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NBCH Releases Report on Health Plans' Performance for Cardiovascular Disease Care and Prevention
Date:7/22/2009

Findings reveal plans are responding to employer urgency for improved care in managing chronic conditions

WASHINGTON , July 22 /PRNewswire/ -- Today the National Business Coalition on Health (NBCH) released a national report on efforts of health plan programs to improve cardiovascular disease (CVD) care and prevention. NBCH used data from eValue8(TM), the nation's leading standardized Request for Information (RFI), a tool utilized by employers and coalitions to measure and compare health plan performance.

It is estimated that 80 million Americans have some form of heart disease including high blood pressure, coronary heart disease, stroke or heart failure. Risk factors for heart disease begin in the working age population and almost 40 percent of the working age population between the ages of 40 to 69 has some type of cardiovascular disease with risk factors including high blood pressure, high cholesterol and diabetes.

Employers expect health plans to develop and provide innovative ways to help members reduce risk factors and control risks to reduce heart disease. Designed to support employer purchasing strategies, the report offers purchasers a snapshot of health plan practices and identifies areas for improvement. The information is publicly available and can be accessed at: http://nbch.org/documents/CVD_2009.pdf.

Over 100 million Americans, or about two-thirds of those insured by employers, are members of health plans that respond to eValue8. In 2008 more than 150 HMO and PPO health plans responded to the eValue8 RFI, and 103 of the responses were validated by local business coalitions.

"eValue8 is a tool that helps health plans understand the urgent need of employers," said Andrew Webber, president and CEO of NBCH. "We simply must find a way to prevent chronic disease and manage risks more effectively. Employers expect health plans to adopt value-based practices to improve care, and to innovate in new ways to reach patients and providers to improve the health status of employers and their families."

Employer expectations of health plans include:

  • Prevention and Identification of CVD: 100 percent of health plans offer a web-based personal health assessment (PHA, formerly called HRA) and most offer other options such as telephonic or personalized versions. Over half of the plans are capable of offering incentives for patients to complete health risk assessments, including cash payments (36%), discounts on health and wellness services (44%), and co-pay or deductible reductions (38%).
  • Pharmacy Management: For individuals with chronic diseases, about 40 percent of plans have the capability to reduce co-pays and deductibles on essential medications to encourage adherence to treatment. For patients on CVD medications, 85 percent of plans are capable of alerting the patient when a medication needs to be refilled, 76 percent can notify the physician, and 52 percent can notify the pharmacist to intervene.
  • Physician Performance Improvement: To improve physician quality, 85 percent of plans offer member-specific reports to physicians to show them which patients need care. Fifty-two percent of plans offer comparative reports to help physicians see how they are doing compared to their peers.

"CVD is a huge cost driver," said Bruce Sherman, MD, director, Health & Productivity Initiatives for the Employers Health Purchasing Corporation of Ohio. "The real issue is that once employees have CVD it's often late in the process of the disease. We need to start focusing on risk factor reduction before employees get sick. We need health plans to reach our employees and help them with better nutrition, exercise, and weight management, to head off CVD before it causes a debilitating problem."

This report was developed through a charitable contribution from AstraZeneca.

About the National Business Coalition on Health

NBCH is a national, non-profit, membership organization of nearly 60 employer-based health care coalitions, representing over 7,000 employers and approximately 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. For additional information visit: www.nbch.org.

Available Topic Expert(s): For information on the listed expert(s), click appropriate link.

Andrew Webber

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SOURCE National Business Coalition on Health
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