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	<title>Health Plan Innovation News &#187; health care</title>
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	<link>http://healthplaninnovation.com</link>
	<description>Thought leadership on the use of innovation to solve health care access, quality, and funding issues.</description>
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		<title>Blue Cross &amp; Blue Shield&#8217;s Online Social Network Supports Member Discussions on Health and Wellness Topics</title>
		<link>http://healthplaninnovation.com/2010/08/blue-cross-blue-shields-online-social-network-supports-member-discussions-on-health-and-wellness-topics/</link>
		<comments>http://healthplaninnovation.com/2010/08/blue-cross-blue-shields-online-social-network-supports-member-discussions-on-health-and-wellness-topics/#comments</comments>
		<pubDate>Wed, 11 Aug 2010 18:58:58 +0000</pubDate>
		<dc:creator>Martin Trussell</dc:creator>
				<category><![CDATA[Consumer-driven Health Care]]></category>
		<category><![CDATA[Innovation]]></category>
		<category><![CDATA[Social media]]></category>
		<category><![CDATA[wellness]]></category>
		<category><![CDATA[health care]]></category>
		<category><![CDATA[Health IT]]></category>

		<guid isPermaLink="false">http://healthplaninnovation.com/?p=2828</guid>
		<description><![CDATA[Blue Cross &#38; Blue Shield of Rhode Island (BCBSRI) this week announced that is has launched a safe and secure online social forum, My Blue CommunitySM, for members to interact with other Blue Cross &#38; Blue Shield members from around the nation on health and wellness-related topics such as allergies and asthma, cold and flu, [...]]]></description>
			<content:encoded><![CDATA[<p></p><p><strong>Blue Cross &amp; Blue Shield of Rhode Island (BCBSRI)</strong> this week announced that is has launched a safe and secure online social forum, <strong>My Blue Community<sup>SM</sup></strong>, for members to interact with other Blue Cross &amp; Blue Shield members from around the nation on health and wellness-related topics such as allergies and asthma, cold and flu, diabetes, addiction, cancer and dental.  Members not only get guidance from experts such as chefs, trainers and health coaches, they can interact with one another, exchange information, share experiences, and offer advice to individuals who can relate to a similar situation or challenge.  				﻿</p>
<p>“A recent study from the <strong>Yale School of Public Health</strong> suggests that women who have had a heart attack can be susceptible to depression and other health challenges without the appropriate social support<sup>1</sup>,” said <strong>Jim Gallagher</strong>, BCBSRI assistant vice president of strategic marketing and product innovation.  “My Blue Community is designed to be an extension of the support one may receive from providers or family members and can have a positive effect on health outcomes.”</p>
<p>In one recent discussion, a member, who recently lost 60 pounds and plans to lose 100 more, inquired about strategies to fight the constant need to chew.  Other members offered suggestions from eating a handful of sunflower seeds to chewing gum to eating ice.  Additionally, a health coach made suggestions like taking small packages of vegetables to drinking the recommended daily water intake.   The member who posted the question commented favorably on the suggestions and thanked the others in support of his “food addiction.”</p>
<p>When BCBSRI asked My Blue Community members to comment on why they like the site, one user said:  “Thanks for the opportunity to share, which is the best thing about the site.  I feel connected to those people that might be sharing the same thoughts.  Feeling scared, frustrated or just want to share an experience – this is the place.  It’s a safe environment to seek advice, share a recipe or talk about health issues.  I feel these peers are in it with me and that they are trustworthy.”</p>
<p>My Blue Community currently has more than 50,000 health-related discussions already under way and about 25,000 members across the nation.  The new online network can be accessed from <a href="http://www.bcbsri.com/">www.BCBSRI.com</a>.</p>
<p><strong>About Blue Cross &amp; Blue Shield of Rhode Island:</strong></p>
<p>Blue Cross &amp; Blue Shield of Rhode Island is the state’s leading health insurer and covers more than 600,000 members. Blue Cross &amp; Blue Shield of Rhode Island is an independent licensee of the Blue Cross and Blue Shield Association.</p>
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		<title>Humana Introduces &#8216;Points of Caregiving&#8217; Program, Providing Comprehensive Resource to Nation&#8217;s 52 Million Caregivers</title>
		<link>http://healthplaninnovation.com/2010/06/humana-introduces-points-of-caregiving-program-providing-comprehensive-resource-to-nations-52-million-caregivers/</link>
		<comments>http://healthplaninnovation.com/2010/06/humana-introduces-points-of-caregiving-program-providing-comprehensive-resource-to-nations-52-million-caregivers/#comments</comments>
		<pubDate>Tue, 29 Jun 2010 19:14:13 +0000</pubDate>
		<dc:creator>Martin Trussell</dc:creator>
				<category><![CDATA[Innovation]]></category>
		<category><![CDATA[quality]]></category>
		<category><![CDATA[Consumer-driven Health Care]]></category>
		<category><![CDATA[health care]]></category>

		<guid isPermaLink="false">http://healthplaninnovation.com/?p=2780</guid>
		<description><![CDATA[“Caregivers play a critical support role in the U.S. health care system and often are considered the backbone of our long-term care system,” said Gail Miller, vice president, senior product development, strategy and business planning for Humana. ]]></description>
			<content:encoded><![CDATA[<p></p><p><strong><a href="http://cts.businesswire.com/ct/CT?id=smartlink&amp;url=http%3A%2F%2Fwww.humana.com&amp;esheet=6343317&amp;lan=en-US&amp;anchor=Humana+Inc.&amp;index=1&amp;md5=a503814ddebd94c951b1a0ee0ff4ba1a">Humana        Inc.</a></strong> (NYSE: <a href="http://finance.yahoo.com/q?s=hum&amp;d=t">HUM</a> &#8211; <a href="http://finance.yahoo.com/q/h?s=hum">News</a>) today introduced <strong><a href="http://cts.businesswire.com/ct/CT?id=smartlink&amp;url=http%3A%2F%2Fwww.pointsofcaregiving.com&amp;esheet=6343317&amp;lan=en-US&amp;anchor=Points+of+Caregiving&amp;index=2&amp;md5=24276ebed8b65f7086e8d97c48ed4c18">Points        of Caregiving</a></strong>, a comprehensive resource for the nation’s 52 million        caregivers. Designed as a complete caregiver’s destination, the program        includes an easy-to-use interactive website, telephonic support and        customized reminders to help caregivers make decisions with confidence        and to find support from peers.</p>
