Purchasers have pointed the finger at health plans, providers and technology to explain the rise in health care costs
Washington (Vocus) December 1, 2009 –-
The current rate of health care cost increases are unsustainable and health care purchasers are increasingly recognizing the impact of lifestyle choices and management of chronic conditions to contain costs. To assist employers in understanding how to more effectively work with their health plans to implement programs to lower costs, the non-profit National Business Coalition on Health (NBCH) developed a new guide around health plan capabilities to support Value Based Benefit Design (VBBD). VBBD is a purchaser strategy which incorporates focused consumer incentives into health plan and related benefits to steer consumers to better health and lifestyle decisions.
The publicly available report, Health Plan Capabilities to Support Value Based Benefit Design, highlights data reported by health plans that participate in eValue8 TM. NBCH’s eValue8 is the nation’s leading standardized Request for Information (RFI) tool used by employers and coalitions to gather health care data from more than 70 HMO and PPO health plans. More than 96 million Americans, or about two-thirds of those insured by employers, are members of health plans that respond to eValue8.
“Purchasers have pointed the finger at health plans, providers and technology to explain the rise in health care costs,” said Dennis White, senior vice president, Value Based Purchasing at NBCH. “They are correct to do so, but they often fail to recognize and leverage the influence that employee incentives can have as a driver of health status and cost. Value Based Benefit Design is not just about health and wellness programming that too often is separated from other benefits, including the health plan. Employers should explore the breadth and depth of VBBD options, many of which are challenging administratively and this report helps identify all of the moving parts and profiles the ability of health plan to support this growing area for employers.”
Key findings in this report from the eValue8 survey related to VBBD programs include:
-- Cash and cash-equivalent rewards for preventive activities like filling out personal health assessments and tobacco cessation are well established and commonplace as is elimination of co-pays and deductibles for preventive services like cancer screening.
-- For chronic care services, over half of the responding plans (54%) are now able to adjust co-pays and deductibles contingent upon program participation (e.g. coaching) with a higher proportion of national plans reporting this capability than regional plans (88% versus 24%).
-- Acute care incentives are still in their infancy with only 26% of responding plans reporting offering plans that provide incentives for choosing more cost effective treatment alternatives.
-- The report also considers incentives for choice of better performing doctors and hospitals and the availability of tools to support consumer choice beyond financial incentives.
The report was authored by Margaret Houy, JD, MBA, senior consultant, Bailit Health Purchasing, LLC, with contributions from Michael Joseph, senior consultant with Bailit, and Laura Jacobus-Kantor, PhD, assistant research professor, Center for Integrated Behavioral Health Policy, George Washington University Medical Center. NBCH gratefully acknowledges the support of the National Pharmaceutical Council (NPC) for development of this information.
“Value based benefit design is helping to promote a healthier workforce, with reductions in absenteeism, medical disability, and productivity losses associated with health conditions,” said NPC President Dan Leonard. “That’s why it’s important to gain a better understanding of the health plan infrastructure that is necessary to support value based benefit design and maximize its benefits for employees.”
About the National Pharmaceutical Council
NPC’s overarching mission is to sponsor and conduct scientific analyses of the appropriate use of biopharmaceuticals and the clinical and economic value of innovation. The organization’s strategic focus is on evidence-based medicine (EBM) for health care decision-making, to ensure that patients have access to high-quality care. NPC was established in 1953 and is supported by the nation’s major research-based pharmaceutical companies. For more information, visit http://www.npcnow.org.
About the National Business Coalition on Health and eValue8
NBCH is a national, non-profit, membership organization of 60 business and health coalitions, representing over 7,000 employers and 25 million employees and their dependents across the United States. NBCH and its members are dedicated to value-based purchasing of health care services through the collective action of public and private purchasers. eValue8™ is a product of the National Business Coalition on Health and is the nation’s leading evidence-based request for information (RFI) tool used by coalitions and major employers to assess and manage the quality of their health care vendors. For additional information visit: http://www.nbch.org.
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