Bookmark & ShareFor Immediate Release: 10/23/2009
Alliance sets foundation to establish shared priorities and encourage health plan improvement over time>
SEATTLE, October 23, 2009—Ten of Washington’s largest employers who are health care purchasers have been working with six of the state’s largest health plans (insurers) to identify shared priorities for health plan programs and activities. As a result of this collaborative work, information about health plans is now available in the region’s Community Checkup report
“Adding health plans along side medical group and hospital measures already in the Community Checkup report expands accountability and transparency for this region,” said David Fleming, M.D., Puget Sound Health Alliance. “This sets a foundation for community agreement on priority areas such as encouraging health plans to participate in national standard measurement and to advance strategies to address waste and hold down health care costs.” Board Chair and Director of Public Health – Seattle and King County.
By engaging in this process through the Puget Sound Health Alliance, the group of ten large employers intends to achieve four objectives in collaboration with health plans:
- Generate consistency in health plan assessment that enables transparency of health plan performance and permits comparison within and across markets over time, including national benchmarks and best practices;
- Stimulate improved performance from health plans, with a particular focus on information, systems and tools that support provider quality improvement, as well as promote consumer behavior for wellness and informed decision-making;
- Enable purchasers and plans to work collaboratively to structure programs to reward value; and
- Inform purchasers’ procurement decisions about health insurance for their employees and dependents.
This expansion of the Community Checkup report acknowledges the vital role that health plans play in promoting health and value in the local health care system. Specifically, the report now shows seven categories related to health plans: overall profile, consumer engagement; provider measurement; pharmaceutical management; prevention and health promotion; chronic disease management; and, behavioral health.
The measures in each category are based on standards from national organizations including the Centers for Disease Control, American Board of Internal Medicine, National Committee on Quality Assurance, Agency for Healthcare Research and Quality, Substance Abuse and Mental Health Services Administration, Centers for Medicare and Medicaid Services, The Joint Commission, URAC, eHealth Initiative, Pharmacy Quality Alliance, and The Leapfrog Group.
“This is a journey started in 2007, with the first round of results in 2008 shared privately with the health plans and participating employers,” said Mary McWilliams, Executive Director of the Alliance. “With this first public reporting on health plans using results from the 2009 process, this community takes the first step in creating the ability to publicly compare health plans across this region and with others in the nation.”
The process was sponsored by ten of the Puget Sound region’s largest employers: Alaska Air Group; The Boeing Company; City of Seattle; King County; Pierce County; Port Blakely Companies; Puget Sound Energy; Recreational Equipment, Inc.; Snohomish County and the Washington State Health Care Authority. The six health plans who voluntarily participate in the process are AETNA, a national preferred provider organization (PPO); CIGNA, a national PPO; United Health Care, also a national PPO; Group Health Cooperative, a regional health maintenance organization (HMO); Premera Blue Cross, a regional PPO; and, Regence Blue Shield, a regional PPO.
“Health plans are large, complex organizations and each will take a different approach in responding to this market,” noted Roger Neumaier, Chief Financial Officer for Snohomish County and an employer participant in the Alliance. “But the shared commitment to focusing on the priority areas included in the Community Checkup is a testament to the quality of health plan leaders in this region.”
The health plan categories in the Community Checkup report are drawn from eValue8™, a tool developed and maintained by the National Business Coalition on Health (NBCH). The Puget Sound Health Alliance worked with NBCH to conduct a rigorous evaluation of Puget Sound-area health plans in 2008 and again in 2009.
McWilliams explained that after the 2008 results stimulated useful dialog between the large employers and each health plan, the Board agreed to repeat the evaluation share summary results with the public in 2009. “All health plans showed improvement in 2009,” she said. “Discussion continues about priorities and actions health plans are taking to meet national standards.”
Puget Sound Health Alliance leaders commend all of the health plans for their commitment to this process, which requires time and resources to submit information to be scored by NBCH. This resulted in four of the health plans recently being selected as finalists for the NBCH’s 2009 eValue8 Innovation Awards. Officials from Premera, Regence, Group Health and Aetna will learn in November if they are among the three to receive the national award.
With eValue8™, each health plan submits responses to a standardized national Request for Information - with extensive documentation - that describes the health plan’s performance in a number of clinical areas and administrative practices. The focus is on improving the quality of healthcare delivery and on improving the wellbeing and health of members. The information is then assessed and scores tabulated so employers and other health care purchasers can compare the health plans against each other in this region as well as to other health plans across the nation. This allows the Community Checkup report to also show scores for the top performing PPO and HMO health plans in the country as a benchmark.
“Alliance participants, including many large purchasers - public and private employers, governments and union trusts - are committed to promoting the use of national, evidence-based standards and greater transparency for all aspects of the health care system,” McWilliams said.
The Community Checkup report on health care in King, Pierce, Snohomish, Thurston and Kitsap counties is available at www.WACommunityCheckup.org. For Rules of Use regarding certain restrictions to ensure fair and constructive use of the health plan information in the report, go to: www.pugetsoundhealthalliance.org/services/reports.html.
The Puget Sound Health Alliance (www.pugetsoundhealthalliance.org) is a non-profit made up of those who provide, pay for and use health care, working together to improve quality of care at a price more people can afford. About 150 organizations participate in the Alliance, including Alaska Airlines, The Boeing Company, Starbucks, Puget Sound Energy, REI, the Washington State Health Care Authority, King County and many other employers, physician clinics, hospitals, consumer groups, unions and trusts, health plans, pharmaceutical companies, and other organizations.
