NBCH Releases 2012 eValue8(TM) Top Performing Health Plans, Key Findings and 2013 Survey
WASHINGTON, Dec. 11, 2012 /PRNewswire/ — To help health care purchasers assess and manage the quality and efficiency of America’s health plans, the non-profit National Business Coalition on Health (NBCH) released the 2012 eValue8(TM) top performing plans, key findings, and 2013 RFI. A critical element of a purchasers’ value-based purchasing strategy, eValue8 is an annual health care accountability and quality improvement assessment process used by employers and coalitions to gather health care data from plans across the nation.
2012 Top Performing Plans
Three plans garnered the top overall performing spots this year: Kaiser Permanente Southern California and Kaiser Permanente Northwest for HMO; and Cigna Pennsylvania for PPO. Plans who achieved the highest scores (benchmark) for specific modules include: Cigna in California, Colorado, New Jersey, Tennessee and Washington; and Tufts Health Plan Massachusetts for PPO; Kaiser Permanente in Southern and Northern California, Colorado, and Northwest; Group Health Cooperative in Washington; and Cigna Colorado for HMO.
eValue8 asks health plans to respond and document their activities in support of purchasers, members and providers including: how it works with employers to promote safe and effective care; tools available for consumer engagement; physician performance measurement and payment reform; pharmaceutical management; prevention and health promotion; behavioral health and chronic disease management. The information is then verified, and scores are tabulated so that purchasers can compare their health plans against previous year’s activities as well as against regional and national benchmarks.
“eValue8 sets the stage and provides a forum for employers, health plans and business coalitions to begin working together on community-based solutions,” said Laurel Pickering, president and CEO, Northeast Business Group on Health. “This process enables us to make strides in improving health care quality and value.”
2012 eValue8 Findings
The 2012 eValue8 process identified opportunities for all health plans to reduce waste, address gaps in care, structure payment reforms and improve consumer engagement. While plans have made progress in transparency of provider measurement, more needs to be done in the area of payment reform. Key findings include:
- There was wide variation among plans reporting C-section rates within their markets with a high rate of just over 40% to a low rate of 19%. With an overall mean C-section rate of 30%, much can be done to educate consumers and reduce the rate of unnecessary C-sections in the market.
- Plans are working to identify gaps in diabetes care using a variety of methods. Most plans report tracking patient adherence to diabetes medications (87%) and to recommended diabetes services such as retinal exams (97%) and foot exams (62%).
- Just over half of plans provide publicly available comparative reports on physician performance related to diabetes care, 37% of plans provide comparative performance on perioperative care, and 47% provide comparative performance reports on patient experience.
- Over 80% of plans systematically track and are able to report data on hospital readmissions, but only one in three plans (34%) report that readmissions measures are used to determine financial incentives.
- The majority of responding plans (81%) steer users to better-performing physicians through the use of financial incentives. However, plan use of incentives for consumer engagement activities has been slow, with only 16% providing consumer financial incentives for web consultation and 34% incentivizing use of a personal health record (PHR).
2013 Survey Released
The 2013 eValue8 survey is now available for health plans to complete. New this year, questions related to payment reform have been more closely aligned with those in the Catalyst for Payment Reform Scorecard and Compendium RFI. The information also supports more closely the efforts of state health insurance exchanges and there is an increased focus on consumer tools. The deadline for plans to complete the survey is February 11, 2013.
NBCH believes that local business coalitions are key in facilitating multi-stakeholder collaborations at the community level to educate consumers, and improve quality and efficiency of the health delivery system. Purchasers interested in having their plans report performance in a variety of health services can contact NBCH or their local business coalition.
An annual health care purchasing and quality improvement assessment process, eValue8 was created by business coalitions and employers like Marriott and General Motors to measure and evaluate health plan performance. eValue8 asks health plans questions about how they manage critical processes that control costs, reduce and eliminate waste, ensure patient safety, close gaps in care and improve health and health care.
Plans provide detail on how they educate, engage and incent consumers to promote health and manage disease, as well as measure and pay providers. Plans and purchasers receive objective scores enabling comparison of plans against regional and national benchmarks and a roadmap for improvement. As a result of face-to-face discussion of findings and roadmap, plans learn what they need to do to align their strategies with purchaser expectations to maximize the value of the health care investment and ultimately, improve health and quality of care.
About the National Business Coalition on Health
Celebrating its 20(th) anniversary, NBCH is a national, non-profit, membership organization of purchaser-led business and health coalitions, representing over 7,000 employers and 25 million employees and their dependents across the United States. NBCH and its members are dedicated to value-based purchasing of health care services through the collective action of public and private purchasers. For additional information visit: www.nbch.org.
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SOURCE National Business Coalition on Health