Eugene F. Yen, M.D.

Eugene F. Yen, M.D.

Eugene F. Yen, M.D.

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Personal Bio

Treatment Philosophy

I have specialty training in colon cancer prevention and the management of patients with Inflammatory Bowel Disease. In addition, I am actively involved in research in microscopic colitis as well as Clostridium difficile infection. I lead an active research team and am also involved in clinical trials for ulcerative colitis and Crohn’s disease. I pride myself on being readily accessible to accommodate the needs of my patients, and am involved in educating my peers as well as patients on the complex nature of IBD.

Conditions & Procedures

Conditions

Celiac Disease, Colitis, Collagenous Colitis, Colorectal Cancer, Crohn's Disease, Inflammatory Bowel Disease (IBD), Lymphocytic Colitis, Microscopic Colitis, Pregnancy and Inflammatory Bowel Disease (IBD), Ulcerative Colitis

Procedures

Barryx, Bravo Placement, Chromoendoscopy, Colonoscopy, Confocal Laser Endomicroscopy, Endoscopic Retrograde Cholangiopancreatography (ERCP), Endoscopic Retrograde Cholangiopancreatography (ERCP) with sphinterotomy and/or stent placement, Esophageal Stent Placement, Flexible Sigmoidoscopy, Radiofrequency Ablation, Small Bowel Enteroscopy, Tumor Ablation, Upper Endoscopy

General Information

Gender

Male

Affiliation

NorthShore Medical Group

Expertise

Crohn's Disease, Ulcerative Colitis, Microscopic Colitis

Academic Rank

Clinical Assistant Professor

Languages

English

Board Certified

Gastroenterology, Internal Medicine

Education, Training & Fellowships

Medical School

Tufts University, School of Medicine, 2001

Internship

Barnes-Jewish Hospital, 2002

Residency

Barnes-Jewish Hospital, 2004

Fellowship

University of California San Francisco, 2007

Locations

A

NorthShore Medical Group

1000 Central St.
Suite 615
Evanston, IL 60201
847.657.1900 847.733.5041 fax Get Directions This location is wheelchair accessible.
B

NorthShore Medical Group

2150 Pfingsten Rd.
Suite 3000
Glenview, IL 60026
847.657.1900 847.570.5041 fax Get Directions This location is wheelchair accessible.

