NBCH Releases Annual eValue8 Report on Performance of Health Plans in Preventing Diabetes, Promoting Quality Care

Employers want plans to get in front of diabetes wave

WASHINGTON, May 24, 2011 /PRNewswire/ -- The non-profit National Business Coalition on Health (NBCH) released its annual report on the performance of America's health plans on improving care and controlling costs for diabetes. Based on the annual eValue8™ health plan survey and evaluation used by health care purchasers, the analysis indicates that while plans have shown incremental progress each year, there is still a long way to go in improving health and controlling costs.

"Employers are faced with growing numbers of employees with diabetes and continually rising obesity rates will only make this worse," said Andrew Webber, NBCH president and CEO. "While the Patient Protection and Affordable Care Act includes important delivery system reforms, employers still have a direct hand in affecting health outcomes by selecting health plans and making choices about the value of their plan offerings. Using information from eValue8, purchasers are holding their plans accountable to close quality of care gaps, engage their members and focus on preventing costly chronic conditions such as diabetes."

The eValue8™ Employer Report on 2010 Health Plan Diabetes Care Performance is available on NBCH's website. The information outlines the landscape of diabetes for employers including the importance of treatment goals and the approaches plans are using to prevent the disease and improve its care, as well as eValue8 health plan performance trends. The report was developed with support from sanofi-aventis.

eValue8 report findings

• The overall findings indicate that health plans are moving forward on diabetes quality efforts, however there have been no major transformations in approaches or outcomes.
• Trends related to motivating beneficiaries, areas where purchasers can play a direct role by providing incentives and support services to increase consumer engagement and keep people healthy, include:
  • Value-based insurance design approaches continue to grow as a means to encourage members to use high value services with 59 percent of plans able to waive/adjust out-of-pocket payments for diabetes tests, treatments and prescriptions.
  • All health plans reported the ability to promote the use of personal health assessments (PHA) to members and the capability to provide incentives, however many employers elect not to use incentives or the plan as the wellness vendor, resulting in only three percent of members completing a PHA. When the employer chooses to use an incentive program, 81% have the capability to administer a financial incentive program for members, and 78% have the capability to administer non-financial incentives such as gift cards, contests, etc.
  • Diabetes disease management is almost universally offered, with 88 percent of plans reporting the service.
• Provider contracting is generally under the control of the health plan, but purchasers can set expectations for those relationships that involve incentives and support for better outcomes instead of rewarding more procedures. Trends related to motivating doctors and hospitals in the report include:
  • Plans are leveraging the data on physician performance to drive improvements, with 91 percent of plans indicating they have the capability to report back to doctors on gaps in quality of care for individual patients. Seventy-eight percent of plans can now show physicians how they compare with peers.
  • Plans are investing in, developing and testing coordinated care systems. Approximately 60 percent of plans are participating in patient-centered medical home (PCMH) pilots, 55 percent use enhanced payments to reflect higher intensity services delivered by the PCMH and 79 percent report making performance based payments.

About eValue8

An annual health care purchasing and quality improvement assessment survey and process, eValue8 was developed by NBCH to help purchasers understand the value of their health and health care decisions. eValue8 asks health plans from across the U.S. to submit information on areas such as how doctors are paid, gaps in care, consumer engagement, price transparency and administrative efficiency across hundreds of measures of quality and performance. This enables purchasers (such as public and private employers and union trusts) to compare plans in their region and against national benchmarks and effect change by partnering with their plans to improve treatment of costly chronic health conditions such as diabetes, asthma and cardiovascular disease.

About the National Business Coalition on Health

NBCH is a national, non-profit, membership organization of 53 purchaser-led business and health coalitions, representing over 7,000 employers and 25 million employees and their dependents across the United States. NBCH and its members are dedicated to value-based purchasing of health care services through the collective action of public and private purchasers. For additional information visit: www.nbch.org.

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Andrew Webber

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SOURCE National Business Coalition on Health