CIGNA and Merck Help Customers Better Manage Diabetes

BLOOMFIELD, Conn., October 28, 2010 – The first national outcome-based contract between a pharmaceutical company and a pharmacy benefit management company (press release) resulted in an increase in the number of people with type 2 diabetes who were able to control their blood sugar levels by taking their medications appropriately. Extensive studies have shown that lowering blood sugar levels and increasing medication adherence results in better health for people who have diabetes. Blood sugar is generally considered under control when it is less than 8 percent.

The CIGNA (NYSE:CI) results demonstrated improved blood sugar levels of more than 5 percent for those continuously enrolled in the program regardless of which diabetes drug they were taking. Customers who actively participated in CIGNA’s diabetes support program were 3 percent more likely to have their blood sugar under control than those who were not in the program. There was also a 4.5 percent increase in blood sugar lab testing during the period.

“Merck is pleased to partner with CIGNA on this program,” said Sethu Reddy, M.D., MBA, FRCPC, FACP, MACE, vice president medical affairs, Merck. “As the number of people with diabetes continues to increase in the United States and globally, achieving blood sugar control and increasing adherence to diabetes treatment regimens are important goals for patients with type 2 diabetes and their doctors.”

Medication adherence was 87 percent for people taking Januvia® (sitagliptin) and Janumet® (sitagliptin/metformin), Merck’s oral anti-diabetes medications. The medications are used in conjunction with diet and exercise to improve blood sugar control in adults with type 2 diabetes, a condition that has reached epidemic proportions in the United States.

“Because CIGNA is able to coordinate data and resources within our company, we are better able to support the health needs of the whole person,” said Dr. Jeffrey Kang, CIGNA’s chief medical officer. “By integrating medical and pharmacy programs, we can identify people who may need extra support early in the diagnosis and progression of their diabetes, which means customers can potentially stay healthier longer.”

Kang said CIGNA is uniquely positioned in the industry to successfully complete an outcome-based contract, and that this is the first of what the company expects will be many more such contracts with pharmaceutical manufacturers. “It’s a key aspect of the future of pharmacy contracting,” added Kang.

The two-part contract with Merck provided discounts if CIGNA customers with diabetes lowered their blood sugar levels, regardless of the medication they were taking, and also provided for additional discounts if people who were prescribed Merck’s drugs Januvia and Janumet took their medications according to their physicians’ instructions. Discounts will be shared in various ways with CIGNA employer clients.

Kang said that the idea of paying less for medications if they are successful is counter-intuitive and not at all like other performance-based contracts on the market today. What makes this unique approach so successful is that everyone’s incentives line up behind helping customers keep their diabetes under control. CIGNA’s costs are lowered, medication adherence increases, resulting in health benefits for individuals and improved productivity and lower health care costs for their employers.

The importance of helping people with diabetes take medications appropriately and monitor and control blood sugar levels cannot be over-estimated. According to a study published in the June 2005 edition of Medical Care, quality of life improves dramatically and estimated savings for individuals and employers could be up to $8,000 per person when medication adherence is between 80 and 100 percent. These savings are primarily due to reduced hospitalizations and emergency room visits.

CIGNA offers a range of programs that coordinate pharmacy, medical and behavioral clinical programs, including outreach to customers to support them in their journey to better health. Programs include:

CIGNA’s Well Informed program identifies potential gaps, omissions, and errors in an individual’s health care through analysis of medical, behavioral, pharmacy and lab data. When a gap is found, CIGNA contacts the individual and his or her doctor to inform them so that necessary adjustments to the individual’s treatment plan can be made.

CIGNA Well Aware for Better Health®, CIGNA’s chronic condition support program, helps people who have chronic conditions such as asthma, diabetes, depression and weight complications better manage their conditions. Through this program, CIGNA offers access to a personal, experienced nurse and provides reminders about important tests and exams. Well Aware can help people with chronic conditions follow their doctors’ plan of treatment, avoid complications and improve their quality of life.

CIGNA Pharmacy Management’s CoachRx program involves reaching out to individuals who are not on track with their medication schedule. Online tools and pharmacy coaches are available to help people overcome challenges maintaining their medication schedule, change behaviors and, ultimately, improve their health.

