Personal Health Statement To Enhance Conversation.

In an effort to enhance the conversation with its members, Arkansas Blue Cross and Blue Shield has created the Personal Health Statement (PHS), a new health care benefit report that helps them have a more clear and complete picture of their health benefits and health care costs.

The PHS replaces the previous Explanation of Benefits (EOB), which was generated and mailed to members each time a physician or hospital filed a claim with the health plan.

“Health insurance is a complex industry with lots of moving parts and a language all its own,” said Karen Raley, vice president of Communications and Product Development.  “We want the conversations we have with our members to be understandable, whether we’re talking by telephone, through our Web sites or in any of our many written pieces of communication.

“The EOB was one of the most frequent forms of communication our members received from us and that valuable tool has undergone dramatic changes all in an effort to create better communication with our members.  The PHS more thoroughly explains a member’s health insurance benefits, outlines our obligations and clearly shows members what they need to pay regarding a claim that has been filed for services they received.”

With the new PHS, industry terms have been simplified into everyday language, claims are more clearly explained, and members know exactly where they are with their out-of-pocket costs (deductibles, copayments, coinsurance and more).

The Personal Health Statement is more comprehensive than the old EOB and is designed to make claims processing easier for members to understand.

The new PHS provides:

  • a better description of the discounts members receive on their health-care services
  • information on how to get in touch with the health plan
  • a quick understanding of how much members owe and to whom
  • help in understanding the benefits members have and how they work

Pharmacy information has been added for the first time and test groups found this to be a valuable record of the medications they take and the dosage.  Another new feature on the PHS is personal health messages and reminders to get recommended health screenings when they are due.

All the detailed claims information that members are accustomed to receiving in their EOB will continue to be found in their PHS, but with easier to understand explanations and in a more user-friendly format.

Member participants in the PHS pilot indicated that the new PHS is user-friendly and informative – “…the first time for many people to see what a prescription really costs then see what the generic would cost…;” descriptive – “…a valuable tool for helping explain our health-care benefits and costs…;” and educational – “…will help all of us become better consumers of health care because we can actually see how money is being spent.”

“We love to hear from our members,” Raley said.  “We see the new PHS as a product of their feedback, an educational tool for increasing their knowledge about health care cost and coverage, and a resource for making our conversations with members more meaningful.”

About Arkansas Blue Cross and Blue Shield
Founded in 1948, Arkansas Blue Cross and Blue Shield, an independent licensee of the Blue Cross and Blue Shield Association, is the largest health insurer in Arkansas.  Arkansas Blue Cross and its affiliates have more than 2,700 employees.  If combined, the 39 independent, locally operated Blue Cross and Blue Shield Plans collectively provide healthcare coverage for nearly 100 million – nearly one in three – Americans.

$27 Million in Funding Awarded for Chronic Disease Self-Management Programs for Older Americans

Older Americans with chronic diseases can learn how to manage their conditions and take control of their health using the $27 million in grants announced today by the to provide self-management programs to older adults with chronic diseases Secretary Kathleen Sebelius.  The Communities Putting Prevention to Work Chronic Disease Self-Management Program, funded by the American Recovery and Reinvestment Act of 2009, will allow 45 states, Puerto Rico and the District of Columbia to provide self-management programs to older adults with chronic diseases build statewide delivery systems and develop the workforce that delivers these programs.

“Prevention activities can strengthen the nation’s healthcare infrastructure and reduce healthcare costs,” said Secretary Sebelius. “These new grants will provide an important opportunity for states, tribes, territories and communities to advance public health across the lifespan and to help reduce or eliminate health disparities.”

Chronic disease can negatively affect quality of life and threaten the ability of older adults to remain independent within their own homes and communities.  The more chronic diseases an individual has, the more likely that individual will become hospitalized.  Two-thirds of Medicare spending is for beneficiaries with five or more chronic conditions.

“The number of older adults with chronic conditions will increase dramatically in the coming years as our aging population grows,” said Assistant Secretary for Aging Kathy Greenlee, whose agency, the Administration on Aging (AoA), will administer the grants.  “This opportunity will allow states to build the foundation for an infrastructure that embeds health prevention programs into the nation’s health and long term care system and expands a system of care that addresses the growing prevalence of chronic conditions.”

