Highmark Direct health insurance store to open in Erie, PA

PITTSBURGH (June 21, 2012) — Highmark Inc. announced today that it will open a Highmark Direct retail health insurance store in Erie, Pa. The store will be the ninth location in Pennsylvania.

“Across other parts of the state, the Highmark Direct stores have helped customers better understand health insurance and make more informed decisions about their health,” said Matt Fidler, Highmark vice president of consumerism and retail marketing. “With the addition of the Erie store, we’ll be able to reach even more Pennsylvanians who need health insurance support.”

Highmark opened its first two Highmark Direct stores in March 2009, added four stores in 2010 and two additional stores in 2011. Since inception, the stores have seen more than 144,000 visitors and provided health insurance to thousands of individuals and their families.

The Highmark Direct Erie store is scheduled to open in August and will be located at 5753 Peach Street in Kingswood Plaza. Eight additional employees will be hired as staff for the new store location.

Highmark Direct offers consumers in Highmark’s service area the opportunity to meet one-on-one with a health insurance specialist to discuss their health insurance options and their benefits as a Highmark member. The stores sell health insurance plans to individuals, seniors and small businesses, as well as ancillary products such as dental insurance, critical illness and accident insurance as well as a personalized genetic health program.

About Highmark
Highmark Inc., based in Pittsburgh, is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. Highmark serves 4.9 million members in Pennsylvania, West Virginia and Delaware through the company’s health care benefits business and is one of the largest Blue plans in the nation. Highmark has 20,000 employees across the country and provides a broad range of health and wellness related services through subsidiary and affiliate companies. For more information, visit www.highmark.com.

 

Aetna And Consult A Doctor™ Come Together As A 24/7 Telemedicine And Work Life Service

HARTFORD, Conn., June 19, 2012 — Aetna’s (NYSE: AET) work life platform Aetna Resources For Living has been combined with the Consult A Doctor™ 24/7 telemedicine service to provide employees with easier access to resources that help improve overall health, work/life balance and workplace productivity. Consult A Doctor Plus™ is a unique, on-demand solution that also allows employers to better manage health care costs by providing members with the help and support they need – where, when and how they need it.

Consult A Doctor Plus (CADR+) enables consumers to contact physicians, either by phone or email, for specific questions they may have. This product provides members with a variety of benefits, including:

  • Confidential 24/7 telephonic consultation and prescription-writing.
  • Access to Aetna Resources for Living work life resources and support.
  • Patient advocacy bill review/mediation, provided by The Karis Group.
  • Access to online wellness tools and health records.
  • Legal and financial consulting.

“We are pleased to work with Providence Financial Group to provide those in need with support and services in all areas of physical, emotional, psychological and social well-being,” said Louise Murphy, head of Aetna Behavioral Health. “Aetna Resources For Living is a suite of offerings designed to engage people in addressing lifestyle issues and workplace stresses by providing a comfortable and safe environment for our members. This platform together with Consult A Doctor creates a concrete combination of medical and work life services.”

Powered by TeleCare 3.0, Consult A Doctor provides customized versions of its telemedicine platform to meet the needs of all the major constituents in healthcare, including practices, hospitals, clinics, health plans and employers.

“With Consult A Doctor Plus, we are able to work hand-in-hand with Aetna to reach beyond traditional, primary care settings and explore new opportunities within the telemedicine spectrum of health care,” said Wolf Shlagman, founder and CEO, Consult A Doctor. “We are excited to provide employers with a faster, more convenient and affordable resource that gives members access to such services anytime and anywhere.”

About Providence Financial Group

Providence Financial Group (PFG) is a sales and marketing organization of industry-leading financial products and services, marketed primarily through contracted agents and brokers.
PFG is an authorized representative of both Aetna Behavioral Health and Consult A Doctor, and Reseller/Administrator of the Consult A Doctor Plus program. For more information please visitwww.pfgef.com or contact us at www.pfgef.com/contact.

