Survey Indicates Health Plans Could do Better on Info Release

November 12, 2007 ( - According to the eValue8 report of health plan performance released by the non-profit National Business Coalition on Health (NBCH), health plans could do a better job of sharing important information with their customers.

All surveyed health plans (100%) said they offer provider directories, according to an NBCH press release. Almost 58% of health plans indicated they provide information on office hours and 60% said they provide publicly available, evidence-based measures of quality.

However, only 28% of respondents said they provide mortality or complication rates where applicable, and only 31% provide patient experience data.

NCBH said it also found consumers are rarely informed about which physicians have adopted standard health information technology, with only 28% of plans providing information on a physician’s accessibility of email communications, 15% including information on availability of Web consultations, and 10% including information on prescribing.

“This year’s eValue8 results prove health plans are collecting information that would be helpful to doctors and patients, however many are not leveraging it to improve health and health care,” said Andrew Webber, president and CEO of NBCH, in the release.

Eighty-one percent of health plans indicated they send some type of education material to members. For breast cancer screening, 68% of health plans use claims data to trigger reminders to plan members and 40% of plans send reminders for colorectal cancer screening where early detection is proven to save lives.

While health plans have the claims data and know which members need screenings due to how old the member is or if they have not gotten a screening, not enough health plans are using the information to ensure members are getting important screenings. Further, only 56% of health plans send reminders to doctors regarding which members need breast cancer screening, and only 46% of health plans send reminders to doctors regarding which members need colorectal cancer screening.

Almost all health plans indicated they send notices to members about switching to lower cost generics as well as send notices to doctors. However, few plans reported they look retrospectively at drug conflicts to notify consumers and doctors when dangerous drug-drug conflicts emerge or when consumers are taking inappropriate medication for their age.

In addition, NCBH pointed out increasing co-pays discourages patients from getting the care they need. Health plans can create plan designs that encourage members who need care the most to get that needed care, yet, for diabetes, only 38% of health plans indicated they modify co-pays for pharmaceuticals, tests, and/or equipment, and only 28% said they modify deductibles. For depression, only 15% of health plans modify co-pays and 11% modify deductibles.

NBCH’s eValue8 program gathers health care data from nearly 200 health plans and health insurers. A report of the overall findings – Connecting the Dots in Health Care – is available at .