About CIGNA

CIGNA (NYSE: CI) is a global health service and financial company dedicated to helping people improve their health, well-being and sense of security. CIGNA Corporation’s operating subsidiaries in the United States provide an integrated suite of health services, such as medical, dental, behavioral health, pharmacy and vision care benefits, as well as group life, accident and disability insurance. CIGNA offers products and services in over 27 countries and jurisdictions and has approximately 60 million customer relationships throughout the world. To learn more about CIGNA, visit www.cigna.com. To sign up for email alerts or an RSS feed of company news, log on to http://newsroom.cigna.com/rss. Also, follow us on Twitter at @cigna, visit CIGNA’s YouTube channel at http://www.youtube.com/cignatv and listen to CIGNA’s podcast series with healthy tips and information at http://www.cigna.com/podcasts or by searching “CIGNA” in iTunes.

Healthways and BlueCross BlueShield of Tennessee Partner to Improve Health, Well-Being of Seniors

NASHVILLE, Tenn., Oct 26, 2010 (BUSINESS WIRE) — As part of a statewide campaign promoting well-being and prevention to its older adult members, BlueCross BlueShield of Tennessee will be offering the Healthways (NASDAQ: HWAY) SilverSneakers(R) Fitness Program to subscribers of their Medicare Advantage (BlueAdvantage) and Medicare Supplement Plans (BlueElite) throughout Tennessee. SilverSneakers is the nation’s leading social support and exercise program and was designed specifically to improve the health and well-being of seniors.

“We are pleased BlueCross BlueShield of Tennessee will be providing this important program, SilverSneakers, to its Medicare members,” said Ben R. Leedle, Jr., Healthways CEO. “While regular exercise is a crucial part of healthy living for people of all ages, it is particularly effective in preventing or more effectively managing chronic diseases for older adults. By offering SilverSneakers to its senior population, BlueCross BlueShield of Tennessee is showing that it values the health and well-being of its members. We commend the company for its continuing dedication to our shared home state.”

BlueAdvantage and BlueElite subscribers can join the award-winning program at no additional cost and reap the rewards of fitness, fun and friends for which the acclaimed program is best known. SilverSneakers is designed exclusively for older adults and taught by certified instructors, offering eligible members an innovative blend of physical activity, healthy lifestyle direction and social opportunities. Studies have found individuals who participate in SilverSneakers’ unique combination of exercise and social support have improved health and well-being and required fewer admissions to the hospital.

SilverSneakers’ robust network provides eligible members with access to a variety of participating fitness and wellness facilities throughout the country. Many sites offer amenities such as exercise equipment, treadmills and free weights and the signature SilverSneakers fitness classes. Additional signature classes, such as YogaStretch and SilverSplash(R), may be available at select locations. Designated SilverSneakers staff members are available to guide members along the way.

About Healthways

Healthways is the leading provider of specialized, comprehensive solutions to help millions of people maintain or improve their health and well-being and, as a result, reduce overall costs. Healthways’ solutions are designed to keep healthy people healthy, mitigate or eliminate lifestyle risk factors that can lead to disease and optimize care for those with chronic illness. Our proven, evidence-based programs provide highly specific and personalized interventions for each individual in a population, irrespective of age or health status, and are delivered to consumers by phone, mail, internet and face-to-face interactions, both domestically and internationally. Healthways also provides a national, fully accredited complementary and alternative Health Provider Network and a national Fitness Center Network, offering convenient access to individuals who seek health services outside of, and in conjunction with, the traditional healthcare system. For more information, please visit http://www.healthways.com.

SOURCE: Healthways

CIGNA and Holston Medical Group (HMG) Launch “Patient-Centered Medical Home” Pilot Program for the Tri-Cities and Southwest Virginia Region

BLOOMFIELD, Conn. & KINGSPORT, Tenn., October 26, 2010 – CIGNA (NYSE:CI) and Holston Medical Group (HMG) have launched a pilot of the patient-centered medical home model, in which a primary care physician is responsible for monitoring and coordinating nearly all aspects of a patient’s medical care. This is CIGNA’s only such pilot in the Tri-Cities and southwestern Virginia area.

This pilot represents a collaborative approach between CIGNA and the 150 health care professionals of Holston Medical Group to improve patient access to care, to improve continuity, coordination and quality of care, and to lower medical costs. It encompasses:

  • use of electronic medical records to track medical history
  • case management/disease management within the practice
  • onsite urgent care
  • extended hours
  • education to help people navigate their health care system
  • better availability of appointments
  • pay for performance – doctors will be rewarded for improving quality and lowering costs

The pilot program, which began August 1, focuses on individuals, especially those with chronic illness or ongoing medical needs, who receive care from Holston Medical Group’s primary care physicians who practice family medicine, internal medicine and pediatrics.

