Priority Health Becomes Michigan’s only Health Plan to Earn Wellness Accreditation

GRAND RAPIDS, Mich.–()–Priority Health has become the only health plan in Michigan to receive wellness accreditation from the National Committee for Quality Assurance (NCQA). The accreditation from the NCQA, an organization focused on improving the quality of health care, certifies Priority Health as a leader in implementing wellness programs in the workplace. This recognition comes as Priority Health renews its commitment to improve the health and lives of the people it works with by enhancing its employer-based wellness programs. Continue reading

SoloHealth Station Surpasses the 40-Million Mark for Consumer Engagements

Atlanta, GA (PRWEB) December 20, 2013, SoloHealth®, a consumer-driven healthcare technology company, announced today that its SoloHealth Station® consumer health and wellness kiosk has surpassed the 40-million mark for user engagements, averaging almost 130,000 users per day. The company says it’s pacing 10 million users per quarter and projecting 40M annually. Texas, Florida, California, Georgia and North Carolina are leading all states in consumer engagement and usage rates.

SoloHealth Stations are currently located in more than 3,500 retail locations across the nation with users spending approximately 4.5 minutes per session. The SoloHealth Station’s nationwide network provides consumers with free interactive health tools and services to better manage their health and wellness for better healthcare outcomes. SoloHealth also delivers advertisers, health plan providers and employers an engaging platform to reach, connect and interact with users when health care is top-of-mind. Continue reading

Insurance CEO Says Spending for Health Care ‘Unsustainable’

At its current level, health care spending is “unsustainable,” Highmark CEO and President Dr. William Winkenwerder Jr. told an assemblage of business leaders attending the West Virginia Chamber of Commerce’s annual meeting at The Greenbrier Thursday morning.

His company, Winkenwerder said, is working on several fronts to stem the tide of health care spending through such programs as an in-house wellness and prevention initiative that lowers health insurance premiums for Highmark employees who take steps like quitting smoking, losing weight and adopting a regular exercise regimen.

Another Highmark initiative seeks to boost “cost/quality transparency,” a needed service, according to Winkenwerder, because nobody appears to know how much each item in health care costs.

See the full story at Register-Herald.com

Virtual Coaching: One Health Plan’s Clever Weight Loss Program

In June of this year, the Government Employee Health Association (GEHA), Independence, Mo., the nation’s second-largest health plan for civilian federal employees and retirees, enrolled 1,500 members in a virtual weight loss management program that it says was successful with nearly 80 percent of participants in 2012. That’s a significant milestone, because it demonstrates that a Web-based technology can be an effective and relatively low-cost way for individuals to lower their health risks.

Read the full story at healthcare-informatics.com

TriZetto Founder Jeff Margolis Fusing Healthcare Population Management and Social Networking

DENVER, Jan. 9, 2012 /PRNewswire via COMTEX/ — Well known for founding healthcare payer software powerhouse, The TriZetto Group, and growing it to return $1.4 billion to shareholders in just 10 years, as well as authoring The Healthcare Cure, Jeff Margolis is now focusing on the opportunity to improve healthcare value through social networking technology.

Margolis recently became executive chairman of WellTok, Inc., developer of the social health hub network, CafeWell(TM), which is already being utilized by healthcare payers to actively engage thousands of members in improving their health. Health plan customers of WellTok have recently begun to offer expanded sponsorship onto the CafeWell channel to over 1 million members.

“Healthcare population managers, whether they are health plans or health providers, have struggled to get consumers meaningfully engaged with their health, and the nation’s health statistics and costs reflect that,” noted Margolis. “Despite having more than 80% of the U.S. population is some form of private or public ‘organized system of health care’, consumers’ knowledge and behaviors are not reflective of the ever-growing body of information available to help them optimize their health.

Social networking platforms, such as Facebook and Twitter, have changed the culture of information flow in communications. And research, such as the work of Dr. Nicholas Christakis at Harvard Medical School, has documented the impact of a person’s social network on their health behaviors.

“Harnessing both social power and social networking technology with security, privacy and alignment is a critical mandate for healthcare,” Margolis added. “At TriZetto, we delivered platforms to help population managers massively cut administrative costs, improve care management and accelerate connectivity among healthcare constituents. Now, social networking technology applied in a systematic way to consumers within managed populations can similarly lead to significant breakthroughs that will drive greater value for the money being spent in our healthcare system. That’s the desired outcome of Social Health Management.”

