Mcol Weekend for Paid Members    |  April 10, 2010    |   Volume 13 Issue 14

The State of Employers Using Value Based Design

This week  the Center for Health Value Innovation, released results of a survey, “Value-Based Design 2009,” conducted by Buck Consultants, a global employee benefits and human resources consulting firm. The survey of 101 employers ranging from 500 to 200,000 employees indicated that 46% had VBD programs in place for two or more years, another 17% had VBD programs in place for less than two years, and 38% had no VBD programs. The survey then focused on employers with programs in place for two or more years.

The Center defines Value Based Design as involving "benefit design and delivery to align incentives for workers, employers, and providers to improve health and financial outcomes through behavior change."

Given that VBD programs provide various forms of incentives, including applicable waivers of cost sharing, an obvious concern in a down economy would be that employers would feel pressure to pull back in these areas to in the name of achieving short term savings. However the survey indicated 79 % of the employers with VBD in place two or more years made no VBD changes in 2009 and 56% did not plan to make changes in 2010.

Of the 44% who did anticipate changes in 2010: 64% of them plan to pass more of the cost of brand drugs to the employee; 16% plan mandatory enrollment in disease management programs; and 16% plan to pass more of the cost of generic drugs to the employee.

Other survey results regarding use of various VBD components by these employers, indicated in their 23 page report,  included:

• 87 % use for prevention/wellness
• 60 % use for chronic care management
• 80 % use for disease management
• 63 % waive employee cost sharing for yearly screening exam
• 40 % provide insurance premium incentive for completion of a Health Risk Assessment (HRA)
• 54 % cover depression under care management program
• 70 % reduce/waive co-pay for utilizing the lowest cost appropriate site of care (e.g., urgent care, convenient care, onsite services, medical travel)
• 58 % provide incentives for the use of EAP programs
• 35 % provide incentives for financial counseling
• 20% reduced applicable prevention screen cost for age/gender appropriate groups
• 18% provided an insurance premium incentive for completion of a biometric screen
• 13% reduced OOP costs for setting and/or achieving health promotion goals
• 13% provided insurance premium incentive for complying with recommended prevention exam
• 12% adjust their condition-based formulary (all tiers lowered for specified conditions)
• 12% link co-pay/coinsurance waivers to mandatory condition management

Employers also indicated these as their top challenges to deploying their VBD programs (more than one answer allowed):

• 53% - Increasing engagement with employees: slow to use the new benefits
• 45% - Enrolling employees in disease management programs
• 42% - Keeping the momentum going
• 34% - Obtaining and integrating data
• 34% - Lack of communication with physicians/pharmacists/clinicians
• 34% - Communicating benefits with the covered lives
• 32% - Segmenting and interpreting data
• 18% - Communicating success with the covered lives
• 13% - C-Suite support

For More Information:

Value-Based Design Programs Improve Employee Health: Survey by Center for Health Value Innovation and Buck Consultants
Business Wire, April 6, 2010
http://www.businesswire.com/portal/site/home/permalink/?ndmViewId=news_view&newsId=20100406006302&newsLang=en

Value-Based Design 2009 - Survey Report January 2010
Center for Health Value Innovation and Buck Consultants, Released April 2010
http://www.vbhealth.org/wp-content/uploads/CHVI-BUCK-VBD-2009-FINAL-Report1.pdf 

Hewitt Associates this week released data indicating that employees in 2009 were more engaged in selected their health benefits than in previous years. That being said, Hewitt concluded their choices weren’t all that different than before, they were just more involved in the process.... Click to continue
 
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1. 2 insurers to resume sales with old rates
The Boston Globe reports that seeking to tone down their dispute with state regulators, two Massachusetts health insurers yesterday said they will, as ordered, resume making new policies available for individuals and small businesses — using last year’s base rates, not the requested double-digit increases rejected by the state last week.
Boston Globe, April 8, 2010
http://www.boston.com/business/healthcare/articles/2010/04/08/2_insurers_to_resume_sales_with_old_rates/

2. Mo. Lt. Gov. Plans Lawsuit Over Health Care Bill
The Associated Press reports that Missouri Lt. Gov. Peter Kinder says he'll seek private funding for his own legal challenge to the new federal health care law.
Associated Press via The New York Times, April 8, 2010
http://www.nytimes.com/aponline/2010/04/08/business/AP-US-Health-Overhaul-Lawsuit-Missouri.html

3. Surgery-owning doctors do more operations
UPI reports that doctors who invest in an outpatient surgery center perform on average twice as many surgeries, U.S. researchers found.
UPI, April 8, 2010
http://www.upi.com/Health_News/2010/04/08/Surgery-owning-doctors-do-more-operations/UPI-56981270706655/

4. HCA Said to Prepare $3 Billion IPO Four Years After Buyout
Bloomberg reports that HCA Inc., the hospital chain bought four years ago in a $33 billion leveraged buyout led by KKR & Co. and Bain Capital LLC, is preparing an initial public offering that may raise $3 billion, said two people with knowledge of the matter.
Bloomberg via BusinessWeek, April 8, 2010
http://www.businessweek.com/news/2010-04-08/hca-said-to-prepare-3-billion-ipo-four-years-after-buyout.html

5. Study: Health care-savvy workers cost-conscious
The Associated Press reports that workers who better understand their health insurance plans -- from their share of premiums to co-payments for doctor office and emergency room visits -- are more likely to make more cost-efficient decisions, a new study finds.
Associated Press via The Boston Globe, April 7, 2010
http://www.boston.com/news/local/massachusetts/articles/2010/04/07/study_health_care_savvy_workers_cost_conscious/ 

6. Health reforms to be clear, transparent: Sebelius
Reuters reports that U.S. health officials aim to move swiftly and clearly to implement newly enacted healthcare reforms, health secretary Kathleen Sebelius said on Tuesday in remarks aimed at selling Americans on the benefits of the controversial changes.
Reuters, April 7, 2010
http://www.reuters.com/article/idUSTRE63540S20100407

7. Wis. gov creates office to implement health care
The Associated Press reports that Gov. Jim Doyle announced the creation of a new office Wednesday to help Wisconsin residents and businesses understand how the new federal health care law will affect them.
Associated Press via BusinessWeek, April 7, 2010
http://www.businessweek.com/ap/financialnews/D9EUDOOG1.htm

8. Florida says challenge to healthcare reform widens
Reuters reports that five more U.S. states are joining a Florida-led group of states in a lawsuit challenging President Barack Obama's overhaul of the U.S. healthcare system, Florida's attorney general said on Wednesday.
Reuters, April 7, 2010
http://www.reuters.com/article/idUSN079896320100407?type=marketsNews

9. Highmark to Open Four Additional Health Insurance Stores in Pennsylvania
PRNewswire reports that Highmark today announced that it will open four additional Highmark Direct retail health insurance stores in Pennsylvania, including three stores in the Pittsburgh area and one store in Harrisburg.
PRNewswire, April 7, 2010
http://www.prnewswire.com/news-releases/highmark-to-open-four-additional-health-insurance-stores-in-pennsylvania-90079422.html

10. CT and MRI scans: Shorter hospital stays?
UPI reports that a U.S. study suggests the use of computed tomography scans and magnetic resonance imaging might shorten the length of a person's hospital stay.
UPI, April 5, 2010
http://www.upi.com/Science_News/2010/04/05/CT-and-MRI-scans-Shorter-hospital-stays/UPI-64001270485144/