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Health insurance is complicated, but you don't have to figure it out alone. Understanding terms and definitions is important when comparing health insurance plans. When you know more about health insurance, it can be much easier to make the right choice for you and your family. A common question when it comes to health insurance is, "Who pays for what?" Health insurance plans are very diverse and depending on your plan, you can have different types of cost-sharing: the cost of a medical visit or procedure an insured person shares with their insurance company. Two common examples of cost-sharing are copayments and coinsurance. You've likely heard both terms, but what are they and how are they different? Copayments Copayments (or copays) are typically a fixed dollar amount the insured person pays for their visit or procedure. They are a standard part of many health insurance plans and are usually collected for services like doctor visits or prescription drugs. For example: You go to the doctor because you are feeling sick. Your insurance policy states that you have a $20 copay for doctor office visits. You pay your $20 copay at the time of service and see the doctor. Coinsurance This is typically a percentage of the total cost of a visit or procedure. Like copays, coinsurance is a standard form of cost-sharing found in many insurance plans. For example: After a fall, you require crutches while you heal. Your coinsurance for durable medical equipment, like crutches, is 20% of the total cost. The crutches cost $50, so your insurance company will pay $40, or 80%, of the total cost. You will be billed $10 for your 20% coinsurance.

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Breast milk. It's often referred to as liquid gold. And fortunately, it can be safely refrigerated or frozen for later use, which can allow you to be a bit more flexible in your new routine with baby. Whether you're getting ready to return to work, planning for the chance date night out or just exclusively pumping, it's crucial to understand the guidelines for proper breast milk storage. Storing Breast Milk Use clean bottles with screw caps, hard plastic cups that have tight caps or nursing bags (pre-sterilized bags meant for breast milk). Be sure to label each container with the date the milk was pumped and your baby's name if the milk is going to childcare providers. You can add fresh, cooled milk to milk that is already frozen, but add no more than is already in the container. For example, if you have two ounces of frozen milk, then you can add up to two more ounces of cooled milk. For healthy full-term infants, milk can be stored as follows: Room temperature - six to eight hours (no warmer than 77°F, or 25°C). Refrigerator - up to five days at 32°-39°F (0°-3.9°C). Freezer– Varies depending on freezer type. Up to two weeks in a freezer compartment located within the refrigerator. Three to six months in a freezer that is self-contained (standard kitchen fridge/freezer combination) and kept at 0°F (-18°C). Breast milk should be stored in the back of the freezer and not in the door. Six to 12 months in a deep freezer that is kept at -4°F (-20°C). Be sure to leave about an inch of space at the top of the container or bottle to allow for expansion of the milk when it freezes. Thawing Breast Milk Place frozen breast milk in the refrigerator to thaw (about 24 hours) then warm by running warm water over the bag or bottle of milk and use it within the next 24 hours. If you need it immediately, remove it from the freezer and run warm water over it until it's at room temperature. Never microwave breast milk and do not refreeze it. Once your baby has started to drink from the bottle, you should use it within one hour. You may find that different resources provide different recommendations about the amount of time you can store breast milk at room temperature, in the refrigerator and in the freezer. Talk to your doctor or lactation consultant if you have any concerns or questions.