About Consult A Doctor
Consult A Doctor is the leading innovator of cloud-based telemedicine services and technology platform solutions empowering organizations to lower healthcare costs, provide revolutionary access and improve outcomes. With years of experience delivering direct-to-employer and consumer telemedicine services that offer convenient 24/7 access to doctor consultations by phone, email and video, Consult a Doctor has saved employers millions of dollars in unnecessary healthcare costs, and added millions of dollars of productivity to the bottom line by helping keep employees at work and healthy. Its telemedicine network of U.S. board certified physicians in all 50 states has made it possible to give on-demand care, anytime, anywhere with access to care in the lowest cost setting. Consult A Doctor is further transforming the economic equation of care by partnering with payers, providers and other organizations to deploy its telemedicine platform solution that grants its members and patients unmatched access to quality care, offers a new revenue source for providers, and lowers costs for health plans, employers and groups. For more information about Consult A Doctor, please visit www.consultadr.com, emailtelecare@consultadr.com or call 888-688-DOCT (3628).

About Aetna
Aetna is one of the nation’s leading diversified health care benefits companies, serving approximately 36.1 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services and health information technology services. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com.

 

Consumer Driven Health Care Plans Can Help Reduce Health Care Spending and Make Positive Behavior Changes: HCSC

CHICAGO, June 13, 2012 /PRNewswire via COMTEX/ — Consumers enrolled in Consumer Driven Health Plans (CDHPs) are more likely to make sustainable, positive behavior change leading to significant health plan spend reductions year over year, according to data studied by Health Care Service Corporation (HCSC), operator of the Blue Cross and Blue Shield Plans in Illinois, Texas, Oklahoma and New Mexico. Members who migrated to CDHP plans – those that have a higher deductible, prompting consumers to be more directly involved with the selection and usage of health care services – reduced their health care spending significantly.

This study is unique because of its focus on tracking individual members who migrated from traditional health plan coverage to CDHP coverage in order to analyze their health care behavior and their health care spending habits both before and after the switch. The data also showed that changes in behavior, including increases in preventive care and use of generic prescriptions, helped contribute to a reduction in health care spending for both employers and members.

The CDHP program, BlueEdge(TM), is offered through the four Blue Cross and Blue Shield Plans, and includes Health Savings Account (HSA) and Health Reimbursement Account (HRA) options. BlueEdge enrollment surpassed 1.5 million members earlier this year, after experiencing double-digit percentage increases for six straight years.

Key results from the study indicate that, following migration from a traditional non-CDHP plan to a CDHP, on average, the CDHP members studied:

  • were four percent more likely to take advantage of preventive services.
  • reduced health care utilization by an aggregate of more than 12 percent.
  • were 10 percent more likely to fill their prescriptions with generics.
  • spent 24 percent less on inpatient hospital services and eight percent less on outpatient services.
  • had a 12 percent decrease in emergency room visits.
  • reduced combined medical and pharmacy spend by an aggregate of 11 percent

In addition, data showed that employers who offered only a CDHP saw even greater spend reductions – up to an aggregate of 14.4% over the three years following migration from a traditional plan to a CDHP.

“Our BlueEdge CDHP program gives consumers the flexibility and tools to help make positive decisions to reduce their healthcare spend, coupled with broad access to care, award-winning service, comprehensive incentives, wellness and care management programs, and a personalized, engaging health care experience,” said Thomas Meier, Vice President, product development, HCSC. “Our experience finds that CDHP members tend to be more engaged and informed in making better health care decisions.”

This is the second year that HCSC has done this analysis, this year studying more than five years of data for more than 265,000 members (with pharmacy data available on 121,000 of those members). HCSC continues to invest in more consumer focused approaches, adding more robust incentives and value-based insurance design products in 2013 to complement both traditional and CDHP plans.

“Our findings are significant because they indicate both real and potential health care spend reductions. Rather than comparing the utilization of different groups of consumers, we have focused on the utilization changes of members who migrated from traditional plans to CDHP. The fact that we are comparing the same members in both plans allows us to minimize inherent risk differentials,” said Guy McGinnis, Vice President, client analytics, HCSC.

