Headlines about "Health plan costs - disease management"

Gathered from the web by the editors at BenefitsLink.com.
Alabama Board Approves Plan To Charge State Employees for Obesity, Health Problems
Excerpt: "The Alabama State Employees' Insurance Board last week approved a plan that will require state employees who are obese or have health problems to make progress to address those issues or pay a monthly charge for health insurance, the AP/Philadelphia Inquirer reports." (KaiserNetwork.org)

Making the Business Case: How Engaging Employees in Preventive Care Can Reduce Healthcare Costs (PDF)
19 pages. Excerpt: "This white paper focuses on four leading types of cancer – breast cancer, colorectal cancer, cervical cancer and cancers associated with tobacco use. The paper illustrates how: Cancer costs burden businesses. Offering prevention and early detection health insurance benefits reduce both the direct and indirect costs of cancer for employers. Companies can start offering preventive and cancer-screening services." (C-Change)

Disease Management Programmes for Major Depression: Making the Financial Case (PDF)
44 pages. The report is geared to depression management in the United Kingdom. (Milliman)

Building a Value-Based Health Benefit Culture - Manatee County, FL As an Example
Excerpt: "Manatee County's Your Choice medical and drug benefit plan designs offer strong financial incentives for healthy behaviors and cost-effective decision making. The medical benefit offers three levels of cost sharing linked to health management activities. Employees and insured family members qualify for the Basic, Better or Best cost-sharing options based on their participation in health screenings, wellness programs and condition management programs." (Pharmacy Benefit Management Institute, LP)

Innovations Lacking in Provider Payment Reform for Chronic Disease Care
Excerpt: "While there is broad agreement that existing provider payment methods are not well aligned with optimal chronic disease care, there are significant barriers to reforming payment for chronic disease care, including (1) fragmented care delivery; (2) lack of payment for non-physician providers and services supportive of chronic disease care; (3) potential for revenue reductions for some providers; and (4) lack of a viable reform champion." (Center for Studying Health System Change)

[Opinion] Employee Health Insurance 'Services' Migrating to Medical Underwriting
Excerpt: "[A Wall Street Journal article discusses] how smaller companies can buy services such as chronic disease management services for their employees at a reasonable price. The entire focus is on how small and medium businesses can lower healthcare cost through employee behavioral changes. But, employers are frustrated by the low level of volunteering.. . . When do rewards for good behavior cross the line to become medical underwriting?" (iStockAnalyst.com)

Study Will Provide Cash Payments To Encourage People With Chronic Diseases To Take Medications
Excerpt: "The Hartford Courant on Sunday examined a new lottery-like program that offers patients a chance at winning daily cash prizes of $10 or $100 if they promptly take their prescription medications." (Kaiser Family Foundation)

[Opinion] Is There a Disease Management Backlash? (PDF)
2 pages. Excerpt: "More research is needed to provide a conclusive answer to the question of whether or not population-based disease management can improve quality of care and, if so, which interventions have which effects under which conditions." (The American Journal of Managed Care)

Employer Group Launching Depression Treatment Plan
Excerpt: "Employer coalition Bridges to Excellence is launching a pay-for-performance program that will reward physicians for optimal treatment of depression. The Depression Management Care Link will be piloted in Minnesota among members of the Buyers Health Care Action Group, a statewide employer coalition. BHCAG was also an early adopter of BTE's diabetes and cardiovascular care programs." (Workforce Management; free registration required)

[Opinion] Is Disease Management Effective? Well, Some Is...
Excerpt: "[A]bsent the application of a rigorous definition, disease management has become a meaningless, homogeneous phrase that means whatever the person . . . asking the question wants it to mean." (Robert E. Stone, published by American Journal of Managed Care)

Coaches Can Help Employees Become More Accountable for Maintaining and Improving Their Own Health
Excerpt: "A recent NBGH/Watson Wyatt study revealed that 44 percent of large employers offered health coaching in 2007, with an additional 13 percent planning to offer it this year. Coaches work with employees (usually over the phone, but sometimes in person) to set goals for the treatment of their conditions and to keep them informed of potential risks." (Human Resource Executive Online)

Work-Site Support Groups for Health Conditions
Excerpt: "Some employers have formed work-site support groups for employees struggling with certain health conditions and lifestyle issues as a way to bolster their wellness programs and their bottom lines. While support groups have yet to become widely accepted by employers, experts say such support systems have the potential to be the next big thing in wellness and disease management initiatives." (Workforce Management; free registration required)

