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National Survey Finds Employers are Challenging Health Plans to Better Use Resources to Prevent Illness and Improve Patient Safety
Date:11/12/2007

National Business Coalition on Health releases nationwide eValue8 findings

SCOTTSDALE, Ariz., Nov. 12 /PRNewswire/ -- According to the eValue8 (TM) report of health plan performance released today by the non-profit National Business Coalition on Health (NBCH), health plans could do a better job of sharing important information with their customers, enabling improvements in patient safety, care coordination, consumer selection of the best providers and member health maintenance. Released at NBCH's Twelfth Annual Conference, a report of the overall findings -- Connecting the Dots in Health Care -- is publicly available and can be accessed at: http://nbch.org.

NBCH's eValue8 program is the nation's leading standardized request for information (RFI) tool that employers and coalitions use to gather health care data from nearly 200 health plans and health insurers. Over 100 million Americans, or one in every three Americans, are members of health plans that respond to the eValue8 RFI.

"This year's eValue8 results prove health plans are collecting information that would be helpful to doctors and patients, however many are not leveraging it to improve health and health care," said Andrew Webber, president and CEO of NBCH. "NBCH and its coalition members call on health plans to better utilize the trove of claims data at their fingertips to provide information for consumers."

Key eValue8 findings include:

-- Plans need to share information with consumers

All surveyed health plans (100 percent) said they offer provider directories, a critical tool for consumers. However, as consumers navigate the complex health care system they need more information to make informed choices. Almost 58 percent of health plans indicated they provide information on office hours and 60 percent said they provide publicly available, evidence-based measures of quality. However, only 28 percent provide mortality or complication rates where applicable and 31 percent provide patient experience data.

Consumers are rarely informed about which physicians have adopted standard health information technology with only 28 percent of plans providing information on a physician's accessibility of email communications, 15 percent include information on availability of web consultations and ten percent include information on prescribing.

-- Increasing co-pays discourages patients from getting the care they need

Health plans can create plan designs that encourage members who need care the most to get that needed care. Yet, for diabetes, 38 percent of health plans indicated they modify co-pays for pharmaceuticals, tests and/or equipment and only 28 percent modify deductibles. For depression only 15 percent of health plans modify co-pays and 11 percent modify deductibles. In addition to reducing overall health care costs, these strategies can provide significant down-stream benefits to consumers and employers alike through increased productivity and decreased absences due to illness and complication.

-- Health plans should remind patients about cancer screening

Eighty-one percent of health plans indicate they send some type of education material to members. For breast cancer screening, 68 percent of health plans use claims data to trigger reminders to plan members and 40 percent of plans send reminders for colorectal cancer screening where early detection is proven to save lives. Health plans have the claims data and know which members need screenings due to how old the member is or if they have not gotten a screening. Yet not enough health plans are using the information to ensure members are getting important screenings. Further, since few track it on their own, doctors need that information as well. Only 56 percent of health plans send reminders to doctors regarding which members need breast cancer screening and only 46 percent of health plans send reminders to doctors regarding which members need colorectal cancer screening.

-- Plans impact drug safety

Almost all health plans indicate they send notices to members about switching to lower cost generics as well as send notices to doctors. Yet few look retrospectively at drug conflicts to notify consumers and doctors when dangerous drug-drug conflicts emerge or when consumers are taking inappropriate medication for their age. Health plans have the capability to send members reminders when switching to lower cost drugs is concerned. Employers want health plans to use that same capability and ensure members are taking drugs safely.

"Our employer members -- the purchasers of health care -- utilize the eValue8 process to voice common expectations and measure performance for the health plan marketplace," said Barbara Belovich, executive director of the Health Action Council in Cleveland. "Through this process we're able to identify plans that use electronic clinical data, manage chronic diseases, and help consumers choose providers and manage their own conditions. eValue8 helps us work with plans to improve health care quality and provide value for the health care dollar."

The eValue8 RFI includes hundreds of benchmarks on critical issues such as plan administration, provider performance, pharmacy benefit management, disease management, patient safety, and member and provider communication. The information collected allows purchasers to compare apples to apples when deciding which health plan offers quality health care and to make better decisions about the value of the health care options they provide, raising the level of health for plan members as well as the entire community. Ensuring Solutions, a division of The George Washington University Medical Center, analyzed the data for the report.

About the National Business Coalition on Health and eValue8

Celebrating 15 years of value based purchasing, NBCH is a national, non-profit, membership organization of nearly 70 employer-based health care 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 http://www.nbch.org.


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SOURCE National Business Coalition on Health
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