Insurance

Commercial Plans - Employer Sponsored
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Choice POS II
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SPECIALTY CARE
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Aetna Health Network Only
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Aetna HMO
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Aetna Managed Choice
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Aetna Network Options
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Aetna Open Access Aetna Select
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Aetna Open Access Managed Choice
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Aetna Open Choice PPO
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Aetna Savings Plus
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Aetna Select
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Aetna Sub- Cofinity
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Aetna Sub- First Health
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SPECIALTY CARE
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Aetna Traditional Choice-Indemnity Plan
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SPECIALTY CARE
HOSPITALS
Aetna Whole Health Chicago (All Metal Tiers)
Not Available In 2017
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SPECIALTY CARE
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Beechstreet PPO Network
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Blue Cross Blue Shield Blue Advantage HMO
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Blue Cross Blue Shield Blue Choice Options
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Verify PCP Participation
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Blue Cross Blue Shield BlueCare Direct (All Metal Tiers)
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Blue Cross Blue Shield PPO Value Choice
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Cigna Exclusive Provider Organization EPO
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Cigna Medical Open Access POS
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Cofinity PPO (an Aetna Company)
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Coventry Consumer Choices (C3)
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Coventry PPO
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Galaxy Health Network
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Health Alliance HMO, PPO, POS, POS-C
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Health Link HMO
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Health Link PPO
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Health Link-Open Access I, II, III
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Healthcare's Finest Network- FHN 10 & 20
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Healthcare's Finest Network- FHN Platinum
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Humana Advocate Centered EPO
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Humana Edward- Elmhurst Value HMO
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Available In 2017
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Humana Level Funded Premium
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Humana Simplicity (HMO, POS, PPO)
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Humana Total Health (100 or more employees)
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Multiplan/ PHCS- Health EOS Network
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Multiplan/ PHCS- MultiPlan Complementary
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Multiplan/ PHCS- MultiPlan Limited Benefit Plan
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Multiplan/ PHCS- MultiPlan Practitioner Only
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Multiplan/ PHCS- MultiPlan Shared Savings
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Multiplan/ PHCS- PHCS Healthy Directions
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Multiplan/ PHCS- PHCS Practitioner Only
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Multiplan/ PHCS- PHCS Savility
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Multiplan/ PHCS- ValuePoint by MultiPlan
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NorthShore Employee Network
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Preferred Network Access
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Preferred Plan- HealthSmart Get Better
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Preferred Plan PPO
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Stratose- National Preferred Provider Network
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Three Rivers Provider PPO Network (TRPN)
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UniCare HMO
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UniCare HMO Performance Select
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Unicare PPO
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UniCare Travel Access
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United Healthcare Catalyst
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United Healthcare Choice
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United Healthcare Heritage
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United Healthcare Multi-Choice
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United Healthcare Navigate and Navigate Plus
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United Healthcare Options Non-Differential PPO
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United Healthcare Options PPO
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United Healthcare Tiered Benefits
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Exchange Plans
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Aetna Whole Health Chicago (All Metal Tiers)
Not Available In 2017
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Aetna Whole Health Chicago Bronze Deductible Only HSA Eligible
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Ambetter Balance Care 10+ Vision+ Adult Dental
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Ambetter Balanced Care 1
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Ambetter Balanced Care 1+ Vision+ Adult Dental
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Ambetter Balanced Care 10
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Ambetter Balanced Care 2
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Ambetter Balanced Care 2+ Vision+ Adult Dental
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Ambetter Essential Care 1
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Ambetter Secure Care 1 w/ 3 Free PCP Visits
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Blue Cross Blue Shield Basic 103 Multi-State Plan
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Blue Cross Blue Shield Blue Choice Preferred PPO (Plan #'s 101-107; All Metal Tiers)
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HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Choice Preferred Security PPO 100
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Blue Cross Blue Shield Blue Precision HMO (Plan #'s 101-103; All Metal Tiers)
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Blue Cross Blue Shield Blue Premier 101 Multi-State Plan
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Blue Cross Blue Shield BlueCare Direct with Advocate (Plan #'s 101-103; All Metal Tiers)
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Blue Cross Blue Shield Solution 102 Multi-State Plan
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Coventry $15 Copay; Silver & Gold
Not Available In 2017
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Coventry Bronze $ 20 Copay
Not Available In 2017
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Coventry Bronze $10 Copay Carelink St. John's
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Coventry Bronze $15 Copay Carelink St. John's
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HOSPITALS
 
 
 