About Health Care Service CorporationHealth Care Service Corporation, a Mutual Legal Reserve Company, is the country’s largest customer-owned health insurer and fourth largest health insurer overall, with more than 13 million members in its Blue Cross and Blue Shield plans in Illinois, New Mexico, Oklahoma and Texas. HCSC is an independent licensee of the Blue Cross and Blue Shield Association. For more information, please visit www.HCSC.com , visit our Facebook page or follow us at www.twitter.com/HCSC .

SOURCE Health Care Service Corporation

 

New Program Helps Aetna Members Make Informed Decisions When Considering Surgery

HARTFORD, Conn., June 07, 2012 — Surgery often is the most extreme approach to care for most health conditions, and in many cases, alternative options for care are available. Aetna (NYSE: AET) recently made the Welvie Surgery Decision Support Program available to help Aetna members who are considering surgery work with their health care providers to make the best choices for their unique situations.

The online program – which includes easy-to-understand video content – guides members through six steps. The first three steps focus on helping members work with their doctors to determine an accurate diagnosis and understand all of the potential treatment options, including surgery. If surgery is the determined course of treatment, the last three steps help members prepare for the procedure and recovery.

“We are consistently looking for ways to help our members become more informed and allow them to take control of their own health care,” said Paul Marchetti, head of Aetna’s National Care Management. “The Welvie decision support program can help members work in concert with their health care provider to make the right decision when surgery is one of the options for care.”

Aetna members can access Welvie through Aetna Navigator®, a secure member website. The decision support program provides information related to nearly 60 medical procedures, including lower back surgery, C-section delivery and tonsillectomy.

“Surgery should never be taken lightly,” said Welvie Executive Chairman Chip Tooke. “We designed our program to show people that they can take an active part in the surgery process. And when they do, they can help improve the outcome.”

Positive Feedback from Employers and Members
The Welvie program is available to all Aetna members. Plan sponsors can also select a premium version that includes increased communications to members about the program, as well as reporting on usage among an employee population. Beginning in April 2011, Aetna conducted a pilot study featuring the premium Welvie program with five large national employers who collectively cover approximately 800,000 Aetna members.

“As a company that relies on a physically active group of employees, we want to offer programs that can help our employees maintain their health and well-being,” said Randy Moon, Vice President, Benefits and Human Resources Information Services at Lowe’s, which participated in the pilot program. “The Welvie program is a resource for entire families, whether we have employees looking for more information about their own health options or those of a parent, spouse or child. Our employees who used the Welvie program were very satisfied with how easy it was to use and how helpful it was as they were evaluating their health care options, including surgery.”

Member satisfaction rates among individuals who used the Welvie tool were also extremely high:

• 96 percent were satisfied with how Welvie prepared them for surgery
• 95 percent are likely to take the steps necessary to prepare for surgery as a result of the Welvie program
• 92 percent are likely to recommend the Welvie program to family and friends
• 93 percent feel that Welvie helped prepare them to speak with their health care provider about surgical options

About Welvie

Welvie is a pioneering surgery decision support company. Its shared decision-making program helps consumers make fully informed decisions about surgery, while helping employers and health plans ensure patients receive the best outcome, whether they choose surgery or not.

About Aetna
Aetna is one of the nation’s leading diversified health care benefits companies, serving approximately 36.1 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services and health information technology services. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com.

 

Consumers Are Ready to Adopt Mobile Health Faster than the Health Industry is Prepared to Adapt;

NEW YORK, June 7, 2012 /PRNewswire/ — Widespread adoption of mobile technology in healthcare, or mHealth, is now viewed as inevitable in both developed and emerging markets around the world, but the pace of adoption will likely be led by emerging markets and lag consumer demand, according to a new global study conducted for PwC Global Healthcare by the Economist Intelligence Unit (EIU).

The ground breaking study, Emerging mHealth: paths for growth, found that consumers have high expectations for mHealth, particularly in developing economies as mobile cellular subscriptions there become ubiquitous. In emerging markets, consumers perceive mHealth as a way to increase access to healthcare while patients in developed markets see it as a way to improve the convenience, cost and quality of healthcare.

