Category Archives: quality

Allegheny Health Network, Highmark Health and Johns Hopkins Medicine Announce Collaboration

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PITTSBURGH, Pa., Dec. 22, 2014 (GLOBE NEWSWIRE) — via PRWEB – Officials at Highmark Health, Allegheny Health Network, Highmark Inc. and Johns Hopkins Medicine today announced the signing of a new master collaboration agreement that will complement the formal oncology collaboration that began earlier this year. These collaborations aim to leverage the collective strengths of the organizations and improve the availability and affordability of health care to Pennsylvania patients.

“Highmark Health is proud and excited to expand the scope of our partnership with Johns Hopkins to improve patient care today and in the future,” said David L. Holmberg, president and chief executive officer of Highmark Health. “Our goal is to ensure that patients have affordable access to high-quality health care services, and the increased collaboration we anticipate with Johns Hopkins through this agreement is an important step in the fulfillment of that mission.” Continue reading →

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Consumer Reports Releases Annual Health Insurance Plan Rankings – Including 114 “Best Value” Plans

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YONKERS, N.Y., Sept. 26, 2013 /PRNewswire-USNewswire/ — For the fourth year in a row, Consumer Reports published rankings of hundreds of health insurance plans across the United States to help consumers determine which ones may be best for them. This marks the first time the organization took additional steps to identify plans that both provide high-quality care and avoid costly care.

“Consumer Reports’ analysis found that expensive care doesn’t mean better care. Many people incorrectly assume that the more money that’s spent on health care, the better health care will be,” said John Santa, M.D., medical director of Consumer Reports Health. “But as these ratings show, the data found no connection between cost and quality.”

The full report is available in the November issue of Consumer Reports. The latest health plan rankings are available for free online at www.ConsumerReports.org/healthinsurance.

 

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Highmark Health Services Receives CEO Cancer Gold Standard Accreditation

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CARY, N.C.–(BUSINESS WIRE)–Highmark Health Services, the nation’s fourth-largest Blue Cross and Blue Shield-affiliated health insurer, has earned CEO Cancer Gold StandardTM accreditation from the CEO Roundtable on Cancer . The organization recognized Highmark Health Services for its efforts to reduce the risk of cancer for its employees and covered family members by promoting healthy lifestyle choices and encouraging early detection through cancer screenings.

Read the full story at Businesswire.com

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WellPoint Earns Industry Recognition for Health Care Consumer Empowerment and Protection

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INDIANAPOLIS, Oct. 20, 2011 /PRNewswire via COMTEX/ — WellPoint, Inc., (NYSE: WLP) today announced it has been awarded Silver and Honorable Mention honors for Health Care Consumer Empowerment and Protection by URAC, a leading health care accreditation organization. The awards recognize industry achievements in advancing the role of consumers as active participants in their health care through heightened awareness and education.

“URAC’s Best Practices awards program is a unique celebration of innovative health care management programs. These organizations have implemented leading programs that have made a difference in the lives of the consumers they serve with demonstrable results that matter,” said Alan P. Spielman, president and CEO of URAC. “This year’s winners are recognized for their leadership in delivering on the promise of a quality health care system that puts consumers first.”

WellPoint received the Silver Award for the MyHealth Advantage member messaging program and honorable mentions for the Imaging Cost and Quality Program and the Emergency Room Utilization Management Initiative, which are available to members in select health plans.

“Helping people understand that they play a vital role in their health care and providing the resources they need to get quality, affordable care when they need it and in the right setting is our top priority. This recognition underscores our companywide commitment to continuous improvement and highlights our associates’ hard work and ingenuity in developing programs that empower consumers to make better decisions about their health care,” said Sam Nussbaum, M.D., chief medical officer for WellPoint.

The MyHealth Advantage program involves clinical messaging to members and physicians that leads to improved evidence-based compliance, better member health and a potential reduction in avoidable costs. For instance, members taking a prescription medication may receive messages to restart that medication if they are not adhering to the prescribed regimen or to stop taking a medication that is contraindicated. A study on the program demonstrated that messaging both members and physicians about gaps in clinical care significantly improves compliance with medical care guidelines.

The Emergency Room Utilization Management Initiative helps members find information through online search engines, interactive calls and print brochures. This educational information assists members in knowing what conditions may be treated at a retail health clinic or urgent care centers and their out-of-pocket costs associated with each. A pilot study conducted by HealthCore Inc. in Virginia demonstrated a 14 percent decrease in ER visits for those who participated in the program compared with those who did not.