The Stanford University Chronic Disease Self-Management Program, which serves as a model for this initiative, emphasizes the patients’ role in managing their illness and building their self-confidence so they can be successful in adopting healthy behaviors.

The first baby boomers will turn 65 in 2011 and of these, more than 37 million – or 6 out of 10 – will be managing more than one chronic condition by 2030.  For example, 14 million boomers will be living with diabetes while almost half of the boomers will live with arthritis (that number peaks to just over 26 million in 2020).

State agencies on aging, public health departments, and Medicaid agencies will work together to support the deployment of evidence-based chronic disease self-management programs targeted at older adults with chronic conditions.  Grantees will serve at least 50,000 older adults and gather evidence regarding the impact of these programs on health behavior and the health status outcomes of the participants.

Two federal evaluation activities will complement required state reporting. Additionally, AoA will collaborate with the Centers for Medicare and Medicaid Services (CMS) to develop a pilot test in one state as a quality assurance process that will track Medicare claims data of chronic disease self-management program participants and Medicare beneficiaries not participating in the program.  Data from all these sources will be used to assess the impact of this Recovery Act program on participant health behaviors, health status, health care utilization and health care costs.

To see the Chronic Disease Self-Management Program State Funding Table, visit www.hhs.gov/recovery/cdc/awardschronicdisease.html

To learn more about the Chronic Disease Self-management Program grantees, visit http://www.aoa.gov/AoAroot/PRESS_Room/News/2009/03_18_09.aspx

To learn more about the Communities Putting Prevention to Work Initiative, visit http://www.hhs.gov/recovery/programs/cppw/factsheet.html

To learn more about the HHS Implementation of Recovery Act funding, visit http://www.hhs.gov/recovery

Efforts to Promote Use of Lower-Cost Physicians May Be Based on Misleading Profiles.

Increasingly common insurance plans that encourage patients to receive care from physicians who keep medical costs lower are based on unreliable estimates of doctor performance and may not achieve the intended savings, according to a new RAND Corporation study.

The first major assessment of physician cost profiling found that about one-fourth of the 13,788 physicians studied would be misclassified under the system of cost ranking commonly used by insurance plans, according to findings published in the March 18 edition of the New England Journal of Medicine.

Cost profiling increasingly is used to decide which physicians will be included in health plan networks, and patients often are provided financial incentives to use physicians that have lower cost profile scores.

“Our findings raise questions about the utility of cost profiling tools for high-stakes activities such as tiered health plans and the likelihood that wide use of these strategies will reduce health care spending,” said John L. Adams, the study’s lead author and a senior statistician at RAND, a nonprofit research organization. “Consumers, physicians and those who pay for health care are all at risk of being misled by the results from these tools.”

Studying 28 physician specialties in detail, researchers found that only about 40 percent of physicians had cost profile scores that were at least 70 percent reliable—a common threshold for reliability—and fewer than 10 percent of physicians had cost profiles that were at least 90 percent reliable.

Among physicians in a hypothetical two-tiered insurance plan, nearly 40 percent of internists and nearly two-thirds of vascular surgeons labeled as lower cost were not lower cost, according to the RAND study. Physicians in surgical specialties, in particular, appear to have low reliability cost profile scores, while dermatologists’ cost profile scores were the most reliable.

Health purchasers have focused cost-saving efforts on physicians because they write the orders that can drive increased heath care spending. Health plans are limiting the number of physicians who receive in-network contracts, offering patients lower co-payments to see preferred doctors and paying bonuses to doctors who keep spending down.

Researchers from RAND Health analyzed information from insurance claims for 2004 and 2005 from four health plans in Massachusetts that provide coverage to about 80 percent of the non-elderly with private insurance. They used commercially available software to examine the costs of treating episodes of common illnesses such as diabetes and heart attack, assigning each episode of care to a physician and creating a cost profile for each physician based on all similar episodes of care.

