MBGH Convenes Members to Improve Depression Care for Employees

Thank you to Donna Marshall, Executive Director of the Colorado Business Group on Health, for meeting with 9 Memphis employers to encourage them to improve the depression care their employees receive. Donna's visit is part of a National Institutes of Mental Health-funded research project to understand how employers make benefit decisions regarding depression care. MBGH's eValue8 project shows that there is significant improvement needed in behavioral health care in Tennessee. Attendees learned that they should encourage their plans to:

• 
  
  Provide feedback to physicians about the quality of depression care they provide their patients
• 
  
  Lower co-pays, co-insurance for depression medication
• 
  
  Lower co-pays, co-insurance for behavioral health physician visits.

These 3 actions lead to improved adherence to therapy which results in better outcomes,  health, and productivity. In other words, cuts total costs.

Attendees have access to Donna for technical assistance and will provide study investigators information at 12 and 24 months on any changes made in benefits or benefit design.  Thanks again Donna for bringing this valuable information to our members!!

Addressing Over-Use by Reducing Diagnostic Imaging Services

The quality crisis is generally described as consisting of:

• Under-use
• Mis-use, and
• Over-use.

Addressing under-use has generally been greeted with universal support, as increasing use of high value services makes sense to employers and purchasers and generally increases revenues for providers and  health care organizations because more services are provided.

Addressing mis-use has generally been philosophically supported because, after all, how can someone morally support harming people in the system? Although philosophical support has been there, what to do to reduce or eliminate mis-use has been very controversial and progress has been slow.

But, work on over-use has been almost non-existent. Reducing over-use will directly impact health care organization's revenue. But now that cost has reared its head again as a major issue for purchasers, reducing over-use of services that provide little to no clinical value is back on the front burner.

In November 2008, the National Priorities Partnership, a group of 32 organizations convened by the National Quality Forum, announced 6 priorities, including reducing "overuse" of services that provide little to no clinical value (click here to learn more about all 6 priorities). The Partnership actually listed potential areas of over-use that should be addressed.

The over-use that seems to be front and center is diagnostic imaging. Significant work is being conducted
in both Washington state and Minnesota. Click here to read Bruce Seigel's (National Director of the Aligning Forces for Quality project) blog post on how organizations in these states are addressing overuse of imaging services by publicly reporting physician use of imaging services and establishing community-wide standars for appropriate use of imaging.

Two-Track Approach to Making Health Reform Happen

Pelosi has indicated that a two-pronged approach will be taken to health reform:

1. Pass those reform items where there is general agreement between the Senate and House versions now.
2. Delay more comprehensive health reform.

Reforms likely to be passed soon address financial access to insurance, underwriting issues, and Medicare value-based purchasing.

Delayed issues are likely to include new taxes, insurance exchanges, and expansion of Medicaid.

Click here to read the article, which includes detailed lists of what is likely to be in any health reform package that is passed in the short-term and those reforms that will, most likely, have to wait.

A Thoughtful Commentary on Health Reform

I can't do this piece justice to summarize, so please just read. You (and/or I) may not agree with all he says, but he does lay the issues out in a thoughtful manner. Well worth the read..

Click here to read more.

Health Care Reform & GINA Update Week of January 25, 2010

NBCH reports on the latest strategies being considered by the Democrats regarding health reform. The update describes the strategy and comments on how likely the strategy is to succeed.

The update also includes the latest on GINA.


Click here to go to MBGH's temporary website to download the full health reform update.

Cleveland Clinic Expands Wellness Benefits to Dependents

Cleveland Clinic now offers their wellness programs free of charge not only to employees, but to dependents as well. Free benefits include weight loss programs, smoking cessation treatment and medications, and fitness center memberships.

This is just one more step in a progressive wellness initiative that began in 2005. That year, Cleveland Clinic instituted smoke free campuses and in 2007 stopped hiring smokers. Since then, they have banned trans fats from their cafeterias and paitent meals.

By making wellness a "family benefit" Cleveland Clinic hopes to be an employer of choice.

Click here to read more.

Health Care Reform Update: Implications of the MA Election

The following update is made possible through MBGH's membership in the National Business Coalition on Health. It was provided on January 20,2010.

Congressional leaders and the Obama Administration reportedly remain close to a very delicate and tedious agreement on several aspects of a final health care reform bill, though the process may be seriously influenced by result of the special senatorial election in Massachusetts (MA) yesterday to fill the seat of Senator Edward Kennedy (D-MA). The Republican senatorial candidate, Scott Brown (R) won yesterday with 52 percent of the votes against Massachusetts State Attorney General Martha Coakley, who garnered 46 percent of the votes.

