended intake of vegetables. These numbers come with great consequences. An unhealthy diet contributes to approximately 678,000 deaths each year in the U.S.

The Current Nutrition Landscape and Type 2 Diabetes

Thirty-eight million Americans are diagnosed with diabetes (90-95% being type 2 diabetes) another 1.2 million are diagnosed every year. For many patients, receiving a diabetes diagnosis can be life-changing. Having diabetes puts you at a higher risk for comorbidities, or having multiple medical conditions at once. People with diabetes are twice as likely to have heart disease or a stroke compared to someone without. High blood sugar, which is a key characteristic of diabetes, can damage your blood vessels and nerves over time. Uncontrolled diabetes and persistent high glucose levels can lead to blindness, amputations, kidney disease, sexual dysfunction, infections, and poor wound healing.

To prevent and effectively manage type 2 diabetes and other chronic diseases, nutrition education must be prioritized.. Unfortunately, the general lack of awareness and access to nutrition education only furthers the growing numbers of those living with chronic diseases.. Barriers like finances, insurance coverage and dietician availability all lend to the growing challenge for patients to receive the nutrition counseling they need. Additionally, those who are overweight or obese may have had negative experiences with a medical professional when discussing their weight and diet that has created a fear or stigma around discussing their health with a professional.

An Emerging Solution – Medical Nutrition Therapy

Medical nutrition therapy is an evidence-based, client-driven process for managing or treating medical conditions through nutrition. Medical nutrition therapy is delivered by a Registered Dietitian.

According to the Academy of Nutrition and Dietetics, Registered Dietitian Nutritionists (RDNs) are food and nutrition experts who:

  • Have a minimum of a graduate degree from an accredited dietetics program
  • Complete a supervised practice requirement
  • Pass a national exam
  • Continue professional development throughout their careers.

This title ensures that the professional has adequate training and provides evidence-based interventions. Importantly, titles like “nutritionist” don’t require any specific education or training. The Registered Dietitian assesses a patient’s nutritional status, recommends dietary changes, and supports the patient through counseling strategies that promote long-term behavior change.

The Benefits of Medical Nutrition Therapy for a Patient with Type 2 Diabetes

Medical nutrition therapy and lifestyle intervention improve conditions like obesity, inactivity, high blood pressure, and high cholesterol. Diabetes is a chronic disease where dietary and physical activity interventions can make a measurable impact. Type 2 diabetes can be well managed and even put into remission with quality diet and exercise.

For patients with diabetes, it may feel like there’s no right answer when grocery shopping, planning meals, and dining out. They may feel isolated from family and friends due to different dietary needs and may develop fears of food due to misinformation about certain food groups. Also, people who are overweight or obese often are assigned stigmas due to their weight and navigating day-to-day life in settings built for smaller-bodied people can be physically challenging.

Registered Dietitians partner with patients and help them achieve key habits including:

  • A diet rich in whole grains, lean protein, fiber, and plant foods
  • A diet low in saturated fat, sodium, and meat
  • Mild to moderate weight loss
  • 150 minutes a week of moderate-intensity physical activity
  • Stress reduction
  • Familial, professional, and community support

Registered Dietitians meet patients where they are and help them work towards sustainable lifestyle changes. These changes are transformative for reducing the risk of disease complications and increasing quality of life. More insurance plans are covering medical nutrition therapy, making this life-changing service increasingly available.

Aeroflow Nutrition Services

At Aeroflow Health, we recognize the need for increased access to nutrition education and empower patients to support their health. Personalized medical nutrition therapy helps patients manage chronic disease and prevent complications in a way that works for their lifestyle. This growing gap in care spurred our teams to launch Aeroflow Nutrition Services.

Aeroflow Nutrition Services, initially targeting patients with type 2 diabetes, will simplify and support nutrition counseling by providing patients with access to a Registered Dietitian, often with zero out-of-pocket costs.

Patients will receive a transparent, compassionate customer experience from a Registered Dietitian. During sessions, detailed notes will be recorded and available for the patient’s complete medical team. Aeroflow’s team has a keen understanding of insurance that allows patients to utilize their full insurance benefits to their advantage. We remove the stress associated with finding a qualified Registered Dietitian who accepts their insurance plan. From the start, patients will be made aware of how many visits are covered and all care is also provided via telehealth, alleviating the need to travel to a provider’s office. Additionally, with Aeroflow Health’s network, patients can also get connected to additional products and supplies for diabetes, incontinence, blood pressure monitoring, sleep apnea, and wound care.

The program will expand to provide group medical nutrition therapy sessions, around topics such as introductory nutrition, heart health, and weight loss. Group-based sessions will allow patients to learn key nutrition concepts in a supportive and interactive environment of their peers with a Registered Dietitian facilitator. Aeroflow Nutrition Services’ next phase will expand to see patients with a variety of medical concerns, carrying out our mission of providing nutrition education to as many patients as possible.

To learn how Aeroflow Health can support your members and gain more insights, subscribe to our communications.
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Sophie Lauver, MS, RD, LDN, NBC-HWC

Sophie Lauver is a Registered Dietitian and Board Certified Health and Wellness Coach passionate about helping people take control of their health and get excited about nutrition. Sophie has a Bachelor's degree in Communication from the University of Delaware and a Master’s degree in Dietetics from Eastern Michigan University. Sophie has worked in a wide variety of settings including hospitals, long-term care, rehabilitation, and wellness technology, and most recently, served as the director of the nation's largest diabetes prevention program. Sophie lives in Baltimore, MD with her husband, infant son, and their two dogs and two cats. When she’s not working with clients, she enjoys cooking, not doing dishes, trying new restaurants, and spending time being active outside (especially on warm and sunny days).

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Amanda Minimi, MSBA

Director of Corporate Development at Aeroflow Health

This content has been reviewed for accuracy by Mike Cantor, MD, JD, Chief Medical Advisor for Aeroflow Health. 

The US healthcare system has long struggled to create a fair and efficient payment model that supports the needs of patients and rewards payers and providers for providing high-quality care that results in the best health outcomes.   Accelerating the tension between efficiency and quality is the pressure to slow and reduce rapidly  growing healthcare costs. 

Health insurance as we generally think of it today began in the 1930s with the Great Depression. Previously, coverage was less related to health insurance but would be similar to what we refer to was disability insurance today.  Until the creation of those health insurance models health care was paid for through “fee for service” (FFS) models where providers received payments when they provided services.  Health insurance shielded patients from high and often unexpected health costs, but the lack of incentives to provide comprehensive care led to the development of new approaches.  A good example of this new approach is the  Patient Centered Medical Home (PCMH) model, launched by a group of pediatricians who focused  on meeting the needs of sick children who required coordination in navigating between the various specialists responsible for treating their care

In the 1970s the term Health Maintenance Organization (HMO) was coined by Dr. Paul Ellwood. HMOs offered comprehensive care within a designated provider network in exchange for fixed annual payments, a very different approach than the traditional  FFS model. The use of capitated payments created a fixed budget for healthcare expenditures, which incentivized provider network  to coordinate care and deliver preventive medicine.  HMOs delivered promising but variable results in inpatient care cost reduction.

In an effort to contain inpatient costs, another VBC model was popularized: The Diagnosis Related Grouping (DRG). First piloted in New Jersey, the DRG consisted of a bundled payment made to hospitals for an episode of inpatient acute care, regardless of what the episode actually cost to

deliver.  The development of the DRG took into consideration the kinds of care required to produce positive outcomes while avoiding unnecessary costs. This incentivized providers to deliver appropriate level care while minimizing waste. 