Coventry Bronze Deductible Only HSA Eligible
Not Available In 2017
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HOSPITALS
Harken Health - an Affiliate of United Healthcare
Verify physician participation and out of pocket expenses with Harken
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Health Alliance HMO (All Metal Tiers)
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Health Alliance POS (All Metal Tiers)
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Health Alliance PPO (All Metal Tiers)
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Humana Chicago HMOx (All Metal Tiers)
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Land of Lincoln Health Traditional PPO
Plan Ending 9/30/16
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United Healthcare Compass (All Metal Tiers)
Not Available In 2017
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Medicaid
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Aetna Better Health FHP
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Aetna Better Health ICP
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Blue Cross Blue Shield Community FHP
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Blue Cross Blue Shield Community ICP
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Cigna HealthSpring ICP
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Community Care Alliance- ICP
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Family Health Network- FHP
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Harmony/WellCare FHP Plan
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Humana ICP
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Illinicare Family Health Plan (FHP/ACA)
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Illinicare ICP
Primary Care- Current Patients Only
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Illinois Department of Public Aid (IDPA)
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Meridian FHP/ACA Expansion
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Meridian ICP
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Molina ICP
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Next Level ACA/FHP
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Medicare Advantage Plans
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Aetna Medicare (SM) Plan (HMO)
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Aetna Medicare (SM) Plan (PPO)
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Aetna Medicare Advantage Group Plans
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Aetna Medicare Connect Plus (PPO)/PPO Connect Plus
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Aetna Medicare Standard Plan (PPO)/PPO Standard Plan
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Aetna Medicare Value Plan (HMO)/HMO Value
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Aetna Medicare Value Plan (PPO)/PPO Value Plan
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Aetna Traditional Choice Plan
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Blue Cross Blue Shield Medicare Advantage Basic HMO
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Blue Cross Blue Shield Medicare Advantage Basic Plus HMO-POS
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Blue Cross Blue Shield Medicare Advantage Choice Plus PPO
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Blue Cross Blue Shield Medicare Advantage Choice Premier PPO
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Cigna-HealthSpring Advantage HMO
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Cigna-HealthSpring Premier HMO-POS
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Cigna-HealthSpring Primary HMO
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Cigna-HealthSpring TotalCare HMO-SNP
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Community Care Alliance Complete HMO-D-SNP
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Community Care Alliance HMO
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Harmony/WellCare Access (HMO-SNP)
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Harmony/WellCare Choice (HMO-POS)
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Harmony/WellCare Health Plan
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Harmony/WellCare RX (HMO)
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Harmony/WellCare Value (HMO-POS)
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Harmony/WellCare-Medicare HMO Plans
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Harmony/WellCare-Medicare Special Needs Plans
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Humana Choice PPO
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Humana Community HMO Diabetes and Heart (SNP Program)
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Humana Gold Plus HMO
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Humana Gold Plus PFFS
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Meridian Medicare Advantage
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Molina Medicare Advantage
PRIMARY CARE
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United Healthcare - AARP Medicare Complete
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United Healthcare AARP Medicare Complete Access
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United Healthcare- AARP Medicare Complete Plus (HMO-POS)
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United Healthcare Medicare Advantage Focus
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United Healthcare- Medicare Solutions/Medicare Advantage
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Medicare Medicaid Alignment Initiative (MMAI) Plans
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Aetna Better Health MMAI
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Blue Cross Blue Shield Community MLTSS/LTSS
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Blue Cross Blue Shield Community MMAI
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Cigna-HealthSpring MMAI
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Humana MMAI
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Illinicare MLTSS/LTSS
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Illinicare MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Meridian MMAI
PRIMARY CARE
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HOSPITALS
Molina MMAI
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HOSPITALS
 
 
 
Commercial - Individual Plans
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Bronze Deductible Only HSA Eligible Savings Plus OAMC PD
Not Available In 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Bronze Deductible Only HSA Eligible Savings Plus OAMC- PD
Not available for 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Aetna Savings Plus OAMC PD ( All Metal Tiers)
Not available for 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Savings Plus OAMC PD (All Metal Tiers)
Not Available In 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Whole Health Chicago (All Metal Tiers)
Not available for 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Whole Health Chicago Bronze Deductible Only HSA Eligible
Not available for 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Ambetter Balanced Care 1
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 1+ Vision+ Dental
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 10
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 10+ Vision+ Dental
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 2
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 2+ Vision+ Dental
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Essential Care 1
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Secure Care 1 w/ 3 Free PCP Visits
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Choice Preferred PPO (Plan #'s 101-107; All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Choice Preferred Security PPO 100
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
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Publications

  • Rectal Optical Markers for In Vivo Risk Stratification of Premalignant Colorectal Lesions.

    Clinical cancer research : an official journal of the American Association for Cancer Research 2015 Oct 1

    Authors: Radosevich AJ, Mutyal NN, Eshein A, Nguyen TQ, Gould B, Rogers JD, Goldberg MJ, Bianchi LK, Yen EF, Konda V, Rex DK, Van Dam J, Backman V, Roy HK
    Abstract
    Colorectal cancer remains the second leading cause of cancer deaths in the United States despite being eminently preventable by colonoscopy via removal of premalignant adenomas. In order to more effectively reduce colorectal cancer mortality, improved screening paradigms are needed. Our group pioneered the use of low-coherence enhanced backscattering (LEBS) spectroscopy to detect the presence of adenomas throughout the colon via optical interrogation of the rectal mucosa. In a previous ex vivo biopsy study of 219 patients, LEBS demonstrated excellent diagnostic potential with 89.5% accuracy for advanced adenomas. The objective of the current cross-sectional study is to assess the viability of rectal LEBS in vivo.
    Measurements from 619 patients were taken using a minimally invasive 3.4-mm diameter LEBS probe introduced into the rectum via anoscope or direct insertion, requiring approximately 1 minute from probe insertion to withdrawal. The diagnostic LEBS marker was formed as a logistic regression of the optical reduced scattering coefficient [Formula: see text] and mass density distribution factor D.
    The rectal LEBS marker was significantly altered in patients harboring advanced adenomas and multiple non-advanced adenomas throughout the colon. Blinded and cross-validated test performance characteristics showed 88% sensitivity to advanced adenomas, 71% sensitivity to multiple non-advanced adenomas, and 72% specificity in the validation set.
    We demonstrate the viability of in vivo LEBS measurement of histologically normal rectal mucosa to predict the presence of clinically relevant adenomas throughout the colon. The current work represents the next step in the development of rectal LEBS as a tool for colorectal cancer risk stratification.
    PMID: 25991816 [PubMed - as supplied by publisher]
  • Non-IBD colitides (eosinophilic, microscopic).