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Health insurance might be one of the most complicated purchases you will make throughout your life, so it is important to understand the terms and definitions insurance companies use. Keep these in mind as you are comparing health insurance plan options to choose the right plan for you and make the most of your health insurance benefits. One area of health insurance that can cause confusion is the difference between a plan's deductible and out-of-pocket maximum. They both represent points at which the insurance company starts paying for covered services, but what are they and how do they work? What is a deductible? A deductible is the dollar amount you pay to healthcare providers for covered services each year before insurance pays for services, other than preventive care. After you pay your deductible, you usually pay only a copayment (copay) or coinsurance for covered services. Your insurance company pays the rest. Generally, plans with lower monthly premiums have higher deductibles. Plans with higher monthly premiums usually have lower deductibles. What is the out-of-pocket maximum? An out-of-pocket maximum is the most you or your family will pay for covered services in a calendar year. It combines deductibles and cost-sharing costs (coinsurance and copays). The out-of-pocket maximum does not include costs you paid for insurance premiums, costs for not-covered services or services received out-of-network.  Here's an example: You get into an accident and go to the emergency room. Your insurance policy has a $1,000 deductible and an out-of-pocket maximum of $4,500. You pay the $1,000 deductible to the hospital before your insurance company will pay for any of the covered services you need. If you received services at the hospital that exceed $1,000, the insurance company will pay the covered charges because you have met your deductible for the year. The $1,000 you paid goes toward your out-of-pocket maximum, leaving you with $3,500 left to pay on copays and coinsurance for the rest of the calendar year. If you need services at the emergency room or any other covered services in the future, you will still have to pay the copay or coinsurance amount included in your policy, which goes toward your out-of-pocket maximum. If you reach your out-of-pocket maximum, you will no longer pay copays or coinsurance and your insurance will pay for all of the covered services you require for the rest of the calendar year.

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When finding a provider to receive your health services, you've probably heard the terms "in-network" and "out-of-network" when it comes to your health plan. But what do these terms mean for a patient? And why should you be aware if a provider is out-of-network? What does it mean when a provider is "in-network" with a health plan? A provider is a person or facility that provides healthcare. When a provider is in-network it means there is a contractual agreement with that health plan regarding the rates for services. The provider will accept negotiated rates for services from the insurance. This means a patient will typically pay less for medical services received and is less likely to receive surprise bills. What does it mean when a provider is "out-of-network" with a health plan? Providers that are out-of-network are those that do not participate in that health plan's network. The provider is not contracted with the health insurance plan to accepted negotiated rates. This mean that patients will typically pay more or the full amount for the service they receive. Why should patients see in-network providers? Seeing an in-network provider for medical services can significantly reduce your medical expenses. Remember that in-network providers have a contractual agreement for negotiated rates with the health plan, so they cannot charge you more than that negotiated rate for a service. Seeing an in-network provider will always ensure any costs you do incur (copays or co-insurance) are applied to your health plan's deductible and out-of-pocket maximum (out-of-network costs don't apply to these amounts). To find the amounts you will pay for specific services, you can check your health insurance plan's Summary of Benefits. What is the best way to find which providers are in-network with a patient's health plan? Most health insurance companies offer multiple ways to find if a provider is in-network. To find the most accurate benefit information from your health plan, you can: Call their Customer Service department Check their website for their online provider directories If offered, check your online member portal.

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I am regularly amazed by medical advancements and innovation in the United States. However, even as we make significant progress in many areas of medicine, there is still much more work to be done in others. One such area is patient safety.   What is Patient Safety? When we talk about patient safety, we are discussing how hospitals and healthcare organizations protect patients from errors, injuries and infections. Anyone can make a mistake at work, but in healthcare these mistakes can result in serious outcomes. In 1999, the Institute of Medicine released a report that estimated 98,000 deaths per year result from medical examination or treatment. The most recent study in 2013 suggested these numbers could range from 210,000 to 440,000 deaths per year. Many of these deaths result from preventable medical errors. This is inexcusable and shows how much more work our industry still needs to do to improve patient safety. Making Patient Safety a Priority Patient Safety is our number one priority at Renown Health. We dedicate a lot of time to establishing, reviewing, and revising our processes to prevent errors. Despite the obvious importance of patient safety, this issue is largely left to individual hospitals and health systems to manage. There is a surprising lack of national attention around this truly important issue. However, a silver lining of the COVID-19 pandemic is that it is igniting interest in hygiene and infection prevention. Patients want to learn more about the processes that are in place to prevent the spread of infections. In addition to the many protocols that guide our treatment of injuries and illness, Renown Health has implemented the following measures to prevent the spread of communicable diseases: Requiring everyone entering Renown sites to wear a mask or face covering. Establishing new processes to help patients and visitors practice social distancing. Limiting the number of visitors in our facilities. Screening all employees and patients for symptoms. Enhancing our already-thorough cleaning and disinfection processes. I hope patient safety and infection prevention remain in the national spotlight long after the COVID-19 pandemic has ended. The healthcare industry must come together to develop stronger systems and regulations to minimize preventable medical errors. We have a responsibility to our patients to do better.