Using statistical tools, researchers evaluated the reliability of physician cost scores by considering factors such as the number and types of patients physicians treated. The results show that the reliability of cost-profiling scores were unacceptably low for physicians in most of the specialty groups.

Researchers also examined how reliability scores might change across several different scenarios, such as requiring at least 30 episodes of treatment in order to create a profile and different methods for assigning episodes to physicians. While some scenarios modestly increased reliability, the results still fell short, according to the study.

“These ranking systems may be useful for some purposes, but they are not reliable enough at this point to make decisions about encouraging patients to see certain providers or excluding some doctors from insurance networks,” Adams said. “Much work remains to be done to improve these systems before they are used for high-stakes activities.”

He said the current systems may be useful for efforts such as warning physicians that their treatment methods appear to cost more than those used by their peers and urging them to reexamine their practice styles.

While cost profiling shows promise as a strategy to reduce health costs, it cannot be successful until more-robust tools are developed to use claims data and other information to create reliable cost profiles for physicians.

Funding for the study was provided by the U.S. Department of Labor. Other authors of the study are Elizabeth A. McGlynn of RAND, Dr. Ateev Mehrotra of RAND and the University of Pittsburgh School of Medicine, and J. William Thomas of the University of Southern Maine.

About the RAND Corporation

The RAND Corporation is a nonprofit research organization providing objective analysis and effective solutions that address the challenges facing the public and private sectors around the world.

MVP Health Care Takes KidPower Youth Sports Program to Facebook.

To help kids to make healthy decisions, MVP Health Care has launched a new and improved version of its KidPower Program, www.mvpkidpower.com on Facebook.

Being on Facebook enables KidPower to actually connect with families in their living rooms or on handheld devices through daily posts that motivate and inspire them to get active, eat better and live healthier lives,” said David Henderson, MVP Health Care executive vice president. “There is rich content for every family interested in a healthy active lifestyle for their children and the site can even be used as a resource for youth sports coaches, summer camp staff or anyone running a program for young people,” Henderson added.

While Facebook users can become fans of the page and actively participate in dialogue and discussions, anyone can access the site to view upcoming events in their area, flip through photos and videos from past events and get connected with expert advice from top athletes such as Olympic Gold Medalist soccer player Abby Wambach, legendary lacrosse star (now Syracuse University coach) Gary Gait and the MVP Health Care cycling team.

The MVP KidPower program began hosting free youth soccer clinics lead by Abby Wambach in 2004. Added to the clinic circuit in 2009 was Gary Gait. Combined, the two athletes have attracted more than 22,000 aspiring young athletes for instructional demonstrations, skill drills and motivational talks. The site will be used to advertise registration for these clinics, in addition to promoting community marathons, road races, kids’ fairs and safety rodeos sponsored by MVP Health Care.

MVP Health Care:
MVP Health Care provides fully insured and self-funded employer health benefits plans, dental insurance, and ancillary products, such as flexible spending accounts in New York state, Vermont, and New Hampshire through its operating subsidiaries. For details, visit www.mvphealthcare.com.

Survey Shows that CDHPs Increase in Adoption.

Pressured by rising health care costs and a recession, more U.S. employers used cost shifting in 2010 than the prior year, according to the Wells Fargo Benefits Marketplace Survey. According to the report, employers also continue to offer Consumer Directed Health Plans (CDHPs) and wellness programs in order improve health and lower costs.

“The survey results validated our suspicions,” said Dan Gowen, senior vice president, for Wells Fargo Insurance Services. “As inflationary adjustments from insurance companies remain in the 10-11 percent range and companies continue to struggle in today’s economy, many employees are being asked to share a greater percentage of overall healthcare costs.”

The survey found that the majority of employers made few changes to the basic components of their plan designs, with 84 percent remaining with their current medical carrier. Seventy one percent made no revisions to their prescription plan and 97 percent made no reductions to their dental plan. The most common strategy used was to ask employees to pay more via the medical plan design (46 percent) or to absorb a greater percentage of the costs, through payroll deductions (41 percent). The survey found 26 percent made no changes to their plan design, funding, insurance carrier, plan offerings or contribution percentage.