The Imaging Cost and Quality Program uses technology from WellPoint subsidiary American Imaging Management (AIM) to proactively identify members whose health care providers have recommended they receive an imaging service such as an MRI or CT scan. The program calls those members to offer them an opportunity to switch to a high-quality but lower-cost facility, promoting quality care and transparency while enabling them to use their health care dollars more wisely.

Additionally, WellPoint associate, Patricia Moreno, a health promotion consultant working in its state sponsored business division, received a URAC Health Care Stars! award. This individual honor recognizes Moreno’s work in promoting the welfare of health care consumers by helping to improve lives and prevent adverse health outcomes.

Entries were judged by a distinguished 20-member panel of prestigious, independent judges including recognized experts in program evaluation, care coordination, health information technology, employer and purchaser decision making and patient safety. Entries were reviewed and scored by the judges based on objective criteria including whether the program was measurable, if it was reproducible and delivered through a collaborative approach. Honors were awarded in the categories of Consumer Decision-Making and Consumer Health Improvement.

About WellPoint, Inc.

WellPoint works to simplify the connection between Health, Care and Value. We help to improve the health of our members and our communities, and provide greater value to our customers and shareholders. WellPoint is the nation’s largest health benefits company in terms of medical membership, with 34 million members in its affiliated health plans, and a total of more than 69 million individuals served through its subsidiaries.

About URAC

URAC, an independent, nonprofit organization, is well-known as a leader in promoting health care quality through its accreditation, education and measurement programs. URAC offers a wide range of quality benchmarking programs and services that keep pace with the rapid changes in the health care system, and provide a symbol of excellence for organizations to validate their commitment to quality and accountability. Through its broad-based governance structure and an inclusive standards development process, URAC ensures that all stakeholders are represented in establishing meaningful quality measures for the entire health care industry. For more information, visit http://www.urac.org/.

SOURCE: WellPoint, Inc

 

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Kaiser Permanente Leads the Nation in 11 Effectiveness of Care Measures

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OAKLAND, Calif. — Kaiser Permanente leads the nation with the most No. 1s receiving top marks in 11 out of 40 effectiveness of care measures among all reporting commercial health plans. These conclusions were based on information in the 2011 National Committee for Quality Assurance’s Quality Compass® data.

Kaiser Permanente received top marks for:

  • Weight assessment for children — body mass index percentile
  • Counseling for nutrition for children
  • Counseling for physical activity for children
  • Chlamydia screening in women (ages 16–20, 21–24 and total)
  • Appropriate testing for children with pharyngitis
  • Appropriate use of medications for people with asthma (ages 12–50, total)
  • Comprehensive diabetes care — LDL control less than 100 mg/dl
  • Comprehensive diabetes care — medical attention for nephropathy
  • Antidepressant medication management (effective acute phase)
  • Antidepressant medication management (effective continuation phase)
  • Annual monitoring for patients on persistent medications — anticonvulsants

“At Kaiser Permanente, our doctors and care teams excel in proactive prevention of illness, early detection of disease, and better treatment of ongoing conditions,” said Amy Compton-Phillips, MD associate executive director, Quality, The Permanente Federation. The data from the Quality Compass demonstrates our commitment to providing high-quality care to our members through evidence-based measures.”

Kaiser Permanente’s nation-leading scores in 11 effectiveness of care measures from NCQA’s Quality Compass® are a result of expert care and medical teams supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. A key differentiator in performance has also been Kaiser Permanente’s increasing use of health information technology and its integrated electronic health record, Kaiser Permanente HealthConnect®, which is the largest private electronic health record in the world. KP HealthConnect provides members with convenient, 24/7 access to their personal health information and to their care teams, with goals of increasing self-management and improving health outcomes.

“Kaiser Permanente has a long history of providing high-quality care to our members and patients,” said Jed Weissberg, MD, senior vice president, Quality and Care Delivery Excellence, Kaiser Permanente. “Our approach to delivering quality is through our integrated system, which focuses on patient-centered care that meets the needs of each of our members. The data from this year’s Quality Compass supports our great accomplishments in this area, and it provides consumers with the important information they need as they make choices about their health care.”

Kaiser Permanente Leads the Nation in 11 Effectiveness of Care Measures

NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA is committed to providing health care quality information for consumers, purchasers, health care providers and researchers.