Holston Medical Group passed a significant review process by CIGNA before qualifying for the patient-centered medical home pilot program.

Currently, more than 10,000 individuals who are covered by a CIGNA health plan receive ongoing medical services from Holston Medical Group. Of these, approximately forty percent are employed by Eastman Chemical Company or are beneficiaries covered by Eastman Chemical Company’s CIGNA health care benefit plan.

“We are honored to be designated a medical home for our patients who are employees and families of Eastman Chemical Company and CIGNA health plan-covered individuals,” Dr. Scott Fowler, president of Holston Medical Group, said. “We are excited to participate in this opportunity with CIGNA and to formalize a concept our physicians have been pursuing for some time.”

Eastman’s Director of Integrated Health David Sensibaugh said, “The current U.S. health care system is not sustainable. Self-insured employers like Eastman are very interested in innovative models of health care delivery that reward clinicians who provide high-quality and cost-effective care. It is critical that all health plans and health care professionals work collaboratively to drive systemic quality improvements that will in turn result in a more sustainable model of health care delivery.

“We commend CIGNA for being proactive in advancing new approaches to improve quality of health outcomes in our region. We also appreciate the leadership and foresight of Holston Medical Group to partner with CIGNA in a new model of health care delivery. This model will result in better health outcomes for the individual in addition to controlling costs for both the individual and company.”

Primary care physicians affiliated with Holston will be paid as usual for the medical services they provide and will also be rewarded through a “pay for performance” structure if they meet targets for improving quality and enhancing access to appropriate health care. According to Dr. Robert McLaughlin, CIGNA’s senior medical director for Tennessee, emphasizing the value of the primary care physician as the overall coordinator of their patients’ health will help increase the professional satisfaction and financial rewards for doctors who practice in primary care.

To obtain the benefits of the medical home pilot, people simply access care from one of the numerous Holston Medical Group primary care physicians participating in the program. There is no change in choice of primary care doctor or in any plan requirements regarding referrals to see specialists.

“We think a patient-centered accountable care model that pays doctors for improving outcomes, lowering medical costs and providing greater value to their patients is a better model of health care than the current system that rewards doctors for performing more procedures,” Dr. McLaughlin said. “By shifting the focus from specialization to coordinated primary care, patient-centered medical homes can help improve outcomes and patient satisfaction.”

CIGNA will evaluate results after the program has been operational for at least 12 months. The pilot is one of many that CIGNA participates in nationally and is intended to help the company gather data about the effectiveness of the patient-centered models of care. CIGNA’s programs include multi-payer pilots in Colorado, New Hampshire, Pennsylvania, and Vermont, as well as CIGNA-only accountable care pilots in Connecticut, Georgia, Missouri, New Hampshire and Texas. CIGNA has been a member of the Patient-Centered Primary Care Collaborative since October 2007.

About CIGNA

CIGNA (NYSE:CI) is a global health service and financial company dedicated to helping people improve their health, well-being and sense of security. CIGNA Corporation’s operating subsidiaries in the United States provide an integrated suite of health services, such as medical, dental, behavioral health, pharmacy and vision care benefits, as well as group life, accident and disability insurance. CIGNA offers products and services in over 27 countries and jurisdictions and has approximately 60 million customer relationships throughout the world. To learn more about CIGNA, visit www.cigna.com. To sign up for email alerts or an RSS feed of company news, log on to http://newsroom.cigna.com/rss. Also, follow us on Twitter at @cigna, visit CIGNA’s YouTube channel at http://www.youtube.com/cignatv and listen to CIGNA’s podcast series with healthy tips and information at http://www.cigna.com/podcasts or by searching “CIGNA” in iTunes.

About Holston Medical Group

As one of the largest multi-specialty providers within the Southeast, Holston Medical Group’s “Family of Care” consists of more than 800 employees, including 150 physicians and mid-level providers in its provision of 24-hour medical/surgical coverage. Regarded as a national leader in clinical research as well as electronic health record integration and utilization, Holston Medical Group provides convenient locations throughout Northeast Tennessee and Southwest Virginia, offering two Urgent Care Clinics (Bristol & Kingsport) and state-of-the-art diagnostic capabilities. On-site ancillary services available include digital x-ray and mammography, CT, MRI, ultrasound and cardiac services. Additionally, HMG provides the patient convenience of on-site laboratory services.