The HMO model was adapted to Medicare in 1982 by the Tax Equity and Fiscal Responsibility Act (TEFRA) which established Medicare Part C (now called Medicare Advantage). The following  year  Medicare policy changed to permit  use of DRGs. TEFRA provided new incentives for HMO’s to enroll Medicare beneficiaries on an at-risk basis.

Despite these efforts to manage growing Medicare costs, the 1997 Balanced Budget Act’s (BBA) reduced Medicare rates.  This change, coupled with years of  minimal payment increases, left hospital systems with low margins, physicians facing burnout, and bankruptcies among health management and delivery organizations. As Managed Care Organizations (MCOs) experienced their own “profitability crisis,”  consumer and physician backlash emerged because the general public viewed commercial managed care as responsible for turning physicians into profit-driven entrepreneurs who withheld necessary care  to maximize margin. This backlash caused a sharp decline in HMO plans, and fee-for-service payment models became even more dominant. The result is that instead of payers, providers and patients working together,  misaligned incentives led to ongoing battles.

In 2006, scholars Michael Porter and Elizabeth Olmsted Teisberg coined the term Value-Based Care in their landmark book Redefining Healthcare. They argued that competition in healthcare should be based on value to the patient instead of shifting costs, increasing bargaining power or restricting services, and that patients should  be empowered and remain at the center of health care. 

In 2010, after over 75 years of efforts to increase access to affordable and nearly universal health insurance the Affordable Care Act  (ACA) introduced comprehensive reforms to expand access and promote value-based principles. 

Through the ACA, a new division of the Centers for Medicare and Medicaid Services (CMS) was created, the Center for Medicare and Medicaid Innovation (CMMI), which is  focused on developing and testing new payment methodologies (Alternative Payment Models (APMs)).  CMMI focuses on improving patient experience of care, improving the health of populations, and reducing per-capita cost of healthcare: the Triple Aim. 

Because of their mandate to support innovation and new payment models, CMMI has proposed and tested several innovative models.  In 2011, President Obama began advocating for Accountable

Care Organizations (ACOs) for Medicare and Medicaid.  ACOs are integrated networks of doctors, hospitals, and other medical care providers that work together with a goal of reducing costs and, if the ACO meets certain benchmarks for quality and costs, it could receive bonuses from the government. The model incentivizes providers to collaborate together and rewards success.  ACOs have saved billions of dollars in Medicare costs, and have been adopted by some commercial insurers.  

The evolution of VBC payment models continued in April of 2015 with the signing of the Medicare Access and CHIP Reauthorization Act (MACRA) into law. MACRA introduced the Quality Payment Program (QPP) in 2015. This program incentivizes healthcare providers to prioritize quality and value through the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs). MACRA changed the way Medicare physicians are reimbursed and increased funding. It incentivized the use of health information technology by physicians and other providers. 

In 2023, the Biden Administration set an ambitious goal which would mark the 100 year journey of insurance: to transition every individual to a value-based model by 2030. The imminent deadline is rapidly approaching while new models are continuing to grow and evolve. 

One area that has  not changed over the past 100 years is the ebb and flow of incentives among payers, providers, and patients. A clear lesson from this time is that  it is critical to appropriately align financial incentives and  empower patients to make optimal healthcare decisions.  Initiatives that tie health plans and provider organizations together to empower the patient show promising results in improving patient outcomes and delivering true value-based care.

Stay informed and empowered with the latest insights from Aeroflow Health on revolutionizing healthcare through value-based care. Subscribe to our email communications to explore how we leverage value-based care models, drive positive outcomes, and navigate the dynamic landscape of healthcare transformation.
Picture of Amanda Minimi, MSBA

Amanda Minimi, MSBA

Amanda Minimi serves as the director of Corporate Development at Aeroflow Health. In her role, Amanda oversees business development activities, program development, and payor solutions across all lines of business, including Medicare, Medicaid, and the commercial market. As the Director of Corporate Development, she leads a team of skilled individuals focused on business development, advocacy, and business support.

References

 Morrisey, M. (2013) Health Insurance, Second Edition. Health Administration Press. 

 O’Dell, M. L. (2016). What is a patient-centered medical home?. Missouri medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139911/

 Toner, R. (1993, February 28). Hillary Clinton’s Potent Brain Trust on Health Reform. The New York Times. https://www.nytimes.com/1993/02/28/business/hillary-clinton-s-potent-brain-trust-on-health-reform.html 

 Dhanani, N., O’Leary, J. F., Keeler, E., Bamezai, A., & Melnick, G. (2004, October). The effect of hmos on the inpatient utilization of Medicare beneficiaries. Health services research. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361086/ 

 Kimberly, John; Pouvourville, Gerard de; d’Aunno, Thomas; D’Aunno, Thomas A. (2008-12-18). “Origins of DRGs in the United States: A technical, political and cultural story”. The Globalization of Managerial Innovation in Health Care. Cambridge University Press. ISBN 9780521885003.

 Mayes R. (2005). Medicare and America’s healthcare system in transition: from the death of managed care to the Medicare Modernization Act of 2003 and beyond. Journal of health law, 38(3), 391–422.

 6 Key Milestones in the History of Full-Risk, Value-Based Care. (n.d.). Chenmed.com. Retrieved from https://www.chenmed.com/sites/default/files/2023-08/108208%20-%20CHENMED%20CORP%20-%20Infographic_%206%20Key%20Milestones%20in%20the%20History%20of%20Full%20Risk%2C%20Value-Based%20Care.pdf.

 Forbes Magazine. (2011, March 1). ACOs are obama-speak for hmos. Forbes. https://www.forbes.com/2011/02/28/obamacare-aco-hmo-opinions-sally-pipes.html?sh=1c95453b31dc 

 Value-based care is the future of healthcare. here is its origin story. Enlace Health Value-Based Healthcare. (2022, May 19). https://www.enlacehealth.com/value-based-care-is-the-future-of-healthcare-here-is-its-origin-story/#:~:text=A%20pioneering%20value%2Dbased%20model,several%20primary%20care%20accredited%20organizations. 

 Macra: MIPS & apms. CMS.gov. (n.d.). https://www.cms.gov/medicare/quality/value-based-programs/chip-reauthorization-act 

 Press releases CMS announces increase in 2023 in organizations and beneficiaries benefiting from coordinated care in accountable care relationship. CMS.gov Centers for Medicare & Medicaid Services. (n.d.). https://www.cms.gov/newsroom/press-releases/cms-announces-increase-2023-organizations-and-beneficiaries-benefiting-coordinated-care-accountable 

Picture of Sophie Lauver, MS, RD, LDN, NBC-HWC

Sophie Lauver, MS, RD, LDN, NBC-HWC

Registered Dietitian for Aeroflow Health

Aeroflow Health recognizes the need for increased access to nutrition education and empowerment. This growing gap in care led our teams to launch Aeroflow Nutrition Services.  We believe that personalized medical nutrition therapy not only aids in preventing long-term health complications but it also is one way that we as providers can extend a helping hand and come alongside you as you manage your chronic disease and strive for a healthy lifestyle.