<p>Research reveals that one in five American adults, many of whom have        children or other dependents, provide care to a relative, friend or        neighbor. Caregivers often take on this role suddenly or unexpectedly,        and frequently must make major health and financial decisions quickly        for the person under their care. These new challenges and critical        decisions can leave caregivers puzzled and hesitant. Humana developed        the Points of Caregiving program to meet this need and to provide expert        support and resources.</p>
<p>“Caregivers play a critical support role in the U.S. health care system        and often are considered the backbone of our long-term care system,”        said <strong>Gail Miller</strong>, vice president, senior product development, strategy        and business planning for Humana. “With Points of Caregiving, we strive        to provide a supportive, interactive community that will help informal        and unpaid caregivers make the best decisions.”</p>
<p>Points of Caregiving is available to any caregiver, from those who        perform “light” care – such as helping with shopping, transportation and        cleaning – to “heavy” care, such as administering medication or        injections and performing personal hygiene services like bathing.        Program members receive access to a variety of tools that help support        caregivers physically, emotionally and financially:</p>
<ul>
<li> Tools and resources, such as worksheets and cost calculators to budget          and plan for care-management, easing caregivers’ minds as they          estimate income changes and caregiving expenses</li>
<li> Telephone consultation and support, including phone reminders members          can personalize for medications, doctor’s appointments, or anything          else a caregiver with a busy schedule must remember</li>
<li> Library of expert articles on health, insurance, legal matters and more</li>
<li> Interactive community forums where caregivers can connect with peers          to receive support and advice from people in similar situations</li>
<li> Information about national, state and local community resources, such          as clinics, doctors and public-service agencies that can act as          advocates, support and assist with care planning, which is especially          helpful to people caring from afar</li>
<li> Discounts on products and services that help caregivers save time and          money as well as care for themselves and their dependents – such as          discounted diet and exercise products, books, games, pill box with an          alarm clock reminder, and more</li>
</ul>
<p>Humana developed Points of Caregiving with its LifeSynch subsidiary; the        program is available for Humana members and non-members for $20 a month        with a one-year agreement ($240 a year), a cost quickly offset by the        time and energy saved by the caregiver. Visit <a href="http://cts.businesswire.com/ct/CT?id=smartlink&amp;url=http%3A%2F%2Fwww.PointsofCaregiving.com&amp;esheet=6343317&amp;lan=en-US&amp;anchor=www.PointsofCaregiving.com&amp;index=3&amp;md5=8df7c31f0bf77a400d4a4ca3c924e371">www.PointsofCaregiving.com</a> to learn more about caregiving.</p>
<p><strong>About Humana</strong></p>
<p>Humana Inc., headquartered in Louisville, Ky., is one of the nation’s        largest publicly traded health and supplemental benefits companies, with        approximately 10.4 million medical members and approximately 7.2 million        specialty-benefit members. Humana is a full-service benefits solutions        company, offering a wide array of health and supplemental benefit plans        for employer groups, government programs and individuals.</p>
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		<title>Engaging Public Health Insurance Consumers Through Social Media</title>
		<link>http://healthplaninnovation.com/2010/05/engaging-public-health-insurance-consumers-through-social-media/</link>
		<comments>http://healthplaninnovation.com/2010/05/engaging-public-health-insurance-consumers-through-social-media/#comments</comments>
		<pubDate>Wed, 12 May 2010 17:36:57 +0000</pubDate>
		<dc:creator>Martin Trussell</dc:creator>
				<category><![CDATA[Consumer-driven Health Care]]></category>
		<category><![CDATA[Innovation]]></category>
		<category><![CDATA[Social media]]></category>
		<category><![CDATA[consumer-directed health care]]></category>
		<category><![CDATA[Health]]></category>
		<category><![CDATA[health care]]></category>
		<category><![CDATA[medicaid]]></category>

		<guid isPermaLink="false">http://healthplaninnovation.com/?p=2675</guid>
		<description><![CDATA["Members saw that we established a presence on the social media sites they regularly frequent, offering them a new way to get information, offer instant feedback and even ask questions."]]></description>
			<content:encoded><![CDATA[<p></p><p><span class="drop_cap">M</span><strong>AXIMUS</strong> (NYSE:MMS), a leading provider of government services worldwide, announced today that the Company and the <strong>South Carolina Department of Health and Human Services</strong> will co-present a case study on engaging public health insurance program participants using social media at the upcoming <strong>Medicaid Managed Care Congress</strong>.</p>
<p>The South Carolina Department of Health and Human Services has been working with MAXIMUS, the Medicaid managed care enrollment counselor for the<strong> South Carolina Healthy Connections Choices</strong> program, on a demonstration project to examine the usefulness of social media technologies for outreach to low-income populations. The demonstration project, in partnership with the <strong>MAXIMUS Center for Health Literacy</strong>, has been successful in providing health and enrollment information to consumers and program stakeholders who are actively engaged in social media networks.</p>
