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Sponsored content by UnitedHealthcare, a WBA Associate Member

Now’s the time to start thinking about your employee benefits package and how an Associated Health Plan (AHP), serviced by UnitedHealthcare, could help you save. Gain similar purchasing power advantages and options that larger employers receive when you join other Wisconsin banks by enrolling in our AHP.

Through your enrollment in an AHP, your bargaining position is strengthened to help you obtain more favorable rates. A variety of flexible plan options are available to help balance costs and your administrative costs can be reduced through economies of scale.

And your employees will benefit too. They’ll have access to UnitedHealthcare’s provider network – the largest in Wisconsin – resulting in less disruption and a smoother transition. Wellness programs designed to motivate healthier habits and cost estimator tools to assist with making more informed care choices will help your employees with their overall health and budgetary goals.

The advantages don’t stop there. If you’re looking to add vision to your employee benefits package, UnitedHealthcare has you covered. Like their medical network, UnitedHealthcare has one of the nation’s largest vision networks. That means your employees will have the freedom to visit their favorite provider or retailer for vision services and eyewear needs. Alliances with Warby Parker® and GlassesUSA.com are included.

Learn more by visiting uhc.com/wba.

By BOK Financial Institutions Group

2020 may be behind us, but the year’s historic economic shocks and financial market volatility will leave a lasting impact on our business markets and balance sheets. As we strategize for the future, the importance of a dynamic and scenario-driven ALCO decision-making process is abundantly clear—especially given it may be harder than ever to predict the path ahead, and thus your bank’s performance.

Marginal Momentum

Net interest margin (NIM) is, of course, a key performance metric, especially for community banks. Although NIM compression is not a new topic, banks overall had experienced margin improvement during the 2016–18 FOMC tightening cycle. This was a welcome change from the years of near zero rates and flat margins. The industry’s overall asset sensitivity was on full display as margins peaked to end 2018.

However, looking back at industry trends, banks’ asset sensitivity increased over that period. The opposite tends to occur as well—when rates are low, the thinking is they must go higher, but when rates move higher, no one wants to catch that falling knife. An important takeaway is long-term margin performance suffers from these trends. When margins are improving, more should be done to reduce asset sensitivity and protect margin. The pandemic’s effects have been substantial, but any shift in Fed policy to lower rates can swiftly change a bank’s margin position.

Swirling Tailwinds  

The good news first—it appears as if margins have stabilized a bit, and despite margin pressures, 2020 income was strong. While the Fed has indicated a zero-bound target rate through 2023, the curve has steepened a bit, improving asset yields. The Fed’s bond buying spurred significant housing market activity, refinancing and the related fee income. The government’s programs to stimulate consumer spending and help small businesses have improved economic activity, also boosting fee income.

Now to challenges ahead—the efforts above led to substantial consumer savings, increased business’ cash positions, and delivered a surge in bank deposits. Consumer spending isn’t likely to overshoot, and small business optimism has weakened significantly. Other than PPP lending, consumer and commercial lending has declined, as have overall loan portfolios. Loan-to-deposit ratios have dropped significantly, and legacy assets continue to reprice or roll off all together.

Excess cash build appears to be the most pressing issue. Collective actions have significantly reduced major credit issues, but earnings pressures are mounting. Without participation in new or refinance mortgage origination, and if non-interest income isn’t a significant driver of performance, both margin and income levels will likely struggle in 2021 and beyond.

An ALCO Call to Action  

As we move forward, it is key to work through balance sheet scenarios and incrementally improve margin wherever possible. As we see it, there are three hypothetical scenarios to play out:

  • Scenario 1: Status quo, keep excess cash—this is likely the worst outcome, as NIM shrinks and income declines.
  • Scenario 2: Shrink the balance sheet, reduce deposits, improve NIM as a ratio—in this scenario net income would marginally increase, but sub-optimal.
  • Scenario 3: Deploy excess cash in the loans or securities, incrementally improve NIM—bottom-line net income optimized versus shrinking scenario; plus size and increased capital can maximize future opportunities.