The source for data contained in this publication is Quality Compass® 2011 and is used with the permission of the National Committee for Quality Assurance (NCQA). Quality Compass 2011 includes certain CAHPS data. Any data display, analysis, interpretation, or conclusion based on these data is solely that of the authors, and NCQA specifically disclaims responsibility for any such display, analysis, interpretation, or conclusion. Quality Compass is a registered trademark of NCQA. CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).

 

About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 8.8 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: www.kp.org/newscenter.

 

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HealthAmerica and Preferred Primary Care Physicians Launch Pilot to Deliver Accessible, Patient-centered and Coordinated Primary Care

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PITTSBURGH–(BUSINESS WIRE)–HealthAmerica and Preferred Primary Care Physicians (Preferred) in Pittsburgh, Pennsylvania, have launched a new pilot program with the goal of providing more coordinated and patient-centered primary care and improved communications among patients, their physicians and their care team.

“HealthAmerica will play an important role because of the data we track on quality measures, which is critical for coordinating care and reporting on the results. Our data are also key to promoting the practice of evidence-based medicine and using decision-support tools to guide clinical decision making.”

Preferred consists of 32 board-certified physicians and five physician extenders specializing in internal medicine and family practice. Preferred has 14 practice locations in the South Hills and three locations in Uniontown in Fayette County. In addition, Preferred offers state-of-the-art outpatient centers for cardiac testing, sleep disorders, and physical therapy.

This unique pilot program, which was effective September 1, 2011, leverages the advanced medical home model established by the American College of Physicians. The medical home is a team-based model of care led by a personal physician who provides continuous and coordinated care throughout a patient’s lifetime to maximize health outcomes. Care is facilitated by the patient’s personal physician across all elements of the complex health care system, including subspecialty care, hospitals, home health agencies and nursing homes.

“This arrangement is unique in that patients and families will participate in quality improvement activities at the practice level,” said Dr. Robert S. Mirsky, chief medical officer for HealthAmerica. “HealthAmerica will play an important role because of the data we track on quality measures, which is critical for coordinating care and reporting on the results. Our data are also key to promoting the practice of evidence-based medicine and using decision-support tools to guide clinical decision making.”

“Under this pilot program, we will continue to leverage our advanced technologies and care management capabilities to support the goal of optimal patient outcomes. These are driven by a care-planning process and effective communication among HealthAmerica, the patient, the patient’s family and his or her physician,” said Gregory Erhard, executive director for Preferred Primary Care Physicians. “We will place a focus on prevention and seamless, coordinated care. Our electronic health record (EHR) and our robust data mining capabilities will be crucial in supporting optimal patient care, performance measurement, patient education, and communication.”

HealthAmerica members who use participating practices in the program will benefit from the highly coordinated care. Customers benefit from the cost savings generated by improved outcomes and avoiding unnecessary tests and procedures. Provider incentives for achieving quality goals help keep costs down and keep medical care focused on prevention strategies and managing patients with chronic diseases.

About HealthAmerica

With over 36 years of providing health care benefits, HealthAmerica has earned a reputation as one of the most trusted and experienced health insurers in Pennsylvania. The company ranks among the highest rated health plans in the nation for HMO and POS plans by the National Committee for Quality Assurance.* Its Medicare plan, HealthAmerica Advantra, ranks 24 out of 341 Medicare plans evaluated nationwide, ranking second in the state and among the top 25 health plans in the nation.* HealthAmerica provides a range of traditional and consumer-directed health insurance products, including self-funded, Medicare, Medicaid, indemnity, nongroup, and pharmacy plans. It currently has “Excellent” accreditation by the National Committee for Quality Assurance for its commercial HMO, POS, and Medicare plans. HealthAmerica’s corporate offices are in Harrisburg, Philadelphia, and Pittsburgh, Pennsylvania. For more information, visit HealthAmerica’s website at www.healthamerica.cvty.com.

*NCQA’s “Health Insurance Plan Rankings 2011-12 – Private; NCQA’s “Health Insurance Plan Rankings 2011-12 – Medicare.