<p><strong>Jeff Stensland</strong>, Director of Communications for the South Carolina Department of Health and Human Services, and <strong>Sunaina Menawat</strong>, Manager of Business Development for MAXIMUS Health Services, will present their case study entitled &#8220;Utilize Social Media for Greater Member Engagement, Communication and a Broader Reach.&#8221; Stensland and Menawat will present the demonstration project from its inception, the methodology and the social media tools used, and preliminary results. They will also discuss social media in the broader context of engagement and communication.</p>
<p>&#8220;One of the things I like about the demonstration project is that it tests the notion that lower-income people are somehow disconnected from the changes occurring in mass media. The project&#8217;s use of social media allowed us to interact with our members in new ways,&#8221; Stensland commented. &#8220;Members saw that we established a presence on the social media sites they regularly frequent, offering them a new way to get information, offer instant feedback and even ask questions. We look forward to sharing the insight garnered from the project with the Medicaid Managed Care community.&#8221;</p>
<p>&#8220;We are continuously looking for new ways to bring added value to our clients by improving outreach and education efforts to program participants,&#8221; commented <strong>Bruce Caswell</strong>, President and General Manager of MAXIMUS Health Services. &#8220;Until now, social media was often seen as an unconventional channel for communicating with participants of public health insurance programs, but this demonstration project shows that social media can be effectively used to reach program participants and help them make informed choices for improved long-term health outcomes.&#8221;</p>
<p>The Medicaid Managed Care Congress will take place May 17-19, 2010, at the Hyatt Regency in Baltimore, Maryland. The Congress brings together State and Federal Medicaid Officials, Medicaid Managed Care Executives and National Policy Experts in a collaborative environment to create efficiencies while improving access to high quality care.</p>
<p><strong>About MAXIMUS</strong></p>
<p>MAXIMUS is a leading provider of government services worldwide and is devoted to providing health and human services program management and consulting services to its clients. The Company has more than 6,500 employees located in more than 220 offices in the United States, Canada, Australia, the United Kingdom, and Israel. Additionally, MAXIMUS is included in the Russell 2000 Index and the S&amp;P SmallCap 600 Index.</p>
<p>Source<br />
<strong>Healthy Connections Choices </strong></p>
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		<title>HealthPartners to Launch Online Convenience Care Service</title>
		<link>http://healthplaninnovation.com/2010/05/healthpartners-to-launch-online-convenience-care-service/</link>
		<comments>http://healthplaninnovation.com/2010/05/healthpartners-to-launch-online-convenience-care-service/#comments</comments>
		<pubDate>Thu, 06 May 2010 19:06:59 +0000</pubDate>
		<dc:creator>Martin Trussell</dc:creator>
				<category><![CDATA[Consumer-driven Health Care]]></category>
		<category><![CDATA[Health]]></category>
		<category><![CDATA[Innovation]]></category>
		<category><![CDATA[wellness]]></category>
		<category><![CDATA[consumer-directed health care]]></category>
		<category><![CDATA[health care]]></category>

		<guid isPermaLink="false">http://healthplaninnovation.com/?p=2651</guid>
		<description><![CDATA["Virtuwell is all about bringing more choices, affordable and easy-to-use options and high-quality health care," said Mary Brainerd, president and CEO.]]></description>
			<content:encoded><![CDATA[<p></p><p><span class="drop_cap">H</span><strong>ealthPartners</strong>, the nation&#8217;s largest consumer-governed, nonprofit health care organization, today announced plans to launch a new online convenience care service this fall.</p>
<p>The service, to be named <strong>Virtuwell</strong>, will provide online diagnosis and treatment of common medical conditions. The custom-designed service will combine proven, trusted medical expertise with the convenience of 24/7 online access to care including prescriptions if needed.</p>
<p>&#8220;Virtuwell is all about bringing more choices, affordable and easy-to-use options and high-quality health care,&#8221; said <strong>Mary Brainerd</strong>, president and CEO. &#8220;As we&#8217;ve watched the popularity of our online care options grow in recent years, we&#8217;ve continued to develop new ways to help patients get the right care at the right time at the lowest-possible cost. We&#8217;re excited about Virtuwell and what users will experience &#8212; a convenient, friendly and easy-to-use way to get better.&#8221;</p>
<p>With Virtuwell, medical professionals will be available online &#8212; on demand and around the clock &#8212; to provide personalized diagnoses, treatment recommendations, and prescriptions for routine medical conditions such as cold, cough and allergy, ear pain, yeast and urinary tract infection, and others. Users will receive a rapid diagnosis and treatment plan at a lower cost than visiting a clinic.</p>
<p>HealthPartners expects to begin offering Virtuwell services this fall, at which time further details will be announced.</p>
<p><strong>About </strong><strong>HealthPartners </strong><br />
Founded in 1957, the $3 billion <a href="https://www.healthpartners.com/routing.jsp">HealthPartners</a> family of health care companies serves 1.25 million members and provides care to over 500,000 patients in our HealthPartners care delivery system which includes 70 clinics and three hospitals. It is the largest consumer-governed, nonprofit health care organization in the nation, providing care, coverage, research and education to improve the health of members, patients and the community. HealthPartners is among the top 25 commercial health plans in the nation and is the top-ranked plan in Minnesota according to <em>U.S. News &amp; World Report</em>/NCQA &#8220;America&#8217;s Best Health Insurance Plans 2009-10.&#8221;</p>
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		<title>Personal Health Statement To Enhance Conversation.</title>
		<link>http://healthplaninnovation.com/2010/03/personal-health-statement-to-enhance-conversation/</link>
		<comments>http://healthplaninnovation.com/2010/03/personal-health-statement-to-enhance-conversation/#comments</comments>
		<pubDate>Wed, 31 Mar 2010 19:06:00 +0000</pubDate>
		<dc:creator>Martin Trussell</dc:creator>