According to the report, if the promise of mHealth is realized by consumers, the impact on healthcare delivery could be significant and fundamentally alter traditional relationships within the healthcare industry.  The use of mHealth and speed of adoption will be determined in each country by stakeholders’ response to mHealth as a disruptive innovation to overcome structural impediments and align interests around patients’ needs and expectations.

“Despite demand and the obvious potential benefits of mHealth, rapid adoption is not yet occurring. The main barriers are not the technology but rather systemic to healthcare and inherent resistance to change,” said David Levy, MD, global healthcare leader, PwC.  “Though many people think mobile health will be ancillary or bolted on to the healthcare industry, we look at it differently:  mHealth is the future of healthcare, deeply integrated into delivery that will be better, faster, less expensive and far more customer-focused.”

In the report, the EIU examines the current state and potential of mHealth (defined as the provision of healthcare or health-related information through the use of mobile devices) and the barriers to adoption and opportunities for companies seeking growth in the mHealth market.  The report includes findings of two surveys conducted by the EIU:  one of consumers and one of physicians and government and private payers in 10 markets, including Brazil, China, Denmark, Germany, India, South Africa, Spain, Turkey, the UK and the US.

The consumer survey found:

  • Roughly one-half of consumers predict that within the next three years, mHealth will improve the convenience (46 percent), cost (52 percent) and quality (48 percent) of their healthcare.
  • Fifty-nine percent of emerging market patients use at least one mHealth application or service, compared with 35 percent in the developed world. Nearly half of consumers said they expect mHealth will change the way they manage chronic conditions (48 percent), their medication (48 percent) and their overall health (49 percent).  Six in ten consumers (59 percent) expect mHealth to change the way they seek information on health issues and 48 percent expect it to change the way they communicate with physicians.
  • Among consumers who already are using mHealth services, 59 percent said they have replaced some visits to doctors or nurses.
  • The top three reasons consumers want to use mHealth is to have more convenient access to their doctor or healthcare provider (46 percent), to reduce out-of-pocket healthcare costs (43 percent) and to take greater control over their health (32 percent).
  • Sixty percent of consumers said they believe doctors are not as interested in mHealth as patients and technology companies are.

The study found that physicians and payers are more cautious than consumers in their outlook for mHealth. Specifically:

  • Nearly two-thirds (64 percent) of doctors and payers said that mHealth offers exciting possibilities but there are too few proven business models.  In addition, the effectiveness of mHealth changing patient behaviour is evolving.  For example, more than two-thirds of consumer respondents who have used mHealth wellness or fitness applications with manual data entry discontinued it after the first six months.
  • Only 27 percent of physicians encourage patients to use mHealth applications to become more active in managing their health, and 13 percent of physicians actually discourage it.
  • Forty-two percent of doctors surveyed worry that mHealth will make patients too independent.
  • Payers appear to be far more supportive of mHealth than physicians. Forty percent of payers compared to 25 percent of physicians encourage patients to let doctors monitor their health and activities using mHealth services and devices.
  • Payers and providers both cited multiple barriers to the adoption of mHealth, notably the complexity and scope of change associated with mHealth. Public sector doctors and payers cited lack of existing technology as the biggest barrier to greater use of mHealth adoption.  Sixty-three percent of physicians in the private sector versus only 40 percent in the public sector have access to wireless connectivity at work.
  • Forty-five percent of doctors and payers said that the application of inappropriate regulations originally developed for earlier technologies is slowing the adoption of mHealth.
  • More than one quarter – 27 percent of doctors and 26 percent of payers – cite an inherently conservative culture as a leading barrier to the adoption of mHealth.

“The adoption of mobile health in emerging markets versus developed markets is a paradox,” said Christopher Wasden, EdD, global healthcare innovation Leader, PwC. “In developed markets, mHealth is perceived as disrupting the status quo, whereas in emerging countries it is seen as creating a new market, full of opportunity and growth potential.  In younger, developing economies, healthcare is less constrained by healthcare infrastructure and entrenched interests. Consumers are more likely to use mobile devices and mHealth applications, and more payers are willing to cover the cost of mHealth services.”