About Preferred Primary Care Physicians

Preferred Primary Care Physicians (Preferred) was founded in 1995 by ten primary care physicians in the South Hills of Pittsburgh. These physicians shared a common commitment to provide the highest quality care to the patients that they served. To that end, the group initiated quality improvement programs, participated in research studies to advance primary care practice, and implemented electronic medical records (EHR) in 2003, well before most other practices. Today, Preferred Primary Care Physicians consists of 32 board-certified physicians specializing in internal medicine and family practice. PPCP has 14 practice locations in the South Hills and three locations in Uniontown in Fayette County. In addition, PPCP offers state-of-the-art outpatient centers for cardiac testing, sleep disorders, and physical therapy. Preferred Healthcare Informatics, LLC, a subsidiary of Preferred Primary Care Physicians delivers EHR and information technology consulting services to physician practices and hospitals, including readiness assessment, implementation, support, content development, and meaningful use achievement.

 

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The Blue Cross and Blue Shield Association Unveils Action Plan To Improve Healthcare Quality And Rein In Rising Healthcare Costs

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WASHINGTON – The Blue Cross and Blue Shield Association (BCBSA)  released a comprehensive, interconnected action plan that fundamentally transforms the healthcare system, moving it away from a fee-for-service model to a patient-centered model.  The action plan, Building Tomorrow’s Healthcare System:  The Pathway to High-Quality, Affordable Care in America, provides specific recommendations to improve healthcare quality and tackle rising costs and is based on the experience of BCBSA’s 39 Plans in all 50 states and federal territories, in every market and every zip code.  An independent economic analysis of the recommendations shows that, if adopted, this action plan will achieve more than $300 billion in federal savings over the next 10 years.

“We believe that the healthcare system needs to fundamentally change so that people get the best, most affordable care possible.  We need to put the patient back in the center of healthcare and this is going to take a significant collaborative effort between both public and private sectors,” said Scott P. Serota, president and CEO of BCBSA.  “It’s time to stop the finger pointing and start working together to make our system the best for patients.  In Building Tomorrow’s Healthcare System, we make specific recommendations for what the government should do and show how Blue companies nationwide have been working with doctors, hospitals, consumers and policymakers to transform the healthcare system.”

The proposal lays out specific, actionable steps the government should take in four key areas:

  1. Reward Safety:  National and local leadership along with new provider incentives are needed to eliminate preventable medical errors, infections and complications that harm hundreds of thousands of people each year and cost billions of dollars.
  2. Do What Works:  The incentives in our system must be changed to advance the best possible care and reward quality outcomes, instead of paying for more services that are ineffective or redundant and add unnecessary costs to the system.
  3. Reinforce Front-Line Care:  A higher value must be placed on primary care and on ensuring there is an adequate workforce of professionals to deliver necessary, timely and coordinated care that results in better outcomes and lower costs.
  4. Inspire Healthy Living:  With 75 percent of today’s healthcare dollar spent on the treatment of chronic illnesses — many of which are preventable — consumers must be empowered and encouraged to make better choices, live healthier lives and better manage their health.

If adopted, the recommendations would save $319 billion over the next decade according to an economic analysis by Ken Thorpe, Ph.D., Robert W. Woodruff Professor and Chair Department of Health Policy & Management Rollins School of Public Health, Emory University.

“The BCBSA proposal reflects a clear understanding of the transformational approach needed to reform our prevention and healthcare delivery system,” said Thorpe.  “Building evidence-based approaches to coordinate care for Medicare and Medicaid patients that will improve the quality and reduce healthcare spending is a discussion we need to have.  Rather than simply shifting federal costs to seniors, the states, or elsewhere, these proposals have the potential to reduce total healthcare spending.”

The proposal contains several examples of Blue Cross and Blue Shield initiatives underway across the country that can work as models for improving care and reducing costs.  One example is the Michigan Health and Hospital Association’s Keystone:  ICU Program, which has dramatically reduced central line-associated bloodstream infection rates and ventilator-assisted pneumonia rates in ICU patients.  More than 70 Michigan hospitals participate in this program and over a six-year period the initiative has saved 1,830 lives, eliminated an estimated 140,700 avoidable hospital days for patients, and saved more than $300 million.

“This action plan recommends changes that will bring about real improvement for our fragmented healthcare system,” said Daniel Loepp, president and CEO, Blue Cross Blue Shield of Michigan.  “In Michigan, and in local communities across the country, the Blues are seeing first hand the difference that these types of programs can make for patients.  That is why we’re encouraging the government to work with the private sector to expand on efforts that improve the quality and affordability of care.”

To read Building Tomorrow’s Healthcare System:  The Pathway to High-Quality, Affordable Care in America, please visit www.bcbs.com/pathway.

