Study: Health Plans Need to Keep Quality of Care Focus

December 19, 2008 ( - The National Business Coalition on Health (NBCH) on Friday said its data show health coverage purchasers increasingly require plans to focus on the quality of care.

A news release from NBCH, a non-profit organization of employer-based health coalitions,said those were the 2008 findings for the eValue8RFI (Request for Information) tool used by NBCH and its member coalitions to compare the quality and efficiency of America’s health plans.

“Given today’s dire economic climate, purchasers need to continue to encourage health plans to adopt plan designs that will enable consumers to keep themselves healthy and not incur higher, preventable health care costs in the future,” said Andrew Webber, president and CEO of NBCH, in the news release.

Other findings include:

  • More health plans are reducing barriers to essential treatments. For patients with diabetes, 27% of health plans waive co-payments for essential drugs and equipment such as blood glucose monitors and 33% of health plans reduce co-payments. For patients with asthma, 19% of health plans waive co-pays for essential drugs and 32% reduce co-pays. For hypertension, 20% of health plans waive co-pays for drugs and equipment and 28% reduce co-pays. For preventive health visits, 43% of health plans waive co-pays.
  • Consumers are being given increasing responsibility for managing their health care, and purchasers want health plans to provide information to consumers so they can effectively make decisions regarding providers and treatments. To that end, it was noted that health plans should have an online directory where consumers can find physicians and hospitals.
  • Purchasers are also demanding that health plans adopt electronic medical records to improve information flow, patient safety and reduce gaps in care.
  • Only about half (57%) of participating health plans remind members about colorectal cancer screening and only 53% of health plans tell members when their colorectal screening is overdue. Health plans can also prompt physicians to ensure their patients receive life-saving cancer screenings. Only 40% of the plans report to physicians if patients have received a colorectal cancer screenings.

Over 100 million Americans,or about two-thirds of those insured by employers , are members of health plans that respond to eValue8. The 2008 findings represent information from 100 HMO and PPO plans, according to a news release regarding the findings.