At Aeroflow Health, we stand by your side as your unwavering healthcare partner, providing you access to top-notch medical essentials such as continuous glucose monitors (CGMs), breast pumps, incontinence products, and CPAP supplies – all covered through insurance. We recognize the distinct health journey you are on and believe it deserves nothing but the best. Our commitment extends beyond products; it’s about elevating health outcomes and bridging care gaps to ensure you receive the quality care you deserve. Our addition of Aeroflow Nutrition Services aligns seamlessly with our mission, reinforcing our dedication to serving you comprehensively with education on your wellness journey.

Aeroflow Nutrition Services – Our Why

Aeroflow Nutrition Services takes a patient-driven, whole-person approach. We explore individual’s unique health desires and needs and guide towards sustainable goals through the impactful method of motivational interviewing. Our philosophy is rooted in curiosity, aiming to empower you with knowledge that becomes a catalyst for positive change. Not only that but we understand the anxieties that can surround the topic of food, and so our mission is to reduce this stress and replace it with enthusiasm for a lifestyle centered on healthy eating and living. At Aeroflow, we take an evidence-based approach to weight loss, meaning we view health holistically on a macro scale rather than reducing it solely to weight. By simplifying concepts like meal planning and energy balance, we’re able to give you actionable nutrition tips for day-to-day living.

Medical Nutrition Therapy –  Who Is It For & What Does It Entail? 

Medical Nutrition Therapy is an evidence-based, client-driven process for managing or treating medical conditions through nutrition. Delivered by a Registered Dietitian, Aeroflow’s nutrition therapy program is designed to help those  interested in understanding how nutrition can lead to a more sustainable and enjoyable lifestyle.

Do you feel anxiety and tension when trying to meal prep? What about feeling isolated from family and friends due to your different dietary needs? We get it. Our program has been built with all of these stressors in mind.  

Registered Dietitians would come alongside you to help you achieve the following:

  • A diet rich in whole grains, lean protein, fiber, and plant-based foods 
  • A diet low in saturated fat, sodium, and meat 
  • Mild to moderate weight loss
  • A game-plan for 150 minutes a week of moderate-intensity physical activity 
  • Stress reduction
  • Familial, professional, and community support

We understand that your health story is the product of many lifestyle and genetic factors. To ensure our Registered Dieticians are able to craft treatment courses catered to your specific needs and goals, those who take part in the program undergo a comprehensive initial evaluation that helps provide a holistic health picture. During medical nutrition sessions, you have the opportunity to explore and discuss your comprehensive health profile, covering medical and nutrition history, sleep patterns, weight fluctuations and goals, stress management, hydration, and physical activity.

Some additional program highlights include:

  • Simple and personalized lifestyle tips to help build sustainable routines that lead to a more positive overall health experience, specifically for those living with diabetes
  • Evidence-based suggestions and support from a caring, creative, and non-judgemental Registered Dietitian
  • Guides to easy-to-prepare meals and snacks that leave you feeling satisfied
  • Reduced blood glucose/A1C levels
  • Reduced risk of heart disease and stroke
  • Reduced cholesterol and blood pressure
  • Increased energy and confidence that will lead to less stress
  • Less anxiety around meal planning, grocery shopping, preparing meals, and going out to eat
  • Knowledge regarding trends and data based on your specific nutritional habits

Interested In Joining The Program?

Are you ready to take a step towards a healthier, more empowered you? We’d love to have a conversation with you. To explore Aeroflow Nutrition Services and how our personalized approach to medical nutrition therapy can support you in managing chronic diseases, building sustainable healthy habits, and achieving your unique health vision, click the “Learn More” button below to see if you qualify for this program for little or no cost through our insurance. Your journey to a healthier you starts here.
Picture of Sophie Lauver, MS, RD, LDN, NBC-HWC

Sophie Lauver, MS, RD, LDN, NBC-HWC

Sophie Lauver is a Registered Dietitian and Board Certified Health and Wellness Coach passionate about helping people take control of their health and get excited about nutrition. Sophie has a Bachelor's degree in Communication from the University of Delaware and a Master’s degree in Dietetics from Eastern Michigan University. Sophie has worked in a wide variety of settings including hospitals, long-term care, rehabilitation, and wellness technology, and most recently, served as the director of the nation's largest diabetes prevention program. Sophie lives in Baltimore, MD with her husband, infant son, and their two dogs and two cats. When she’s not working with clients, she enjoys cooking, not doing dishes, trying new restaurants, and spending time being active outside (especially on warm and sunny days).

This content has been reviewed for accuracy by Amanda Minimi, Director of Corporate Development for Aeroflow Health. 

Health equity is a hot topic among many in the healthcare world. The term refers to the idea that everyone should have a fair and equal opportunity to achieve good health regardless of race, income or social status.  In addition, health equity addresses the social, economic and environmental factors that impact a person’s well-being. As we look at solving health equity issues, it is imperative that we take a true population health approach recognizing that one size does not fit all and leverage new age tools, technology and resources to combat equity issues. This is where telehealth comes into play.

Telehealth Health Equity – Why It Matters

Telehealth leverages digital tools and technology to provide healthcare services remotely, enabling individuals to receive medical advice, diagnoses, and treatment without physical visits to healthcare facilities. Telehealth helps reach those in the underserved communities that would otherwise lack equal access to care.

Underserved communities often include:

  • Low income Americans
  • Rural Americans
  • People of color
  • Immigrants
  • People who identify as LGBTQ
  • People with disabilities
  • Older patients
  • People with limited knowledge of the English language
  • People with limited digital literacy
  • People who are underinsured or uninsured

Those who fall into any of the above categories often face consequences such as higher mortality rates, higher medical costs, higher rates of disease and more. Key drivers of these disproportionate consequences include lack of access to transportation, lack of access to appropriately skilled providers, or time to care. 

For example,  the journey of pregnancy into postpartum care can be both exciting and overwhelming for mothers. Telehealth can serve as a support system that offers convenience and reassurance all from the comfort of home. Virtual consultations from experts on prenatal care, lactation support and mental health, addresses any concerns or complications promptly while also addressing commonly cited challenges in breastfeeding such as lack of time due to childcare responsibilities, lack of finances, or doctor did not explain/ provide support. Telehealth opens a convenient avenue for integrated and comprehensive care that may otherwise be inaccessible. Lactation consults are regularly non-covered by lactation providers and require members to pay upwards of $300 per visit and seek reimbursement directly from the plan following the visit. Where telehealth is not available, breastfeeding becomes a luxury. However, there is both high levels of interest and engagement in utilizing services like lactation consultations via telehealth. Recent data from Aeroflow Breastpumps shows that 87% of their patients who qualify for lactation services and opt-in to telehealth were between the ages of 25 and 40, proving that mothers who are given the option of telehealth visits are very likely to take advantage of the resource.

Access to telehealth provides limitless solutions to a variety of patient needs from PAP therapy set-ups to nutrition counseling for managing diabetes, the possibilities are endless. Telehealth stands as a transformative force not just for patients but also for healthcare providers. Beyond offering convenience and accessibility to patients, telehealth becomes a strategic solution to address staffing shortages and combat physician burnout. By facilitating remote services, clinicians can efficiently monitor patients’ progress, ensuring timely interventions and keeping treatment plans dynamically updated. In this symbiotic relationship, telehealth emerges as a powerful tool for optimizing healthcare delivery and enhancing the overall well-being of both patients and providers.

Barriers to Telehealth

Though telehealth proves to be an ideal alternative for healthcare for many people, there are still a variety of barriers that keep this solution from meeting all people where they are. 