At BOK Financial Institutions Group, our philosophy is to work hand-in-hand with clients, as it’s the strategic decisions we make today that can provide long-term positive momentum. Our team is ready to work with you through balance sheet scenarios to best avoid risks and maximize performance, even in varying interest rate environments.

Contact us at 866.440.6515

Sign up to receive invitations to upcoming webinars offered throughout the year. Go to bokfinancial.com/webinars or scan the QR code.

The opinions expressed herein reflect the judgment of the author(s) at this date, are subject to change without notice, and are not a complete analysis of any sector, industry, or security. The content pro-vided herein does not constitute advice or a recommendation or offer to sell or a solicitation to deal in any security or financial product. It is provided for information purposes only and on the understanding that the recipient has sufficient knowledge and experience to be able to understand and make their own evaluation of the proposals and services described herein, any risks associated therewith and any related legal, tax, accounting or other material considerations. Recipients should not rely on this material in making any future investment decision. To the extent that the reader has any questions regarding the applicability of any specific issue discussed above to their specific portfolio or situation, you are encouraged to consult with a qualified lawyer, accountant, or financial professional.

Certain information displayed herein was obtained from sources we believe to be reliable, but we are unable to offer any guarantees as to its accuracy or completeness.

Bank dealer services offered through Institutional Investments, Bank of Oklahoma, which operates as a separately identifiable trading department of BOKF, NA. Services may be offered under our trade name, BOK Financial Institutions Group. BOKF, NA is the bank subsidiary of BOK Financial Corporation. Some services may be offered through BOK Financial Securities, Inc., member FINRA/SIPC, and an affiliate of BOKF, NA. Investment products are: NOT FDIC INSURED | NO BANK GUARANTEE | MAY LOSE VALUE

BOK Financial Institutions Group is a WBA Gold Associate Member.

The holiday season is at hand, and many Wisconsinites may be modifying plans for travel and celebrations due to COVID-19. With many people staying at home for the holidays, getting or staying healthy is likely top of mind.  

In fact, 53% of Americans plan to make health-related New Year’s resolutions this year, while an equal number have vowed to improve their financial well-being, according to a recent UnitedHealthcare survey. With COVID-19 still spreading in Wisconsin and elsewhere, 10% of survey respondents making health-related resolutions said reducing the risk of catching the virus was their most important health-related resolution, with the most common strategies including improving immune function, wearing a mask when leaving home and frequent handwashing. 

To help people make health a priority while spending more time at home for the holidays, here are four tips to consider:  

Connect with a Primary Care Physician. The number of Americans with a primary care physician has declined recently, with an estimated 25% of people lacking this type of ongoing relationship.  Reversing that trend may be important given people who have a relationship with a primary care physician may be more likely to receive high-value care services, such as preventive cancer screenings, and report better care access and experiences compared to people without a relationship with this type of doctor.  For people who already have a relationship with a primary care physician, some health plans and care providers are offering telehealth appointments, enabling people to remotely visit with a doctor for various types of medical needs, including wellness, routine and chronic condition management. People who do not have a relationship with a primary care doctor are encouraged to check with their health plan to see what options may be available to create a relationship.

Access Other Types of Virtual Care. While virtual care has been historically used to help treat urgent medical issues, including rash, pinkeye and the flu, recent advances are focusing on helping to prevent and detect disease before it starts, while encouraging well-being from head to toe. Some specialists, including cardiologists and dermatologists, are using technology to remotely connect with patients. Other virtual care resources include remote patient monitoring programs that use smartwatches, connected asthma inhalers or continuous glucose monitors to help people better understand how daily habits may influence measures of health, such as the connection between nutrition, activity patterns and blood glucose levels. Plus, the availability of tele-dentistry, tele-eye screenings and tele-hearing programs may make it more convenient to access care and support whole-person health.   

