Benefits November 16, 2010

Health Group Evaluation Data Shows Mixed Picture

November 16, 2010 (PLANSPONSOR.com) – The latest results from the evalue8 health care evaluation program show a decidedly mixed picture, according to the National Business Coalition on Health (NBCH). 
Reported by

An NBCH news release said eValue8 was used by employers and coalitions to gather health care data from 64 health plans across the nation, representing more than 100 million Americans.

 According to the NBCH announcement, the findings included:

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  • a wide variation among plans reporting diagnostic test procedures such as those used to determine cardiac stress, with some conducting relatively few tests (two per 1,000 members), to plans conducting a significant number (99 per 1,000). “These are often expensive and overused diagnostic tools and some plans have been more successful than others in reducing their (over) use,” the group commented.
  • plans have made tremendous progress with high generic dispensing rates. Specifically, 75% for HMOs and 68% for PPOs – a 2.5% improvement just since 2008. Some plans have achieved generic dispensing rates of over 85%.
  • plans could be doing a much better job when it comes to monitoring whether members are taking their medication as prescribed – 33% of plans report having optimal plan monitoring of depression medication adherence; only 5% of plans report optimal plan monitoring of substance abuse medication adherence; and 49% of plans report monitoring of diabetes and coronary artery disease medication adherence.
  • plans are paying doctors more money for higher quality care – 67% report administering incentives to physicians for better performance and 58% of all plans offer financial incentives that are based on either clinical process or outcome measures.
  • identification rates for chronic conditions were low – on average plans have identified only 2% of members as obese and 0.5% as tobacco users. This can be due in part to low personal health assessment completions, averaging only 3%.

NBCH is a national, non-profit, membership organization of 53 purchaser-led business and health coalitions, representing over 7,000 employers and 25 million employees and their dependents across the United States  More information on the eValue8 program is at http://nbch.org/News.

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