Some of those barriers include:

  • Lack of coverage of telehealth benefits
  • Lack of coverage or provider types
  • Lack of listing in provider directory

According to the American Medical Association, 80% of health happens outside of the doctors office. In order to provide equitable health to everyone, healthcare and health plan professionals must adapt to meet the need.

How Health Plans Can Help

Aeroflow Health advocates for healthcare that is both easily accessible and sustainable. This commitment to accessible and convenient care is facilitated through telehealth services. While many health plans have implemented enhanced telehealth policies, promoting health equity involves continued recognition and iterations of improvement to  telehealth access which includes regular monitoring of market trends and adaptation to them. These advancements are critical to expanding access to telehealth services in underserved communities. Healthcare providers and health plans together can promote health equity and achieve healthier outcomes by placing the patient in control and reaching the patient where they want to be met. 

Health plans seeking exemplary models of successful telehealth implementation need not look further than Blue Cross Blue Shield of Oklahoma (BCBSOK) and Sunshine Health. BCBSOK, with its comprehensive telemedicine policy, allows providers under various benefit plans, including fully insured HMO and PPO plans, Blue Cross Medicare Advantage, and self-funded employer group plans, to leverage telehealth for enhanced member care. Although not explicitly stating parity with in-person services, their policy significantly expands coverage, offering flexibility within a diverse range of benefit plans. On the other hand, Sunshine Health, a part of Centene in Florida catering to Medicaid, stands out for its commitment to inclusivity. By covering telemedicine services to the same extent as in-person care, Sunshine Health ensures equitable access for all members, setting a benchmark for telehealth excellence.

Next Steps

In the face of healthcare access  gaps, telehealth emerges as a beacon of hope, seamlessly bridging critical health disparities. While telehealth may not be essential for everyone, it offers an additional and proven option to meet individuals where they are on their health journey regardless of their circumstances.  If you would like more information regarding how you can advocate and build health equity in your workplace and for your members through telehealth, please email our Strategic Partnerships team at  strategic.partnerships@aeroflowinc.com or schedule time with us here.

250,000

The number of telehealth consultations Aeroflow Health conducted in 2023.

1 day

Aeroflow Health’s average time to care via telehealth as of January 2024. This is compared to the 7 days it takes for a home visit. 

50.57%

of Aeroflow patients actively choose to participate in telehealth visits. 

Picture of Written by Joy Payne

Written by Joy Payne

Joy is the Senior Content Coordinator at Aeroflow Health. With over a decade of experience in bringing brand stories to life, Joy has a profound appreciation for the power of storytelling.

As a graduate of Western Carolina University with a bachelor's degree in English: Professional Writing, Joy has actively contributed to various publications, including Grit & Virtue, AdventHealth's Experience Magazine, and Thryve Mag. Through her work, she has demonstrated a keen eye for expressing unique perspectives that resonate with audiences and elevate brand voices.

In her free time, Joy enjoys driving along the Blue Ridge Parkway, writing songs, and discovering the best coffee spots in town. Her diverse experiences and commitment to shining a light on meaningful stories underscore her expertise in the field.

References

Health equity in Telehealth. telehealth.hhs.gov. (2023, August 15). https://telehealth.hhs.gov/providers/health-equity-in-telehealth

Samuel, J. (2023, December 1). Telemedicine can be the oasis in the health care desert. Medical Economics. https://www.medicaleconomics.com/view/telemedicine-can-be-the-oasis-in-the-health-care-desert

O’Reilly, K. B. (2019, October 4). How to improve screening for Social Determinants of Health. American Medical Association. https://www.ama-assn.org/delivering-care/patient-support-advocacy/how-improve-screening-social-determinants-health#:~:text=%E2%80%9CWe%20are%20clear%20that%2080,officer%2C%20said%20in%20an%20interview. 

Table of Contents

Dive into our blog inspired by our webinar, “Elevating Member Experience: Empowering Health Plan Success during Open Enrollment,” where we will provide invaluable insights into optimizing your open enrollment strategy to ensure seamless operations, enhanced member experiences, and improved outcomes.  For a deeper understanding and comprehensive insights, don’t miss the chance to watch the webinar playback.

At the end of the year, do you assess member benefit engagement? If so, do you do any outreach?

Denise: Yes, we look to see if members have gone in for their annual wellness visits and will check to see if there are any gaps in care such as breast cancer or colorectal screenings. It’s a multimodal outreach campaign at this point to encourage their engagement. We engage our broker and provider partners and then we will text, email, mail, and call members to promote overall a healthy living that leads to the care they need. 

Are there any trends that you are observing in terms of open enrollment this year (2023)?

Denise: Open enrollment trends really do depend on the market. For me, in the northeast, we work a lot with broker partners and we are seeing that channel perform exceptionally well. Broker partners play a vital role during AEP as they are the trusted voices among communities. They offer members expert guidance and ongoing assistance. With the ever-present evolution of health plans in various markets, I really anticipate that these partners are going to play an increasingly significant role in future AEP’s. This type of partnership can be somewhat new but I think we need to keep evolving in these relationships to see the best overall success. Additionally, we’re seeing for the first time since COVID-19 that people are getting back to face-to face meetings, pen and paper – tangible elections. With this, it’s pertinent to meet members where they are. Offering a variety of avenues for members to elect coverage communicates intentionality that will set you apart. Whether that’s electronic, mail-in options, or in-person meetings, as health plans, we need to adapt to our members’ needs and speak to them the way they want to be spoken to. 

How do you ensure continuity of care for new members currently using DME? Are there processes or messages that are especially helpful for helping members navigate potential changes? Are they different for current vs. new members? Are there pitfalls that should be avoided?

Denise: Naturally, there are some inevitable complications that come along with open enrollment and so there will be some members that have more challenging plans to navigate depending on their situation. I’ve seen someone trying to join our plan with an oxygen need, and part of their process was having to figure out if their current DME provider would be covered under the new plan and if they were going to have to go to their physician again for another prescription order. All of these considerations can be stressful for members. As a health plan, I believe this is where proactive identification is key and provides a solution to meet people where they are. At Point32, shortly after onboarding new members, we deploy welcome calls to a subset of our members. Our goal is to gather information on this call that could pose a challenge for the member. Also, we deploy health risk assessments to our entire population because we want to identify members’ needs, including those with DME needs, and use that information to avoid any continuity of care challenges. As a health plan, providing a positive experience for members is one thing but ensuring there are no gaps in care is just as important! Many people have come to believe that health plans are like the “Big Bad Wolf” that isn’t there to help at all – we as health plans need to work to eradicate this perception and help people to understand that we want them to be healthy and that we are in their corner. 

What are the best practices in terms of informing current and future members about how their enrollment will impact cost sharing, prior authorization, and other processes used for services they are currently using?

In terms of informing current or potential members about enrollment plan shifts, health plans need to be honed into communicating the benefit information via various channels. Timely notifications, educational meetings highlighting specific changes in cost sharing and processes, and visual aids – these are all options to consider communicating benefit changes. Additionally, health plans should collaborate with healthcare providers and communicate any and all changes to plans. Once collaboration is established, it’s best practice to put a feedback system in place so that you can track progress and shared information. At Point32, our Population Health team really helps engage and communicate with members regarding any changes to their current plans so that they can make the best choice during an upcoming enrollment. This is a year round commitment we make to our members.  Strategies like these will ensure that members understand the impact on their services and hopefully reduce confusion and promote a positive enrollment experience. 

