Horizon Blue Cross Blue Shield of New Jersey Makes Major Investment In Next Generation Health Care For New Jersey

Most health care experts agree that, despite federal health care reform, a great deal of work remains to be done to improve the nation’s health care system.  Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) announced recently it plans to spearhead that work in New Jersey by creating a new company with a mission to energize the transformation of health care delivery to a better system marked by higher quality and more effective care, greater collaboration and efficiency, and increased affordability.

As one of the first Blue Cross plans in the nation, Horizon BCBSNJ was a pioneer in the creation of health insurance.  Horizon BCBSNJ’s new company will tap that same pioneering spirit to develop innovative collaborative models for the delivery and financing of high quality care in New Jersey.

“As the state’s oldest and largest health insurer, Horizon BCBSNJ is in the best position to initiate collaborative partnerships between the many stakeholders who are working to improve the quality of health care and bring cost increases down to a sustainable level,” said William J. Marino, Chairman and CEO of Horizon BCBSNJ.  “We believe that creating a new company is the best way to bring energy, focus, and commitment to improving the delivery and financing of health care, a goal we share with many of our colleagues throughout the health care system.”

The new company is expected to be operational in September, but Horizon Healthcare Innovations (HHI) has already begun work as a division of Horizon BCBSNJ.  HHI is already working on creating partnerships with providers, employers, and health care leaders to develop new models of care that will provide patients with better quality care, increase efficiencies, and contain costs.

“Everyone in New Jersey’s health care system understands that we cannot continue to experience spiraling costs and below average rankings across quality of care measures,” said Dr. Richard Popiel, who served as Vice President and Chief Medical Officer of Horizon BCBSNJ and will lead the new company as President and Chief Operating Officer.  “We’re committed to leading a major collaborative effort among physicians, hospitals, policy makers, employers, patients, and insurers to rethink how we deliver quality care and control costs.”

Horizon BCBSNJ decided this was an opportune time to establish a new company to address the quality and cost issues left out of the recently passed federal health care reform law.  A number of provisions of the new law will increase health care costs and result in higher insurance premiums.  The new law will add to the financial burden of many individuals and employers, who are already struggling with rising health care costs.

Horizon BCBSNJ also believes there is a significant opportunity to improve heath care quality across the state.  A 2009 Commonwealth Fund study ranked New Jersey 30th in the nation for quality of care based on measures such as prevention, treatment and avoidable hospital use and costs.

“Our goal is to energize collaborative partnerships and ignite the flames of transformation that will benefit the entire health care system – individuals, families, businesses, and providers,” added Dr. Popiel.  “The time is right for innovation and rethinking how care is delivered and financed because people are focused on our health care challenges and they know we need to act.  Horizon is making a major investment and we’re ready to act.”

Source: Horizon BCBSNJ

Anthem Blue Cross and Blue Shield in Virginia Launches Initiative to Curb Avoidable Emergency Room Visits

At a time when health care costs continue to rise and hospitals are advertising emergency room availability, it is becoming more important to educate consumers on how to best access ER alternatives and receive the same care with less out-of-pocket cost. If a primary care physician isn’t available, retail health clinics, walk-in doctor offices and urgent care centers can take less time and cost about the same as a regular doctor visit.

Anthem Blue Cross and Blue Shield in Virginia has recently introduced a series of tools designed to provide consumers with the information they need to make the best decision when it comes to seeking treatment.

“Traditionally, emergency room visits are some of the most expensive episodes in the health care industry,” said C. Burke King, president, Anthem Blue Cross and Blue Shield in Virginia. “By utilizing technology to provide general education in innovative ways, we can help our members make better educated health care decisions and be better stewards of their health care dollar.”++

A study of Anthem claims data for its fully insured business found that more than 60 percent of ER visits for its members were in the area of avoidable visits, or diagnoses that potentially could have been treated in urgent care centers. As an example, bronchitis, one of the more expensive conditions to treat, costs on average $646 to treat in the ER, compared with $97 for an urgent care visit and $54 for a retail health clinic visit. Average costs for visits for all conditions studied ranged from $441 for the ER to $98 for urgent care and $52 for retail care. These costs represent total costs, including the portion paid by the health plan member. In 2008 according to statehealthfacts.org, there were more than 3 million total ER visits in Virginia.

Anthem has created a Google Map that identifies all of the ER alternatives (retail health clinics, urgent care centers and walk-in doctor offices) throughout the state so members have this information at their fingertips. To access the information, please visit http://www.anthem.com/eralt or simply type “Anthem urgent care” into Google or Bing. A link to the information is also available on the “member” home page at www.anthem.com. Physicians can access these maps also in order to quickly help direct their patients to the best care based on their specific situation.