    Best practice & research. Clinical gastroenterology 2012 Oct

    Authors: Yen EF, Pardi DS
    Abstract
    Microscopic colitis includes the terms lymphocytic colitis and collagenous colitis, and is a common cause of chronic diarrhoea in older adults. The incidence of microscopic colitis has increased over time and has reached levels comparable to other forms of inflammatory bowel disease. In this chapter, an updated review on the epidemiology, diagnosis and treatment of microscopic colitis has been provided. There is limited data available about eosinophilic colitis, which is the least common of the eosinophilic GI disorders. It is important to rule out the secondary causes of colonic eosinophilia in patients with suspected eosinophilic colitis.
    PMID: 23384806 [PubMed - as supplied by publisher]
  • Current and past cigarette smoking significantly increase risk for microscopic colitis.

    Inflammatory bowel diseases 2012 Oct

    Authors: Yen EF, Pokhrel B, Du H, Nwe S, Bianchi L, Witt B, Hall C
    Abstract
    Cigarette smoking is an important environmental factor affecting inflammatory bowel disease. The role of smoking has not been rigorously studied in microscopic colitis (MC). The aim of this study was to compare the association of cigarette smoking in individuals with MC compared to a control population without MC.
    We reviewed the records of patients with a clinical and histologic diagnosis of collagenous colitis (CC) or lymphocytic colitis (LC). Clinical history, including alcohol and smoking status at the time of diagnosis of MC, were reviewed. In this case-control study, age- and gender-matched patients without diarrhea presenting for outpatient colonoscopy served as the control population.
    We analyzed a total of 340 patients with MC: 124 with CC and 216 with LC. Overall, any smoking status (former or current) was associated with MC (odds ratio [OR] 2.12, 95% confidence interval [CI]: 1.56-2.88). This risk was more prominent in current smokers (adjusted OR 5.36, 3.81, and 4.37 for CC, LC, and all MC, respectively, 95% CI all greater than 1). The association of smoking was not significantly affected by gender or average alcohol consumption.
    In our study population, cigarette smoking is a risk factor for the development of both forms of microscopic colitis. There were no significant differences between LC and CC, and current smoking and the development of microscopic colitis affected men and women similarly. We feel that these data are sufficient to discuss the potential risks of tobacco use in patients with microscopic colitis.
    PMID: 22147506 [PubMed - as supplied by publisher]
  • Decreased colorectal cancer and adenoma risk in patients with microscopic colitis.

