Managed Care


Major Health Plans Unveil New Preventive Care Efforts

MANAGED CARE August 2003. © MediMedia USA
News and Commentary

Major Health Plans Unveil New Preventive Care Efforts

MANAGED CARE August 2003. ©MediMedia USA

Health plans have apparently accepted, with new zeal, what many of them have stated for years: Healthier patients will cost less in the long run, even if preventive care costs more up front. The Wall Street Journal reports on some of the programs that health plans have launched in an effort to "coax, cajole and nag patients into seeing doctors, filling prescriptions, and generally taking better care of themselves."

  • Aetna is phoning enrollees who have been hospitalized with certain conditions, such as pneumonia, after they are discharged to make sure that they are taking their medications.
  • Anthem offers help to women who are at high risk of experiencing premature labor.
  • Highmark calls members if they get an MRI of the spine and consult an orthopedic surgeon.
  • Kaiser Permanente expects its doctors to record patients' body mass indexes at annual physicals. Also, health plan representatives will call those patients who may be in need of diet and exercise counseling, as well as those who could use a prescription for a pedometer.
  • Oxford Health Plans encourages people with diabetes and congestive heart failure who have not visited a specialist in over a year to make that appointment.
  • PacifiCare Health Systems plans to launch a program under which any plan member will get a reduction in his premium if he earns "health credits" by joining a weight-loss program, enrolling in an online health club, and filling out a health risk assessment survey.
  • WellPoint Health Network calls patients who have chronic conditions but who do not fill their prescriptions.


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