HealthPartners Launches 24/7 Online Clinic: virtuwell.com

BLOOMINGTON, Minn. (Oct. 25, 2010) HealthPartners, the nation’s largest consumer-governed, nonprofit health care organization, today launched virtuwell, a new convenience care service offering online diagnosis and treatment of simple medical conditions. The custom-designed service created by HealthPartners and developed by partner AKQA combines proven, trusted medical expertise with the convenience of 24/7 online access to care including prescriptions if needed.

The new service extends HealthPartners delivery of affordable, quality care, offering a low-cost, convenient alternative to office visits, evisits, and phone consultations for routine conditions that don’t require an in-person examination.

Our customers tell us they want quality health care that’s simple, friendly, convenient and affordable, said Mary Brainerd, HealthPartners president and CEO. Our commitment is to find innovative ways to meet these needs. With virtuwell, HealthPartners is able to provide individuals yet another option to access quality care.

At virtuwell.com, experienced nurse practitioners are available online on demand and around the clock to provide personalized diagnoses, treatment recommendations, and prescriptions for conditions such as cold, cough and allergy, ear pain, yeast and urinary tract infection, and others.

HealthPartners Clinics offer a wide-range of specialties and services and virtuwell is one more example of bringing care to consumers in a new way that respects their personal choices and busy lives, said Brian Rank, MD, medical director of HealthPartners Medical Group. We’ve made clinical excellence a foundational element by creating this new way to deliver highly reliable and evidenced-based care. Its a natural evolution of the 50 years of health care delivery and payment innovations in our heritage.”

Users receive a rapid diagnosis and treatment plan and a prescription if necessary for $40 or less, depending on the customers insurance coverage. Customers do not need to be HealthPartners health plan members to use virtuwell, and the list of participating insurers will be updated regularly at virtuwell.com. The service is now available to customers living in or visiting Minnesota, and extension of the service to additional locations is planned.

During the development of virtuwell, HealthPartners offered previews of the service and gathered feedback from a number of major employers, including Polaris Industries and Andersen Corporation.

We’re always looking for new ways to provide our employees and their families the right kinds of health care while helping to manage costs, said Danielle Thorvilson, Benefits/HRIS Manager, of Minnesota-based Polaris Industries. Many of our employees live and work outside of major cities and have had relatively limited options for lower-cost, on-demand, 24/7 care. The introduction of virtuwell extends the options of care available to our employees, and were pleased to support it.

Kathy Prondzinski, Corporate Benefits Design Director at Andersen Corporation, said When an employee has a minor medical condition, they want to get better quickly with little inconvenience, the least down time and at the lowest cost. As a large employer, we want to support these needs which is why virtuwell is so appealing to us, she said. We are pleased our employees now have a new choice for receiving high-quality care from a strong organization like HealthPartners.

The new service available at virtuwell.com was developed by HealthPartners in conjunction with the global firm AKQA, an award-winning ad agency recognized for its innovation in creative and technology. With a focus on streamlining digital medicine, HealthPartners and AKQA partnered to develop a software application that would assist nurse practitioners to provide accurate quality care with an effective set of questions. AKQA and HealthPartners also collaborated to create a fresh and seamless consumer user experience, while balancing strict regulatory health care laws to secure personal health and payment information.


HealthPartners
Founded in 1957, the HealthPartners (www.healthpartners.com) 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. 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 “Americas Best Health Plans 2009.”

MedMarketLink Partners With Intuit Health for Website Patient Portals

DENVER, Oct. 22 /PRNewswire/ — Vanguard Communications, the company offering MedMarketLink – an integrated suite of marketing and technology services for specialty medical practices – announced today a partnership with Intuit Health to provide Internet-based portals for health care consumers to go to doctors’ websites and directly request appointments, fill out new-patient forms, pay bills, refill prescriptions and check lab results, among other patient-doctor conveniences.

Vanguard – whose MedMarketLink program has delivered tens of thousands of new patients since 1999 to specialists in fertility and in vitro fertilization (IVF), neurosurgery, urology, and oncology, among others – selected Intuit Health as a portal partner due to its unique breadth of software interfaces.

“Medical software companies capture medical practices as data captives,” Vanguard CEO Ron King said. “Building bridges between these proprietary systems is quite tricky. Our research found other portal developers had managed to negotiate access to a grand total of two medical database systems at most.”

In contrast, King noted, Intuit Health – whose parent company sells TurboTax, Quicken and QuickBooks software – has negotiated access to more than 40 providers of practice-management software and electronic medical records (EMR). As a result, the Intuit portals can work with dozens of practice-management and EMR systems from Centricity to Misys to meridianEMR to TSI Healthcare.