Earn Incentives for Socially Distanced Activities. More than two-thirds of employers plan to expand their well-being programs, with the average annual incentive exceeding $780. Some programs reward people for activities that can be done outside or at home amid COVID-19, such as walking, cycling or using an at-home elliptical. With some gyms closed or people avoiding public venues for exercise, subscribing to a digital fitness app or enrolling in an online weight-loss program may provide additional support and structure. In fact, exercising more (25%) and losing weight (20%) ranked as the top two health-related resolutions, according to the UnitedHealthcare survey.    

Prepare to Use Your 2021 Benefits. This year’s open-enrollment season recently wrapped up for most Americans, which means some people might have a new plan starting New Year’s Day. Before the year is out, take time to review your health plan and check with your employer’s HR department to determine what well-being incentives or other resources might be available when 2021 starts. Many people have spending accounts with funds earmarked for eligible health care services, such as health savings accounts (HSAs) or flexible spending accounts (FSAs). Take time to understand what accounts may be available to you and how you plan to fund – and use – those accounts to help maintain or improve your health. 

The new year often brings optimism; however, for some people resolutions may go unfulfilled. Following these tips may help you achieve your resolutions and help you maintain your health for years to come. 

By, Alex Paniagua

As many people in WI and across the country transitioned to working from home amid COVID-19, office furniture may have been replaced by makeshift desks and household chairs. However, the dining room table or a spot on the couch may not have the same ergonomic design as a traditional office setup, which may have contributed to a spike in low back pain since COVID-19 emerged. 

About 80% of people experience low back issues at least once in their lifetime, with pain ranging from a minor nuisance to a major disability. When severe pain lingers, people may think about seeking a prescription to help – however, clinical guidelines recommend avoiding these medications as the initial treatment for low back pain. Unfortunately, low back pain ranks as a driver of opioid prescriptions in the United States1, and opioid usage comes with possible unnecessary risks of addiction and potential complications. 

While sometimes low back pain can’t be avoided, here are five preventive steps and evidence-based care methods to help address this common issue: 

Focus on Posture. Whether you are now working at the kitchen table or on the couch, focusing on proper posture may help. Make sure you are sitting up straight with your knees at a 90-degree angle, with your shoulders in a straight line over your hips and your ears directly over your shoulders. If you’re working at a computer, adjust the screen height to eye level and consider elevating the keyboard to help keep your hands, wrists and forearms in line and parallel to the floor. Also, note how often you are on the phone, which may contribute to poor neck posture. Instead of tilting your chin down, raise the device to eye level and avoid tucking it between your ear and shoulder, or opt for a speakerphone or headset.

Take Breaks. You may notice you feel sore even if you maintain good posture throughout your workday. If you stay in one spot for too long, your muscles and joints may get stiff. Consider taking quick breaks every 30 minutes to get up and stretch or walk around. This may promote better blood flow for your muscles and joints, and it may also give your eyes and mind a break.

Stay Active. While some people with low back pain may be tempted to consider bed rest, staying active in many cases may be the best option. Low impact activities to consider include walking and swimming, while research indicates that strengthening leg muscles may also prove helpful. You might also try yoga and tai chi, as they’ve been shown to ease moderate to severe low back pain. If time is a factor, a brief walk at lunch or going up and down the stairs a few times can help you stay active.

Eat a Healthier Diet. The bones, muscles, discs and other structures in your back may need proper nutrition to help support your body. Eating a balanced diet rich in fruits, vegetables, lean protein and healthy fats may help reduce inflammation, often a contributing factor to chronic back pain. Eating a healthier diet may also help you maintain a healthy weight, which may also reduce your risk for back pain.

Consider care options. The American College of Physicians (ACP) recommends exercise-based therapies as the first line of treatment. If low back pain persists, ACP encourages the use of nonsurgical options for initial treatment, including physical therapy, chiropractic care, acupuncture and over-the-counter anti-inflammatory drugs. These noninvasive treatment options, which in some cases may be covered by your health benefit plan, may help 95% of people with low back pain recover after 12 weeks. Muscle relaxants should be secondary options, and imaging (such as an MRI) and surgery should be a last resort. However, certain “red-flag” symptoms, such as fever or loss of bladder and bowel control, may require immediate testing and intervention.