“We as health plans have a lot of information that can help us look for members that need assistance. It behooves us to be intentional about member engagement and outreach. Look at the data you have regarding your offerings and engage your members based on the facts. At the end of the day - help build plans that result in more positive health outcomes for your members.”

To schedule time with the Aeroflow Strategic Partnership team, please schedule below.
Picture of Michael Cantor, M.D.

Michael Cantor, M.D.

Dr. Mike Cantor is a geriatrician and attorney who has extensive experience designing and implementing value-based care, quality improvement, and care management programs for healthcare providers and health plans. He works as a fractional (part-time) Chief Medical Advisor for Aeroflow Healthcare, Uber Health, and other technology-enabled health services companies, value-based care organizations and digital health companies. Previous roles include: CMO for Bright Health Plan, an innovative health
insurer; CMO for CareCentrix, a leading outsourced home health, durable medical equipment, and post- acute care benefits manager recently acquired by Walgreens; and CMO for the New England Quality Care Alliance (NEQCA), the physician network affiliated with Tufts Medical Center, where he implemented network-wide quality improvement and care management programs for 150,000 managed care lives. He trained in internal medicine at Beth Israel Hospital in Boston and did his geriatrics fellowship at Harvard Medical School. He has degrees in law and medicine from the University of Illinois.

Picture of Denise Doucette-Ginise, MSN, RN, CCM, CHPN

Denise Doucette-Ginise, MSN, RN, CCM, CHPN

Denise is an accomplished nurse executive with a unique background combining clinical expertise, entrepreneurial leadership, and a breadth of experience across the healthcare industry.She currently serves as the Director of Medicare Member Experience for Point32Health, the parent organization of New England’s iconic managed care organizations, Tufts Health Plan and Harvard Pilgrim Healthcare. Tufts Medicare Preferred is one of very few HMO plans in the country to achieve 5-STAR from the Center for Medicare & Medicaid Services for eight years.

Table of Contents

This content has been reviewed for accuracy by Mike Cantor, Chief Medical Advisor at Aeroflow Health.

Dive into our blog inspired by our webinar, “Health Plan Best Practices: Leveraging Continuous Glucose Monitors (CGMs) to Improve Diabetes Care,” where we discuss how health plans can support members to ensure CGMs are maximally effective in improving diabetes care, the future of CGM management and more. For a deeper understanding and comprehensive insights, don’t miss the chance to watch the webinar playback. 

What is a continuous glucose monitor (CGM) and how does it work? How does a CGM improve the quality of care for people with diabetes, and what is the impact on costs of care and patient experience?  How is the value of a CGM different for people with Type I vs Type II diabetes?

Dr. Gabbay: Continuous glucose monitors or CGM’s are one of the largest advances in diabetes care in the last decade. CGM’s are like a movie of someone’s day instead of photos that only show a quick snapshot. With CGM’s, you are able to get continuous glucose monitoring over 24 hours, as well as be alerted when glucose levels are too high or too low. These readings are particularly useful for clinicians. Something to note is that there are 3 types of continuous glucose monitors – those that continuously monitor over 24 hours,  those that require intermittent scanning every 8 hours  with a reporting device such as an iPhone and then the most recent model on the market is one that is inserted in the abdominal region and stays in place for 6 months. CGM’s allow people to better understand how their actions impact their insulin levels and what activities or lifestyle choices they can make to promote a healthier outcome. CGM’s, while a useful data tool, in its simplest and most impactful form is a lifesaver for many. Being able to be alerted when levels are dangerous can make all the difference between life and death.  At the end of the day, all of these tools  help manage diabetes more effectively and lead to better life quality for those living with diabetes. 

Every 5 years, the American Diabetes Association publishes the Economic Costs of Diabetes report. This year, we’ve found that 1 in 4 healthcare dollars are spent on people with diabetes and their complications. Most of the cost by far comes from the complications of living with diabetes, such as, eye disease, kidney disease, nerve damage, strokes and more.  CGM’s allow people to monitor glucose levels and keep them at healthy levels, therefore,  preventing these complications that lead to higher costs. According to several studies of those with Type II diabetes, of those using a CGM, those individuals were less likely to go to the emergency room and/or be hospitalized. 

CGMs are part of optimal management of diabetes – what are the other key factors for people with diabetes to successfully manage their diabetes?  Where does diet and exercise fit in? 

Sophie: CGM’s are a tool that constantly remind people about their goals. Whether that be what they are eating, drinking or their activity, they are getting real-time data on how their lifestyle is impacting their glucose levels. I have seen that those using a CGM are much more invested in their dietary and lifestyle choices than those who are not. CGM’s should be seen as a partner in care, not a fix all. CGM’s provide data but people have to choose to take action based on the data.  In my world, diet and exercise are the two largest points of discussion in determining how to make an impact on the disease. By striving for a healthy body weight and trying to get in at least 150 minutes of moderate physical activity per week, those living with diabetes can more effectively manage the disease. When it comes to diet, I encourage patients to eat fewer foods that are highly processed and high in empty refined sugar and instead eat more whole grains, fiber, healthy fats and lean protein. Whole foods and plant-based options, in my opinion, are the gold standard. In addition to diet and activity, stress, water intake, and sleep can play a huge role in managing diabetes. I’d encourage patients to also work with their providers to determine what medications may be beneficial for their diabetes and if they are on medications, to speak with their providers before making any changes to their diet or exercise routines.

Is adherence a challenge for patients using CGMs?  What are the barriers to patients successfully using CGMs, and what can be done to address those issues? 

Sophie: Access due to lack of insurance coverage, transportation, or in general the cost being too high continues to be one of the largest barriers for patients needing CGM’s for their diabetes management. Additionally, the use of a CGM can often feel overwhelming and isolating. Historically, finger sticks have been the most common way of checking blood sugar levels, so for individuals who are now using CGM’s, even if they have family members with a history of diabetes, it can feel isolating to be the only one with a CGM. Today, providers are able to meet with patients via telehealth which has lowered some barriers to access; however, there are still those who may not have access to the internet. Our goal should be to figure out as many ways as it takes to meet these patients where they are and make it easy for them to get the care and medical supplies they need.  

Gabbay: Medications have become easier for patients to access via their insurance coverage but for CGM’s there still remains red tape that creates gaps in access that leads to patient frustration. For those that have come to rely on CGM’s as their diabetes partner, the thought of not being able to have continued access is a real fear. Changes to health plan rules and regulations such as the restrictions that come along with pharmacy benefits or durable medical equipment benefits, can often cause a process of steps and documentation with clinicians and providers that cause those gaps in care. 

What are the current recommendations about which patients qualify for CGMs? Have these recommendations changed recently, and if so, how?

Dr. Gabbay: Based on randomized controlled trials that the American Diabetes Association has supported, we found that regardless of age, if someone is on insulin, whether they have Type 1, Type 2 or gestational diabetes, everyone should be offered a continuous glucose monitor because of the benefits of use. CGM’s are safer and give better outcomes as far as blood glucose levels, especially when compared to hemoglobin A1C, which is a 3-month average of blood glucoses that can predict the major complications of diabetes.  Patients have better health outcomes with CGM’s and so they are very much the standard of care. In just the last year, our research has shown that anyone on insulin should be offered a CGM and it has ultimately led to the Centers for Medicare and Medicaid Services (CMS) expanding its coverage to include CGM coverage for anyone on insulin or on agents that can cause low blood glucoses. Additionally, we’ve been advocating with the Veterans Administration and they have changed their rules to cover CGM’s for anyone on insulin.  Recently, the conversation has shifted to how CGM’s might prove beneficial to those who are not using insulin. The research hasn’t proven strong yet but I expect this to be an ongoing focus point.

