"Transparency is a core principle of the Alliance's work," said Nancy Giunto, the Alliance's executive director. "Knowing how health plans perform stimulates improved performance from health plans and enables purchasers and plans to work collaboratively to organize strategies and structure programs to improve value in our market."
In addition to achieving best national performance overall, Group Health's HMO product also achieved best national performance in two of eValue8's eight modules: "Helping Members Get and Stay Healthy" and "Helping Members Manage Chronic Conditions."
"Since our founding, Group Health has focused on delivering the best patient experience, quality patient outcomes and affordability. Our teams continue to work hard daily to meet our members' needs. That's why we are very proud to be recognized by eValue8 as the nation's top performing plan. We support using transparency to help all health care payers determine value for every dollar spent," says Scott Armstrong, President and CEO of Group Health Cooperative.
Ongoing ratings help improve quality outcomes for Washington residents
Every two years, the Alliance joins together with employers and union trusts in Washington state to sponsor eValue8, a nationally standardized Request for Information managed by NBCH, a national organization of purchaser-led health care coalitions, of which the Alliance is a member.eValue8, asks health plans over 200 probing questions about health plan accreditation, how the plan measures and pays physicians and hospitals, how well the plan meets consumers' needs for getting needed care and plan information, how well the plan engages and incents consumers to promote health and manage disease, as well as the plan's strategies to reduce and eliminate waste, ensure patient safety, and control costs.
Health plans as well as employers and union trusts receive objective scores enabling comparison of plans locally and against national benchmarks. Once scores are available, health care purchasers have a face-to-face discussion of findings with each health plan to learn what they each need to do to align their strategies, maximize the value of the health care investment and ultimately, improve health and quality of care for residents of Washington state. Employers and union trusts use the information to inform their decisions about which health plans offer the best service and quality.
Details of the 2016 eValue8 analysis
In 2016, six Washington-based health plans voluntarily agreed to participate in the eValue8 process. These six plans include: Aetna, Cigna, Group Health HMO, Group Health Options, Regence Blue Shield, and UnitedHealthcare. A seventh plan, Premera Blue Cross, was invited but they declined to participate in eValue8.
Cigna WA achieved best national performance in "Pharmaceutical Management," one of eValue8's eight modules. Aetna WA achieved best national performance in "Business Profile," one of eValue8's eight modules that largely reflects health plan accreditation, resource use and level of collaboration.
While each health plan differentiates itself with strong programs and results in select areas, the following represent some of the areas of opportunity to improve for most or all health plans:
- Increase the level of support for physicians for identifying and managing patients with depression, alcohol use, obesity and tobacco use
- Improve cancer screening and childhood immunization rates, including member reminders
- Improve tools available to consumers to select physicians and hospitals; ensure that the quality measures used are transparent and integrate quality and price information into the same tool
- Improve quality results for maternal and child health; take steps to lower the rate of C-sections
- Improve patient experience and satisfaction, especially on overall rating, getting needed care and shared decision-making
Results from the 2016 eValue8 survey are available on http://wahealthalliance.org/alliance-reports-websites/alliance-reports/evalue8/.
About the Washington Health Alliance
The Washington Health Alliance is a place where stakeholders work collaboratively to transform Washington state's health care system for the better. The Alliance brings together organizations that share a commitment to drive change in our health care system by offering a forum for critical conversation and aligned efforts by stakeholders: purchasers, providers, health plans, consumers and other health care partners. The Alliance believes strongly in transparency and offers trusted and credible reporting of progress on measures of health care quality and value. The Alliance is a nonpartisan 501(c)(3) nonprofit with more than 185 member organizations. A cornerstone of the Alliance's work is the Community Checkup, a report to the public comparing the performance of medical groups, hospitals and health plans and offering a community-level view on important measures of health care quality (www.wacommunitycheckup.org).
Washington Health Alliance
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SOURCE Washington Health Alliance