Even for people with chronic low back pain, only a small percentage may need more invasive procedures or surgery. Taking preventive steps – and selecting evidence-based care approaches – may help reduce the risks and complications associated with low back pain.

For more information on the WBA Association Health Plan go to www.uhc.com/WBA or contact Brian Siegenthaler at 608-441-1211 or bsiegenthaler@wisbank.com.

  1. OptumLabs. 2018 Opioid KPI Metrics

By, Ally Bates

This year’s flu season may feel a bit different, in the midst of a pandemic. Waking up with a scratchy throat or a fever may have you wondering whether it’s the flu — or this year, COVID-19. Both are respiratory viruses producing similar symptoms, but it’s important to be able to help detect some of the differences.

Understanding the similarities and differences may help you determine which virus you’re dealing with, but you should contact your doctor to help ensure an accurate diagnosis. 

Similarities of COVID-19 and flu

According to the Centers for Disease Control and Prevention (CDC), both the flu and COVID-19 may include these symptoms:

  • Fever or chills
  • Cough
  • Fatigue
  • Sore throat
  • Runny or stuffy nose
  • Muscle pain or body aches
  • Headache
  • Vomiting and diarrhea (though this is more common in children than adults)

Additionally, both viruses may:

  • Spread through droplets released when talking, sneezing or coughing
  • Lead to serious complications for those 65 and older, those with chronic conditions and pregnant women
  • Take one or more days for symptoms to appear, after a person is infected

Different symptoms with COVID-19

“Influenza and COVID-19 share many of the same symptoms. One of the most distinct characteristics that occur with COVID-19 is the sudden loss of taste and smell,” said Dr. Donna O’Shea, medical director for UCS Population Health. “It also may take longer to develop symptoms when you have COVID-19 versus the flu. With flu, symptoms typically develop within four days of infection. With COVID-19, symptoms may appear as late as 14 days after infection. People with COVID-19 may also be contagious and at risk for spreading the virus longer.”

Help protect yourself from flu and COVID-19

While it’s possible to contract the flu all year round, flu viruses are most common in the fall and winter. And with the pandemic still in full force, it may be more important than ever to protect against both viruses.

Dr. O’Shea and Dr. Jennifer Brueckner, leader of the national flu core team for UnitedHealthcare, share five tips to help avoid getting influenza — and COVID-19.

  1. Consider getting your flu shot as soon as possible this fall. You can find a UnitedHealthcare vaccination location here.
  2. Wear a face covering at indoor public places or when you’re within six feet of others and avoid touching your nose, eyes and mouth.
  3. Wash your hands often with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer, if soap and water aren’t available.
  4. Stay home and self-isolate, if you’re feeling symptoms.
  5. Support your overall health by eating healthier, getting adequate sleep and managing your stress levels.

“If you think you have symptoms of the flu or COVID-19, call your doctor,” Dr. O’Shea said. “Most employers and health plans offer 24-hour telehealth providers who can also help you determine the next step that is right for you.”

Taking these precautions is an important step to help prevent the spread of these highly contagious viruses. For more information about COVID-19 vs. the flu, click here.

For more information on WBA Association Health Plan go to www.uhc.com/WBA or contact Brian Siegenthaler at 608-441-1211 or bsiegenthaler@wisbank.com.

By, Ally Bates

The COVID-19 pandemic has prompted many companies in Wisconsin and nationwide to operate differently, presenting new challenges and requiring some to respond to a newly at-home workforce.

Whether employees are working remotely or in-person, this fall’s open-enrollment season for health benefits will likely be different than in the past. In fact, a recent UnitedHealthcare survey found that 44% of respondents expect to change the health plan they select due to COVID-19, including 16% opting for an option with lower out-of-pocket costs and 10% selecting more comprehensive coverage1. More than one-third (35%) of respondents said they expect to spend more time evaluating their benefits this year1, and with good reason: The financial and health care challenges created by COVID-19 may make health benefit decisions especially important.  