Today more than 2.8 million patients and 400,000 health providers use Intuit portals in medical practice websites. (Practices that implement portals may qualify for the $44,000-per-physician reimbursement funded by the American Reinvestment and Recovery Act.)

“This is a proven turnkey product,” King said. “We’ve seen medical groups spend years and sometimes millions of dollars to roll out even the basics of a system. However, we can integrate the Intuit portals into our clients’ websites for availability to patients almost overnight.”

The Intuit portals are the latest addition to a sophisticated package of marketing and technology services in the MedMarketLink program that includes practice public relations, website development and publishing, search-engine optimization (SEO), Internet advertising (pay-per-click), and online and offline practice and physician reputation management.

About MedMarketLink

MedMarketLink uniquely delivers the force of multiple professional disciplines to the growth of private medical practices by merging the art of marketing communications with the science of technology through direct-to-consumer and physician-to-physician marketing and reputation management. For more information http://www.medmarketlink.com/.

About Intuit Health

Intuit Health is the industry leader in communication solutions for patients, providers, and health plans. For more information please visit http://www.medfusion.net or call (877) 599-5123.

SOURCE Vanguard Communications

Humana Introduces New Interactive Tool to Educate People About Workplace Voluntary Benefits

LOUISVILLE, Ky.–(BUSINESS WIRE)– Humana Inc. (NYSE:HUMNews) has launched a new “Virtual Guidance Tool” – an interactive, web-based resource that educates consumers on voluntary benefit options – such as critical illness, disability and accident coverage – and shows how these benefits can help protect people financially in the event of an injury or illness.

Unexpected illnesses and injuries cause 350,000 personal bankruptcies each year, according to the Council on Disability Awareness (2009 report). Many individuals and families don’t plan for the financial burdens that can occur as a result of a critical illness or accident. Expenses such as loss of income, child care, and travel to treatment centers can be considerable.

Employers can share the new online tool with their employees to educate them about the plans being offered to them. The product tutorials encourage the user to view content at their own pace through an interactive experience which includes questions about their lifestyle, video tutorials, and benefit information. The Virtual Guidance Tool helps consumers learn and choose the benefit options that are best for them as well as their families.

“We developed this resource to assist employers and, ultimately, give employees more information and reasons why to consider purchasing these benefits for themselves and their families,” said Beth Bierbower, chief operating officer of Humana Specialty Benefits. “Every individual’s needs and circumstances are different. This tool gives employees a personalized online experience to learn about benefit options and determine which plans are best for them.”

Humana, which strives to help consumers achieve lifelong well-being, is offering the online tool free to consumers. The tool can be customized for large employers, and easily integrates with many online enrollment technologies. To learn more about Humana’s new Virtual Guidance Tool go to www.humana.com/virtualguidancetool.

About Humana

Humana Inc., headquartered in Louisville, Kentucky, is one of the nation’s largest publicly traded health and supplemental benefits companies, with approximately 10.3 million medical members and 7.3 million specialty-benefit members.

Humana is a full-service benefits-solutions company, offering a wide array of health and supplementary benefit plans for employer groups, government programs and individuals.

Sentara Healthcare Saves $3.4 Million & Improves Employee Health

VIRGINIA BEACH, Va., Oct. 19 /PRNewswire/ — A three-year, incentive-based wellness program at Sentara Healthcare, implemented in partnership with Optima Health, a division of Sentara Healthcare, demonstrated a substantial improvement in employee health and a $3.4-million savings in healthcare costs.

To view the multimedia assets associated with this release, click:  http://multivu.prnewswire.com/mnr/optimahealth/46413/

“For every dollar spent to incentivize employees to improve their health, Sentara Healthcare saved $6,” says Optima Health President and CEO Michael M. Dudley.

Called “Mission: Health,” the program was launched in 2008 for over 11,200 benefit-eligible Sentara Healthcare employees in Virginia and North Carolina. Sentara Healthcare partnered with Optima Health, as its insurance carrier, to help manage employee health costs.

Nearly 80 percent of employees participated in the program, which demonstrated significant clinical improvements in risk factors such as cholesterol, blood pressure, body mass index (BMI), exercise and tobacco use.

“The most important outcome of the wellness program for Optima Health is the difference it has made in people’s lives,” comments Dudley.

Sentara Healthcare Senior Vice President for Human Resources Michael Taylor says Sentara Healthcare leaders didn’t want to continue increasing employee co-pays and premiums, so they sought another solution. Realizing that 20 percent of employees were producing 80 percent of healthcare costs, Sentara leaders believed they could significantly cut costs if employees were encouraged to better manage their chronic diseases.