In addition to utilizing the information on the company’s website, members with the 24/7 NurseLine benefit can also contact an Anthem registered nurse to learn the best place to seek care for their medical problem they are dealing with.

Manish Oza, M.D., Anthem medical director and practicing ER physician, said, “By leveraging technology and cataloging all the necessary information, Anthem’s nurse hotline can effectively triage members and provide them with all of their choices ultimately for the member to decide the appropriate venue for care.”

Not only is Anthem providing resources for members to utilize, the company is also leveraging proactive communications like interactive voice recognition calls and e-mail messaging to inform members of options. An iPhone application will launch later this year.

“We plan to leverage technology in multiple ways to touch members when they visit an ER for an avoidable visit without being intrusive,” said Oza.

Generally, urgent care clinics may be used for the following and retail health clinics in certain circumstances:

  • Minor allergic reactions
  • Mild asthma
  • Coughs, sore throat
  • Bumps, minor cuts, scrapes
  • Rashes, minor burns
  • Sprains, strains
  • Minor fevers, colds
  • Minor headaches
  • Ear or sinus pain
  • Eye swelling, irritation, redness or pain
  • Back pain
  • Nausea, vomiting, diarrhea
  • Minor animal bites
  • Vaccinations
  • X-rays
  • Stitches

About Anthem Blue Cross and Blue Shield in Virginia

Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of Virginia, Inc. (serving Virginia excluding the city of Fairfax, the town of Vienna and the area east of State Route 123.). Anthem Blue Cross and Blue Shield and its affiliated HMOs, HealthKeepers, Inc., Peninsula Health Care, Inc. and Priority Health Care, Inc. are independent licensees of the Blue Cross and Blue Shield Association. (R)ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Additional information about Anthem Blue Cross and Blue Shield in Virginia is available at www.anthem.com.

SOURCE Anthem Blue Cross and Blue Shield in Virginia

Blue Shield of California Joins Forces with HealthCompare

Blue Shield of California, a not-for-profit health plan with 3.4 million members, is working with HealthCompare, (www.healthcompare.com), a one-stop online guide to help individuals and families easily research, compare, buy and enroll in the right health insurance plan at the right price.

“We are always looking for ways to make health care easier for consumers,” said Brent Hitchings, vice president of sales and account management at Blue Shield of California. “We look forward to working with HealthCompare to help consumers choose the right health plan for their needs.”

Using proprietary technology, HealthCompare presents easy to understand information on health plans – including PPO and indemnity health plans – providing the tools to transform choice into real decisions. Users simply enter their information and receive instant quotes online based on Blue Shield’s local offerings.

“With more than 9.5 percent of our nation’s population currently unemployed, it is crucial that our industry works to help the millions of people who are currently without proper health coverage,” said Kathy Feeny, Senior Vice President of HealthCompare. “Our goal is to reach those that may not be able to afford COBRA and make them aware of the available cost-effective alternatives.”

With over two decades of experience and 600,000 policies managed by its corporate parent, The Word & Brown Companies, all HealthCompare customers can rely on HealthCompare client support representatives to always be at their side, providing them with a renowned and unbiased “Service of Unequalled Excellence.”

About Blue Shield of California

Blue Shield of California, an independent member of the Blue Cross Blue Shield Association, is a not-for-profit health plan with 3.4 million members, 4,800 employees, and one of the largest provider networks; it offers a wide range of commercial and government products throughout the state. Blue Shield of California has contributed more than $120 million over the past four years to the Blue Shield of California Foundation — which this year was named one of BusinessWeek’s 20 most generous corporate foundations. Contact your local agent or broker for more information about Blue Shield products and services, or visit the Blue Shield of California web site at www.blueshieldca.com.

HealthPartners Announces Plans to Enhance Mobile Communications

HealthPartners 1.3 million mobile subscribers will soon receive enhanced services, thanks to an agreement with Diversinet Corp., a leading innovator of secure mobile applications. HealthPartners has licensed the company’s MobiSecure® Health platform to support applications, developed with Diversinet, to build upon the HealthPartners mobile portfolio. HealthPartners plans to begin rolling out applications this fall.

Initially, HealthPartners will offer programs to help subscribers communicate with their care managers via secure, two-way messaging on a range of smart phones and devices that the MobiSecure platform supports, including the Apple iPhone, Google Android, RIM BlackBerry, Windows Mobile, Symbian and Palm devices.

