Wellmark, Hy-Vee & UnityPoint Health Collaborate on New Health Insurance Plans

Wellmark Blue Cross and Blue Shield, Hy-Vee and UnityPoint Health jointly announced a unique new option in health insurance, collaboratively designed to reward customers for healthy behaviors. Blue RewardsSM integrates the true coordinated care of the UnityPoint Health provider network combined with the retail convenience of Hy-Vee’s pharmacy, healthy food, wellness and dietitian services all in an affordable ACA-health insurance option from Wellmark Blue Cross and Blue Shield.

“This collaboration is part of our strategy to keep health care local and sustainable, and promote health through convenience,” said Laura Jackson, Wellmark’s executive vice president for Health Care Innovation & Business Development. “We know consumers turn to brands they know and trust, which makes this collaboration among three strong Iowa brands even more meaningful for Iowans.” Continue reading

Fallon Health Partners With Cognizant to Become the First Massachusetts Health Insurer to Provide Quotes for Merged Market Plans Under Affordable Care Act

TEANECK, N.J., Feb. 25, 2014 /PRNewswire/ — Cognizant (NASDAQ: CTSH) today announced that it has enabled Fallon Health, a Massachusetts-based not-for-profit health care services organization, to become the first Massachusetts health insurer to provide quotes for merged market plans mandated by the Affordable Care Act (ACA). Continue reading

Blue Cross Blue Shield of Michigan to Provide Low-Cost Individual Health Plans

DETROIT – Blue Cross Blue Shield of Michigan, four southeast Michigan hospital systems, four independent community hospitals and more than 4,700 doctors will partner in 2015 to provide low-cost insurance coverage and health care services to local residents.

The localized network – called an Exclusive Provider Organization (EPO) – is coming together following responses to a comprehensive RFP issued by Blue Cross last year to hospitals asking for participation. Physicians – totaling 4,789 on Jan. 13 – are still coming aboard.

“In a region where hundreds of thousands of people are without health insurance coverage, the Affordable Care Act gives insurers and providers new opportunities to work together to provide people with affordable access to coverage and care,” said Susan Barkell, BCBSM senior vice president for Health Care Value. “Local hospitals and doctors are committed to providing quality care and keeping it affordable. Blue Cross is very pleased to join with local healthcare leaders to offer a quality, localized and low-cost insurance product to meet the needs of people not covered at work.”

For more news and information go to bcbsm.com/news and mibluesperspectives.com.

New Research Shows ACA Exchanges Will Compete with Private Insurers; None are Easy

CHANGE SCIENCES HEALTH INSURANCE INFOGRAPHICNEW YORK, /PRNewswire/ — Web researchers Change Sciences Group released new data this week comparing the insurance shopping experience on public health exchange web sites, including the new HealthCare.gov site, with the shopping experience on private health insurance sites. According to the research, the new HealthCare.gov site (released on November 30) offers an insurance shopping experience which is now on par with leading private insurer web sites such as Aetna, eHealth and Kaiser Permanente. Continue reading

Independence Blue Cross Enhances its Consumer Outreach and Engagement Strategy

Independence Blue Cross, (IBC) has announced that it extended its partnership with Relay , a new channel for customer communications, to enhance its successful mobile communication program, IBX Wire™.

Launched earlier this year, IBX Wire helps IBC members stay on top of vital personal health information, complete transactions, and get customized support from their smartphones. IBC is now taking this capability beyond its member base to educate and engage with consumers to help them understand the changes driven by the Affordable Care Act, and provide an easy way to get more information or enroll in a health plan.

IBC said that this mobile communication program is a key element of its consumer outreach and engagement strategy which also includes multi-lingual educational materials; online resources like ibx.com/careforme and ibx4you.com ; social media outreach; outreach through seminars and webinars by trained health care reform experts; and direct mail. In addition, IBC launched the Independence Express , a state-of-the-art, mobile education and retail health care experience that has been traveling throughout Southeastern Pennsylvania this summer and fall helping consumers understand the important changes associated with the Affordable Care Act. – See more information at IBX.com.