In most cases, the practice of employees gathering in a conference room to review health plan options has been postponed. Even before COVID-19, technology was reshaping how many employers select and offer health care benefits to employees, improving access to information and creating a more seamless and interactive health care experience. To help simplify the health care experience for employees, support their well-being and potentially curb costs, here are five tips Wisconsin employers should consider during open enrollment and year-round.

Help Improve Health Care Literacy: According to a UnitedHealthcare survey, more than 78 percent of Americans say they are prepared for open enrollment1, yet previous research has shown that some people struggle to fully understand common health care terms and concepts, including plan premium, deductible, and co-insurance. Employers may help improve “health care literacy” by sharing public resources such as JustPlainClear.com, which provides definitions for thousands of common health care terms in English, Spanish and Portuguese.

Make Virtual Care a Priority: Given COVID-19 has changed how and where people obtain health care services, it may be important to offer a health plan that includes coverage for virtual care, ideally including options for telehealth visits with their own doctors and 24/7 access to a national provider network. If fact, the use of virtual care resources has surged more than 10-fold compared to 20192, enabling some people to connect with a health care provider via a smartphone, tablet or personal computer. Telehealth resources are designed to be a more convenient way to visit with a doctor about various health issues, ranging from urgent and routine care, on-going chronic condition management, behavioral health and specialty care such as oral and eye health. 

Leverage Big Data: Employers now have important access to online resources that may enable managers to analyze and make sense of health data, taking into account aggregate medical, prescription and specialty claims, demographics, and clinical and well-being information. This may provide an analytics-driven roadmap to help employers implement tailored clinical management and employee-engagement programs, which may help improve health outcomes, mitigate expenses, and help employees take charge of their health.    

Encourage Employees to Move More: Some health plans offer programs for employers that may enable their employees to earn financial incentives, such as gift cards or deductible credits, for completing health assessments, signing up for health coaching, lowering cholesterol, going to gyms or using fitness trackers to monitor daily movement. For instance, employers may be able to provide virtual programs that give employees personalized, interactive online weight loss and exercise support, while other initiatives may provide various wearables to help with the early detection of COVID-19 and assist people during recovery (if needed).

Bundle Benefits: While many people may focus on medical coverage during open enrollment, it may be important that employees avoid overlooking specialty benefits such as vision, dental, hearing and accident protection. In fact, the recent UnitedHealthcare survey found that 84% of employees said having access to specialty benefits is “important.1” Plus, companies that combine medical coverage with specialty benefits through a single health care company may be able to leverage data to help improve health outcomes, flag gaps in care, drive productivity, and reduce costs3. Some “bundle and save” programs enable employers to save up to possibly 4% on medical premiums* through administrative efficiencies and proactive clinical interventions.  

By considering these tips, employers may help increase employee retention, satisfaction and build a culture of well-being.

*Savings may differ depending on the employer size, plans chosen and premiums; program may not be available in all states or for all employer sizes. 

For more information on the WBA Association Health Plan go to www.uhc.com/WBA or contact Brian Siegenthaler at 608-441-1211 or bsiegenthaler@wisbank.com.

  1. UnitedHealthcare Consumer Sentiment Survey of more than 1,000 Americans, 2020, https://newsroom.uhc.com/2020-consumer-survey.html 
  2. UnitedHealthcare internal analysis, 2020
  3. UnitedHealthcare 2019 BoB performance for clients with integrated UnitedHealthcare Specialty and UnitedHealthcare Medical; based on elected Specialty products.

By, Ally Bates

The on-going COVID-19 emergency continues to change the way Americans live and work, while altering how people navigate the health system. Given more than half of Americans have health care benefits through their place of work,1 employers are uniquely positioned to help employees maintain or improve their well-being during these difficult times.

