Retail RD Roles in Health Insurer Programs

Retail RD Roles in Health Insurer Programs

August 6, 2014

By Amanda Rhubizhevsky, MPH

In an effort to keep health care local  and sustainable, and to promote health through convenience, Hy-Vee has collaborated with Wellmark Blue Cross / Blue Shield as well as UnityPoint Health to provide a unique new option in health insurance. Designed to reward customers for healthy behaviors, Blue RewardsSM integrates true coordinated care with the UnityPoint Health provider network and the retail convenience of Hy-Vee’s pharmacy and dietitian services, all bundled into an affordable, Affordable Care Act (ACA)-health insurance option from Wellmark Blue Cross / Blue Shield.

Like other ACA plans, members will be able to select the level of coverage that’s right for them. Members will have access to Wellmark’s extensive physician and hospital network, however, they will receive the lowest out-of-pocket costs when they select a UnityPoint Health-associated provider or hospital and fill prescriptions at Hy-Vee pharmacies. Individuals and small businesses will be able to purchase Blue Rewards during the 2015 open enrollment period, which will open in November 2014.

Blue Rewards members will find it easy to extend their wellness experience beyond what’s available in their plan. They will also have the added access to a variety of convenient health-related options at Hy-Vee, such as health assessments, wellness screenings, nutrition counseling and of course, healthy food options. Through this collaboration, Hy-Vee dietitians and pharmacists will work with patients and provide a high level of coordinated care, hand-in-hand with their physicians, thus yielding better health outcomes with an overall lower health care cost.

What do retail dietitians need to know?
As retail dietitians begin to form relationships with provider networks, HIPAA compliance is of upmost importance.  A key consideration is whether a private, HIPAA -compliant counseling space is available within the store where the dietitian can conduct Medical Nutrition Therapy with customers.

To provide coordinated care with provider networks, communication between the retail dietitian and referring physician is key. A few things to consider before pursuing consultation services include whether the retail dietitian has a National Provider Identifier (NPI) number and if there is a HIPAA-compliant process in place for the retail dietitian to securely transmit personal health information to the physician.

What about legalities?
Dietitians offering Medical Nutrition Therapy (MNT) in a retail setting need to follow all Commission on Dietetic Registration (CDR) and state licensure regulations. Dietitians should also utilize the Nutrition Care Process, a standardized model created by the Academy of Nutrition and Dietetics, as a guide to provide high quality nutrition care. The Health Insurance Portability and Accountability (HIPAA) and Health Information Technology for Economic and Clinical Health (HITECH) Acts are also important components in offering MNT in a retail setting. A private office or location for conducting consultations and secured storage (electronic or locked) for personal health information is a necessity. Your retailer's legal team should play an integral role in this process to ensure compliance with state regulations and HIPAA.

Partnering with a health insurer strengthens reimbursement opportunities for retail dietitians.

In addition to her work with Hy-Vee Inc., Allison is an active member of the Academy of Nutrition and Dietetics, and currently serves as the Meeting Chair-elect for the Iowa Academy of Nutrition and Dietetics. In her spare time, Allison enjoys spending time with her family, hiking, and card making.