				<category><![CDATA[Consumer-driven Health Care]]></category>
		<category><![CDATA[Innovation]]></category>
		<category><![CDATA[health insurance]]></category>
		<category><![CDATA[health care]]></category>

		<guid isPermaLink="false">http://healthplaninnovation.com/?p=2559</guid>
		<description><![CDATA[The PHS replaces the previous Explanation of Benefits (EOB), which was generated and mailed to members each time a physician or hospital filed a claim with the health plan.]]></description>
			<content:encoded><![CDATA[<p></p><p><span class="drop_cap">I</span>n an effort to enhance the conversation with its members, <strong>Arkansas Blue Cross and Blue Shield</strong> has created the <strong>Personal Health Statement (PHS)</strong>, a new health care benefit report that helps them have a more clear and complete picture of their health benefits and health care costs.</p>
<p>The PHS replaces the previous <strong>Explanation of Benefits (EOB)</strong>, which was generated and mailed to members each time a physician or hospital filed a claim with the health plan.</p>
<p>&#8220;Health insurance is a complex industry with lots of moving parts and a language all its own,&#8221; said <strong>Karen Raley</strong>, vice president of Communications and Product Development.  &#8220;We want the conversations we have with our members to be understandable, whether we&#8217;re talking by telephone, through our Web sites or in any of our many written pieces of communication.</p>
<p>&#8220;The EOB was one of the most frequent forms of communication our members received from us and that valuable tool has undergone dramatic changes all in an effort to create better communication with our members.  The PHS more thoroughly explains a member&#8217;s health insurance benefits, outlines our obligations and clearly shows members what they need to pay regarding a claim that has been filed for services they received.&#8221;</p>
<p>With the new PHS, industry terms have been simplified into everyday language, claims are more clearly explained, and members know exactly where they are with their out-of-pocket costs (deductibles, copayments, coinsurance and more).</p>
<p>The Personal Health Statement is more comprehensive than the old EOB and is designed to make claims processing easier for members to understand.</p>
<p>The new PHS provides:</p>
<ul>
<li>a better description of the discounts members receive on their health-care services</li>
<li>information on how to get in touch with the health plan</li>
<li>a quick understanding of how much members owe and to whom</li>
<li>help in understanding the benefits members have and how they work</li>
</ul>
<p>Pharmacy information has been added for the first time and test groups found this to be a valuable record of the medications they take and the dosage.  Another new feature on the PHS is personal health messages and reminders to get recommended health screenings when they are due.</p>
<p>All the detailed claims information that members are accustomed to receiving in their EOB will continue to be found in their PHS, but with easier to understand explanations and in a more user-friendly format.</p>
<p>Member participants in the PHS pilot indicated that the new PHS is user-friendly and informative – &#8220;…the first time for many people to see what a prescription really costs then see what the generic would cost…;&#8221; descriptive – &#8220;…a valuable tool for helping explain our health-care benefits and costs…;&#8221; and educational – &#8220;…will help all of us become better consumers of health care because we can actually see how money is being spent.&#8221;</p>
<p>&#8220;We love to hear from our members,&#8221; Raley said.  &#8220;We see the new PHS as a product of their feedback, an educational tool for increasing their knowledge about health care cost and coverage, and a resource for making our conversations with members more meaningful.&#8221;</p>
<p><strong>About Arkansas Blue Cross and Blue Shield</strong><br />
<em>Founded in 1948, Arkansas Blue Cross and Blue Shield, an independent licensee of the Blue Cross and Blue Shield Association, is the largest health insurer in Arkansas.  Arkansas Blue Cross and its affiliates have more than 2,700 employees.  If combined, the 39 independent, locally operated Blue Cross and Blue Shield Plans collectively provide healthcare coverage for nearly 100 million – nearly one in three – Americans.</em></p>
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		<title>Sebelius, Solis Announce Nearly $1 Billion Recovery Act Investment in Advancing Use of Health IT, Training Workers for Health Jobs of the Future.</title>
		<link>http://healthplaninnovation.com/2010/02/sebelius-solis-announce-nearly-1-billion-recovery-act-investment-in-advancing-use-of-health-it-training-workers-for-health-jobs-of-the-future/</link>
		<comments>http://healthplaninnovation.com/2010/02/sebelius-solis-announce-nearly-1-billion-recovery-act-investment-in-advancing-use-of-health-it-training-workers-for-health-jobs-of-the-future/#comments</comments>
		<pubDate>Mon, 15 Feb 2010 17:53:03 +0000</pubDate>
		<dc:creator>Martin Trussell</dc:creator>
				<category><![CDATA[Health]]></category>
		<category><![CDATA[Health IT]]></category>
		<category><![CDATA[Innovation]]></category>
		<category><![CDATA[health care]]></category>

		<guid isPermaLink="false">http://healthplaninnovation.com/?p=2359</guid>
		<description><![CDATA[The awards will help make health IT available to over 100,000 hospitals and primary care physicians by 2014 and train thousands of people for careers in health care and information technology.]]></description>
			<content:encoded><![CDATA[<p></p><p><span class="drop_cap">H</span><strong>ealth and Human Services Secretary Kathleen Sebelius </strong>and <strong>Labor Secretary Hilda Solish</strong> have announced a total of nearly $1 billion in <strong>Recovery Act </strong>awards to help health care providers advance the adoption and meaningful use of health information technology (IT) and train workers for the health care jobs of the future. The awards will help make health IT available to over 100,000 hospitals and primary care physicians by 2014 and train thousands of people for careers in health care and information technology. This Recovery Act investment will help grow the emerging health IT industry which is expected to support tens of thousands of jobs ranging from nurses and pharmacy techs to IT technicians and trainers.</p>
