 |
Customized Health Plan Chooser Tool Helps
Consumers Weigh Cost and Quality
Two PBGH members, Stanford University and the University
of California, now offer employees a customized version of PBGH’s
Health Plan Chooser, a unique Intranet tool that helps employees
evaluate their health plan options for affordability, physician
access and quality. The tool allows users to easily rank their options
according to personal budgets and needs as part of their open enrollment
process. Early results indicate that users found the tool easy to
use and helpful in making their selection. To experience how a customized
Health Plan Chooser works, visit http://demo.chooser.pbgh.org/.
In a further instance of PBGH members making quality information
available to their employees, eight members recently installed customized
versions of HealthScope on their employee Intranets. With a customized
HealthScope, PBGH members offer employees a health quality resource
that focuses exclusively on health plans, hospitals—including
Leapfrog patient safety information—and medical groups that
are available to those employees. To view a sample customized HealthScope
site, go to www.healthscope.org/csaa/.
PBGH members who would like more information on offering employees
a customized Health Plan Chooser or HealthScope via Intranet should
contact William Garnsey, Executive Producer, Consumer Engagement,
PBGH, (415) 615-6350, wgarnsey@pbgh.org.
Consumers Gain Access to More Quality
Information on Medical Groups/IPAs
With the recent release of the second annual Consumer Assessment
Survey (CAS), Californians now have even more comparative information
on how medical groups and IPAs (independent practice associations)
deliver care. Eighty physician groups voluntarily participated in
the 2002 survey of their patients, up from 59 groups in 2001. These
groups represent 72 percent of the state’s commercial and Medicare
HMO-POS population. Sponsored by the California Cooperative Healthcare
Reporting Initiative, a statewide collaborative of health plans,
providers and purchasers, CAS asks respondents to look at patient
access to care, communication between doctors and patients, counseling
on preventive care topics and overall ratings of care.
Besides extending accountability below the health plan level, CAS
is important because it provides a set of quality indicators for
the emerging Pay for Performance initiative that seeks to reward
providers financially for better quality care. With more than 35,000
respondents, survey results showed overall improvement for most
measures, compared with the previous year. Recruiting is under way
for the 2003 survey and so far, a record 130 medical groups/IPAs
have agreed to participate in the voluntary program. Individual
group ratings can be viewed by county at PBGH’s consumer Web
site, www.healthscope.org.
Click here for more information on the Consumer
Assessment Survey.
PacAdvantage Serves as Platform for
County Insurance Subsidy Program
Partnering with PacAdvantage, the small business purchasing
pool affiliated with PBGH, Sacramento County has initiated an innovative
program to subsidize health coverage for previously uninsured low-income
employees of small businesses that have not offered health coverage
to their employees. Dubbed SacAdvantage, the two-year pilot program
will offer qualified small employers and qualified workers the full
array of PacAdvantage health plan options, with a premium subsidy
based on income.
SacAdvantage is the first program in California to partner with
the private sector to use tobacco litigation settlement funds to
subsidize employee health benefits for uninsured workers in small
businesses. It will target uninsured, full-time workers who are
not eligible for any other government health care program. The subsidy
will be tied to PacAdvantage’s lowest-cost HMO in the county.
Sacramento County has set aside $2 million in tobacco settlement
money for the program, and it hopes to sign up about 500 individuals
in about 100 small businesses the first year. To learn more about
SacAdvantage, call 916-876-5825. To learn more about PacAdvantage,
go to www.pacadvantage.org.
Report on Health Plans’ Disease Management
Shows Investments & Gaps
A recent evaluation by PBGH of disease management (DM) programs
of California’s leading health plans finds that despite extensive
groundwork by plans, much work remains to achieve an effective response
to chronic illness. The report found that DM programs are often
hampered by poor quality of data, inadequate tools for assessing
data and limited influence on physicians.