“The biggest challenge is keeping people engaged,” says Optima Health Vice President of Clinical Care Services Karen Bray, PhD, RN, who was central in the program design. While Sentara, like an estimated 86 percent of the country’s employers, offered a wellness program in the past, it achieved only modest success through nominal rewards to employees. Much larger incentives were provided through Mission: Health to motivate employees.

Employees were asked to complete a voluntary personal health profile (PHP) that measured risk factors. Those with low risk factors were immediately awarded a $500+ annual premium reduction. Those with two or more risk factors could earn the incentive by working with a health coach. Those who declined to participate forfeited the discounts.

Employees with targeted chronic diseases such as diabetes, coronary artery disease or congestive heart failure – or who were pregnant – were eligible for additional incentives if they worked with disease managers who monitored their medication, medical check-ups and other crucial health activity. Those employees earned an additional $460 per year.

Bray predicts the cost savings are likely to continue for the next three to five years and then reach a plateau where costs will remain relatively flat. At that point, the program will keep costs from increasing, she says.

For additional information about employee wellness programs or to download a copy of the white paper, listen to our podcasts, or view our video visit www.optimahealth.com/wellness. For questions about Mission: Health, contact 1-866-380-9668 or email the wellnesspayoff@sentara.com.

About Sentara Healthcare and Optima Health

Sentara Healthcare, based in Norfolk, Virginia, is a leading not-for-profit system in Virginia and North Carolina and one of the most highly-integrated healthcare companies in the nation.  Sentara offers an award-winning safety culture and a commitment to customer satisfaction and community service.  Sentara operates more than 100 sites of care, including eight hospitals, and offers a 380-member Sentara Medical Group and Optima Health, an award-winning health plan with 430,000 members. To learn more, visit www.sentara.com.

Optima Health offers a suite of commercial products including consumer directed, employee-owned and employer-sponsored plans; individual health plans; employee assistance programs; and plans serving Medicare and Medicaid enrollees and features a provider network of 21,000 providers.  Optima Health offers integrated clinical and behavioral health services, pharmacy management and customized wellness programs. To learn more about Optima Health, visit www.optimahealth.com.

SOURCE Optima Health

CIGNA CDHP Study Shows How Americans Can Reduce Their Health Care Costs Without Compromising Care

When Americans engage in health-smart habits such as participating in health coaching and disease management programs, substituting generic medications for brand name drugs and avoiding unnecessary trips to the emergency room, their total medical costs went down 15 percent — an average $358 per person in the first year — according to a new multi-year study comparing the health care claims experience of 897,000 CIGNA customers in consumer driven health (CDH) plans, PPOs and HMOs.

The 2010 Fifth Annual CIGNA Choice Fund Experience Study findings show individuals covered by CIGNA Choice Fund CDH plans improve their costs without compromising care by becoming more engaged in improving their health and by becoming informed health care consumers:

  • Health coaching and disease management program participation: CIGNA CDH plan customers are up to 19 percent more likely to participate in the CIGNA Health Advisor® health coaching program compared to those enrolled in a traditional plan. Individuals with chronic illnesses covered by CDH plans are 21 percent more likely to participate in their plan’s disease management program.
  • Generic medications: CIGNA CDH plan participants who also have CIGNA Pharmacy Management benefits choose generic equivalent drugs 70 percent of the time.
  • Avoiding Unnecessary ER visits: The study also shows that CDH plan enrollees use the emergency room at a 13 percent lower rate than individuals who have HMO and PPO plans. When CIGNA Choice Fund customers visit an urgent care facility, their doctor’s office or convenience clinic instead of the ER, they saved an average of $800.
  • Informed choices: Customers enrolled in a CIGNA CDH plan are more likely to use online information and tools through myCIGNA.com; use of myCIGNA increases by 40 percent when customers are enrolled in a CDH plan. The study also shows CDH plan enrollees are five times more likely to complete a health assessment compared to those enrolled in a traditional plan.

One company that is realizing the benefits of CIGNA Choice Fund plans is Starwood Hotels & Resorts. According to Starwood Executive Vice President and Chief Human Resources Officer Jeff Cava:

“Starwood is demonstrating that by giving our associates affordable health plan choices supported with education and health advocacy resources to help them make better health care decisions, people will make good decisions about their health and wealth. Early on it has become clear that more Starwood associates are using their preventive benefits, increasingly choosing generic medications over costlier brand names and taking advantage of free preventive prescriptions through CIGNA Home Delivery Pharmacy. Moreover, our associates are literally “buying into” their plans — with 83 percent contributing their own pre-tax dollars to their health savings accounts.”