BCBSM Give Michigan Consumers Option to Text to Determine ACA Subsidy Qualification Status

Blue Cross Blue Shield of Michigan says it is first health plan to give Michigan consumers the ability to determine eligibility for ACA subsidies through text messaging.

Under Blue Cross’ “Text for Subsidy” program, people can text “4Subsidy” to 222-752 to initiate a back and forth exchange, detailing their eligibility. Normal data plan charges will apply. The consumer will be asked to provide their zip code, age, income and number of dependents. Blue Cross will respond with whether or not they are eligible for a subsidy. – For more information see BCBSM.com.

 

 

Will ACOs Usher in a New Era of HMO-Style Managed Care?

Amber May has published an article on BenefitsPro.com that recalls a time in the 1990s when HMOs were the biggest thing in health care. She points out that the most obvious benefit of an HMO system is the coordination of care the organizations facilitate and how, since 1995, the National Health Insurance Law in Israel made participation in one of the four Israeli HMOs compulsory for all Israeli citizens.

May points out that once again the United States is experimenting with managed care. She notes that the Patient Protection and Affordable Care Act (PPACA) is attempting to address the lack of care coordination that’s developed in the American health care system by creating provisions for accountable care organizations (ACOS), coordinated groups of health care providers that provide care for specific populations of patients and are accountable for the quality, cost and outcomes of that care.

She notes that through PPACA, ACOs are tied to Medicare and speculates that a universal managed care system similar to Israel’s may be a long way off for the U.S. – To learn more see benefitspro.com.

Medical Home Common Theme in ACA State Grant Programs

We have been tracking some of the health plan innovations that are being funding as part of the Affordable Care Act. (ACA). Stateline, the daily news service of the Pew Charitable Trusts, has published an article that looks into the progress states are making in their efforts to grapple with the relatively high cost and low quality of U.S. health care.

Stateline notes that out of the $1.8 trillion the ACA is projected to cost over the next decade, $10 billion is dedicated to innovation programs. Susan Dentzer of the Robert Wood Johnson Foundation, a nonprofit group that promotes improvements in the U.S. health care system told Stateline, “The idea is to take governors up on their claim that states are the laboratories of democracy where meaningful innovations can occur.”

So far, Stateline reports, Arkansas, Maine, Massachusetts, Minnesota, Oregon and Vermont have applied for funds under the under an ACA program called the State Innovation Models Initiative, and this year, they began testing new health care financing models. Another 19 states are in various stages of developing similar experiments. Continue reading

Blue Cross Blue Shield of Michigan and Munson Healthcare Embrace New Approach to Reimbursement

Nov. 12, 2013 – TRAVERSE CITY, Mich. — Munson Healthcare and Blue Cross Blue Shield of Michigan say they are launching a new value-based hospital reimbursement agreement in northern Michigan designed to improve patient care and medical outcomes while also enhancing efficiency and holding down the cost of care.

According to a press release posted on BCSCM.com, their agreement provides a fair base-rate increase in reimbursement from BCBSM to the hospital. In addition Blue Cross will reward the hospitals with a share of the savings achieved when hospitals and physicians coordinate the delivery of efficient and effective care, eliminate reuse and overuse of care, and prevent re-hospitalizations. Continue reading

CMS to Providers Looking to Support ACA Premiums: Not so Fast!

On November 4, 2013, the Department of Health & Human Services, Centers for Medicare & Medicaid Services issued a Q&A warning hospitals, other healthcare providers, and other commercial entities that it had “significant concerns” about those entities  supporting premium payments and cost-sharing obligations with respect to qualified health plans purchased by patients in the Marketplaces.

The guidance stated that HHS has significant concerns with this practice because it could skew the insurance risk pool and create an unlevel field in the Marketplaces. HHS said it discourages this practice and encourages issuers to reject such third party payments. The agency said it intends to monitor this practice and to take appropriate action, if necessary. – See the Q&A at cms.gov.