The first users will be women with high-risk pregnancies, as well as patients with chronic illnesses who have been recently discharged from hospitals. Goals will include avoiding premature births and reducing hospital readmissions.

“The new Diversinet-powered applications will enable us to extend our commitment to use technology to reach our members how and when it’s convenient for them,” said Scott Aebischer, senior vice president, customer services and product innovation. The MobiSecure platform also surpasses other solutions in delivering broad device support, wide functionality, and easy-to-understand features.”

“We are delighted that such an innovative, respected healthcare payer and provider has selected our MobiSecure platform to advance its mobile outreach,” said Mark Trigsted, Diversinet executive vice president, healthcare. “HealthPartners’ vote of confidence demonstrates early results of our strategic focus on mobile healthcare. We look forward to working with HealthPartners to leverage our secure, connected and simple solution to meet its needs.”

Babette Apland, HealthPartners senior vice president, health and care management, said: “Diversinet’s platform will enable us to communicate with and increasingly monitor patients in a more personalized, more detailed and continuous manner. We expect the new applications to contribute to our ongoing efforts to improve quality of care, patient outcomes and affordability.”

About HealthPartners
Founded in 1957, the HealthPartners (www.healthpartners.com) family of health care companies is the largest consumer-governed, nonprofit health care organization in the nation. For the fifth year in a row, HealthPartners is rated one of the best commercial health plans in the nation by U.S. News & World Report, NCQA’s “America’s Best Health Insurance Plans 2009-10.” The HealthPartners family of health plans includes HealthPartners, Inc., Group Health Plan, Inc., HealthPartners Insurance Company, and HealthPartners Administrators, Inc.

Blue Care Network introduces Healthy Blue Living Rewards

Introducing Healthy Blue Living Rewards, an extension of Blue Care Network’s successful Healthy Blue Living product. This new product is an innovative outcome-based HMO health care plan that takes personal accountability to the next level by lowering insurance costs for people who succeed in improving their health and thereby making health care more affordable.

“We are truly excited to introduce Healthy Blue Living Rewards because this is a product the business community is demanding, and BCN is once again first to market with an innovative and affordable solution,” said Kevin Klobucar, president and CEO, Blue Care Network. “Healthy Blue Living has done extremely well in the market with more than 850 employers and 114,000 members making it their product of choice, and we believe Healthy Blue Living Rewards moves this product to the next level and capitalizes on the successes we’ve had to date.”

What makes Healthy Blue Living Rewards different from Healthy Blue Living and other products in the marketplace? This product is the second outcome-based wellness product launched by the Blues this year, with Healthy Blue Outcomes being the other product we released earlier this spring. These two outcome-based products are unique in Michigan and are among the first such products to be offered anywhere in the country. While Healthy Blue Living members are rewarded for committing to working toward certain health measures, Healthy Blue Living Rewards members and families are further rewarded for actually meeting the health measures. Healthy Blue Living Rewards follows the same criteria as Healthy Blue Living but adds even more flexibility by offering three benefit levels for individuals who are at different stages of achieving their wellness goals.

The ultimate goal of Healthy Blue Living Rewards is to improve the health of our members, thus building a healthier workforce overall. This is achieved by looking at specific health measures individuals can manage.

  • Tobacco use
  • Weight (body mass index)
  • Blood pressure
  • Cholesterol
  • Blood sugar
  • Depression

These measures are chosen because they have a huge impact on health care costs and the likelihood that an individual will develop a chronic or disabling condition such as cardiovascular disease, cancer, diabetes or obesity.

Through participation in a wellness screening and health assessment, Healthy Blue Living Rewards members are educated on their greatest lifestyle risk factors. By including the financial reward of a lower cost share benefit plan, this product encourages members to address those factors and improve their health. There are a number of free tools and resources available to educate members and help them achieve their health goals, including BlueHealthConnection®, Quit the Nic! (tobacco cessation program), BCN-sponsored weight management programs, 24-hour health coaching and industry leading personalized online tools.

This product became available to groups on July 1, 2010 with an October 1, 2010 effective date and is being offered to groups of two or more employees. For more information on Healthy Blue Living Rewards visit MiBCN.com.

Blue Care Network of Michigan features award-winning disease management programs and the largest HMO network of physicians and hospitals in the state, with more than 4,000 primary care physicians, 13,000 specialists and every acute care hospital in Michigan and most of the state’s other leading hospitals. Blue Care Network, a nonprofit corporation, is the affiliated HMO of Blue Cross Blue Shield of Michigan and an independent licensee of the Blue Cross and Blue Shield Association. For further information, visit MiBCN.com.