[Opinion] Current Trends in Employee Health Management
Excerpt: "The biggest trend relates to the scope of 'employee health', including the number of employees, types of health challenges, and measures of impact that are being addressed. From original modest 'worksite wellness' efforts by employers, and disease management efforts by insurers, the scope is moving to 'total population health management', with virtually all employees targeted for some kind of health maintenance, risk condition or behavior correction, or disease management, together with productivity and performance impairment factor reduction." (World Health Care Blog)

2008 Dartmouth Atlas of Health Care: Tracking the Care of Patients with Severe Chronic Illness (PDF)
184 pages. Excerpt: "This edition of the Dartmouth Atlas will focus on disentangling the phenomenon known as 'unwarranted variation,' or variation in different regions of the country that is not explained on the basis of illness, patient characteristics or preferences, or the dictates of evidence-based medicine. Like the last edition, it focuses on supply-sensitive care delivered to chronically ill Medicare beneficiaries in the last two years of life." (The Dartmouth Institute for Health Policy and Clinical Practice)

Predictive Modeling Can Help Prevent Illness Before It Even Occurs
Excerpt: "Predictive modeling (PM), by basic definition, is the process of developing health care programs for at-risk populations based on statistical probabilities obtained through advanced software tools. The idea is to target patients who have a good possibility of developing a disease somewhere down the road, and then administer treatment early on in an effort to stop the illness, or at least limit its severity." (Employee Benefit News; free registration required)

Practice Note on Disease Management (PDF)
37 pages. Excerpt: "Practice Notes from this work group describe what the work group believes to be the common practices of U.S. health actuaries. This Practice Note discusses some common approaches to evaluation in the disease management field." (American Academy of Actuaries)

More Employers Link Health Risk Appraisals to Open Enrollment
Excerpt: "Employers are redefining open enrollment by using the process to encourage workers to sign up for health risk appraisals and disease management programs. They see the benefits enrollment period as the perfect time to educate workers on how healthier lifestyle decisions affect health care costs." (Employee Benefit News; free registration required)

Conversations on The Changing Face Of Managed Care: Insights from Managed Care Magazine's Podcast Series (PDF)
34 pages. Articles include 'Seeing Through Transparency [from the Employer's Perspective],' 'Electronic Health Information,' 'The Future of Disease Management' and 'Consumer-Directed Health Plans." (Managed Care)

Disease Management Effectiveness Called Into Question
Excerpt: "Disease management does appear to improve the quality of care (except for asthma and chronic obstructive pulmonary disease) and reduces hospitalization rates for patients with congestive heart failure." (Wolters Kluwer Financial Services)

U.S. Has Highest Rate of Preventable Deaths Among Industrialized Nations
Excerpt: "The U.S. has the highest rate of preventable deaths among 19 industrialized nations, and although the U.S. rate has declined over the past five years, it is doing so at a slower rate than other countries, according to a London School of Hygiene & Tropical Medicine analysis published on Thursday in the journal Health Affairs, Bloomberg News reports." (Kaiser Family Foundation)

Disease Control No Panacea to Health Cost Reduction, Study Finds
Excerpt: "An analysis by the RAND Corp. shows disease management programs can improve quality of health care and reduce hospital admission rates for patients with congestive heart failure but finds no conclusive evidence that the strategy saves money." (The Chattanooga Times Free Press via MSNBC.com)

More Health Plans Strategically Manage Diabetes
Excerpt: "Evidence is growing that effective management of diabetes can reduce complications and health care costs, while boosting employee productivity, reports the National Business Coalition on Health, which recently released a study on health plans and diabetes performance." (Employee Benefit News; free registration required)

Does Disease Management Save Anybody Money?
Excerpt: "The evidence on disease management (DM) at least the 'scientific' evidence involving controlled trials and rigorous analysis, has been consistently discouraging. In the latest example, involving a meta-analysis of 317 separate studies, the authors concluded that while the evidence consistently indicated positive effects on care process quality, there was no conclusive support for either improving health outcomes or saving money, once the costs of DM, itself, was included." (World Health Care Blog)