<p>The over $750 million in HHS grant awards Secretary Sebelius announced are part of a federal initiative to build capacity to enable widespread meaningful use of health IT. This assistance at the state and regional level will facilitate health care providers&#8217; efforts to adopt and use electronic health records (EHRs) in a meaningful manner that has the potential to improve the quality and efficiency of health care for all Americans. Of the over $750 million investment, $386 million will go to 40 states and qualified State Designated Entities (SDEs) to facilitate health information exchange (HIE) at the state level, while $375 million will go to an initial 32 non-profit organizations to support the development of regional extension centers (RECs) that will aid health professionals as they work to implement and use health information technology &#8211; with additional HIE and REC awards to be announced in the near future. RECs are expected to provide outreach and support services to at least 100,000 primary care providers and hospitals within two years.</p>
<p>&#8220;Health information technology can make our health care system more efficient and improve the quality of care we all receive,&#8221; said Secretary of Health and Human Services <strong>Kathleen Sebelius</strong>. &#8220;These grant awards, the first of their kind, will help develop our electronic infrastructure and give doctors and other health care providers the support they need as they adopt this powerful technology.&#8221;</p>
<p>The more than $225 million in DOL grant awards Secretary Solis announced will be used to train 15,000 people in job skills needed to access careers in health care, IT and other high growth fields. Through existing partnerships with local employers, the recipients of these grants have already identified roughly 10,000 job openings for skilled workers that likely will become available in the next two years in areas like nursing, pharmacy technology and information technology. The grants will fund 55 separate training programs in 30 states to help train people for secure, well-paid health jobs and meet the growing employment demand for health workers. Employment services will be available via the Department of Labor&#8217;s local One Stop Career Centers, and training will be offered at community colleges and other local education providers.</p>
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		<title>Capital BlueCross and P4 Healthcare Launch Cancer Pathways Initiative.</title>
		<link>http://healthplaninnovation.com/2010/01/capital-bluecross-and-p4-healthcare-launch-cancer-pathways-initiative/</link>
		<comments>http://healthplaninnovation.com/2010/01/capital-bluecross-and-p4-healthcare-launch-cancer-pathways-initiative/#comments</comments>
		<pubDate>Thu, 14 Jan 2010 18:48:04 +0000</pubDate>
		<dc:creator>Martin Trussell</dc:creator>
				<category><![CDATA[Innovation]]></category>
		<category><![CDATA[health insurance]]></category>
		<category><![CDATA[quality]]></category>
		<category><![CDATA[health care]]></category>

		<guid isPermaLink="false">http://healthplaninnovation.com/?p=2198</guid>
		<description><![CDATA[We are constantly looking for ways to improve the care delivered to our members. This program is compelling because it is driven by evidence-based pathways that include the guidance of local oncologists who understand the unique needs of those facing health challenges, said Capital BlueCross President and CEO Bill Lehr.]]></description>
			<content:encoded><![CDATA[<p></p><p><span class="drop_cap">C</span><strong>apital BlueCross</strong> and <strong>P4 Healthcare</strong> announced today the launch of an innovative initiative to create clinically proven, evidence-based oncology treatment protocols aimed at enhancing the quality of care for patients. The <strong>P4 Pathways Program</strong> will provide the tools to establish disease-specific and locally-based pathways for the treatment of patients with cancer, as well as protocols for supportive care (treatment of complications and adverse events that arise from the medical condition or administration of treatment). The pathways are a collaborative effort that will be developed with oncologists across the entire Capital BlueCross network as a way to provide cost-effective care and improve the quality of health care delivery without comprising the integrity or delivery of treatment.</p>
<p>We are constantly looking for ways to improve the care delivered to our members. This program is compelling because it is driven by evidence-based pathways that include the guidance of local oncologists who understand the unique needs of those facing health challenges, said Capital BlueCross President and CEO <strong>Bill Lehr</strong>.</p>
<p>Capital BlueCross and P4 Healthcare have assembled a panel of local physicians to develop and maintain an up-to-date framework for the P4 Pathways Program based on clinical evidence to ensure best patient outcomes. The P4 Pathways are designed to provide high-quality patient care and reward physicians for delivering appropriate care while managing costs.</p>
<p>The P4 Pathways Program brings together the key stakeholders in the care of a patient. The intent of this program is to ensure highest quality of cancer care for Capital BlueCross patients through the adoption of evidence-based clinical pathways, said<strong> Jeffrey Scott, M.D.</strong>, Chief Executive Officer, P4 Pathways.</p>
<p>P4 Healthcare, creators of the P4 Pathways Program, will provide proprietary technology, tools, expertise, educational programs, and hands-on training for developing, implementing, and continually monitoring and reporting on anything relating to the P4 Pathways Program. Practices implementing P4 Pathway programs have historically shown less variability in regimens, reduced misuse of chemotherapy, better managed toxicity, optimized use of biologics and better defined treatment milestones.</p>
<p><strong>About Capital BlueCross:</strong></p>
<p>Capital BlueCross is the leading health insurer in its region, providing health insurance coverage to nearly one million people in central Pennsylvania and the Lehigh Valley. Capital BlueCross is committed to making health insurance simple for its customers and members through all the stages of life by offering nationally acclaimed customer service and a full range of innovative benefit programs at competitive prices. The company has been providing health security to the people and communities of central Pennsylvania and the Lehigh Valley for more than 70 years and employs about 2,100 people in the region. Capital BlueCross is an independent licensee of the Blue Cross and Blue Shield Association.</p>