“Jeff’s vision and entrepreneurship has driven tremendous shareholder value across many companies over the past twenty years,” said Robert DiGia, global head of healthcare investment banking at UBS Investment Bank. “I expect that Jeff’s deep understanding of the healthcare ecosystem will create significant value for WellTok’ customers and investors.”

“Jeff has provided important input to Washington, D.C. stakeholders’ understanding of the impact information technology can have on healthcare,” said Ian Adler, senior managing director of healthcare at the Marwood Group. “Social network technology is a new frontier for healthcare and I look forward to Jeff’s continued leadership in developing this new technology to improve the cost and quality of care.”

Delivering Social Health Management(TM) (SHM)

It seems that everything you hear about today is ‘social’. As Facebook, Twitter, LinkedIn and others have introduced consumers to networking and sharing information online. But how can we harness and direct that power to make a meaningful and sustainable impact on individuals’ and population health?

“I’ll tell you this, it takes a lot more than friending on Facebook, tweeting on Twitter, or blogging on a single-topic healthcare site,” added Margolis. “In CafeWell, we’ve pioneered the infrastructure of Social Health Management, which learns from both the strengths and limitations of existing social networks, while knitting together multiple social point solutions. CafeWell is a fusion engine for creating social health engagement among members.”

Social Health Management gives population managers – whether they be health plans, employers, or physician and care delivery organizations — a new channel through which they can quickly provide programs and information to consumers, in a fun, engaging, independent and safely anonymous network.

To create true SHM, social health hub networks, such as CafeWell, must create the self-sustaining social engagement among members to get people motivated to participate repeatedly. CafeWell does that through proven engagement drivers such as challenge competitions, sponsorship and aggressive merchandising, use of engaging game mechanics, meaningful rewards, mobile capabilities, and fun and useful content providers, such as veteran professional athletes.

And, what makes Social Health Management a full solution, is that it provides the activity itinerary and analytics feedback loop that allows population managers to understand engagement, activity patterns and to gauge the relative effectiveness of social health management and wellness programs they sponsor.

WellTok can even help integrate consumer activities with value-based benefit plans to drive higher levels of engagement that truly impact the cost and quality of healthcare.

About CafeWell and WellTok, Inc.

CafeWell is a social health network that makes getting better connected to your health and fitness more fun and more rewarding. CafeWell provides one stop for consumers’ health, wellness and fitness — including social networking; advice from experts, peers and veteran professional athletes; fun health challenges with family members and co-workers; and reliable health and fitness information. Through CafeWell, sponsors can offer rewards and incentives to promote activity and health improvement. Users control the degree to which their identity is shared, with complete anonymity as the default. To learn more about CafeWell, visit www.cafewell.com.

WellTok is pioneering Social Health Management(TM) (SMH), the complete social networking solution for healthcare population managers. WellTok’s SHM suite provides a complete solution for population managers, including the industry’s most engaging social health network, CaféWell, broad member and group analytics, and integration with healthcare payers and providers’ corporate systems and MLR requirements. WellTok, Inc. is headquartered in Denver, Colo.

SOURCE WellTok, Inc.

 

IncentOne Launches Outcomes-Based Biometrics Incentive Solution

Lyndhurst, NJ (PRWEB) December 08, 2011, IncentOne, a provider of incentive solutions to the healthcare industry, has launched what it says is the first outcomes-based biometric incentive program through its Health Power™ platform. With this solution, IncentOne will enable payers, health service companies, employers, governments and administrators to align incentives to outcomes and improvements in 20 different biometric measures.

Key features of the solution include the ability to:

  • Combine outcomes and participation-based programs
  • Set desired biometric outcomes for 20 measures including Body Mass Index, Blood Pressure, Waist Circumference, Waist to Hip Ratio, Total Cholesterol, HDL Cholesterol, HDLc Ratio, Triglycerides, Glucose, A1C, Cotinine, and LDL Cholesterol
  • Set absolute, percentage or minimum improvements for each measure
  • Incentivize for single or multiple biometric measures attained
  • Set different target levels for men and women for each measure
  • Implement pass/fail criteria for each measure
  • Integrate data from past testing periods
  • Utilize multiple testing periods
  • Utilize physician attestation forms for alternative facilities
  • Allow for reasonable alternative health activities based on physician recommendations
  • Manage the process for contested measures

“Biometrics are a central component of any outcomes-based engagement strategy.” says Michael Dermer, President and CEO of IncentOne. “Our customers can now execute a wide variety of outcomes-based designs tied to biometric data that have demonstrated cost savings. We believe that Incentive Driven Healthcare™ is the next wave in healthcare and this is one step to help our customers see that movement in action.”

