Managed Care - January 2009 - (Page 38)

Diabetes measures for HealthPartners members, 2007 HbA1c screening in measurement year HbA1c < 7 LDL screening in measurement year LDL < 100 Blood pressure control 40) in measurement year Tobacco non-use Source: HealthPartners 2008 Clinical Indicators Report 93.3% 53.9% 84.6% 58.0% 53.2% 89.0% 83.7% particular concerns were rising health care costs and an aging employee population with a higher-thanaverage prevalence of diabetes and heart disease. Besides revamping its food service to encourage healthier food choices and initiating a voluntary fitness program, BAE worked with HealthPartners to provide financial incentives to workers who tried to improve their health status. To earn lower copayments and coinsurance, covered employees and their spouses must complete a yearly health assessment and people at risk for diabetes or heart disease must complete a phonebased counseling program or the 10,000 Steps walking program. Now in its sixth year, the HealthPartners program generates 90 percent participation in the annual health assessment. Tobacco use has fallen by 37 percent, and the number of adults achieving their physical activity goals has increased by 52 percent. More than 80 percent of workers have increased their consumption of fruits and vegetables. During that time, hospital admissions, excluding obstetrical/gynecological admissions, fell by 17 percent, and BAE has saved $1.8 million — more than 5 percent — on reduced medical claims. Those measures, Courneya says, provide HealthPartners with the data necessary to persuade other employers to use incentives to change their employees’ health habits. HealthPartners started JourneyWell, an organization focused on health improvement, in mid2008. Its services — online and telephone-based behavioral modification programs, health coaches, and other supports — are designed to help mem- bers avoid diabetes and other chronic conditions before they start. “As a physician in an exam room, if I have someone come in with a health assessment and it identifies things they should be doing, it’s really pretty difficult to pull together a bunch of tools that are going to help them make those changes,” Courneya says. “This program makes it easy for me.” Pay for performance It is not exactly the Oscars, but the public recognition that physicians earn by providing top-quality care to HealthPartners members is no small thing. An annual ceremony draws nearly 200 health care leaders and employers to recognize top performers. “It’s fascinating and actually very invigorating to see enlightened medical leaders in our community competing over how they get their systems to do a better job of delivering care and being proud about the measures and the numbers that they are able to report to the public,” Courneya says. The insurers’ Partners in Excellence program provides financial bonuses for medical practices that hit what Courneya calls “stretch targets — things that are not a slam dunk.” Bonuses are available for a variety of primary care and specialty measures, including percentage of patients who receive optimal care for diabetes. HealthPartners’ various pay-for-performance programs paid physicians more than $21 million for meeting goals in 2007. The Partners in Excellence bonus program paid out $678,000 to primary and specialty physicians who hit certain 38 MANAGED CARE / JANUARY 2009

Table of Contents Feed for the Digital Edition of Managed Care - January 2009

Managed Care - January 2009 Editor's Memo Contents Legislation & Regulation News and Commentary Medication Management Compensation Monitor Health Care's Disruptive Innovations Q&A With Clayton Christensen 'Disruption' May Be Plans' Best Bet Avoid the PBM Rebate Trap HealthPartners Puts Diabetes on Notice Formulary Files Plan Watch Tomorrow's Medicine Ad Index Outlook Unmet Needs in the Management of Plaque Psoriasis Impact of RSV: Implications for Managed Care

Managed Care - January 2009

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