    Digestive diseases and sciences 2012 Jan

    Authors: Yen EF, Pokhrel B, Bianchi LK, Roy HK, Du H, Patel A, Hall CR, Witt BL
    Abstract
    Microscopic colitis is currently considered to harbor no increased risk for colorectal cancer, based on a few small studies with limited long-term follow-up. Our aim was to identify patients with microscopic colitis, and to compare long-term rates of colorectal cancer or adenoma to a control group of patients without microscopic colitis.
    We reviewed the records of patients diagnosed with microscopic colitis, as identified by a hospital-based pathology database from January 2000 to August 2008. Clinical factors, including history of adenoma or adenocarcinoma, and all colonoscopy findings, were recorded. Age and gender-matched patients without microscopic colitis served as the control in a 1:1 fashion.
    A total of 647 patients (153 male: 494 female) were identified with microscopic colitis (MC). Any history of colorectal cancer was detected in 1.92, 1.81, and 4.17% of patients with collagenous colitis (CC), lymphocytic colitis (LC), and controls, respectively (P = 0.095, P = 0.040, P = 0.015 for CC, LC, and all MC, respectively, comparing to controls). Overall, covariate-adjusted risk (odds ratio) of any history of colorectal cancer and colorectal adenoma in MC patients was 0.34 (95% confidence interval [CI] 0.16-0.73, P = 0.006) and 0.52 (95% CI 0.50-0.76, P < 0.0001), respectively. The mean duration of follow-up was 4.63 years, with 147/647 (22.7%) of patients with clinical follow-up >7 years.
    In this case-control study involving a large retrospective cohort, microscopic colitis is negatively associated with the risk for colorectal cancer and adenoma. Further studies are required to determine a temporal relationship between microscopic colitis and the future development of colorectal neoplasia.
    PMID: 21847567 [PubMed - as supplied by publisher]
  • Review of the microscopic colitides.

    Current gastroenterology reports 2011 Oct

    Authors: Yen EF, Pardi DS
    Abstract
    Microscopic colitis is a common cause of chronic diarrhea in predominantly older adults. Incidence rates of microscopic colitis (including lymphocytic and collagenous colitis) have increased over time to levels comparable to other forms of inflammatory bowel disease. The possibility of drug-induced microscopic colitis is an important consideration when evaluating these patients, although this concept requires further investigation. There are few controlled treatment trials in microscopic colitis, with much of the data on treatment coming from retrospective studies. In patients with microscopic colitis, a systematic approach to therapy often leads to satisfactory control of symptoms. In this review, we will provide an updated assessment of the epidemiology, diagnosis, and treatment of microscopic colitis.
    PMID: 21773709 [PubMed - as supplied by publisher]
  • Review article: Microscopic colitis--lymphocytic, collagenous and 'mast cell' colitis.

    Alimentary pharmacology & therapeutics 2011 Jul

    Authors: Yen EF, Pardi DS
    Abstract
    Microscopic colitis is a relatively common cause of chronic diarrhoea in predominantly older adults, traditionally termed lymphocytic colitis and collagenous colitis. Increased mast cells found in the colonic biopsies of some patients with chronic diarrhoea may represent a distinct type of microscopic colitis.
    To provide an updated review of the epidemiology, diagnosis and treatment of microscopic colitis, and to discuss the role of mast cells in the gastrointestinal tract and their potential role in cases of functional diarrhoea.
    A MEDLINE literature search was performed to identify pertinent articles. Relevant clinical abstracts were also reviewed.
    Incidence rates of microscopic colitis (lymphocytic and collagenous colitis) have increased over time, to levels comparable with other forms of inflammatory bowel disease. The possibility of drug-induced microscopic colitis and concomitant coeliac sprue are important considerations when evaluating these patients. There are few controlled treatment trials in microscopic colitis, with much of the data on treatment coming from retrospective studies. Mast cells have been implicated in functional bowel disorders, with increased mast cells possibly contributing to cases of otherwise unexplained chronic diarrhoea, although this concept requires further investigation.
    In patients with microscopic colitis, a systematic approach to therapy often leads to satisfactory control of symptoms. The role of mast cells in chronic diarrhoea represents an evolving field, with the potential to offer alternative treatment pathways in patients with otherwise unexplained functional diarrhoea.
    PMID: 21545473 [PubMed - as supplied by publisher]
  • Cost-effectiveness of 5-aminosalicylic acid therapy for maintenance of remission in ulcerative colitis.