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While breastfeeding is natural, it's not always easy. We asked Certified Lactation Counselor Sarah Mitchell for some tips to help make the process easier for mom and baby. From increased infant immunity to improved maternal health and well-being, the benefits of breastfeeding are many. Still, only 60 percent of U.S. moms in the United States continue to breastfeed past their baby's first six months. There are for many reasons for why moms stop, including the mother's their need to return to work. We reached out spoke to Sarah Mitchell, a certified lactation counselor at The Lactation Connection at Renown, for some expert advice. Tip 1 At first, it's normal to expect obstacles. Even in cultures where close to 100 percent of moms breastfeed, they can experience issues, including getting the baby to "latch on," sore nipples, and milk production. In addition, it sometimes can take several weeks for mom and baby to get comfortable. Tip 2 Line up a coach, even before the baby is born. This can be a professional lactation coach, family member, or friend who is experienced and encouraging. While online videos can be helpful, most new moms need the one-on-one guidance that a coach can provide. Renown offers outstanding resources in its Lactation Connection center, including expert consultants, products, and support. Tip 3 Well ahead of the due date, set up a support network of friends, family members, or community groups such as La Leche League. Women historically have relied on extended support systems to help them with raising children, and breastfeeding is one of those areas that, while natural, still needs encouragement from the women who’ve been there. Tip 4 Don’t get discouraged if you need to supplement at times with formula. This, too, as it turns out, is not uncommon in other cultures. In other parts of the world, babies are given beverages and foods such as tea, broth, soup, juice, mashed bananas, and papaya. The American Academy of Pediatrics recommends supplementation only with approved formula -- but the point is, it’s ok to supplement if you need to. Finally, don’t forget the importance of breastfeeding for connecting with your baby. It’s essential to maintain breastfeeding over the weekends, preferably “on-demand,.” and will keep that special bond strong after you have returned to your job.

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If you think sore nipples are just a normal part of breastfeeding, think again. Robin Hollen, APRN, and Breastfeeding Medicine Specialist, says that nursing can be an enjoyable experience for mom and baby without pain and discomfort. A top concern of nursing moms within the first week after delivery is how to prevent sore nipples. Even moms who’ve nursed before struggle with this common issue. While many women think it is a regular part of the nursing experience, it is actually a sign that something isn’t quite right. “Nursing your baby should be enjoyable,” says Robin Hollen, Breastfeeding Medicine Specialist with Renown Health. For over 30 years Robin has been supporting moms to breastfeed. Below she shares some valuable information and tips, helping you create a happy and healthy breastfeeding experience for you and your baby. What causes sore nipples? The most common cause of sore nipples involves incorrect latching. For a proper latch, a baby’s mouth takes in the entire nipple and some of the breast, so that the nipple rests at the back of the mouth where the palate is soft. With an improper latch, the mouth may slip down to the tip of the nipple while the baby nurses. This constant pressure on your sensitive skin may cause discomfort and pain. A board-certified lactation consultant can help assess if your baby is latched correctly and troubleshoot your breastfeeding concerns. Less common causes of sore nipples include: • Improper tongue placement of baby • Clenching • Incorrect breast pump use How can a mother prevent sore nipples from an improper latch? Breastfeeding is a learning experience for both mom and baby. Ask for help with the latch so your baby learns it correctly and maintains its depth. In the past, new mothers were surrounded by a community of women — their own mothers, grandmothers, or other family and friends — to provide assistance and guidance with every latch at the beginning of an infant’s life. In today’s culture, new moms can find themselves on their own with no extended family to lend their knowledge. Nurses, pediatricians and lactation consultants now fill that role; they are the eyes and hands along with the much-needed experience to guide new mothers. Our Breastfeeding Medicine experts assist nursing moms with latch every day. Even a single visit with a lactation consultant observing your breastfeeding baby can provide valuable insight on achieving, and maintaining, the proper latch - preventing future nipple soreness and discomfort. How to heal sore nipples from breastfeeding To heal sore nipples, you must first fix the cause, and correcting the latch prevents further damage. A lactation consultant can also help you address the pain. Below are some breast healing tips: • Your own expressed breast milk is excellent to rub into the nipple for anti-bacterial protection. • For those moms who need more lubricant or fat than breast milk offers, use a lanolin or a cream that is labeled safe for the baby. • Soothies are a gel pads providing comfort in between feedings, but should not be used with lanolin products. • Breast shells, not to be confused with shields, can guard the nipples from irritation or pressure in between feedings. If you have more questions about preventing and healing sore nipples or general breastfeeding concerns, talk to your pediatrician or a Renown Health Breastfeeding Medicine specialist at 775-982-6365.