As with previous CIGNA studies, the Fifth Annual CIGNA Choice Fund Experience Study confirms that CDH plans reduce health care costs relative to other types of plans without compromising care or shifting costs to employees:

  • Immediate and sustainable cost savings: CIGNA CDH medical costs are 15 percent lower than traditional plans during the first year, cumulative cost savings rise to 18 percent in the second year, 21 percent in the third year, 24 percent in the fourth year, and 26 percent in the fifth year.
  • Higher levels of care: New CIGNA CDH customers had the same or better statistical compliance with 400 evidence-based medical best practice measures than their counterparts in traditional plans, and compliance among CIGNA CDH customers is 14 percent higher for those enrolled in CDH plans for multiple years. Moreover, CDH customers sought preventive care 8 to 10 percent more frequently than those enrolled in a traditional plan.
  • Less cost for those with chronic conditions: Medical cost trend was substantially less for CIGNA CDH customers with joint disease (21 percent less), diabetes (8 percent less) and hypertension (7 percent less), than for individuals with any of those diseases in traditional CIGNA health plans.
  • No cost-shift from employers to employees: CIGNA CDH customers with health reimbursement accounts paid out of their own pockets an average of $35 less per year compared to customers in traditional plans, demonstrating that savings can be achieved without cost shifting; also the percentage of total cost was the same for both men and women.

“Our studies have consistently shown individuals in CIGNA Choice Fund plans reduce their annual health care costs without compromising care, and now the data are rolling in showing why,” explains CIGNA Chief Medical Officer Jeffery Kang, M.D. “The evidence is clear. Given the right incentives, the right health improvement programs, useful cost and quality information, and easy-to-understand correspondence, individuals are making rational, wise and successful health care decisions.

“Perhaps because most individuals covered by CIGNA Choice Fund plans are receiving the same or better levels of care for lower cost, 83 percent of those surveyed report that they are “satisfied” or “very satisfied” with the service for their CDH plans – slightly higher than the 82 percent satisfaction rate across all of our health plans.”

About CIGNA

CIGNA (NYSE:CI), a global health service company, is dedicated to helping people improve their health, well being and sense of security. CIGNA Corporation’s operating subsidiaries provide an integrated suite of medical, dental, behavioral health, pharmacy and vision care benefits, as well as group life, accident and disability insurance, through 60 million customer relationships with individuals in the U.S. and around the world. To learn more about CIGNA, visit www.cigna.com.

Highmark Inc. Honored for Innovative Program that Helps Consumers Live Healthier Lives

The Blue Cross and Blue Shield Association (BCBSA), in collaboration with the Harvard Medical School Department of Health Care Policy, has recognized Highmark for its innovative and successful approach to improving access to high quality, safe and affordable health care for consumers.

Highmark was awarded a Best of Blue Clinical Distinction Award for QualityBLUE, its hospital pay-for-performance program. The Best of Blue Clinical Distinction Award program is presented in collaboration between BCBSA and the Harvard Medical School Department of Health Care Policy, through which Harvard researchers evaluate and select programs by Blue Cross and Blue Shield companies for recognition based on their innovation, effectiveness and potential for replication.

“Through the development of this winning program, Highmark has delivered on the Blues’ commitment to deliver the greatest value through innovative, consumer-focused solutions resulting in healthier lives and affordable access to safe and effective care,” said Scott P. Serota, BCBSA president and CEO. “And most importantly, this program shows that patients win when there is a strong collaboration between insurers and the provider community.”

Highmark’s hospital pay-for-performance program emphasizes safety and reducing health care costs. The program started in 2002 and today, 64 hospitals participate in the program covering Central and Western Pennsylvania and West Virginia hospitals. The program saves hundreds of lives each year and reduces costs by millions of dollars.

“Harvard is pleased to recognize Highmark for developing a program that sets such high standards for its effectiveness in improving patient care,” said Barbara J. McNeil, Ph.D., head of the Department of Health Care Policy of Harvard Medical School. “The Blues’ focus on quality, safety and access plays a critical role in improving the health care delivery system and enhancing quality and value for consumers.”

“This program has been so positive because it focuses on collaboration between hospitals and Highmark that ultimately creates a safer clinical environment,” said Linda Weiland, vice president of provider performance and management at Highmark. “We continue to grow and evolve our program, and at the same time, are excited because this is one that can be replicated by other plans across the country.”