IMPACT ON HEALTH CARE REFORM (HCR): Once Senator-elect Scott Brown is sworn in (the date has yet to be announced), the Democrats will lose their filibuster-proof "supermajority" in the Senate, and the House of Representatives could be compelled to pass the earlier Senate-passed bill outright or quickly negotiate a compromise bill before the new Senator can be sworn in.

At that stage, the budget reconciliation process (requiring only a simple, 51-vote majority in the Senate) could be used to advance a possible second health bill that would follow closely on the heels of the first measure to carry out the key provisions currently being negotiated among congressional leaders and the Obama Administration.

As a contingency plan, the Senate and the Obama administration also still seem to be “courting” centrist Senate Republicans such as Olympia Snowe (R-ME) to solidify the 60 votes needed to pass HCR. The White House and Senate leadership also is working to ensure their own caucus is behind the bill (i.e. Senators Nelson (OK) and Landrieu (LA). In addition, the House is struggling to maintain the 218 votes needed to pass their newest version of HCR when the time comes. Caucus defections are plentiful though the latest House version seems to be more moderate (no public plan and no Cadillac plan excise tax) which could capture more conservative Democrat votes (this is the group that defected during the original House vote in July due to cost and abortion language concerns).

In terms of advocacy, everyone still is moving forward in the belief that the final product can still be improved before its final consideration by the House of Representatives and Senate.

Some of the major priority employer concerns with HCR legislation include

• the need for the legislation to reduce health care costs and improve quality,

• avoidance of onerous mandates that would limit the flexibility and innovation that are the foundation of the employer-based system,

• maintenance of the ERISA regulatory structure and

• the need for supportive tax policy that will not undermine employer-sponsored health coverage or add to its cost.

Value-Based Insurance Design Can Be Cost Effective

A study released in the January 21, 2010 edition of Health Affiars conducted by Michael Chernew at Harvard Medical School showed that a value-based insurance design that reduced copays to encourage employees to use high value medical services lead to reduced use of  "non-drug services" which more than offset the increase in prescription drug use encouraged by the lower copay.

Click here to read the abstract and to access the full article.

Senate Health Reform Bill Could Cost Businesses Additional 7-10%

The HR Policy Association, a group of the country's 300 largest firms, estimates that if the Senate version of health reform were to pass, large businesses could see their health care benefit costs increase an additional 7-10% over the next decade. This cost increase is in addition to current trend increases.

The analysis, performed by Applied Economic Strategies, includes costs associated with new taxes and cost-shifting to private sector payors that is likelys to occur with decreases in Medicare and Medicaid funding.

Click here to read more.  

Whole Foods Kicks Off "Health Starts Here" Initiative

Look for the new "Health Starts Here" program for Whole Foods team members and customers. In-store programs, recipes & educational material, and identifying healthy, nutrient-dense foods by posting signs with Aggregate Nutrient Density Index (ANDI) scores are all part of the program.

Whole Foods Team Members have two additional programs to support their healthy eating: more significant discounts off Whole Foods purchases if they are nicotine-free and meet cholesterol, blood pressure, and BMI targets; and a total immersion program, which includes medical consultation at no cost to the employee, at certain locations.

Click here to read more.

Study Shows Incentive-based Fitness Programs Reduce Cost

A study published in the American Journal of Health Promotion on January 21, 2010 shows that members participating in an insurance plan's incentive-based fitness wellness program had lower healthcare costs, fewer hospital admissions, and shorter lengths of stay in the hospital when they were hospitalized. The study does indicate that more research is needed to understand the long-term effectiveness of these incentive-based programs.

Click here to read more.

Chattanooga Hospital Not Hiring Tobacco Users

Memorial Hospital in Chattanooga has decided not to hire tobacco users. The Hospital indicates this decision was made as part of its commitment to a healthy community and not to save health benefit costs. The new rule does not impact current employees. The hospital will add nicotine testing to its existing program to screen for illegal drugs.

Click here to read more.

Workplace Wellness Programs Do Generate Savings!

A recent article in Health Affairs reports that Harvard University investigators found workplace wellness programs can generate $3.27 in savings for every $1.00 spent & absenteeism savings of $2.73 for every dollar spent!!

Click here to read more.

Health Care Reform Premium Impact

Although it looks like health reform is not moving forward in it current form for now (or maybe ever), it is still interesting to know what type of impact reform would have on premium costs. Wellpoint has calculated the impact of health reform on premium rates in 14 states where Wellpoint operates. Taking a look at Georgia, Kentucky & Missouri, the closest states to TN, may give us an idea of what TN could expect in the individual and small group (fully insured) market. Click here to access the detailed information.