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Medicaid plays a significant role in our health care system and is the nation’s public health insurance program. In addition, this program is the predominant source of long-term care coverage for Americans. Renown Health is contracted with two Medicaid plans: Molina and Anthem. If you currently have a different plan but want to change to one that Renown accepts, you can request to change plans during the open enrollment period from January 1 to March 31. Request to change your Medicaid plan in one of three ways: Request a change to your plan, or managed care organization (MCO), by reviewing the available MCO plans online at bit.ly/MCOPlansNV and filling out the form on the webpage. Email Nevada Medicaid to ask for a plan change and include your name, Medicaid ID and the names and Medicaid IDs of any dependents in your home: MCORedistribution@dhcfp.nv.gov. Call your local Medicaid district office at 775-687-1900 (northern Nevada) or 702-668-4200 (southern Nevada) to ask about changing your plan.  For more information about the Medicaid plans accepted at Renown Health, please visit: Anthem Molina Healthcare   Renown Health accepts most insurances, but please visit the link below for the full list. Click here for all accepted plans

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In recent years, workplace violence against healthcare workers has been on the rise. According to the Occupational Safety and Health Administration (OSHA), about 75 percent of nearly 25,000 reported annual workplace assaults occur in healthcare and social service settings. Those who don’t work in healthcare may be surprised to learn that violent altercations are so common in our field. Hospital settings can create fear and stress for patients and their families. Pain, mind-altering medications and drugs, and difficult prognoses can amplify these feelings. While inappropriate responses may be understandable, violence cannot be tolerated. As the leader of a health system, protecting our employees is an issue that I take seriously. Reporting Workplace Violence Unfortunately, sometimes employees don’t report dangerous incidents fearing they might be blamed, or not realizing it’s a reportable offense. At Renown Health, we take these events seriously. We have clear, mandatory policies and protocols for reporting and investigating violent incidents. Each incident is investigated to ensure follow through and accountability. We also teach de-escalation skills to our hospital security teams, clinicians, and other frontline employees. As an added layer of protection, Renown Health has a first-rate security team that closely monitors activity on our campuses, addressing potential issues before they escalate. Our organization values our partnerships with community organizations including local law enforcement agencies like the Washoe County Sheriff’s Office and the Reno Police Department. Renown Health maintains a close relationship with these partners, and we alert them when our care teams experience an increase in violent incidents. I also recognize that workplace violence is a national problem that demands collaborative solutions. That’s why I am also proud to serve as a member of the American Hospital Association’s Hospitals Against Violence Advisory Committee. Nurses, doctors, paramedics, and frontline health workers care for us every day. It’s our responsibility to support them by ensuring they feel safe at work.

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