The Best of Blue Clinical Distinction Awards were presented in Chicago on Wednesday, Oct. 6 at the BCBSA Blue National Summit, a gathering of Blue Cross and Blue Shield Plans designed to share best practices and recognize programs that can lead to improvements in health care delivery throughout the country.

About Highmark Inc.
As one of the leading health insurers in Pennsylvania, Highmark serves 4.7 million people through the company’s health care benefits business.

Highmark Inc. is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. For more information, visit www.highmark.com.

Medica Personalized Products and Programs Rolled Out for 2011 Open Enrollment

Medica is offering a number of new programs and products during 2011 open enrollment this fall designed to engage members in their health care decisions while personalizing their experience. The offerings range from programs that customize health information a member receives and reward healthy behaviors to a new consumer-directed health plan product. For employers offering the programs, and their employees who participate in them, the incentives could include lower premium contributions, enriched benefits and financial rewards.

New online health assessment drives personalization
A central feature of Medica’s new programs is a new, research-backed health assessment that is unique and proprietary to Medica. It identifies members’ knowledge, skills and confidence levels for managing their health – valuable insights that help Medica better tailor support for each individual. Eligible members age 18 and older take the assessment the first time they sign on to Medica’s newly redesigned online health and wellness center.

Through Medica’s new online health and wellness center, members will be encouraged to complete eight health topics. The topics are suited to each member’s ability as identified in the health assessment.

Personalized scorecards
Another personalized feature of Medica’s new offerings is a scorecard that allows members to follow the status of their health in a simplified manner. The program creates personalized scorecards with health actions tailored to each individual through an evaluation of claims data, biometric results and health assessments. The scorecard captures preventive cancer screenings based on age and gender. Additionally, it will identify disease-specific care requirements and highlight corresponding gaps in care. Members will receive incentives and rewards for completing the health action items on their scorecard. The scorecard is accessed through Medica’s online health and wellness center.

Biometric screening
Biometric screening is one way to assess risk for heart disease, diabetes, and high blood pressure. Medica is promoting the screenings in workplace settings. During a biometric screening, a health professional collects a drop of blood to measure cholesterol and glucose. In addition, the health professional will measure body mass index, height, weight and blood pressure. Results are available immediately and health education and wellness resources are provided to each participant. Like other Medica programs that provide personalized results, members who have a biometric screening are rewarded for their participation.

Medica Personal RewardsSM
Depending on the benefit package designed by their employers, members who participate in the above programs could be rewarded with gift cards, lower premium contributions, richer benefits and most importantly, improvements in their health and well-being. It’s all part of a reward program called Member Personal RewardsSM.

Employers, meanwhile, have the opportunity to be rewarded with healthier, more productive employees, rate guarantees and reduced premiums.

Physician Transparency Program
In addition to programs that personalize members’ health care experience, Medica is introducing a new physician transparency program for care and cost information. Medica Premium Designation is unique to the Minnesota market in its use of evidence-based, medical society and national industry standards to evaluate individual physicians across 20 specialties for quality and cost efficiency. Physicians who achieve a quality rating will receive one star, while physicians achieving both quality and cost-efficiency ratings will receive two stars. Physicians must first achieve a quality rating before being evaluated for cost efficiency.

CDHP with OptumHealth Financial
In 2011, Medica will also offer a new slate of comprehensive consumer-directed health plans (CDHP). It has teamed with OptumHealth Financial Services (OptumHealth) to deliver enhanced CDHP solutions to customers of all sizes. This exclusive partnership with OptumHealth includes CDHPs integrated with Health Savings Accounts, Healthcare Reimbursement Accounts, and Flexible Savings Accounts and also offers retiree solutions and COBRA administration.

About Medica
Medica is a health insurance company headquartered in Minneapolis and active in the Upper Midwest. With nearly 1.6 million members, the non-profit company provides health care coverage in the employer, individual, Medicaid, Medicare and Medicare Part D markets in Minnesota and a growing number of counties in North Dakota, South Dakota and Wisconsin. Medica also offers national network coverage to employers who also have employees outside the Medica regional network.

Medica has the highest accreditation status, Excellent, from the National Committee for Quality Assurance (NCQA®) for its Minnesota Medicaid HMO plans and commercial health plans in Minnesota and North Dakota. Medica’s vision is to become the community’s health plan of choice, trusted for its integrity, respected for its service, and admired for its commitment to innovation and efficiency.

Source: Medica