Need to Know: September 2014

Industry updates in business and health management

Health management

The Independence Blue CrossFoundation awarded more than $2.4 million in 60 community grants to date in 2014 to lead solutions for a healthier community. This funding includes $200,000 to support community health centers  and increase access to healthcare in medically underserved areas; $1.1 million for bolstering the healthcare work force through nursing education; $135,000 to build healthier communities; and $1 million to improve child wellness and reduce childhood obesity.

Many seniors, particularly those with four or more chronic conditions, continue to have difficulty paying for prescriptions in the years since Medicare Part D was first offered, according to a study by Harvard Pilgrim Health Care Institute researchers. Overall, the study, published in Health Affairs, found that medication affordability improved after implementation of Medicare Part D in 2006, and continued to improve for several years (2007 to 2009), but that these gains eroded during 2009 to 2011. Possible reasons for recent worsening trends may be due to accumulating effects of weak economic conditions in the U.S. or increasingly restrictive coverage rules among private Part D plans.



Aetna and Washington Hospital HealthcareSystem have signed a new three-and-a-half year contract that will give Aetna HMO, PPO and Medicare Advantage members in-network access to Washington Hospital Healthcare System for the first time since Oct. 1, 2012. In other Aetna news, the insurer will phase out its CarePass wellness platform. The CarePass consumer website and mobile solution was launched last summer, as part of its “What’s Your Healthy?” national campaign. According to the company, current CarePass users will continue to have access to the platform for now.

Cigna launched its proprietary private retail exchange nationally for employers (with 51 or more employees) in new markets and expanding in others. Medical, pharmacy, dental, vision, life/accident and disability plans will be available through the private exchange. Employees can access online, interactive shopping tools to get a personalized recommendation for benefits. For employers, the exchange offers a benefits administration platform that enables defined contribution funding.

A collaboration between Blue Cross Blue Shield of Michigan, Blue Care Network and 75 Michigan hospitals has saved $597 million over the past five years while improving lives, according to an actuarial analysis. Called “Collaborative Quality Initiatives,” these five programs analyzed the general surgery, bariatric surgery, cardiac surgery, angioplasty and vascular conditions care given to over 200,000 patients annually in Michigan hospitals. Cost savings and improvements in care quality resulted from participating physicians and health professionals reviewing the data and sharing thier experiences to develop best practices and new processes to reduce errors, prevent complications and improve patient outcomes.