    The American journal of gastroenterology 2008 Dec

    Authors: Yen EF, Kane SV, Ladabaum U
    Abstract
    Oral 5-aminosalicylic acid (5-ASA, mesalamine) is effective in inducing and maintaining remission in ulcerative colitis (UC). The relative benefits and costs of maintenance 5-ASA therapy are uncertain. Our aims were to evaluate this strategy's potential cost-effectiveness.
    We constructed a Markov model to compare two strategies over 2 yr: (a) no maintenance 5-ASA, with 5-ASA 4.8 g/day given for flares, (b) maintenance 5-ASA 2.4 g/day, escalated and maintained at 4.8 g/day after the first flare. In both arms, the failure to induce remission led to other treatments, as needed: prednisone, parenteral corticosteroids, cyclosporine, 6-mercaptopurine, infliximab, and colectomy.
    Without maintenance 5-ASA, the mean flares per person were 1.92, and the mean cost per person was $3,402. With maintenance 5-ASA providing a relative risk of flare of 0.7 at 5-ASA cost of $198/month, flares per person decreased to 1.38 at a cost of $8,810/flare prevented. Maintenance 5-ASA increased discounted quality-adjusted life-years per person (QALYs per person) from 1.75 to 1.77 at a discounted cost of $224,000/QALY gained. The results were most sensitive to the flare risk reduction and cost of 5-ASA, the utilities of being in remission without or with 5-ASA, and the colectomy rates. At $15/month (the cost of sulfasalazine), maintenance 5-ASA cost $640/flare prevented and $16,300/QALY gained.
    Maintenance 5-ASA therapy decreases UC flares, but its cost may be substantial, depending on society's willingness to pay. If sulfasalazine can be tolerated and yields comparable benefits, sulfasalazine maintenance therapy is likely to be cost-effective. The cost per QALY gained by 5-ASA maintenance is highly dependent on the quality of life while taking versus not taking maintenance 5-ASA, highlighting the importance of patients' preferences.
    PMID: 18775007 [PubMed - as supplied by publisher]
  • Colonoscopic treatment of acute diverticular hemorrhage using endoclips.

    Digestive diseases and sciences 2008 Sep

    Authors: Yen EF, Ladabaum U, Muthusamy VR, Cello JP, McQuaid KR, Shah JN
    Abstract
    Although colonoscopy is used in the diagnostic evaluation of patients with diverticular hemorrhage, data on colonoscopic treatment outcomes are limited. We reviewed records of inpatients undergoing colonoscopy to identify patients that were colonoscopically diagnosed and treated for acute diverticular hemorrhage. Eleven patients with acute diverticular hemorrhage had active bleeding (n = 7) or non-bleeding visible vessel (n = 4) at colonoscopy. Endoclip treatment (preceded by epinephrine injection in 64%) achieved hemostasis in all patients without procedural complications. Patients were discharged within three days without evidence of early rebleeding. During a median follow-up of 15 months, late recurrent bleeding occurred in two patients (18.2%). Colonoscopic treatment of patients with acute diverticular hemorrhage using endoclips appears to be effective and safe, with high rates of immediate and long-term success. Colonoscopy should be considered in patients with suspected acute diverticular hemorrhage, as it may enable definitive therapy without the need for more invasive treatment.
    PMID: 18157637 [PubMed - as supplied by publisher]
  • Cost-effectiveness of extending Medicare coverage of immunosuppressive medications to the life of a kidney transplant.

    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons 2004 Oct

    Authors: Yen EF, Hardinger K, Brennan DC, Woodward RS, Desai NM, Crippin JS, Gage BF, Schnitzler MA
    Abstract
    Unless they maintain Medicare status through disability or age, kidney transplant recipients lose their Medicare coverage of immunosuppression 3 years after transplantation. A significant transplant survival advantage has previously been demonstrated by the extension of Medicare immunosuppressive medication coverage from 1 year to 3 years, which occurred between 1993 and 1995. The United States Renal Data System (USRDS) was analyzed for recipients of kidney transplants from 1995 to 1999. Using a Markov model, we estimated survival and costs of the current system of 3-year coverage compared with lifetime immunosuppression coverage. Results were calculated from the perspectives of society and Medicare. Extension of immunosuppression coverage produced an expected improvement from 38.6% to 47.6% in graft survival and from 55.4% to 61.8% in patient survival. The annualized expected savings to society from lifetime coverage was $136 million assuming current rates of transplantation. Medicare would break-even compared with current coverage if the fraction of patients using extended coverage was <32%. The extension would be cost-effective to Medicare if this fraction was <91%. Extended Medicare immunosuppression coverage to the life of a kidney transplant should result in better transplant and economic outcomes, and should be considered by policy makers.
    PMID: 15367228 [PubMed - as supplied by publisher]

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