Evidence for the Effect of Disease Management on Quality of Care, Disease Control, and Cost
Excerpt: "Conclusions: Although disease management seems to improve quality of care, its effect on cost is uncertain. Most of the evidence to date addresses small-scale programs targeting highrisk individuals, while only 3 studies evaluate large population-based interventions, implying that little is known about their effect. Payers and policy makers should remain skeptical about vendor claims and should demand supporting evidence based on transparent and scientifically sound methods." (The American Journal of Managed Care)

Marriott Finds Early Success with Value-Driven Health
Excerpt: "One important goal of early value-based insurance models has been to identify patients who truly require chronic drug therapy and offer them significant discounts, so as to lower their stress levels and keep them productive and healthy. Marriott International, a hotel chain with 2,800 properties worldwide, has embraced VBID plans and successfully managed to lower drug costs." (Employee Benefit News; free registration required)

Pitney Bowes Planned to Dramatically Lower Participant Co-Pays for Medications to Treat Several Chronic Illnesses, and Guess What Happened?
Excerpt: "When Pitney Bowes used predictive modeling to take a close look at its health-care costs, Mahoney says, 'We saw that our highest costs were associated with chronic disease -- not people diagnosed with chronic diseases, but people who were diagnosed with a chronic disease and not taking their medication.' The model indicated that managing the underlying medical condition and eliminating access barriers to the appropriate medications had the potential to help control these costs. So, the employer decided to drop by 50% to 85% the participant co-insurance costs for drugs used to treat asthma, diabetes, and hypertension." (PLANSPONSOR.com; free registration required)

Health Care Vendor Summits Promote Integration of Services (PDF)
6 pages. Excerpt: "Plan sponsors that must deal with a plethora of health care management and wellness vendors are pushing for greater coordination and integration among vendors. This trend stems from the fact that employee populations today have a variety of health and wellness issues that require different levels of interventions, such as case management to direct the delivery of care, and disease management for those who have chronic illnesses, as well as health coaching, wellness and prevention." (International Foundation of Employee Benefit Plans)

Vermont's Catamount Health: A Roadmap For Health Care Reform?
Excerpt: "Vermont's new health reform program was enacted under a Republican governor in a state with a Democrat-controlled legislature. It thus serves as an intriguing approach to resolving political differences in health care. [The focus of this article is] on what changed between the 2005 reform failure and the passage of the new reforms. Key to the reform's political success was the recognition by both sides that it focused on issues of bipartisan concern: cost control through the effective management and prevention of disease." (Health Affairs)

Seasonal Allergies Cost Employers Millions Per Year
Excerpt: "The allergy season . . . brings high absenteeism and decreased productivity in the workplace. Dr. David Hagaman, medical director of the Vanderbilt University asthma, sinus and allergy program in Tennessee, estimates his allergy patients miss an average of two days of work during the season." (The Business Journal of Milwaukee via bizjournals.com; free registration required)

Comments on Disease Management and the Pharmaceutical Industry
Excerpt: "Investing in early intervention in chronic disease equates with selling more drugs for hypertension, hypercholesterolemia, early diabetes, appetite suppression in obesity, slowing the progression of arthritis, etc., etc. Just imagine the potential market for the pharmaceutical firms." (Physicians for a National Health Program)

An Unhealthy America: The Economic Impact of Chronic Disease
Excerpt: "In its groundbreaking study, 'An Unhealthy America: The Economic Impact of Chronic Disease,' the Milken Institute details the enormous financial impact of chronic disease on the U.S. economy – not only in treatment costs, but lost worker productivity – today and in the decades ahead. It also describes the huge savings if a serious effort were made to improve Americans' health." (Milken Institute)

Reliable Data Indispensable to Manage Costs of Chronic Illness and Identify Unhealthy Employees
Excerpt: "Cost-conscious employers are gathering detailed data so they can get an accurate picture of their workers' health and develop a highly individualized disease management program. But determining a precise ROI for such an approach still proves elusive." (Workforce Management; free registration required)

More Employers Turn to Disease Management
Excerpt: "According to the [Kaiser/HRET] annual report released September 10, some 35 percent of large employers (those with 200 or more employees) find disease management programs to be 'very effective,' with another 50 percent saying they are 'somewhat effective.' Small employers (three to 199 employees) are also turning to disease management, but in smaller numbers. Twenty-eight percent say it is 'very effective' in controlling costs, while 43 percent say it is 'somewhat effective.'" (Workforce Management; free registration required)

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