Enter telehealth, an increasingly popular option for medical advice amid the COVID-19 situation. Previously overlooked by some employees, local physicians and national telehealth providers are seeing a significant surge in appointments as more people use digital devices to access care and medical advice virtually, including with behavioral health specialists and physical, occupational and speech therapists. The motivation: Improving access to more affordable, convenient routine and preventive care, while reducing potential exposure risks to COVID-19 associated with in-person trips to health care facilities.

As employees enter the fall’s annual open enrollment season to select health benefits for next year, more than half of companies report that virtual solutions rank as a top health priority.2 Among consumers, a recent UnitedHealthcare survey found that 91% of respondents are interested in using telehealth resources in the future.3

Here are strategies employers may consider to help maximize the value of this technology: 

Start or Expand Access: Most large employers offer at least some type of telehealth benefit to their employees,4 so improving employee awareness and use of this technology should be a priority. Corporate executives and human resources leaders at companies of all sizes should continue to evaluate what telehealth options may be currently available to employees through their health plan, local care providers or other telehealth service providers. To help make these resources more convenient, some options give employees 24/7 access to virtual visits that – while unable to diagnose or treat COVID-19 – can provide medical advice related to this condition (including guidance for in-person testing and treatment, if needed) and other health issues such as allergies, rashes or flu. Currently, some health plans are waiving member cost-sharing for telehealth visits, including those related to COVID-19.  

Consistently Communicate: Employers may consider creating consistent – and customized – communication strategies to help encourage the adoption of telehealth resources, especially in connection to COVID-19 and the management of certain chronic conditions. To help encourage people to start and continue using telehealth resources, some employers send out welcome kits, monthly email reminders and direct-mail materials that highlight the potential convenience, flexibility (24/7 or scheduled appointments) and affordability of this technology. Tailored communication strategies – informed by deidentified claims data – may help more employees access relevant resources.  

Offer Incentives: In general, people may be motivated by a combination of intrinsic factors, such as wanting to help maintain or improve personal health and avoid disease, and extrinsic ones, such as financial rewards. To help encourage the latter, employers may consider offering employees financial incentives for using telehealth resources.* For instance, across a group of small, mid-sized and large employers, employees had the opportunity to receive a $5 pre-paid gift card for completing a virtual visit registration, helping generate a 40% increase in sign-ups compared to a control group.5

Add Virtual Wellness Programs: Besides telehealth, employers may consider adding or expanding virtual wellness programs, including ones that are designed to help employees prevent or better manage certain chronic conditions (such as diabetes or obesity) that may be risk factors for complications related to COVID-19.6 For instance, employers may be able to provide virtual programs that give employees personalized, interactive online weight loss and exercise support, which may help motivate people to get active. With some people skipping gyms and other public exercise facilities, at-home support programs and digital fitness resources may be increasingly valuable. Plus, employers may consider telephonic programs that connect people with licensed counselors to help address various issues, including family and marriage difficulties, alcohol or substance misuse, and depression or stress.  

Driving more consistent use of virtual resources may encourage healthier and more productive employees, including helping address the recent decline in preventive services and support people with the management of certain chronic conditions – all with relatively minimal missed time from work. At the same time, telehealth may contribute to curbing health care costs by helping people avoid potentially riskier in-person health care settings amid the COVID-19 emergency and in the future. 

For more information on the WBA Association Health Plan go to www.uhc.com/WBA or contact Brian Siegenthaler at 608-441-1211 or bsiegenthaler@wisbank.com.

  1. United States Census Bureau, 2019, https://www.census.gov/library/publications/2019/demo/p60-267.html
  2. National Business Group on Health, 2019, https://www.businessgrouphealth.org/pub/?id=6B0FADBD-0570-B014-6775-E3C8413D3233 
  3. UnitedHealthcare Consumer Sentiment Survey of more than 1,000 American adults, 2020
  4. Mercer, 2019, https://www.mercer.com/newsroom/mercer-survey-finds-us-employers-shifting-to-innovative-strategies-to-make-healthcare-more-affordable-for-more-employees.html 
  5. UnitedHealthcare internal analysis of more than 90,000 small employers spanning small businesses, key accounts, national accounts and public sector employers, 2020  
  6. Centers for Disease control and Prevention, 2020, https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-higher-risk.html

*Financial incentives may be less or unavailable due to limits under applicable laws.