To schedule time with the Aeroflow Strategic Partnership team, please schedule below.
Picture of Michael Cantor, M.D.

Michael Cantor, M.D.

Dr. Mike Cantor is a geriatrician and attorney who has extensive experience designing and implementing value-based care, quality improvement, and care management programs for healthcare providers and health plans. He works as a fractional (part-time) Chief Medical Advisor for Aeroflow Health, Uber Health, and other technology-enabled health services companies, value-based care organizations and digital health companies. Previous roles include: CMO for Bright Health Plan, an innovative health
insurer; CMO for CareCentrix, a leading outsourced home health, durable medical equipment, and post- acute care benefits manager recently acquired by Walgreens; and CMO for the New England Quality Care Alliance (NEQCA), the physician network affiliated with Tufts Medical Center, where he implemented network-wide quality improvement and care management programs for 150,000 managed care lives. He trained in internal medicine at Beth Israel Hospital in Boston and did his geriatrics fellowship at Harvard Medical School. He has degrees in law and medicine from the University of Illinois.

Picture of Sophie Lauver, MS, RD, LDN, NBC-HWC

Sophie Lauver, MS, RD, LDN, NBC-HWC

Sophie Lauver is a Registered Dietitian and Board Certified Health and Wellness Coach passionate about helping people take control of their health and get excited about nutrition. Sophie has a Bachelor's degree in Communication from the University of Delaware and a Master’s degree in Dietetics from Eastern Michigan University. Sophie has worked in a wide variety of settings including hospitals, long-term care, rehabilitation, and wellness technology, and most recently, served as the director of the nation's largest diabetes prevention program. Sophie lives in Baltimore, MD with her husband, infant son, and their two dogs and two cats. When she’s not working with clients, she enjoys cooking, not doing dishes, trying new restaurants, and spending time being active outside (especially on warm and sunny days).

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Robert Gabbay

Robert A. Gabbay, MD, PhD, FACP, is the Chief Scientific and Medical Officer for the American Diabetes Association (ADA), the global authority on diabetes. Dr. Gabbay leads the ADA’s efforts to drive discovery within the world of diabetes research, care and prevention. Previously, Dr. Gabbay served as the Chief Medical Officer and Senior Vice President at Joslin Diabetes Center, and Associate Professor at Harvard Medical School. At Joslin, he oversaw the clinical care for over 25,000 patients, as well as the education and care programs Joslin delivers nationally and internationally. His research focused on innovative models of diabetes care to improve and to enhance diabetes outcomes and improve the lives of people with diabetes. The reach of his work has been recognized through leadership roles in national and international activities to transform diabetes care. Dr. Gabbay has served as visiting professor, keynote speaker and organizing committees for global meetings of the ADA, International Diabetes Federation, Endocrine Society, and the Diabetes Technology Society. Along with an extensive peer reviewed publication record, his views have appeared in popular press such as the New York Times, CNN, Oprah, the Washington Post and NPR.

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This content has been reviewed for accuracy by Mike Cantor, Chief Medical Advisor at Aeroflow Health.

Dive into our blog inspired by our webinar, “Health Plan Challenges and Strategies for Managing Sleep Apnea in the Post-COVID Era,” where we offer health plans valuable insights into the evolving landscape of sleep apnea diagnosis, treatment, and management. Gain actionable strategies and evidence-based recommendations to adapt your health plan’s approach to sleep apnea care, ensuring optimal outcomes for your members in the evolving healthcare paradigm. For a deeper understanding and comprehensive insights, don’t miss the chance to watch the webinar playback.

What are the greatest challenges health plans currently face in providing affordable positive airway pressure (PAP) therapy to their members with sleep apnea? 

Dr. Rabinowitz: I think the biggest challenge right now is that there are a lot of people living with undiagnosed sleep apnea. We do not have great screening tools so understanding the data side and identifying individuals with sleep apnea can be challenging. Without screening tools we’re unable to urge members to get a proper diagnosis. Another challenge would be the current state of the supply chain and being able to provide members who are diagnosed with adequate resources. 

Dr. Weiss: Because identification is such an ongoing issue, education is crucial. Health plans can help their members by providing information about common sleep apnea red flags such as waking up with a headache in the morning or gasping for air frequently through the night.  Also, educating on the populations who are most at risk, such as African Americans would be beneficial. Incentivizing those members with such symptoms to follow up with a doctor could make a huge difference!

What does the end of the COVID state of emergency mean for members in commercial, Medicaid, and Medicare plans? Are there other factors leading to changes in coverage policies?

Dr. Weiss: Patients and insurance companies should work together during this transition to adjust to “post-COVID emergency” era. Insurance plans are no longer required to cover some services, but they may choose to cover to provide better care. Home tests for obstructive sleep apnea and telemedicine services fall within this category. Patients with commercial insurance plans may have a limited number of at home tests available. Those with Medicaid and Medicare still have access to home and tele services, depending on the state. Most states kept telehealth coverage available after the COVID state of emergency.

Are there challenges with getting access to or using PAP devices due to supply chain issues? What about the use of devices that do not record usage data or cannot upload it remotely? What is the current impact of the Phillips PAP recall? 

Dr. Rabinowitz: Yes, there are still ongoing issues with members accessing PAP devices. There are 2 significant happenings to note that have only heightened this issue.  The Phillips PAP Recall took many units off the market and then created an additional problem for people needing replacement devices. Additionally, the chip shortage was especially acute for medical device manufacturers as they did not have as much clout in the global marketplace. As it relates to the data transmission issues that surfaced with thePhillips recall, compliance was a concern for the equipment that didn’t have built in telemetry. Vendors and infrastructure dealing with this issue made reporting particularly difficult for health plans. 

Dr. Weiss: Even though 2021 was a couple years ago, the Phillips recall is still affecting patients. Patients are still experiencing delays in equipment; however, I am seeing that patients are mostly experiencing fear around the potential problems their equipment might have and not so much the concern of being able to access the equipment. 

How does adherence impact access for patients and what can be done to manage this? 

Dr. Rabinowitz: From a health plan perspective, we’re always looking for the value that PAP therapy provides a patient. We’ve made great strides to help remove the barriers for patients to be diagnosed and treated for sleep apnea but we would like to know our members are benefiting from that therapy. The telemetry data from the device directly impacts how we interact with members. Based on the data, we can better understand next steps that a member might require. For example, a patient might need respiratory therapy, another sleep study or additional coaching –  we wouldn’t know these things without the data. With the additional information we can further assist. 

Home testing for sleep apnea is becoming more and more popular. How do you make sure that patients that test at home get the right testing at the right place?

Dr. Weiss: An FDA- approved home test for sleep apnea (HTSA) can be ordered by a health care provider when there is a potential diagnosis of OSA. Patients and primary care providers should attend to warning symptoms of OSA to request the test when a patient complains of snoring, gasping for air during sleep, and excessive daytime sleepiness, morning headache, dry throat, dry mouth, irritability, and “brain fog”, such as difficulty concentrating. The right time is when these symptoms become noticeable to the patient, their bed partner, a relative or someone close to them. And the right place is an accredited medical provider using an FDA-approved HTSA.  