The Blue Cross and Blue Shield Association is a national federation of 39 independent, community-based and locally-operated Blue Cross and Blue Shield companies that collectively provide healthcare coverage for more than 99 million members – one-in-three Americans.  For more information on the Blue Cross and Blue Shield Association and its member companies, please visit www.BCBS.com.

 

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Value-Based Benefit Designs Improve Community Health Value in Colorado Springs

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COLORADO SPRINGS, CO and ST. LOUIS – August 18, 2011 – To reinforce the importance of engaging a community to lower health care costs and improve health and economic sustainability, the Center for Health Value Innovation (CHVI) has chronicled the efforts of three Colorado Springs employers that worked together to change how they were contracting for health. An organization devoted to health improvement through action, innovation and cost containment, CHVI has released a case study report to support other communities in implementing value-based benefit design, quality improvement and Outcomes-Based Contracting™ (aligning employee incentives to improve outcomes from health systems, drive higher value and offer better choices of providers).

“For the first time, we detail the thinking and benefit design changes that moved a community from waste reduction (use of inappropriate services, lack of medication adherence) through risk management (identifying gaps in care or under-managed conditions) and building individual and corporate accountability in purchasing health care services,” said Cyndy Nayer, CHVI President and CEO. “We detail the focus of the three employers, demonstrating the designs that drove success, so that other communities can follow the pathway to improved health and cost containment by focusing on engagement and health outcomes.”

The report highlights the efforts of three Colorado Business Group on Health (CBGH) members, the City of Colorado Springs, Colorado Springs School District 11 and Colorado Springs Utilities, over a five year period to improve population health and contain health cost inflation. The Colorado Springs employers measured the risk to their employees and their corporations, and then prioritized their individual efforts to change how they were contracting for health care with their plans and providers. The result was the collective influence of improved health care management in their city. Important to their success, they not only secured reduction in costs for prevention, wellness, and chronic care management, they also installed incentives for minimally invasive procedures and improvement in health care quality.

The success of these employer programs reinforces a key CHVI principle – lasting value in health improvement is driven at the community level with multi-stakeholder engagement. By highlighting the efforts and results of these employers who came together to implement value-based benefit design, other companies can learn how to build healthier businesses, healthier communities and healthier people.

CHVI has followed the efforts in Colorado Springs, documenting the maturation of the four-step process of value-based benefit design chronicled by CHVI: data, design, delivery and dividends. Levers – which include insurance plan incentives (i.e. providing a premium discount for completing a health risk assessment), stand-alone incentives and disincentives (such as a reduction in co-pays for appropriate surgical procedures, or an out-of-pocket increase to reduce use of emergency departments instead of primary care clinicians or urgent care centers) – are used for better performance and are fundamental to Outcomes-Based Contracting and building engagement across stakeholders, including consumers.

“We knew we needed to address wellness in particular, since national studies indicate that 70% of health care cost is attributable to life style, said Tamara Kirk, HR Supervisor-Benefits, Colorado Spring Utilities, and CBGH Board Chair. “As we do these types of programs collaboratively, we engage other stakeholders and create reform in our local health care system, while at the same time leveraging employers’ purchasing power.”

About the Center for Health Value Innovation (CHVI)

CHVI (501c3) is focused on the pursuit of innovation in benefit designs that improve engagement, accelerate accountability and create a predictable health cost trend. CHVI members represent over 60 million lives from all market segments in the health value supply chain, sharing the evidence of improved health and economic outcomes through value-based designs, including the Outcomes-Based Contracting™ platform for accelerating meaningful change. The Center for Health Value Innovation’s goal is to improve the health of people, organizations and communities throughout the U.S.  www.vbhealth.org

 

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Humana’s New Provider Quality Rewards Program Awarding Nearly $10 Million to Primary Care Physicians

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LOUISVILLE, Ky.–(BUSINESS WIRE)–Humana Inc. (NYSE: HUM) has begun distributing nearly $10 million to physicians across the U.S. who participate in Humana’s Provider Quality Rewards Program. Approximately 2,800 physician practices will receive payments of as much as $175,000 in recognition of performance improvements their practices made during 2010 related to improved outcomes for Humana’s Medicare members.

“This program begins a shift to a more holistic view of the patient and changes the physician-payer relationship to focus on patients’ quality of life, improving outcomes, and lowering health care costs.”