By, Ally Bates

While some people with a COVID-19 infection may experience relatively mild symptoms (or no symptoms at all), the disease is of greater concern for the 56% of Americans that may have at least one risk factor linked to an increased chance of complications.1

Two increasingly common risk factors for COVID-19 are obesity and Type 2 diabetes, which are in some cases preventable or reversible.2 As the COVID-19 situation evolves, it is important to recognize that daily decisions related to diet and activity may make a difference in the severity of infection. Research shows people with existing diabetes whose blood sugar is well controlled may require fewer medical interventions and are more likely to recover from COVID-19.3

With health now top of mind for many Americans, hopefully these challenging times can serve as a spark to help our nation address its long-standing chronic disease epidemic, which affects more than 196 million people4 and accounts for over $3 trillion in annual health care costs.5

Here are tips to consider related to obesity and Type 2 diabetes amid the COVID-19 pandemic: 

Monitor Your Body Mass: While body mass index (BMI) has potential shortcomings, especially for athletes such as weightlifters, this calculation of height compared to weight may provide a helpful measure to monitor. In fact, people with even moderately elevated BMI levels may have an increased risk of developing complications related to diabetes.6 To monitor your BMI, check with your primary care physician or use an online calculator.

Use Interval Eating: The cliché “you are what you eat” rings true when it comes to preventing or managing obesity and diabetes, but when and how you eat also may be relevant. Also called intermittent fasting or time-restricted eating, this approach alternates periods of fasting and non-fasting during the day or across the week. Lifestyle changes to consider include waiting at least an hour after waking up before eating breakfast and avoiding food within three hours of sleep. In addition, people may consider the order in which they eat food, starting each meal with a lean protein (chicken, fish or turkey), followed by a vegetable (asparagus, broccoli or carrots) and ending with a carbohydrate (beans, brown rice or sweet potato). This ordered approach may lead to lower post-meal glucose and insulin levels for people with Type 2 diabetes.7        

After-Meal Walks: People seeking to better control their blood sugar levels and weight should also consider short walks after eating meals or snacks, especially ones with added sugars such as juice or desserts. Post-meal walks may help the body move sugar from the blood into muscle cells, helping normalize blood sugar levels. Whenever possible, make time for a 15-minute walk after each meal to help reduce the risk of blood sugar spikes.8

Take Advantage of Technology: Smartwatches and activity trackers are potential resources to help monitor various health measures, including daily steps, sleep patterns and blood sugar levels. Recently, some people with diabetes have started using continuous glucose monitors. This technology, which uses a sensor often worn on the abdomen, continuously reads glucose levels and transmits the data to a smartphone. This may give users and health care providers important information in real time, helping reveal relationships between eating, exercise and blood sugar that may be difficult to observe with only test strips and a glucose meter. While these devices may cost $500 or more and require a prescription, some health plans in Wisconsin are starting to provide these at no additional cost to members as part of diabetes management programs. 

COVID-19 may be creating stress for many Americans, especially people with chronic health conditions. By considering these tips, these challenging times may serve as a catalyst for people to improve their health and reduce the possible risk of complications from COVID-19.

For more information on WBA's Association Health Plan go to www.uhc.com/WBA or contact Brian Siegenthaler at 608-441-1211 or bsiegenthaler@wisbank.com.