To learn more about the sleep solutions that Aeroflow Health provides, we encourage you to schedule time with our strategic partnership team below or learn more on the Aeroflow Sleep website.
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Michael Cantor, M.D.

Dr. Mike Cantor is a geriatrician and attorney who has extensive experience designing and implementing value-based care, quality improvement, and care management programs for healthcare providers and health plans. He works as a fractional (part-time) Chief Medical Advisor for Aeroflow Healthcare, Uber Health, and other technology-enabled health services companies, value-based care organizations and digital health companies. Previous roles include: CMO for Bright Health Plan, an innovative health
insurer; CMO for CareCentrix, a leading outsourced home health, durable medical equipment, and post- acute care benefits manager recently acquired by Walgreens; and CMO for the New England Quality Care Alliance (NEQCA), the physician network affiliated with Tufts Medical Center, where he implemented network-wide quality improvement and care management programs for 150,000 managed care lives. He trained in internal medicine at Beth Israel Hospital in Boston and did his geriatrics fellowship at Harvard Medical School. He has degrees in law and medicine from the University of Illinois.

Picture of Carleara Weiss, Ph.D., MS, RN

Carleara Weiss, Ph.D., MS, RN

Dr. Weiss is the Scientific Advisor for Aeroflow Sleep. She has over fifteen years of experience as an Adult-Geriatric Nurse Specialist, with a Master in Science of Health Care and a Ph.D. in Nursing, focusing on Behavioral Sleep Medicine and Circadian Rhythms.Originally from Brazil, Dr. Weiss earned a Bachelor's in Nursing Science, Bachelor's in Education, and completed her medical-surgical & geriatric training and Master's degree at the Federal Fluminense University, Rio de Janeiro. After eight years as Assistant Professor and Clinician overseeing adults and older adults in hospitals, nursing homes, hospices, and private practice, Dr. Weiss moved to the United States where she earned a Ph.D. and Postdoctoral training in sleep and circadian rhythms at the State University of New at Buffalo.

Picture of Phil Rabinowitz, M.D.,FACP

Phil Rabinowitz, M.D.,FACP

An Internist with a background in teaching and clinical internal medicine. Has been with Cigna since 2005. Currently a Senior Medical Director in the Clinical Performance and Quality Organization, based out of Pittsburgh, PA. Major responsibilities include: leading a team of Medical Directors, clinical oversight of National Vendors (managing HHC/DME/Sleep/PT/OT/Chiro/O&P/Cardiac Devices) as well as Strategic Partnerships; MD lead for the High Profile Escalation Team, and MD lead for out-of-network management and No Surprise Act implementation as well as many other customer experience and quality initiatives.

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This content has been reviewed for accuracy by Mike Cantor, Chief Medical Advisor at Aeroflow Health.

Dive into our blog inspired by our webinar, “Building for Maternal Health Equity: Addressing Barriers to Preventative Care,” where we unpack the intriguing findings from Aeroflow Breastpumps‘ recent independent study, discover key insights and standout observations that shed light on essential aspects of maternal care and explore the nuances between CLCs, IBCLCs, and doulas. For a deeper understanding and comprehensive insights, don’t miss the chance to watch the webinar playback.

 What were some of the most outstanding findings from the recent independent study supported by Aeroflow Breastpumps?

Amanda: There is a lot of data worth noting here. For example, 76% of respondents indicated access to tools, resources and support related to breastfeeding/lactation were very important or extremely important. And with that, 1 in 3 indicated it was difficult to access support. What is even more interesting to note about that number is that out of the mother’s who said they struggled finding support, 0% were white women and 13% identified as Asian, Black or African American. According to their experience, the struggle has been due to lack of time due to childcare responsibilities, lack of finances, or their doctors did not explain/provide support. When mother’s don’t receive proper education and support, they are more likely to have a difficult maternal journey. Not only did the study delve into resources and support but it also touched on mental health. Out of the mom’s surveyed, 74% indicated that breastfeeding/lactation challenges impacted their mental health. Only 4% said it did not impact them at all – this was true consistently across all subgroups. These results can be very discouraging. Our hope is that health plans recognize the need to provide equitable access to solutions like lactation consultants and doulas to meet mom’s where they are and give the education and support that every mother deserves. To view another valuable Aeroflow Breastpumps Survey, click here.

What is the difference between a CLC, IBCLC and Doula? How does their care differ?

Kiera: A doula is a trained professional who offers emotional and physical support to individuals and couples before, during, and after childbirth. Their primary focus is on providing comfort, advocacy, and guidance during labor and the postpartum period. Doulas are not medical professionals but rather experienced companions who empower birthing individuals to make informed choices about their birth experiences. While a doula’s role revolves around childbirth support and emotional well-being, a CLC specializes in helping new parents with breastfeeding. They are trained to address common breastfeeding challenges, provide education on proper latching and positioning, and offer guidance to ensure a successful breastfeeding experience. On the other hand, an ICBLC is the highest level of lactation specialist, equipped to handle more complex breastfeeding issues. They undergo extensive training and can assist with more challenging cases. In summary, a doula focuses on emotional and physical support during childbirth, while a CLC and ICBLC are experts in breastfeeding support, with the ICBLC being the most advanced in handling intricate breastfeeding challenges. Each plays a valuable role in the journey of pregnancy, birth, and postpartum care.

How can lactation consultants and doulas positively impact a mother’s mental health journey?

Leteace: Lactation consultants and doulas play a significant role in enhancing a mother’s mental well-being throughout the phases of pregnancy, childbirth, and the postpartum period. Here’s how we make a positive impact:

  • Emotional Support: We offer mothers a supportive environment to openly discuss their emotions, leaving them feeling empowered and self-assured. Our goal is to create a “safe space” where they can find emotional strength.
  • Brain-Boob Connection” Class: Through Aeroflow Breastpumps, we conduct specialized classes that explore the profound connection between the mind and body during pregnancy and postpartum. These sessions include practical stress reduction techniques and exercises we engage in together.
  • Stress Reduction: Our mere presence and assistance can alleviate the stress and anxiety experienced by new or experienced mothers who may otherwise feel isolated. We provide reassurance and support, diminishing emotional burdens.
  • Community Building: We facilitate a weekly “Mom’s Circle” via Zoom, where mothers can come together to form a community, engaging and supporting each other at no cost.
  • Educational Guidance: We offer educational support to prepare mothers for childbirth, early breastfeeding, and the postpartum period. Our classes, such as “Birth and Breastfeeding” and “Ultimate Breastfeeding Prep,” equip mothers with the “what to expect” readiness they need.
  • Addressing Breastfeeding Challenges: As an IBCLC, we assist mothers in navigating early breastfeeding difficulties, recognizing that successful breastfeeding can reduce the risk of postpartum mood disorders. Timely addressing of these challenges is essential for maternal mental health.
  • Promoting Bonding: Our support extends to helping mothers strengthen their bonds with their babies, which is protective for their mental health.

In summary, lactation consultants and doulas are dedicated to positively impacting mothers’ mental health by offering emotional support, building community, providing education, addressing challenges, and fostering maternal-child bonding throughout the unique journey of pregnancy, childbirth, and the postpartum stages.

What are some of the major barriers/gaps that have kept the integrative care model for moms from coming to fruition? 