About IncentOne
IncentOne delivers cost savings and health improvement by engaging healthcare consumers and providers through the use of incentives. IncentOne serves customers representing more than 75 million lives, has processed 20 million health transactions and driven 15 million health milestones through 125 data partners. IncentOne’s Universal Remote™ technology enables customers to drive “any action for any value for any reward via any medium” and to align incentives not only to long-term savings but also to immediate and intermediate savings via its Trifecta™ methodology. IncentOne’s solutions are married with leading-edge strategies such as value-based benefit design, medical homes, accountable care organizations, telehealth, pay-for-performance and provider payment reform to deliver true engagement. IncentOne programs target consumers to improve utilization, increase prevention, avoid hospitalizations, reduce readmissions, choose lower cost providers, reduce health risks, increase medication adherence and steer benefit selection and providers to adopt e-prescribing and EMR technology, adhere to treatment protocols, and improve patient safety. For more information go tohttp://www.incentone.com.

 

2012 Forecast: Five Top Trends in Workplace Benefits

COLUMBIA, S.C., Nov. 10, 2011 /PRNewswire/ — After several years of economic woes and health care reform wrangling, the only certainty in the future of workplace benefits may be continued uncertainty. But employers, human resources professionals and insurance brokers who want to be prepared for 2012 should pay attention to several emerging trends. Here are the top five predictions for the coming year, according to experts at Colonial Life & Accident Insurance Company, one of the nation’s leading employee benefit providers:

1. Products: Critical illness insurance will continue to attract new customers.
With the costs of treating cancer, heart attacks and strokes far exceeding most employees’ major medical coverage, critical illness insurance can provide vital out-of-pocket protection to help with both the medical and nonmedical costs associated with treating and recovering from these diseases. Updated versions of this relatively new product include benefits for multiple occurrences of a critical illness, adding to their value. “One way to think of critical illness insurance is as ‘living life insurance,'” says Randy Finn, assistant vice president of supplemental health products at Colonial Life, where critical illness sales increased 24 percent from 2009 to 2010. “If you get a serious illness such as cancer and die, life insurance helps with that. But what if you survive? You’re likely to have years of financially crippling bills to pay.”

2. Sales: Voluntary insurance sales will rebound strongly.
Increasing workforce diversity and the need to offer choices to employees with widely varying needs will drive an uptick in sales. Group products will continue to grow as a percentage of voluntary sales, while life insurance sales continue to fall. “There’s a big need for better education of workers about the need to protect their most valuable assets with life and disability coverage,” points out Jeff Koll, Colonial Life’s assistant vice president of life and disability products.

3. Services: Wellness programs will become more prevalent as a way for employers to control health care costs and increase productivity and retention.
With no let-up in sight for rising health care costs, employers are increasingly seeing the value of workplace wellness programs as a way to control premium increases and claims costs. Ranging from health screening tools to online nurse services, wellness-related offerings will become a bigger part of benefits providers’ value-added services.

However, the key to seeing a true bottom-line benefit may be as much about employee awareness and engagement as it is about the actual service. “Good communication about wellness programs is essential for them to be effective,” says Steve Bygott, Colonial Life’s assistant vice president of marketing analysis and programs. “Without a focused effort to ensure employees understand the program and its value to them, participation tends to be low.”

4. Technology: Employees will have more options for decision-support tools using online technology.
As employers continue to push benefits decision-making responsibility to their employees, look for a proliferation of websites and interactive tools to help them understand different types of coverage and which ones meet their unique needs. An example is Colonial Life’s Benefits Learning Center website (www.benefitslearningcenter.com), launched last May featuring Youville(SM), an entertaining interactive tool for workers to individualize their benefits education and explore their unique benefits needs.

Research shows most employees don’t actively search for information about their benefits, don’t want frequent communication from their employers about them, and don’t dedicate a significant amount of time to learning more about them.(1) Online decision-support tools such as Youville(SM) offer employees important benefits information with minimal effort, says Dana Bagwell, Colonial Life’s director of benefits communication and education. “These tools give employees easy access to the information they need to make informed benefits decisions, all in one place.”

