Health Care Data Exchange Put Into Service
A group that has been working to put patient health care benefits eligibility information online announced that its system is up and running.
The Council for Affordable Quality Health Care, Washington, says health care providers and hospitals can now have fast access to consistent eligibility and benefits information to verify patient health insurance coverage. The system was completed under new standard business rules developed by CAQH’s Committee on Operating Rules for Information Exchange (CORE).
Nearly 20 leading health organizations have been voluntarily exchanging patient administrative data in accordance with the CORE rules, including ACS EDI Gateway Inc.; Aetna Inc.; Athenahealth Inc.; and WellPoint, Inc. and its 14 Blue Cross and Blue Shield-licensed subsidiaries.
All of these organizations recently completed certification testing to assure that their IT systems and products comply with the CORE rules, according to CAQH.
Article provided by National Underwriter News Service, April 3, 2007.
Safeway Embraces Consumerism
Employers can reduce health care costs and keep their workers happy by promoting wellness programs and preventive measures, placing more responsibility on employees and providing incentives for healthy behaviors, Safeway CEO Steve Burd told attendees yesterday at the World Health Care Congress in Washington, D.C.
Safeway’s health care costs fell 15% between 2001 and 2005, while other employers on average saw their costs increase 12%. The grocery-chain giant reduced costs by increasing the deductible of its health plans to $2,000, promoting health reimbursement accounts and emphasizing the importance of preventive care. Safeway also decreases the health care payroll deduction by $75 a month for employees who take a health risk assessment twice a year. The company motto is to place more responsibility on the employees and get them more involved in the decision-making process, while ensuring they have all the tools necessary to make informed, positive choices.
Article provided by Benefit News 4-24-07
CDHP Users Don't Lack Preventive Care
Patients with consumer-driven health plans seek out evidence-based care and preventive care at rates equal to or higher than those in traditional health plans, according to a new study from UnitedHealth Group, a provider of CDHPs. The company compared its 2004 and 2005 patient information with national benchmark data on 10 million members in traditional health plans.
CDHP users were 16% more likely to have a cervical cancer screening, 16% more likely to receive a prostate screening and 10% more likely to get a cholesterol screening, compared to the benchmark population. In addition, CDHP users with coronary artery disease were 22% more likely to have lipid tests and equally likely to see a doctor, compared to those in traditional plans. Those in CDHPs and traditional plans shared similar rates of receiving colonoscopies and mammograms.
Critics of CDHPs say they may encourage people to skip needed care to save money, but United says these results show that’s not the case.
“Individuals [with CDHPs] are continuing to receive important health services and are not compromising the quality of their care,” says Dr. Miles Snowden, a senior vice president at UnitedHealth. “We are beginning to develop a much more compelling and fact-based view of how consumer-focused strategies are working to support both health care affordability and quality.”
Article provided by Benefit News 4-24-07
Employees Happy With Health Benefits
Although most individuals resist change, research findings released today by the National Business Group on Health show employees are most resistant to changing anything about their health benefits.
Despite rising costs, a majority of U.S. workers say they are very satisfied with their employer-provided health care benefits, consider the health plan to be their most important benefit and have little interest in purchasing coverage on their own.
Information provided by benefit news 4-12-07.
Employers Look Beyond Cost-Shifting
An increasing number of employers will significantly enhance their health benefits by offering or planning to offer tools, wellness programs, quality information, and pay-for-performance programs, according to a report released today by Hewitt Associates.
Nearly two-thirds (63%) of the 450 employers Hewitt surveyed plan to take more aggressive, multi-year approaches to improve health care options offered to workers. This goes against the current thinking by many in the benefits industry who predicted that employers will shift more costs and responsibilities to employees to control spiralling medical costs.
Article provided by BenefitNews - April 19, 2007
Patients Starting To Act Like Consumers
More Americans are starting to approach health care decisions the same way they shop for household appliances. Patients think it’s important to compare cost and quality on medical services and physicians, even though that information may be hard to find, new research from the consulting firm Booz Allen Hamilton shows.
Patients indicated that doctors and hospitals should compete mainly on quality, while health plans should compete on price, and pharmaceutical firms should compete on price and quality. Meanwhile, both traditional health plan enrollees and high-deductible health plan participants thought competition was good thing for the health care sector. Still, those in consumer-driven health plans had a higher expectation for competition.