1. MedRxiv, 2020, https://www.medrxiv.org/content/10.1101/2020.05.02.20088781v1
2. Newcastle University, 2017, https://www.sciencedaily.com/releases/2017/09/170913084432.htm 
3. Cell Metabolism, 2020, https://www.cell.com/cell-metabolism/fulltext/S1550-4131(20)30238-2
4. Rand Corporation, 2017, https://www.rand.org/pubs/tools/TL221.html
5. Centers for Disease Control & Prevention, 2020, https://www.cdc.gov/chronicdisease/about/costs/index.htm
6. Southern Medical Journal, 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4457375/
7. Weill Cornell Medical College, 2015, https://news.weill.cornell.edu/news/2015/06/food-order-has-significant-impact-on-glucose-and-insulin-levels-louis-aronne
8. Borror, A., Zieff, G., Battaglini, C., & Stoner, L. (2018). The effects of postprandial exercise on glucose control in individuals with type 2 diabetes: a systematic review. Sports Medicine, 48(6), 1479-1491.

By, Ally Bates

With the COVID-19 emergency prompting people to stay home more than usual, accessing in-person health care services has become more challenging than a few months ago. 

That has spurred a surge in telehealth appointments, with new state and federal regulations making it easier and more affordable for people to use digital devices to access medical advice related to COVID-19 and a myriad of other health issues. 

While this is a positive development, there are other potentially overlooked ways to access medical care remotely and use technology to cultivate healthier habits at home. These resources may help encourage whole-person health while reducing the risk of possible exposure to COVID-19 associated with in-person care appointments. 

Here are several strategies to consider: 

Physical Health: Nearly three-quarters (73%) of employers offer health and wellness programs, including some with virtual resources that help prevent or better manage certain chronic conditions (such as diabetes or obesity) that may be risk factors for complications related to COVID-19. People can check with their employer or health plan for virtual programs that provide personalized, interactive online weight loss support aimed at motivating individuals to improve their nutrition and get active. With many gyms and other exercise facilities currently closed, at-home support programs are increasingly valuable. Plus, people may consider telephonic programs to connect with a licensed counselor to help address various issues, including family and marriage difficulties, alcohol or substance misuse, and depression or stress. 

Eye Health: People should also take note of their eye health while spending more time at home, in part because of the link between screen use and digital eye strain. Research shows the prolonged use of computers and smartphones may cause symptoms such as headache or sore neck, shoulder or back. To help prevent these symptoms, people should consider keeping computer screens at least 30 inches away from their eyes, resting their eyes every 20 minutes, and blinking frequently to avoid dry eyes. People may consider prescription glasses that help filter "blue light," which is emitted by digital devices and may contribute to eye strain. Also, for the 150 million Americans who use corrective eyewear, online retailers enable people to order glasses from the comfort of their homes, in some cases offering "virtual mirrors" or apps that allow users to extract their prescription from their current glasses. 

Dental Health: With many dentist offices postponing routine cleanings during the COVID-19 emergency, people should consider focusing on recommended at-home hygiene habits. This includes brushing twice a day for two minutes with a fluoridated toothpaste, daily flossing, the use of an alcohol-free mouthwash, a tongue scraper, and water flosser. The recent emergence of "teledentistry" may also help people access dental advice and guidance to care, in part to avoid often unnecessary emergency room visits for oral health concerns. And, because many social events are also being postponed, now may be the time for people to improve their smiles. Teledentistry may enable people to straighten their teeth without the need for an in-person dental appointment, using direct-to-consumer clear aligners that offer improved convenience and savings for orthodontic care. 

Hearing Health: There are also online resources that may be helpful for the estimated 48 million Americans with some degree of hearing loss, a condition that may be linked to depression, dementia, and increased risk of falls. People initially can use free online screeners if they suspect signs of hearing loss but are not ready for an in-person hearing test. For people who have previously had a hearing test—but have not yet moved forward with treatment—home-delivery options may make it more convenient and affordable to order hearing aids without an in-person appointment with a health care professional. 

With a greater focus for many people on practicing healthier habits to help maintain or improve well-being during these challenging times, considering these tips and remote care strategies may prove beneficial amid the COVID-19 emergency, and in the future. 

For more information on WBA Association Health Plan go to www.uhc.com/WBA or contact Brian Siegenthaler at 608-441-1211 or bsiegenthaler@wisbank.com.

Dr. Docimo is chief medical officer at UnitedHealthcare

By, Amber Seitz