According to PwC, innovators seeking opportunities in mHealth, including telecommunications and technology companies, must work to overcome the barriers slowing widespread adoption of mHealth.   They can help to alleviate healthcare’s resistance to change by focusing less on the technology and more on effective, customer-focused solutions that add value for health organizations and patient quality of life.

In its analysis, PwC identifies strategic considerations for companies active in the mHealth arena. In addition, PwC will publish a series of insights over the next several months on the evolving mHealth landscape with perspective on what it means for stakeholders, including government and regulators, pharmaceutical and life science companies, payers and providers.

A full copy of the EIU report is available for download at www.pwc.com/mhealth.

About PwC’s Health Industries Group

PwC’s Health Industries Group (www.pwc.com/us/healthindustries) is a leading advisor to public and private organizations across the health industries, including healthcare providers, pharmaceuticals, health and life sciences, payers, employers, academic institutions and non-health organizations with significant presence in the health market. Follow PwC Health Industries at http://twitter.com/PwCHealth.

About the PwC network

PwC US helps organizations and individuals create the value they’re looking for. We’re a member of the PwC network of firms with 169,000 people in more than 158 countries. We’re committed to delivering quality in assurance, tax and advisory services. Tell us what matters to you and find out more by visiting us at www.pwc.com/us.

© 2012 PricewaterhouseCoopers LLP, a Delaware limited liability partnership. All rights reserved.

PwC refers to the US member firm, and may sometimes refer to the PwC network. Each member firm is a separate legal entity. Please see www.pwc.com/structure for further details.

This content is for general information purposes only, and should not be used as a substitute for consultation with professional advisors.

 

SOURCE PwC

Source: PR Newswire (http://s.tt/1dxBQ)

 

Wellmark and Genesis Health System enter into Accountable Care Organization

Today, Wellmark Blue Cross and Blue Shield of Iowa officially announced a collaboration with Genesis Health System in Davenport to create an Accountable Care Organization (ACO). The new ACO will focus on coordinating patient care to improve quality, provide greater value, and slow increases in health care costs.

Genesis Health System President and CEO, Doug Cropper, said he looks forward to seeing improvements in the quality and reductions in the cost of care, adding, “This collaboration is the next important step of a process that began for Genesis two years ago when we made the commitment to participate in the transformation of health care. Wellmark and Genesis have a long, shared collaboration of serving our customers and patients with a high quality of care and a high level of efficiency.”

In an ACO, providers assume responsibility for managing a population of patients, both who are healthy and those who are in need of care, no matter where in the system the patients receive care. Wellmark offers the providers financial rewards if they reach established quality goals and slow the rate in increase in health care spend in caring for these patients. At the same time, providers will not earn their financial incentive if their quality declines or their costs run higher than expected.

John Forsyth, Wellmark chairman and CEO said, “Wellmark is pleased to enter into this ACO agreement with Genesis Health System, to improve the health care experience, and to help slow the rate of cost increases. This ACO was created to keep healthy people well and improve outcomes for our members when they need care.”

The ACO will enhance Wellmark members’ care in a variety of ways:

  • Providers encouraging their patients to take an active role in their health care.
  • Continued freedom to see the doctors of their choice.
  • Seamless customer experience when setting up an appointment, seeing multiple doctors, and receiving follow up care.
  • A reduction of redundant care and services.

“This has been an extensive and rewarding process,” said William Langley, M.D., executive director of the Genesis Accountable Care Organization. “Since Genesis made the commitment to form an ACO two years ago, we have advanced to the point that it’s now a reality. We are looking forward to collaborating with Wellmark to keep the population we serve healthy.”

