Health care purchasers focus on eliminating overuse and misuse of health care services
WASHINGTON, Dec. 19 /PRNewswire/ -- The National Business Coalition on Health (NBCH), a non-profit organization of employer-based health coalitions, today released the 2008 findings for the eValue8(TM) RFI (Request For Information) tool. Used by NBCH and its member coalitions to compare the quality and efficiency of America's health plans, the findings indicate that purchasers are increasingly requiring plans to focus on the quality of health care delivered to consumers.
eValue8 is the nation's leading standardized RFI tool used by employers and coalitions to gather health care data from nearly 200 health plans. Over 100 million Americans, or about two-thirds of those insured by employers, are members of health plans that respond to eValue8. The 2008 findings represent information from 100 HMO and PPO plans verified by independent reviewers.
"Given today's dire economic climate, purchasers need to continue to encourage health plans to adopt plan designs that will enable consumers to keep themselves healthy and not incur higher, preventable health care costs in the future," said Andrew Webber, president and CEO of NBCH.
2008 eValue8 Findings
Gaps in Care
The 2008 eValue8 results also show there is still work to do to reduce gaps in care. Health plans need to use their data to ensure plan members are receiving preventive treatment such as cancer screenings as research shows early screening saves lives. As an example, just 57% of health plans remind members about colorectal cancer screening and only 53% of health plans tell members when their colorectal screening is overdue. Health plans can also prompt physicians to ensure their patients receive life-saving cancer screenings. Only 40% of the plans report to physicians if patients have received a colorectal cancer screenings.
Additionally, health care purchasers need to be careful about cost-shifting as it may cause plan members not to seek essential and preventive health services. This could lead to poorer health status, increased employment absenteeism, lower work productivity and much higher health care costs down the line.
In 2008, all of the major national health plans responded to the RFI in at least one of their major services areas. Employers include the eValue8 RFI information in their total quality calculators, use incentives to steer their employees to better performing plans and may choose to participate with a health plan based on how they respond. A formal report on the findings will be available in January 2009. George Washington University's Center for Integrated Behavioral Health Policy analyzed the data.
About the National Business Coalition on Health and eValue8
NBCH is a national, non-profit, membership organization of more than 60 business and health coalitions, representing over 7,000 employers and 34 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(TM) 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: www.nbch.org.
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-- More health plans are reducing barriers to essential treatments. For patients with diabetes 27% of health plans waive co-payments for essential drugs and equipment such as blood glucose monitors and 33% of health plans reduce co-payments. For patients with asthma, 19% of health plans waive co-pays for essential drugs and 32% reduce co-pays. For hypertension, 20% of health plans waive co-pays for drugs and equipment and 28% reduce co-pays. For preventive health visits, 43% of health plans waive co-pays. -- Consumers are being given increasing responsibility for managing their health care. Purchasers want health plans to provide information to consumers so they can effectively make decisions regarding providers and treatments. To that end, all health plans have an online directory where consumers can find physicians and hospitals. However, there is room for improvement as 47% of health plans display quality information and only 16% enable consumers to search for physicians based on quality. -- Purchasers are also demanding that health plans adopt electronic medical records to improve information flow, patient safety and reduce gaps in care. Only 25% of health plans indicate on their directory if the physicians use electronic health records.
SOURCE National Business Coalition on Health