Kiera: Creating access to breastfeeding support is very important for new and expecting moms. The most common barriers that create a gap in care is the lack of in-network providers, telehealth options, long wait times and visibility to where they can go to receive care.  Having to plan, prepare and pay for childcare is a barrier that telehealth options could aid. Also, when health plans provide directories that show up to date in-network providers and specialists, it lessens the chance that moms will have to pay copays and deductibles. An example of how Aeroflow has been providing quick and easy access to care is the scheduling model via Lactation Link. If a mom is looking to schedule time with a lactation consultant, she can schedule a same day appointment all via an online portal. IBCLC’s  and CLC’s will always be the gold standard for breastfeeding education. When health plans provide in-network access to these types of specialists, they are choosing to meet moms where they are and partner in their motherhood journey. 

If you are passionate about addressing health disparities and ensuring comprehensive lactation and doula care for both mothers and babies to close critical HEDIS care gaps, we encourage you to schedule time with our team. You can schedule time below to learn how our program can make a significant impact in promoting maternal and infant health through lactation and doula support.
Picture of Kiera Walsh, CD(DONA), CLC

Kiera Walsh, CD(DONA), CLC

Kiera Walsh is a dedicated agent of change in the realm of maternal and infant care, driven by the transformative force of education. As a DONA Certified Birth Doula, Postpartum Doula, and Certified Lactation Counselor, she passionately advocates for the vital role of education in shaping well-informed birth, postpartum, and breastfeeding experiences. 


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Leteace Lee

Leteace Lee, RNC-Maternal and Newborn Care, Full Spectrum Doula, and IBCLC is a Lactation Consultant and Educator with Aeroflow Breastpumps. Leteace is a Holistic Mother-Baby Advocate, who specializes in prenatal and postpartum breastfeeding support and birth education. Currently located in MD, she offers virtual lactation consultations to women everywhere.

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Kellie Green

Kellie Green is the founder and owner of Green Living & Wellness. She is a Speech Pathologist and International Board-Certified Lactation Consultant credential. Driven by her own struggles to breastfeed, she takes pride in providing the best care possible. Her mission is to give families a great beginning, supporting them from birth and beyond to help them reach their feeding goals. She offers in office services for those local to Columbus, OH and virtually, wherever you are, via telehealth. With Aeroflow, Kellie teaches: Birth & Breastfeeding, Navigating Maternity Leave, Pumping 101, Solids, Ultimate Breastfeeding Prep.

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Sarah Law

Sarah-Ashley Law is a Registered Nurse and IBCLC. She started her career in newborn intensive care and worked there for over 8 years while working in the NICU she found a love of supporting families on their feeding journeys and loved learning all about breastmilk’s role in helping preterm babies grow and thrive. So in 2019 she transitioned to lactation and became an IBCLC. She has worked in postpartum, NICU, outpatient clinic, homes and virtually with Aeroflow. Sarah-Ashley teaches Ultimate Breastfeeding Prep, Pumping 101, Sleep for the Breastfed Baby, Babycare for the Breastfed Baby and Solids for the Breastfed Baby.

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Amanda Minimi

Amanda is the Director of Corporate Development at Aeroflow Healthcare, the largest provider of breastfeeding equipment and services in the nation. Amanda has led Aeroflow Healthcare's health plan partnership initiatives where there collaboration-based solutions have led to better outcomes through high patient engagement and increased instances and duration of breastfeeding. Amanda also serves as the co-chair of AAHomeCare's Breastfeeding Coalition, a team that works with states and health plans to advocate to reduce barriers in access to breastfeeding.

As a healthcare company that provides maternal mental health support services, doula care, breastfeeding support and supplies, Aeroflow Healthcare fully supports the passage of Senate Bill 455, also known as the Protecting Moms Who Serve Act. This bill directs the Department of Health and Human Services to study health issues affecting women who serve in the military, including coordinating effectively between veterans health care facilities and non-veterans health care facilities in the delivery of maternity care and other health care services.

Unique Challenges Faced by Pregnant and Postpartum Veterans

Pregnant and postpartum veterans encounter a variety of obstacles that make it difficult to access the comprehensive, high-quality healthcare they deserve. These challenges are often compounded by the unique circumstances of military life, including frequent relocations, deployments, and long periods of separation from loved ones.

According to a study by the Department of Veterans Affairs (VA), pregnant veterans are more likely to experience mental health conditions such as depression and PTSD than their civilian counterparts. Additionally, pregnant veterans who rely on VA healthcare face barriers to accessing care due to limited availability of VA maternity care providers and long wait times for appointments.

Maternal Mortality Disparities Among BIPOC Military Women

Furthermore, women who identify as Black, Indigenous, or people of color (BIPOC) are disproportionately affected by maternal mortality and severe maternal morbidity, and this disparity is even more pronounced among military women who identify as BIPOC. According to a report by the Centers for Disease and Control Prevention (CDC), Black women are two to three times as likely to experience maternal mortality as white women. Access to comprehensive maternal health services is critical to reducing these disparities and improving health outcomes for all mothers who serve in the military.

The Potential Impact of Studying Women’s Health Issues in the Military

Aeroflow Healthcare recognizes the importance of Senate Bill 455, also known as “Protect Moms Who Serve,” and the positive impact it could have on the lives of mothers who serve in the military. As a company that provides maternal health services, including mental health support, lactation support, and supplies, we understand the unique challenges that pregnant and postpartum veterans face in accessing high-quality healthcare services.

This bill directs the Department of Health and Human Services to study health issues affecting women who serve in the military, such as identifying gaps in maternity care services and coordinating between veterans and non-veterans health care facilities. By understanding and addressing these gaps and barriers, this study can improve overall health outcomes for these women.

We commend Senators Applewhite and Smith for their leadership in introducing this critical legislation. As a company that supports the unique needs of pregnant and postpartum veterans, we fully endorse this bill and urge the North Carolina General Assembly to pass this legislation to improve maternal health outcomes for women who serve in the military. Together, we can ensure that all mothers who serve in the military have access to the high-quality healthcare services they need and deserve.

Take Action to Support Veterans Maternal Health Care Today

The Protect Moms Who Serve bill has the potential to make a significant impact on the lives of pregnant and postpartum veterans. If you would like to get involved in supporting this bill and advocating for women veterans’ maternal health care, we encourage you to contact your legislators and express your support for the bill.

You can find your local legislators’ contact information through the North Carolina General Assembly’s
website. It’s important to note that legislators may receive a high volume of calls and emails, so consider using social media or attending town hall meetings to share your support for the bill.

In addition to contacting your legislators, you can also get involved with advocacy organizations that support women veterans’ health care, such as the Service Women’s Action Network (SWAN) or Disabled American Veterans (DAV). These organizations provide resources and information about advocacy efforts and how to get involved.

Together, we can work to ensure that all mothers who serve our country have access to the high-quality health care services they need and deserve.

This bill directs the Department of Health and Human Services to study health issues affecting women who serve in the military, such as identifying gaps in maternity care services and coordinating between veterans and non-veterans health care facilities. By understanding and addressing these gaps and barriers, this study can improve overall health outcomes for these women.

We commend Senators Applewhite and Smith for their leadership in introducing this critical legislation. As a company that supports the unique needs of pregnant and postpartum veterans, we fully endorse this bill and urge the North Carolina General Assembly to pass this legislation to improve maternal health outcomes for women who serve in the military. Together, we can ensure that all mothers who serve in the military have access to the high-quality healthcare services they need and deserve.