“Humana’s Provider Quality Rewards Program seeks to support practices with the goal of improving outcomes and efficiencies in the entire health care delivery system,” said Tim O’Rourke, vice president of provider engagement at Humana. “This program begins a shift to a more holistic view of the patient and changes the physician-payer relationship to focus on patients’ quality of life, improving outcomes, and lowering health care costs.”

Humana’s payments to physician practices are based on the practices’ ability to improve quality in nine National Committee for Quality Assurance (NCQA) preventive and chronic-condition management areas, including:

  • Breast cancer screening
  • Glaucoma screening
  • Colorectal cancer screening
  • Cholesterol screening
  • Diabetes management
  • Osteoporosis medication management
  • Spirometry testing for COPD patients
  • Monitoring patients on persistent medication
  • Anti-rheumatic drugs for patients with rheumatoid arthritis

Physician practices that achieved quality improvements – regarding treatment of Humana Medicare members – in the majority of the nine measures during 2010 are receiving the largest reward payments from Humana.

“The feedback we’ve received from doctors about this program has been very good. We’re excited about the future of Humana’s provider-engagement model, and that this program is continuing in 2011, because of what it represents – a way to recognize and reward the great strides these physician practices are making toward helping their patients achieve lifelong well-being,” O’Rourke said.

About Humana

Humana Inc., headquartered in Louisville, Kentucky, is a leading consumer-focused health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.

 

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CIGNA Offering New Dental Product Features that Reward Preventive Care and Provide Cost Savings

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 PHILADELPHIA, April 05, 2011 – As employers seek ways to control benefit costs, more are focusing on benefit programs that offer preventive options and strategies that encourage participation.1 CIGNA has expanded its dental product suite by adding new features that reward people for getting preventive dental care and also provide employers more plan design flexibility, while controlling benefit costs.

By promoting preventive care, dental benefits can help lead to better overall health, increased workforce productivity, and fewer treatment claims over time, which can decrease overall costs. In fact, every dollar spent on preventive dental care can save between $8 and $50 in restorative and emergency treatments.2

“Incentive-based programs have been shown to improve a person’s health,” said Bebe Shuler-Mure, assistant vice president for CIGNA’s dental products. “People who take advantage of these types of benefits can realize long-term out-of-pocket savings and experience an improvement in overall health, while employers will have a healthier and more productive workforce with more stable benefit costs.”

Three new plan features are now available with CIGNA’s Dental PPO, EPO and Traditional indemnity plans and can be bundled to meet employers’ benefits needs:

  • CIGNA Dental Waiver Saver encourages individuals to get preventive oral health care by not having costs for preventive and diagnostic services (Class 1 services) apply to maximums or deductibles. A plan design such as Waiver Saver focuses on removing any perceived or real financial barriers to preventive treatment. The goal of the program is to promote consistent use of these services, improving oral health of employees over time and helping to control long term benefit costs.
  • CIGNA Dental ProactivePlus provides two options for employers looking for more budget- targeted dental plan designs.
    • Option 1 – The first option includes coverage for preventive and diagnostic services (Class 1 services) only and includes exams, X-rays, cleanings and fluoride treatments.
    • Option 2 – The second option covers preventive, diagnostic and basic restorative services (Class I and II services) Basic restorative services may include fillings, root canals, extractions and periodontal care.
  • CIGNA Dental WellnessPlus rewards individuals for receiving preventive care. When a customer participates in preventive care in one plan year, he or she qualifies for increased coverage in the following plan year. The rewards continue year after year until they reach the maximum specified by the plan design chosen by the employer. This product feature, first introduced in 2006, will now offer more flexibility for employers by including varying coinsurance levels for different types of services, which can help make preventive care services more attractive for customers.

Each new product feature works together with CIGNA’s other preventive care-focused services. The CIGNA Dental Oral Health Integration Program® provides greater access to dental products and services for customers with specific chronic medical conditions, and the Healthy Rewards® program provides discounts on health and wellness products and services.

The CIGNA Dental PPO Radius Network is not only the largest national Dental PPO networks based on the number of unique dentists3, but it also holds a sizable lead over competing “DPPO” networks4. The Radius network has grown 47 percent over the last two years. It includes more than 86,300 unique dentists, which translates to nearly 210,000 dentist locations.

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 65 million customer relationships throughout the world. All products and services are provided exclusively by such operating subsidiaries and not by CIGNA Corporation. Such operating subsidiaries include Life Insurance Company of North America, CIGNA Life Insurance Company of New York, and Connecticut General Life Insurance Company.

 

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