The survey — published by Wells Fargo Insurance Services — collected information on more than 320 employers of different sizes and from different industries nationwide. Surveys were conducted during five-weeks in December 2009 and January 2010 and gathered information on decisions employers made about benefit programs for 2010.

CDHPs continue to increase in adoption

The survey also showed that CDHPs continue to increase in adoption. Four percent of employers added a Health Savings Account (HSA) plan, while three percent added a Health Reimbursement Account (HRA) plan, bringing the total of employers offering a CDHP to 31 percent. Another eight percent indicated they plan to offer a CDHP in 2011.

Other findings showed that employers continued to implement wellness programs. Smoking cessation, weight management and biometric screening programs were the most common programs added in 2010. Connecting participation in a wellness program with financial incentives was also popular. Employers that added a wellness program for 2010, 59 percent offered an incentive to participate. Employers in the Southeast (84 percent) and Midwest (71 percent) offered the highest level of wellness incentives.

“It’s encouraging to see more employers offering financial incentives, in conjunction with the new wellness offerings this year,” said Gowen. “Providing the program is only the start. It’s important to not only get the employees enrolled, but to keep them engaged in the program. Incentives help drive the motivation necessary for success.”

Disease management programs also are offered widely with diabetes, coronary artery disease and asthma being the most common programs added for 2010. Employers also adopted financial incentives (43 percent) more widely than they did a year ago.

The survey addressed the addition of voluntary benefit plans. As employers look to trim their overall benefit budgets, voluntary benefit plans continue to gain in popularity. Of those employers that offered at least one new voluntary program, 50 percent offered two or more. The most common combinations among these products are accident, cancer, and critical illness benefits, with 27 percent of employers adding them.

Lastly, despite the topic of healthcare reform dominating as a yearlong discussion, most employers took a “wait and see” approach. Ninety two percent of employers took no action to better align themselves in the event legislation were to be passed in 2010.

About Wells Fargo Insurance Services

Wells Fargo Insurance Services USA, Inc. is the fourth-largest insurance brokerage and the largest bank-owned insurance brokerage in the United States, with more than 200 offices in 37 states. Its 8,200 insurance professionals place more than $15.5 billion of risk premiums with expertise in property, casualty, benefits, international, personal lines and life products. For more information about Wells Fargo Insurance Services, visit www.wellsfargo.com/wfis.

Wells Fargo & Company is a diversified financial services company with $1.2 trillion in assets, providing banking, insurance, investments, mortgage and consumer finance through more than 10,000 stores and 12,000 ATMs and the internet (wellsfargo.com) across North America and internationally.

SOURCE: Wells Fargo Insurance Services USA, Inc.

New Mobile Features Offer Greater Convenience and Information for HealthPartners Members.

HealthPartners has introduced a new technology benefit for its members, the first of its kind in Minnesota, as part of a suite of online services aimed at todays busy individuals.

HealthPartners members now have the capability to view an image of their insurance card on their smart phone as soon as the card is issued. HealthPartners is believed to be the first organization in the country to offer the mobile ID card, which members can access from any smart phone, including the iPhone, by logging into their account at m.healthpartners.com. Exact images of the cards front and back will be visible.

New application features will be added over the next few weeks, including a “Remember Me” feature that will eliminate the need to log in every time, and a fax capability that will send the image of the card directly to the provider’s fax machine. The mobile feature is available for both HealthPartners medical and dental insurance cards.

“This feature is perfect for when you forget your insurance card but still have your phone with you,” said Scott Aebischer, HealthPartners senior vice president, customer services and product innovation. “And this technology is just another great example of what we are able to offer our members in terms of mobile convenience and access.”

The mobile ID card is part of HealthPartners ongoing commitment to use technology to reach members how they want and when they want. As one of the first organizations in the country to offer patients ways to connect online to schedule appointments, get same-day test results and immunization records. HealthPartners technology portfolio also includes online price comparison tools, clinic quality rankings and online bill pay.

For those constantly on the go, HealthPartners has developed a number of mobile-specific services. Members who get sick while out of town can connect directly to the HealthPartners CareLineSM through m.healthpartners.com on their cell or smartphone. They can find the closest urgent care, access free, 24-hour care advice, refill prescriptions and more.