Although the percent change is different in each state, there are common results: highest increases for younger/healthy individuals or small groups, substantial increases in average age/health individual market, and significant decreases for older/less healthy.

                             Younger/ Healthy     Average Age/ Average Health      Older/ Less Healthy
Georgia:


Individual                      130%                              72%                               -18% (decrease)

Small Employer                69%                              14%                               -38% (decrease)



Kentucky:


Individual                       178%                            106%                              -17% (decrease)

Small Employer                 99%                              21%                              -39% (decrease)

Missouri 


Individual                        178%                           106%                              -17% (decrease)

Small Employer                  89%                             17%                              -26% (decrease)

MBGH Has a New Look

Look at that. It’s our new logo. MBGH is actively engaged with our members and the community, and we wanted a logo that reflects the spirit of MBGH today - bold, strong, focused.

We also have a new way of describing ourselves.

“MBGH is a coalition of employers sharing solutions and providing tools to manage the cost and quality of health benefits in an ever-changing environment. We do this by providing access to critical market data, facilitating best-practice sharing among the market’s leading employers, and offering practical tools for successfully managing healthcare benefits.”

Our new tagline sums it up, we are about “Connections. Tools. Solutions”

Connections. MBGH programs and initiatives support our “sharing solutions”.
• Topic-focused in-person meetings
• MBGH’s Annual Conference
• Webinars addressing health and benefit issues identified by our members
• Newsletters, blogs and social media for networking and learning
• Publication of a membership directory so members can contact each other directly.

Tools. These are the resources MBGH provides our members to help improve performance of health plans. In 2010, we’ll launch a new website with a resource and tool kit section addressing:
• Benefit design
• Vendor management
• Worksite-based programs
• Employee engagement.

Solutions. In addition to sharing tools and solutions targeting what employers can do to improve health benefit plan performance, MBGH remains committed to health care system reform in Memphis and nationally. Our members’ health plans perform best when the health care system is cost-efficient and provides high-quality care. MBGH will continue our leadership in measuring and reporting cost and quality performance and implementing employer-based programs/approaches to facilitate improvement in:
• Hospitals (Leapfrog)
• Physicians (Aligning Forces for Quality through Healthy Memphis Common Table)
• Health plans (eValue8)

We are developing tools for you and your employees to use this information to improve the performance of your health benefits through employee engagement, health plan contracting, and network selection.

It is exciting to have this new look, especially as we enter a new decade. We look forward to working with you in 2010 and beyond.

"No One Knows What Goes On Behind Closed Doors..."

House starts health reform reconciliation process in closed door meetings. Pelosi indicates the House will not necessarily just adopt the Senate bill as written, specifically re: the Public Option.

Click here to read more.

Save Dollars & Improve Health By Avoiding Hospital Acquired Infections

On average, hospital acquired infections add $15,000 to a patient's hospital bill. One in 20 patients admitted to the hosptial get a hospital acquired infection. Your cost and the health of your employees are impacted significantly by these hospital acquired infections!!!

You can reduce your cost and improve the care for your employees and their families by sharing this CDC podcast on your intranet to educate your employees about how to protect themselves and their families from hosptial acquired infections if they are admitted to a hospital. CDC is making this podcast available to hospitals to play for patients upon admission, but being prepared ahead of time is the best policy and the hospitals your employees use may not play this video.



.

Be Prepared for New Health Benefit Mandates in Health Reform

New Metlife survey shows 30% of employers don't expect their health benefits to change after health reform..but, there are plan design mandates in both House & Sentate versions that have profound implications for employers and that would change benefits.

Click here to read the SHRM article that outlines these mandates as well as other interesting findings from the Metlife survey.

Click here for a review of the implications of health reform for employers from Mintz Levin law firm.

No Formal Conference Committee Reconciliation for Health Reform?

It looks like the Dems are considering bypassing the formal Conference Committee reconciliation process of forging a single health reform bill to send back to both the House and Senate. Instead, they are considering letting House and Senate Democratic leaders hammer out a bill (in private meetings), probably largely based on the Senate version, to send back to the House.Upon passage in the House, the bill would then go back to the Senate. This approach is being considered to minimize the Republican's ability to delay passage. But, Republicans are concerned this approach "shuts out the American people and breaks one of President Obama's signature campaign promises."

Click here to read the article.

2009 Was a Great Year for MBGH!!

2009 was great for MBGH..celebrating hospitals, health plans & physicians that are improving quality & efficiency of care in Memphis, holding our first annual conference, hosting the NBCH Board at Graceland & NBCH meetings in Memphis, and representing Memphis employers in Nashville, DC, Pittsburgh, Dallas, Phoenix, Philadpelphia and beyond..We look forward to 2010!!