<p><strong>About P4 Pathways, a P4 Healthcare company:</strong></p>
<p>P4 Pathways partners with payors across the country to establish clinically proven, evidence-based oncology treatment protocols designed to promote the delivery of high quality, cost efficient patient care. These protocols seek optimal patient outcomes by ensuring selections of the most cost effective medications, minimizing side effects, reducing errors, and minimizing toxicities. Patients, Payors and Physicians all benefit alike. Significant cost savings and enhanced care are realized by eliminating unnecessary medical costs, reducing hospitalization and selecting the most cost effective medications. P4 Pathways, LLC is a P4 Healthcare company. For more information, visit <a href="www.p4pathways.com">www.p4pathways.com</a>.</p>
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		<link>http://healthplaninnovation.com/2009/12/cignas-coachrx-%e2%80%a6-a-prescription-for-better-health/</link>
		<comments>http://healthplaninnovation.com/2009/12/cignas-coachrx-%e2%80%a6-a-prescription-for-better-health/#comments</comments>
		<pubDate>Tue, 29 Dec 2009 23:30:35 +0000</pubDate>
		<dc:creator>Martin Trussell</dc:creator>
				<category><![CDATA[Health]]></category>
		<category><![CDATA[Innovation]]></category>
		<category><![CDATA[Pharma]]></category>
		<category><![CDATA[health care]]></category>

		<guid isPermaLink="false">http://healthplaninnovation.com/?p=2114</guid>
		<description><![CDATA[After taking a self-assessment to help individuals determine their own barriers to taking their medications, customers can then sign up for daily reminders through a variety of ways, including cell phone text messages, voicemails or emails.]]></description>
			<content:encoded><![CDATA[<p></p><p><span class="drop_cap">A</span>s former Surgeon General<strong> C. Everett Koop, M.D.</strong> once said, Drugs dont work in patients who dont take them. Thats why <strong>CIGNA</strong> is introducing <strong>CoachRx</strong>, an interactive Web site to help CIGNA Home Delivery Pharmacy customers identify their personal barriers to taking their medications, and then providing ways to help people stay on track with the medications they need.</p>
<p>After taking a self-assessment to help individuals determine their own barriers to taking their medications, customers can then sign up for daily reminders through a variety of ways, including cell phone text messages, voicemails or emails. They can also sign up for reminders to take vital signs such as blood pressure or blood sugar levels, or to remember to schedule, or go to, medical appointments.</p>
<p>We want to reach individuals with information in a way that will do the most good, said <strong>Yi Zheng, PharmD</strong>, assistant vice president of pharmacy clinical programs for CIGNA. Peoples schedules today are already hectic, which is why were trying to help in ways that work best for them.</p>
<p>For those who may need additional assistance, theres a toll-free number to call for medication coaching sessions with a clinical pharmacist, who works with health coaches and nurse case managers to help the individual establish health goals. Coaching help includes:</p>
<ul>
<li> identifying issues such as medication side effects or what can be expected from a particular medication, including working with the physician to see if another medication might be better;</li>
<li> reinforcing the importance of not skipping doses or taking only half           the medication prescribed;</li>
<li> helping to understand why its important to take needed medications even when someone is not feeling sick;</li>
<li> explaining information on the medication bottle or benefit coverage;           and</li>
<li> providing information on ways to lower medication costs.</li>
</ul>
<p>Free pill boxes to help organize medications, educational materials to understand medical conditions, discount coupons to help offset costs, and reminders when its time to refill a prescription are included in the program.</p>
<p>Once people leave the doctors office, physicians have limited ways of knowing if their patients fill a prescription or take their medications correctly, said Zheng. There are many reasons why individuals may not take their medications. People often dont like the side-effects, dont understand why they have to take a medication, or simply forget &#8212; which can hurt their health.</p>
<p>Zheng points out that medication adherence is a complex and costly issue. According to a report by the <strong>New England Healthcare Institute</strong>, non-adherence leads to poorer health, more frequent hospitalizations, a higher risk of death and as much as $290 billion annually in increased medical costs.</p>
<p>We know that staying on track with medications is not always easy, said Zheng. Thats when were here to help.</p>
<p><strong>About CIGNA:</strong></p>
<p>CIGNA (NYSE:CI), a global health service company, is dedicated to helping people improve their health, well-being and sense of security. CIGNA Corporation&#8217;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, to more than 46 million people throughout the United States and around the world. To learn more about CIGNA, visit <a href="http://cts.businesswire.com/ct/CT?id=smartlink&amp;url=http%3A%2F%2Fwww.cigna.com&amp;esheet=6124254&amp;lan=en_US&amp;anchor=www.cigna.com&amp;index=1&amp;md5=8117bb8578d678d8f6ddf366f61f210a">www.cigna.com</a>.</p>
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		<title>The American Board Of Medical Specialties And Blue Cross And Blue Shield Association Announce New Collaboration To Improve Healthcare Quality And Patient Safety.</title>
		<link>http://healthplaninnovation.com/2009/12/the-american-board-of-medical-specialties-and-blue-cross-and-blue-shield-association-announce-new-collaboration-to-improve-healthcare-quality-and-patient-safety/</link>
		<comments>http://healthplaninnovation.com/2009/12/the-american-board-of-medical-specialties-and-blue-cross-and-blue-shield-association-announce-new-collaboration-to-improve-healthcare-quality-and-patient-safety/#comments</comments>