 

About Wellmark

Wellmark, Inc. (www.Wellmark.com) does business as Wellmark Blue Cross and Blue Shield of Iowa. Wellmark and its subsidiaries and affiliated companies, including Wellmark Blue Cross and Blue Shield of South Dakota and Wellmark Health Plan of Iowa, Inc., insure or pay health benefit claims for more than 2 million members in Iowa and South Dakota. Wellmark Blue Cross and Blue Shield of Iowa, Wellmark Blue Cross and Blue Shield of South Dakota, and Wellmark Health Plan of Iowa, Inc. are independent licensees of the Blue Cross and Blue Shield Association.  Contact: Courney Greene, 515-988-0918,greenecm@wellmark.com

 

About Genesis Health System

Genesis Health System, its affiliates and partners offer a full continuum of health care services for a 12-county region of Eastern Iowa and Western Illinois. Genesis hospital affiliates include: Acute and tertiary hospital care at Genesis Medical Center, Davenport and DeWitt, Iowa and at the Illini Campus in Silvis, Illinois. Genesis also manages hospitals in Maquoketa, Iowa and Aledo, Ill.  Genesis also offers home health and hospice services through Genesis VNA and Hospice; Genesis Workplace Services; Clarissa C. Cook Hospice House; senior living facilities offering rehabilitation and long-term care; Genesis Health Group, with more nearly 170 primary care physicians and specialists; the Genesis Quad Cities  Family Practice Residency program. For more information, visit our Web site at www.genesishealth.comContact: Craig Cooper, 563-421-9263,cooperc@genesishealth.com

 

Priority Health Launches MyGo Points Facebook App to Motivate Healthy Lifestyles, Encourage Tourism

GRAND RAPIDS, Mich.–(BUSINESS WIRE)–Priority Health has developed a Facebook app, called MyGo Points, in an effort topromote health and wellness among Michigan residents, as well as support local tourism. The app, which launched May 1, givespeople the opportunity to earn points to win prizes by participating in activity-based events and Facebook challenges.

“Priority Health is always looking for creative ways to motivate people to lead a more active andhealthy lifestyle,” said Joan Budden, chief marketing officer of Priority Health. “MyGo Pointsuses incentives from local businesses to get the community moving. Who doesn’t like to be rewarded for their efforts?

Events eligible for points range from walks to park parties, while Facebook challenges can beas simple as tagging Priority Health in an activity-related photo. The app is available on thePriority Health Facebook page. Those who download the app will automatically begin to trackpoints. At each event, a unique QR code for smartphone scanning and a promotional code foronline use will be given to participants to track points throughout the year. Every point earned enters participants into a monthlyprize drawing, with the opportunity to win the grand prize — a Pure Michigan Ultimate Adventure Package to Crystal Mountain.

“MyGo Points is a creative way to showcase Michigan’s superb natural and recreational assets, while encouraging health andwellness among its residents,” said Christina MacInnes, COO of Crystal Enterprises Inc. “Crystal Mountain and Pure Michiganare thrilled to be part of the program, realizing that its incentives are powerful tools in our collective efforts to inspire and sustainpositive lifestyle changes in communities across the state.

”MyGo Points launched just in time for the Fifth Third River Bank Run on May 12. Other MyGo Points events include the Arts,Beats & Eats Arts in Motion 5K, Royal Oak; Grand Rapids Triathlon; Bike Benzie Tour, Thompsonville; Priority Health RockfordCriterium; Traverse City Cherry Festival Kids Event; and Maranda Park Parties at locations across the state. Additional eventswill be added throughout the year. Participants can submit their health-related activities or events to be considered for MyGoPoints by sending an email to teamph@priorityhealth.com.Prizes include tickets to the Detroit Zoo, West Michigan Whitecaps baseball games and Holland Aquatic Center. The CrystalMountain grand prize is a weekend getaway for four, valued at $2,500. For more details or to sign up for Priority Health’s MyGoPoints, visit facebook.com/priorityhealth

.About Priority HealthPriority Health is an award-winning health plan nationally recognized for creating innovative solutions that impact health carecosts while maximizing customer experience. It offers a broad portfolio of products for employer groups and individuals, includingMedicare and Medicaid beneficiaries. As a nonprofit company, Priority Health serves more than 600,00