P&T
Our
Other
Journal
MediMedia Managed Markets
Managed Care

 

Are Purchasers Now The Ones With the Vision?

MANAGED CARE August 2007. © MediMedia USA
Editor's Memo

Are Purchasers Now The Ones With the Vision?

John Marcille
MANAGED CARE August 2007. ©MediMedia USA

John Marcille

It's not just about wellness anymore. As our cover story shows, for the last three years, employers have been doing much more to improve worker health than simply offering an on-site weight-reduction program (not that there's anything wrong with that).

As we were going to press, a Hewitt Associates study made ripples in the mainstream media. "Nineteen percent of firms installed performance-based medication offerings, waiving copayments for prescription drugs that are proved to be effective and paying a premium for employees to go to higher-rated treatment providers," CNBC reported.

After all, wellness programs, which one expert told us cost about 1 percent of premium to install, are not without drawbacks. "Some employees may resent the [wellness] programs, viewing them as examples of 'father-knows-best' intrusiveness," said the New York Times.

Meanwhile, health plans might be too reticent in this area. Our article by Managing Editor Frank Diamond asks what insurers are missing out on by taking only a spectator's interest in attempts by employers to improve clinical outcomes. Employers know that insurers can participate. For one thing, they have mounds of data that would enhance such efforts, and they trust plans more than they trust providers.

Suzanne Delbanco, the CEO of the Leapfrog Group, touts its Hospital Rewards Program, which rewards hospitals on how they deliver care in five clinical areas. "Additionally, these scores can be incorporated into health plans' existing performance-based incentive and reward programs," she says. "The program is engineered by Leapfrog, with the input of a vast array of providers and health plans, but designed to be implemented by health plans and employers in specific markets." Again: Health plans and employers.