PBGH used an independent consulting firm to analyze the DM programs
for diabetes and two of four other chronic illnesses—asthma,
congestive heart failure, coronary artery disease and depression—selected
by each plan. The seven largest plans contracting with PBGH members
participated.
The analysis found wide variance in plans’ ability to identify
populations for DM. In addition, it saw little internal evaluation
of the effects of various forms of patient education and support.
And there was scant evidence that efforts to communicate with patients’
physicians were having any impact on physician decisions. PBGH members
received confidential versions of the report, with health-plan specific
findings, as part of their ongoing partnership efforts with health
plans to improve the services available to chronically ill employees.
CCHRI Report on HMO Quality Covers New
Ground, Serves as Basis for State-Sponsored Report
For the first time, the annual report on HMO quality by
the California Cooperative Healthcare Reporting Initiative (CCHRI)
asks how many deaths and other negative outcomes are being prevented
over time as a result of some of the preventive measures scored
in the report.
For example, a comparison of 1999 and 2001 rates finds that an additional
48,000 HMO members with diabetes showed improved levels of cholesterol
control, preventing almost 200 deaths or subsequent heart attacks.
If this level of control is maintained over the next five years,
these patients will avoid almost 1,000 deaths or nonfatal heart
attacks.
The CCHRI 2002
Report on Quality provides the data for the HMO report
cards published annually by PBGH’s HealthScope
Web site, and the California Office of the Patient Advocate (OPA)
Report
Card. Both HealthScope and OPA convert numeric data into
a user-friendly four-star scoring system. Viewers can drill down
from stars to numeric scores. Click here to read a
news
release on the CCHRI 2002 Report on Quality.
 |
Pacific
Business Group on Health
221 Main Street Suite 1500 San Francisco, CA 94105
phone: 415.281.8660 For more info, contact info@pbgh.org
www.pbgh.org © 2000-9 PBGH |
|
|
 |
 |
|
|
PBGH in the Spotlight |
|
|
San Francisco
Chronicle, December 2, 2002 — In a guest editorial,
PBGH President and CEO Peter Lee called on the health care
industry to address the problem of wide variations in hospital
costs and quality. He urged hospitals and physicians "to
embrace a culture of accountability in which their payable
charges, efficency and quality are transparent to
consumers."
Click here to read Fighting wide variations in hospital
cost.
Roundtable on Health Care, San Francisco, October 25, 2002
— PBGH and the Committee for Economic Development (CED)
co-hosted a roundtable on the crisis in health care. More
than 130 guests from all sectors of business and health
care participated in a wide-ranging discussion. The featured
speakers addressed issues of quality, how best to provide
consumers with useable information and the challenges of
expanding access to the uninsured. The keynote was delivered
by John Kitzhaber, MD, Governor of Oregon.
As one of only two governors who are physicians, Gov. Kitzhaber
was able to bring a unique perspective to the meeting. Speaking
on the theme of "Health Care in Crisis and How Business
Can Help," the Governor challenged many implicit assumptions
that underlie the current system. Click
here to read Gov. Kitzhaber’s speech. One of
the central background documents for the roundtable was
CED’s recent report, A
New Vision for Healthcare: A Leadership Role for Business.
New England Journal of Medicine, September 19, 2002
— PBGH Medical Director Arnold Milstein, MD, and co-author
Robert Galvin, MD, director of corporate health care and
medical programs at General Electric, outlined current purchaser
strategies for coping with the "stalled efforts of
physicians, hospitals, and insurers to control the cost
of medical care and improve its quality." Milstein
and Galvin spelled out how progressive purchasers are seeking
to establish financial incentives for consumers, measuring
efficiency and quality of care, and using measures of performance
to improve care. They write that consumers will become more
engaged as performance data becomes user friendly and includes
performance information on individual physicians, and as
consumers have financial incentives to seek higher value
providers.
Click here to read "Large Employers’ New Strategies
in Health Care." then click again on the link
to read the article.
|
|
