While employers remain committed to offering health and productivity programs, they are frustrated by the inability of many workers to change their health habits. In an effort to encourage healthy behaviors, a growing number of employers are tightening their requirements for workers to receive financial incentives, according to a survey conducted by Towers Watson (NYSE, NASDAQ: TW), a global professional services company, and the National Business Group on Health (NBGH), a nonprofit association of large U.S. employers.
Currently, more than half (53%) of large employers offer financial incentives to workers who enroll in health engagement activities, such as weight management or smoking cessation programs. But, for many employers, participation alone is no longer enough to earn an incentive. Now, more than one-third of employers (37%) reward only those workers who meet the company’s requirements for completion of a health engagement activity, and almost one-third (29%) only reward members who participate in multiple activities, according to the 15th Annual NBGH/Towers Watson Employer Survey on Purchasing Value in Health Care. Still, most employers (93%) have no plans to eliminate their health promotion programs, and 83% have no plans to cancel or delay adding new ones.
“Employers are frustrated by their employees’ low use of expensive health improvement programs,” said Ted Nussbaum, senior consultant at Towers Watson. “As employers continue to empower workers to be more health focused, they are beginning to target and reward those workers who demonstrate a real commitment to making positive lifestyle changes.”
This year’s survey also found that employers demonstrate dramatic differences in their ability to keep health care cost increases in check. The survey identified a group of “consistent performing” companies that have successfully held cost increases below the median trend for the last four years. In fact, these consistent performers experienced a median cost increase of just 2.1% over the last four years compared with 6.8% for all companies. These companies separate themselves from poorer performing companies in five areas: appropriate financial incentives, effective information delivery, metrics and evidence, quality care, and health and productivity. Consistent performers spent $6,536 per employee on health care benefits in 2009 — nearly $1,200 less per employee than for all survey respondents.
“Employers can learn from the companies that consistently hold down health costs year after year,” said Ron Fontanetta, a senior consultant at Towers Watson. “These employers are doing more than just making temporary changes to individual programs. Consistent performing companies offer a wide array of integrated health initiatives and appropriate financial incentives. Over time, the savings are significant.”
Interest in consumer-directed health plans (CDHPs) continues to expand among employers and their workers. Just over half (54%) of companies now offer a CDHP, and that number is expected to grow to 61% in 2011. Nearly half (46%) of companies that offer a CDHP report at least 20% of their workers enrolled, an increase of nearly 70% in five years. Companies with higher levels of CDHP enrollment also report lower costs. Those with at least 50% of their workers enrolled in a CDHP report average annual costs per employee of nearly $1,000 less than at non-CDHP companies. Similarly, nearly 60% of survey respondents indicate their workers pay premiums that are at least 30% less than those for traditional copay plans.
“Employers and their workers face a challenging road ahead together,” said Helen Darling, president of the National Business Group on Health. “Those companies most effective at empowering their workers to be engaged consumers of care will find greater success at keeping costs low and likely be rewarded with a healthier, more productive workforce — an effort that has never been more important than it is right now.”
Other findings include:
- In 2010, 38% of companies will offer a health savings account (HSA), with an additional 7% expected to do so in 2011.
- In 2010, 46% of employers will provide coverage for use of retail clinics, up from 36% in 2009.
- In 2010, 57% of employers will encourage plans and providers to provide workers with access to online medical records, up from 54% in 2009.
Download the 15th Annual NBGH/Towers Watson Employer Survey on Purchasing Value in Health Care.
Source: Towers Watson
CVS Caremark (NYSE:CVS) today announced the results of the Company’s annual employer client benefit survey about priorities for PBM services in the coming year. The majority of employers surveyed (94 percent) said they will seek opportunities to improve savings even more in 2010, while they look for ways to improve the overall member experience. Overall, employers listed price (86 percent), customer service (86 percent), trust and reliability (84 percent) and consumer engagement capabilities (46 percent) as key priorities for their PBM procurement strategy.
“The economic environment continues to impact companies this year, with 66 percent telling us that reducing overall health care costs is their number one success measure,” said Jack Bruner, Executive Vice President, Strategic Development, Caremark Pharmacy Services. “Employers tell us they are looking for more aggressive solutions to increase generic utilization and manage specialty pharmacy costs, while also focusing on programs to increase medication adherence and manage chronic diseases.”
This annual survey enables CVS Caremark to provide clients with a barometer that highlights shared issues and priorities among their peer group and provides insights into what strategies other companies are implementing or considering. The account teams also use this information to work directly with their clients to determine specific priorities and tailor PBM services that best help them reach their goals.
“We are well positioned to deliver on both of our employer clients’ key priorities – lowering costs while improving the member experience,” said Bruner. “We are able to provide our clients with access to a variety of plan designs that manage costs while also incorporating services that counsel members so that they better understand their options and can make informed decisions that result in savings for both the member and the benefit sponsor.”
With regard to plan designs to help employers manage costs, CVS Caremark offers a variety of options to increase generic utilization and brand to generic conversions. Survey results show that the majority of employer clients are strongly considering adopting some of the more progressive strategies to encourage the use of lower-cost generic medications. For example, almost half of employers surveyed are considering implementing plan designs that require using a generic medication first before moving to a branded drug (48 percent) and those that provide members a co-pay waiver to switch to generic medications (56 percent). In addition, compared to the 2009 survey results, there has been a significant increase in employers who are adopting or considering solutions to improve medication adherence.