		<pubDate>Tue, 08 Dec 2009 23:30:19 +0000</pubDate>
		<dc:creator>Martin Trussell</dc:creator>
				<category><![CDATA[Health]]></category>
		<category><![CDATA[health insurance]]></category>
		<category><![CDATA[quality]]></category>
		<category><![CDATA[health care]]></category>

		<guid isPermaLink="false">http://healthplaninnovation.com/?p=1848</guid>
		<description><![CDATA[BCBSA will explore ways to support ABMS in communicating the value of certification to the public and educate consumers and key stakeholders of ABMS' commitment to career-long professional development and quality within the physician community. ]]></description>
			<content:encoded><![CDATA[<p></p><p><span class="drop_cap">T</span>he American Board of <strong>Medical Specialties (ABMS) </strong>and the<strong> Blue Cross and Blue Shield Association (BCBSA)</strong> announced today that they have created a formal collaboration to work together toward mutual goals of improving healthcare quality, patient safety and affordability. The unique collaboration between ABMS and BCBSA will explore strategies to improve healthcare delivery, optimize professional development and enhance consumer understanding of the value of this healthcare information.</p>
<p>ABMS is a medical organization made up of 24 Member Boards that oversee physician certification in the U.S. It assists the Member Boards in their efforts to develop and implement educational and professional standards for the evaluation and certification of physician specialists with the public&#8217;s interest as their primary concern.</p>
<p>Initially, the focus of the relationship between ABMS and BCBSA will be promoting the value of both board certification and Maintenance of Certification, a process designed to document that physician specialists, certified by ABMS Member Boards, maintain the necessary competencies to provide quality patient care. Over time, the collaboration will expand to include other ways of ensuring patient safety.</p>
<p>&#8220;I am confident that this collaboration will help us bring greater value to doctors who are involved in ABMS Maintenance of Certification as well as value to patients and the public at large,&#8221; said <strong>Kevin B. Weiss, MD</strong>, president and CEO of ABMS. &#8220;This supports ABMS&#8217; efforts to continue to create alignments with the major stakeholders and influencers on healthcare, such as BCBSA, whose 39 independent licensees cover more than 100 million lives.&#8221;</p>
<h4>BCBSA to help increase public knowledge of board certification</h4>
<p>BCBSA will explore ways to support ABMS in communicating the value of certification to the public and educate consumers and key stakeholders of ABMS&#8217; commitment to career-long professional development and quality within the physician community. Concurrently, ABMS will also lead an effort to increase public knowledge and understanding of board certification, Maintenance of Certification and how it differs from state licensing requirements, and to make its certification process more transparent.</p>
<p>&#8220;We look forward to working with ABMS, a national leader in physician certification, on this unique opportunity to enhance the value of board certification and effectively communicate to physicians and patients the importance of professional development and how it can lead to increased healthcare quality,&#8221; said <strong>Allan Korn, MD</strong>, senior vice president and chief medical officer, BCBSA. &#8220;This relationship emphasizes Blue Cross and Blue Shield companies&#8217; commitment to delivering quality, affordable healthcare to all Americans.&#8221;</p>
<p><strong>About American Board of Medical Specialties</strong><br />
For over 75 years, American Board of Medical Specialties is the medical organization overseeing physician certification in the United States. It assists its 24 Member Boards in their efforts to develop and implement educational and professional standards for the evaluation and certification of physician specialists. ABMS Member Boards provide physician certification information to ABMS for its certification verification service programs. ABMS is recognized by the key healthcare credentialing accreditation entities as a primary equivalent source of board certification data for medical specialists. Patients can visit www.abms.org or call toll-free 1-866-ASK-ABMS to see if their physician is board certified by an ABMS Member Board. For more information about ABMS visit www.abms.org or call 312.436.2600.</p>
<p>The 24 Member Boards that make up the ABMS Board Enterprise, cover over 145 medical specialties and subspecialties, and include: American Board of Allergy and Immunology, American Board of Anesthesiology, American Board of Colon and Rectal Surgery, American Board of Dermatology, American Board of Emergency Medicine, American Board of Family Medicine, American Board of Internal Medicine, American Board of Medical Genetics, American Board of Neurological Surgery, American Board of Nuclear Medicine, American Board of Obstetrics and Gynecology, American Board of Ophthalmology, American Board of Orthopaedic Surgery, American Board of Otolaryngology, American Board of Pathology, American Board of Pediatrics, American Board of Physical Medicine and Rehabilitation, American Board of Plastic Surgery, American Board of Preventive Medicine, American Board of Psychiatry and Neurology, American Board of Radiology, American Board of Surgery, American Board of Thoracic Surgery, and American Board of Urology.</p>
<p><strong>The Blue Cross and Blue Shield Association</strong></p>
<p>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 for100 millionmembers &#8211; one-in-three Americans. For more information on the Blue Cross and Blue Shield Association and its member companies, please visit <a href="http://www.bcbs.com/">www.BCBS.com</a>.</p>
<p>Source: Blue Cross and Blue Shield Association</p>
<p><em> </em></p>
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		<title>The Leapfrog Group Announces Its 2009 Top Hospitals.</title>
		<link>http://healthplaninnovation.com/2009/12/the-leapfrog-group-announces-its-2009-top-hospitals/</link>
		<comments>http://healthplaninnovation.com/2009/12/the-leapfrog-group-announces-its-2009-top-hospitals/#comments</comments>
		<pubDate>Thu, 03 Dec 2009 23:31:36 +0000</pubDate>
		<dc:creator>Martin Trussell</dc:creator>
				<category><![CDATA[Health]]></category>
