Perhaps at no time in recent history have more people been talking about the changing health insurance landscape. Cheryl A. Howe is executive vice president for operations at HealthNow, the region’s largest health insurer. Howe sat down with The Buffalo News’ Brian Meyer to talk about recent reform initiatives, efforts to contain costs and other issues. Watch the full six-minute interview at

Meyer: How do we do the balancing act between providing quality health care and yet curbing these spiraling health care costs?

Howe: It’s a very good question, and we’re focused on that. Every year as we submit our rates for approval, we look at the trends in the industry. We pay particular attention to the costs of health care. We take a historical look to see where we’re paying for medical care and predicting what we think that might be in the upcoming year. Given that, we do have very robust case and disease management programs within the company that really help to curb the cost of health care. Most recently, you probably had heard about our relationship with Kaleida. That partnership is also intended to bring the physician, the hospital and the payer together to deliver high-quality, low-cost health care.

Meyer: What are the trends as it relates to insurance rates? Because a lot of people are just frightened to hear these statistics.

Howe: The trends we’re seeing, you know, years ago they were very high – double digits. And everybody now is focused on trying to get to a single-digit rate increase. Is it where we would like it to be? I think there’s always room for lowering the trend. But there also is an opportunity for us as consumers to take more control over our own health and try to live a healthier life. That will also help to bring the costs of health care down.

Meyer: The so-called wellness mantra that we’ve heard so much about, is that overblown? A lot of people are saying: “Wait a minute, are you telling me that eating better is going to make a dramatic difference in my health care premiums?”

Howe: Over time, I think that having the awareness with people focusing on maintaining good health, even understanding where you are in your health continuum: Do you know your numbers? Do you exercise? All of those things definitely have an impact. You know, the majority of the population is healthy. It’s the very small numbers that really contribute to the high-cost cases that we see in health insurance.

Meyer: One might think many of these people would be least likely to be thinking about nutrition programs, exercise or that type of wellness.

Howe: I think that we’re seeing a shift as employers start to shift the cost of health care on to the employee. People are looking for more reasons to try to lead a healthier life. And I think that’s where we’ve been very successful in trying to guide them through it – through case and disease management. We have many work site wellness programs where we actually customize. We look at what are the needs of that particular employer group. We customize a program just for them so that we can try to address the concerns of all employees and get them healthy and keep them healthy.