Additional mobile features, including specific treatment plans will be of future web-based releases. One example of this mobile care focuses on expectant mothers who are at high risk for delivering a premature baby. These patients can choose to access a two-way messaging service or receive a customized treatment plan over their phone from a HealthPartners care manager. The program helps avoid premature births and readmissions to the hospital.


HealthPartners
Founded in 1957, the HealthPartners family of health care companies serves 1.25 million members and provide care to over 500,000 patients in our HealthPartners care delivery system which includes 70 clinics and 3 hospitals.

New Value-Based Health Insurer Aligns Benefits With Preventive Care and Chronic Condition Management.

SAN FRANCISCO–(BUSINESS WIRE)–SeeChange Health today launched the first new value-based health insurance company in California, offering personalized, value-based health plans that provide incentives to encourage individuals to play an active role in their health management and improve their quality of life. As the first value-based health insurance company to launch in the United States, SeeChange Health brings affordable, next-generation insurance designs to the employer group market. The plan will be available initially in Fresno, California, but the company plans to expand their offering to Los Angeles, San Diego, Bakersfield, Monterey, Sacramento and San Francisco in the coming months.

Value-based health care encourages individuals to access preventive care, which will identify looming health problems before they become serious – and expensive. Participants who complete a health questionnaire along with age and gender specific preventive examinations, including cancer screenings and basic lab tests, are rewarded with enhanced benefits such as reduced coinsurance and deductibles along with cash rewards.

Unlike typical health insurance companies, SeeChange Health designed its benefit plans to encourage individuals to see their doctor. SeeChange Health covers preventive examinations, including cancer screenings and associated lab tests, at 100 percent.

“We are thrilled to partner with a health plan that rewards its members for building and maintaining a relationship with their doctor,” said Dr. Daniel Bluestone, Chief Medical Officer of Santé Community Physicians. “SeeChange Health promotes healthy behaviors, which will ultimately reduce chronic illnesses and help people live fuller, healthier lives.”

In addition to providing enhanced benefits for completing preventive examinations and related screenings, SeeChange rewards its members with financial incentives for completing health actions necessary for proactively managing chronic conditions, such as diabetes, asthma and coronary artery disease.

“When SeeChange approached us with its groundbreaking solution, we eagerly embraced the only health plan to completely align its benefits with preventive care and chronic condition management,” said Cyndy Nayer, President of the Center for Health Value Innovation, the nation’s premier information exchange for value-based design.

“The reaction and feedback we are receiving from employers is overwhelmingly positive,” said Chuck Trogdon, CEO of Renberg, Trogdon, & Cavale Insurance Services. “Employers are clamoring for affordable health plans with benefits designed to support individual efforts for staying healthy. This approach drives down health plan costs and promotes a healthier workforce.”

Why the initial focus on California? One out of seven residents is uninsured and the number is growing. In the coming months, SeeChange will expand their health insurance offerings throughout California and into twenty-four states where they are licensed to sell value-based health insurance.

“While the nation debates the merits of a national health care plan, the elephant in the room is who is going to pay for it,” said Martin Watson, CEO of SeeChange Health. “With our new plan, we are effectively showing that you can lower health care costs and improve the quality of care while you’re doing it.”

About SeeChange Health

SeeChange Health provides fully-insured, value-based health insurance to employer groups. The company combines value-based benefit designs, data analytics and an interactive personal health record to consistently improve the health profile of individuals. Preventive health actions are assigned and tracked at an individual level. Individuals with disease states such as pre-diabetes, diabetes, asthma and heart disease receive specific health actions based on their medical condition. SeeChange Health is headquartered in San Francisco and is focused on reducing health care costs through proactive health management and early detection of health conditions.

Employers Frustrated by Inability of Many Workers to Change Health Habits Tighten Incentives Requirements.

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 Annual Employer Survey Finds Majority of Employers Rate Managing Costs as Top Priority in 2010.

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.

Kaiser Permanente Study: Starting Treatment Early Doubles Chance of Success for People with Diabetes.

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