		<category><![CDATA[Hospitals]]></category>
		<category><![CDATA[health care]]></category>
		<category><![CDATA[healthcare system]]></category>

		<guid isPermaLink="false">http://healthplaninnovation.com/?p=1792</guid>
		<description><![CDATA[Leapfrog hospitals have lower mortality and better quality of care than those that don't report to Leapfrog.]]></description>
			<content:encoded><![CDATA[<p></p><p><strong>Leapfrog Adds New a Efficiency Standard to Its Quality Criteria for Top Hospitals and Introduces a Category for Top Rural Hospitals</strong></p>
<p><span class="drop_cap">W</span>hile Congress debates whether healthcare reform would control healthcare costs, today employer purchasers point to 45 hospitals that lead through example &#8212; delivering the best quality care in the nation while attaining the highest levels of efficiency. Thirty-four urban, eight children&#8217;s and three rural hospitals have been named 2009 Leapfrog Top Hospitals, based on results from <strong>The Leapfrog Hospital Survey</strong>. The survey (found at <a href="http://www.leapfroggroup.org/" target="_blank">www.leapfroggroup.org</a>) is the only national, public comparison of hospitals on key issues including mortality rates for certain common procedures, infection rates, safety practices, and measures of efficiency.</p>
<p><a href="http://healthplaninnovation.com/?attachment_id=1800" rel="attachment wp-att-1800"><img src="http://healthplaninnovation.com/wp-content/uploads/2009/12/leapfrog_logo2006_000-300x102.gif" alt="leapfrog_logo2006_000" title="leapfrog_logo2006_000" width="300" height="102" class="alignleft size-medium wp-image-1800" /></a>Qualifying criteria for Leapfrog&#8217;s Top Hospital Award list remain virtually the same as 2008, with one added dimension: once hospitals demonstrate top quality, they must also rise to the top of the list on efficiency.</p>
<p>&#8220;This year&#8217;s class of Top Hospitals not only hits the mark in areas such as medication error prevention and preventing ICU deaths, but they also use their resources wisely, providing excellent and efficient outcomes for patients,&#8221; said <strong>Leah Binder</strong>, CEO, The Leapfrog Group. &#8220;Regardless of what happens to healthcare reform, these hospitals are the future.&#8221;</p>
<p><strong>New this year</strong></p>
<p>New this year, Leapfrog recognizes a new category: Top Rural Hospitals. The award winners in 2009 scored in the top decile nationally for efficiency and are located in Georgia and Maine.*</p>
<p>&#8220;Rural hospitals should be especially recognized as they often have higher hurdles to clear than their larger, urban counterparts in terms of access to capital and other resources,&#8221; said Binder, a former administrator of a rural hospital.</p>
<p>In 2009, Top Hospitals in urban settings fulfill the following criteria:</p>
<ul>
<li>Fully meet Leapfrog standards      for implementing computer physician order entry (CPOE) systems (that have      been shown to reduce medication errors by up to 85%), and for passing      Leapfrog&#8217;s test of their system;</li>
<li>Fully meet stringent      performance standards for complex, high-risk procedures (such as heart      bypass surgery) done in that particular hospital;</li>
<li>Fully meet standards for      staffing the ICU, shown to reduce mortality by 40% or more;</li>
<li>Score in the top decile in      the country for efficiency &#8212; scored by the Leapfrog Hospital Recognition      Program incorporating quality outcomes, length of stay, readmission rates,      and incidence of hospital acquired conditions and infections. The      efficiency standard applies to heart bypass surgery, heart angioplasty,      heart attack and pneumonia patients.</li>
</ul>
<p>&#8220;We know from research that Leapfrog-reporting hospitals are among the best in the country, and they demonstrate through Leapfrog that they set ambitious goals for their performance,&#8221; said Binder, pointing to a study by <strong>Dr. Ashish Jha</strong> at Harvard Medical School, published in the peer-reviewed Journal of the Joint Commission in 2008, concluding that Leapfrog hospitals have lower mortality and better quality of care than those that don&#8217;t report to Leapfrog.</p>
<p>&#8220;Not all hospitals make the top hospital list, but every hospital that participates in Leapfrog deserves credit. They are fundamentally changing the hospital market into one that is highly responsive to the quality, cost and value needs of consumers and large buyers of health care,&#8221; said <strong>David Knowlton</strong>, Chair of The Leapfrog Group and President &amp; CEO of the New Jersey Health Care Quality Institute.</p>
<p>This year&#8217;s top urban hospitals are located in 13 states &#8212; Arizona, California, Illinois, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, Ohio, Pennsylvania, South Carolina, Tennessee and Washington.*</p>
<p>Top pediatric hospitals in 2009 achieved a quality score of 95 or better through Leapfrog&#8217;s Hospital Recognition Program and are located in California, District of Columbia, Massachusetts, Minnesota, Ohio, Pennsylvania, and Tennessee.*</p>
<p><strong>The Leapfrog Group </strong>(www.leapfroggroup.org) uses the collective leverage of large purchasers of health care to initiate breakthrough improvements in the safety, quality, and affordability of health care for Americans. The Leapfrog Group was founded in 2000 by the Business Roundtable, and is now independently operated with support from its members.</p>
<p>The Leapfrog Hospital Survey is the gold standard for comparing hospitals&#8217; performance on the national standards of safety, quality, and efficiency that are most relevant to consumers and purchasers of care. Hospitals that participate in The Leapfrog Hospital Survey achieve hospital-wide improvements that translate into millions of lives and dollars saved. Leapfrog&#8217;s purchaser members use Survey results to inform their employees and purchasing strategies. In 2009, 1206 hospitals across the country completed The Leapfrog Hospital Survey.</p>
<p><strong><em>*For a complete list of 2009 Top Hospitals visit </em></strong><a href="http://www.leapfroggroup.org/" target="_blank"><strong><em>www.leapfroggroup.org</em></strong></a><strong><em> on December 3, 2009. </em></strong></p>
<p>SOURCE The Leapfrog Group</p>
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