5. Economy: Government sector employers will focus on cost containment measures for their benefits plans.
Government employers are strongly feeling the effects of several years of reduced tax revenues, and now find themselves in the unfamiliar position of being forced to reduce benefits or raise their employees’ share of the costs. A recent survey of public sector human resources managers showed 80 percent of them are looking at ways to reduce the cost of their employee benefits plans, and 58 percent said controlling costs is their top priority for their benefits programs.(2)

“The good news is there’s a huge opportunity for government employers to control costs by changing their benefits plan design,” says Pat McCullough, Colonial Life’s public sector practice leader. “Government employers have been slower than other industry segments to shift away from the more comprehensive, paternalistic benefits models of the past, but there are solutions to help them offer strong packages and still save money.”
Colonial Life & Accident Insurance Company is a market leader in providing insurance benefits for employees and their families through the workplace, along with individual benefits education, advanced yet simple-to-use enrollment technology and quality personal service. Colonial Life offers disability, life and supplemental accident and health insurance policies in 49 states and the District of Columbia. Similar policies, if approved, are underwritten in New York by a Colonial Life affiliate, The Paul Revere Life Insurance Company, Worcester, Mass. Colonial Life is based in Columbia, S.C., and is a subsidiary of Unum Group, one of the world’s leading providers of employee benefits.

For more information, call Colonial Life at (803) 798-7000 or visit www.coloniallife.com.

SOURCE Colonial Life

WellPoint Earns Industry Recognition for Health Care Consumer Empowerment and Protection

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

 

Health Insurance Provider Florida Health Care Plans Launches One of a Kind Wellness Solution

Daytona Beach, FL (PRWEB) July 19, 2011 –  Florida Health Care Plans (FHCP) has announced the launch of its new wellness rider.

“We are a local company with the goal of improving the health of our members and our community by promoting an employee/employer culture of wellness education, focusing on healthy habits, preventive care, easier access to wellness programs and educational resources,” says Dr. Wendy Myers, CEO of Florida Health Care Plans.

This new approach is a collaborative effort between employers, employees and FHCP, to team together and work with health data to assist employees in addressing unhealthy habits with the goal of a healthier lifestyle. This employee/employer collaboration can also help control the zooming costs of healthcare, and create a healthier, happier and more productive workforce.

The rider has an attractive price tag, costing only 1%-2% of the group plan premium, for increased focus on employees’ health habits that could see a healthy return on investment (ROI). According to the National Business Group on Health, a non-profit industry advisory group, “Employers can realize as much as $3.27 in financial benefits for every $1.00 invested in workplace wellness programs.”

Another study, done by Sarasota County says, “A review of 32 studies of corporate wellness programs found claims costs were reduced by 27.8%,” and there were also significant declines shown in the number of physician visits, hospital admissions and incidence of injury.

Top of the line technology makes FHCP’s wellness plansaccessible and user friendly. The company provides a 24 hour nurse advice line, a self-paced program for those who want to quit smoking, a weight management program and many other educational programs to encourage preventive healthy habits in addition to regular preventive care. Members also have access to an exclusive member portal, providing an easy way to make appointments with FHCP staff physicians, refill prescriptions at FHCP pharmacies and access “Welcome to Wellness” a state of the art health risk assessment with access to articles and multimedia content personalized for each member. There are also programs for members who have heart disease, asthma, high blood pressure and COPD for no extra charge. All of these programs focus on preventive treatment that helps to ward off serious health problems before they happen.

Dr. Mikelle Streicher PhD, RN Chief Marketing and Sales Officer says, “Workplace Wellness programs are not a passing trend. It is about investing in people and in good health so that good business and a healthy bottom line are all the more possible to obtain.”

For more information about FHCP’s health and wellness plans please visit http://www.fhcp.com.

About Florida Health Care Plans:
FHCP is a health maintenance organization in East Central Florida. Being an HMO, the company brings a strong emphasis on preventive care and health and wellness resources and education. As a local organization, they have been living among their clients for thirty years, working to bring better health care to the residents of Florida. Approximately 2,000 employers have trusted FHCP to take care of their employees with a wide selection of services and health solution products. In January 2009, they joined Blue Cross/Blue Shield of Florida as an independent licensee, which provides FHCP members with nationwide and global access to Blue Cross Blue Shield’s highly regarded and accessible Blue Card network. Their latest response to the needs of the community was in 2011, with the development of an Individual Health Plan product.

 

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

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.