EmblemHealth was nominated for two of its programs—Improving Osteoporosis Screening in Medicare Women who Experience a Bone Fracture and Increasing Annual Dental Visits in the Medicaid Population. The plans, two of eight finalists in the health plan category, were selected from entries across the nation by a distinguished panel of judges and will be honored during URAC's 2013 Quality Summit, September 30 to October 2, 2013 at the Capital Hilton in Washington, DC.
"With the implementation of the Affordable Care Act and implementation of Health Insurance Exchanges, health plans have a great opportunity to innovate new ways to deliver care that is better for patients and improves quality and value," said Kylanne Green, President and CEO of URAC. "URAC is honored to recognize organizations like EmblemHealth that are leading the way with such cutting edge approaches."
EmblemHealth partnered with MedXM to offer bone mineral density screenings at home or in a skilled nursing facility to female Medicare members who recently experienced a fracture, but had no recent evidence of osteoporosis testing or treatment. Fractures in the senior population are often a sign of bone disease and pose an increased risk of future fractures. EmblemHealth's program offers proactive management of osteoporosis, which is critical to the prevention of future bone fractures especially for women in the Plan's Medicare product, who often have multiple comorbidities that can be exacerbated by multiple fractures.
To help low-income children prevent tooth decay—the most common chronic illness in children—EmblemHealth partnered with Healthplex to increase annual dental visits in the Medicaid population through provider and member incentive programs, multiple community screening events, and telephone outreach. Children who have their first preventive dental visit by age one are less likely to have subsequent restorative or emergency room visits, while dental-related costs fall almost 40% ($263 compared to $447) over a five year period.
According to The American Academy of Pediatrics, tooth decay is five times more common than asthma. It is disproportionally concentrated among socially disadvantaged children, especially those who qualify for Medicaid, and its consequences can include poor speech and communication, learning issues, sleep problems, and poor nutrition and quality of life.
"We are honored that our programs were chosen as finalists for URAC's Health Plan Best Practice Award 2013," said William Gillespie, MD, Chief Medical Officer for EmblemHealth. "Our mission is to provide access to affordable quality health coverage to improve the overall health of our members. We believe we have succeeded with these programs."
URAC intends to present Gold, Silver and Bronze award in the Care Coordination and Clinical Integration category, to be announced at the 2013 Quality Summit on October 1, 2013. For complete conference details, go to https://www.urac.org/2013AnnualSummit/AnnualSummit.asp.
EmblemHealth, Inc., through its companies Group Health Incorporated (GHI) and HIP Health Plan of New York (HIP), provides quality health care coverage and administrative services to approximately 3.4 million people. Groups and individuals can choose from a variety of PPO, EPO and HMO plans, as well as coverage for prescription drugs and dental and vision care. EmblemHealth offers a choice of networks, including quality doctors and other health care professionals throughout the region, leading acute care hospitals across the tristate area, and physicians and hospitals across all 50 states. For more information, visit www.emblemhealth.com.
URAC, an independent, nonprofit organization, promotes health care quality through its accreditation, education and measurement programs. URAC offers a wide range of quality benchmarking programs and services that keep pace with the rapid changes in the health care system and provide a symbol of excellence for organizations to validate their commitment to quality and accountability. Through its broad-based governance structure and an inclusive standards development process, URAC ensures that all stakeholders are represented in establishing meaningful quality measures for the entire health care industry. For more information, visit www.urac.org.