In particular, many employer clients are considering programs that impact adherence through counseling and intervention with the member, including: counseling to improve adherence the first time a member fills a maintenance medication (62 percent), outreach to prescribers to resolve gaps in care (56 percent) and outreach to members and prescribers to provide counsel about therapy drop-off (65 percent).
The CVS Caremark client survey was conducted on-line from October 5, 2009 through December 31, 2009 and includes responses from current CVS Caremark clients representing 285 employers and approximately 7.3 million lives.
A new study published in the March issue of Diabetes Care, a journal of the American Diabetes Association suggests that the sooner people with diabetes start taking metformin, the longer the drug remains effective.
According to a Kaiser Permanente study, metformin, an inexpensive, generic drug that helps patients prevent dangerously high blood sugar levels, worked nearly twice as long for people who began taking it within three months of their diabetes diagnosis. This is said to be the first study to compare metformin failure rates in a real-world, clinical practice setting. Other studies compared failure rates of metformin only in clinical trials.
According to a news release announcing the study, metformin is recommended as a first-line agent in the treatment of type 2 diabetes, but in most patients it eventually stops working, forcing them to take additional medications to control their blood sugar. Each additional drug adds extra costs and the possibility of more side effects including weight gain, so this study is welcome news for newly diagnosed patients, researchers said.
“This is an important finding for the 30 million people world-wide who are diagnosed with type 2 diabetes every year. The sooner they start taking metformin, the better and longer it seems to work,” said the study’s lead author Jonathan B. Brown, PhD, an investigator with the Kaiser Permanente Center for Health Research in Portland, Ore. “This study suggests that to gain full benefit from metformin, patients should start taking it as soon as they find out they have diabetes.”
According to the news release, researchers used electronic health records to follow nearly 1,800 people with diabetes in Kaiser Permanente’s health plan in Washington and Oregon for up to five years. Metformin failed at a rate of only 12 percent a year for the patients who began taking it within three months of diagnosis. That compares to a failure rate of 21.4 percent per year for patients who started taking metformin one to two years after diagnosis, and 21.9 percent per year for those who didn’t start taking the drug until three years after they were diagnosed.
“We believe that starting the drug early preserves the body’s own ability to control blood sugar, which in turn prevents the long-term complications of diabetes like heart disease, kidney failure, and blindness,” said study co-author Gregory A. Nichols, PhD, an investigator with the Kaiser Permanente Center for Health Research. “The American Diabetes Association recommends that patients start taking metformin and make lifestyle changes as soon as they are diagnosed. This study provides more evidence to back up that recommendation.”
The press release noteThe study was funded by Novo Nordisk, Inc., a company that does not make or sell metformin and has no financial interest in, or connection to, Kaiser Permanente.
Study authors include: Jonathan B. Brown, PhD, MPP, and Gregory A. Nichols, PhD, from the Kaiser Permanente Center for Health Research in Portland, Ore., and Christopher Conner, PharmD, PhD, from Novo Nordisk, Inc., Seattle.
Click here to read the full study:
http://care.diabetesjournals.org/content/early/2009/12/29/dc09-1749.full.p df+html
Tapping into the increased popularity of online forums, the Blue Cross and Blue Shield Association (BCBSA) says it will add an online health community to its Blue365 program – a comprehensive, nationwide program designed to offer Blue Cross and Blue Shield members innovative healthcare tools and resources.
According to the association, the new online health community will expand upon an award-winning Web site established in 2005 by Portland, Ore-based Regence BlueCross BlueShield. Regence’s online community, myRegence.com, was chosen as the model for the Blue365 online community because of the features it offers, many of which the Blue365 program hopes to include, such as self-directed wellness activities, multimedia content and educational resources, support groups, and health forums on a variety of topics.
“Blue Cross and Blue Shield companies strive to offer our members the best value and resources to support their healthcare decisions and help them maintain a healthy lifestyle,” said Scott P. Serota, president and CEO of BCBSA. “This new online community will give members the opportunity to connect with others about healthcare issues that are important to them.”
The Blue365 Online Health Community will pilot with a select group of Blue Cross and Blue Shield companies that include Blue Cross & Blue Shield of Rhode Island and Blue Cross and Blue Shield of Louisiana, with more Blue Cross and Blue Shield companies expected to sign on in the coming months.
“We are excited that the Blue365 program has chosen our member website as a model for the national platform,” said Mark Ganz, president and CEO of Regence BlueCross BlueShield. “As our online community has grown, we’ve developed the expertise to identify and implement the features our customers want.”
Blue365, which was launched in 2007, helps consumers navigate the healthcare decision-making process, maintain a healthier lifestyle, and maximize the value of their health benefits. In addition to the new Online Health Community, the Blue365 program includes AskBlue™, a decision support tool designed to help educate consumers of their best choices when selecting health insurance coverage options for themselves or their families, and the Affinity Program, which provides members access to special products and discounts at Nutrisystem, Jenny Craig, Reebok, Snap Fitness, Westin Hotels, Polar, eDiets, Everlast, and other nationally recognized suppliers.
The Blue365 Online Health Community will officially launch in select markets in fall 2010. For more information about Blue365, please visit http://www.bcbs.com/365community.
Source: BCBSA