Patients cited doctors, family and friends and independent sources, such as Consumer Reports, as reliable sources for medical cost and quality data. However, many viewed their health plans among the least trustworthy sources of health information, followed by employers, the government and pharmaceutical companies. Oddly enough, 60% of doctors thought health plans were the best source for data on physician prices.
David Knott, senior vice president at Booz Allen Hamilton, says, “Consumers are turning away from traditional information sources, such as employers and the government, in search of new, independent sources.”
Article published by Benefit News 4-17-07
Twists in the Road to True Consumer-Driven Health Care
The theory of this new model in health care -- in which consumers make rational decisions based on cost, quality and an incentive to save money -- is hitting up against the realities of a marketplace that has just started changing to meet the demands of health care users.
To read article click on
Consumer Driven Healthcare.
Walk Off the Weight
No doubt about it, walking can become an addiction. Apart from the obvious benefits of improved fitness, going for a stroll relaxes you and even helps you think more clearly.
Springtime is a glorious season for walking, but getting your regular "fix" can be tricky as spring turns to summer and the temperature starts to climb. Pitfalls range from the potentially dangerous (heatstroke) to the downright irritating (blisters). Here's what you need to know to beat the heat and keep walking.
Click on
Protect Yourself to read more.
Wal-Mart Begins To Implement Wellness Program for Employees
Wal-Mart Stores has begun to implement a voluntary program to help employees "develop individual goals to improve their health and wellness" and improve the environment, the Arkansas Democrat-Gazette reports. In a news release, Andy Ruben, vice president for corporate strategy and sustainability at Wal-Mart, said that the Personal Sustainability Project is "about making and sustaining one simple change in life that you can be passionate about -- anything from riding a bike to work or using eco-friendly household cleaning products to eating healthy meals instead of fast-food or recycling at home."
To read this article in its entirety click on
Wellness
Good Savers, Good Habits
We hear so often that Americans are poor savers that we forget there are plenty of workers who amass sizable sums with little fanfare.
They might be in the next cubicle, next door or next-of-kin. It's not that they save because they make tons of money. Many good savers have modest incomes. They just don't spend every penny of it.
To read this article in its entirety click on
Savers.
Thorough Psychiatric Care Saves Money
Extensive face time with a care provider proved to be instrumental for patients seeking mental health services, new research shows.
Patients who had routine contact with care advocates (the study group) improved their medication compliance by 14.9%, compared to just 2.9% for those without routine contact (the control group), according to a study by CIGNA Behavioral Health.
Psychiatric hospital intakes dropped by 53% in the study group, which resulted in a 49% decrease in cost after individuals enrolled in the program. Conversely, psychiatric admissions jumped by 11% in the control group, which resulted in a 225% cost increase, CIGNA reports. Moreover, the study group showed a 52% decrease in ER visits, and the total health care savings per patient was more than $3,000.
The study group members had behavioral and medical services arranged by care advocates and 24/7 access to help, in case of a crisis event or bad medical side effects.
Jodi Aronson Prohofsky, senior vice president of clinical operations at CIGNA Behavioral Health, says, “Now that we we’ve measured the data, we want to expand the program to reach more members to achieve ever greater outcomes.”
Article provided by Benefitnews.com 4-5-07
Why Men Lose Faster than Women
Some couples working to lose weight may notice that the man usually loses at a fast pace than the woman. What's going on? Do men really lose more weight faster or does it just appear that they do?
The truth is, men have two major weight-loss advantages over women: One involves their
body composition, which enables them to burn calories at a faster rate than women; the second revolves around the fact that men tend to be more active than their female counterparts. These two major factors—more calories burned at rest and more calories burned in activity—translates into faster weight loss for guys.
To read this article in its entirety click on
Weight Loss.
CVS Buys Caremark
It’s official. CVS will acquire Caremark for $27 billion. The new enterprise will fill more than one billion prescriptions per year. CVS and Caremark conservatively estimate their annual cost savings from the merger to be $500 million and expect revenue from new offerings to be $800 million to $1 billion in 2008 and increasing thereafter.
What the merger of the pharmacy retail giant and the large pharmacy benefit manager will mean for consumers remains to be seen. It should lead to increased purchasing power, says Sean Brandle, national pharmacy consulting practice leader for The Segal Company. “Health plan sponsors can use this purchasing leverage to obtain additional cost savings for their plans and members. Both plan sponsors and members stand to gain access to increased service levels, new products and aggressive drug prices at CVS retail stores.”
Information provided by BenefitNews March 20, 2007.
