Friday, January 27, 2006

The Commonwealth Fund- Press Release 1-27-2006

Half of Insured Adults with High-Deductible Health Plans Experience Medical Bill or Debt Problems
High-Deductible Health Plan Enrollees More Likely to Experience Cost-Related Access Difficulties, Warning of Hazards of Health Savings Accounts for Poorer and Sicker Adults
Washington, D.C., January 27, 2005—About half of insured adults with a high-deductible health plan have medical bill problems or debts, compared with less than one-third (31%) of those with lower-deductible plans, according to new research from The Commonwealth Fund. Individuals with high-deductible plans are also more likely than those with lower-deductible plans to experience access problems such as not filling a prescription, or skipping a medical test, treatment, or follow-up when needed, due to cost.
"Health savings accounts coupled with high deductible health plans have potential pitfalls, especially for families with low incomes or individuals with chronic health conditions, who are at greater risk of accruing burdensome medical debts and facing barriers to needed health care," said Commonwealth Fund President Karen Davis. "The evidence is that increased patient cost-sharing leads to underuse of appropriate care."
Davis presented the findings today at the annual meeting of the National Academy of Social Insurance (NASI) in Washington, titled "Medicare Modernization in a Polarized Environment: Facing the Challenges," as part of a panel discussion of health savings accounts. HSAs are tax-deductible savings accounts individuals can use to pay for out-of-pocket health care expenses, enacted as part of the Medicare Modernization Act (MMA) of 2003. To be qualified to establish HSAs individuals must be insured by a health insurance policy with a minimum deductible of $1,000 for individuals and $2,000 for families.
In her presentation, "High Deductible Health Plans and Health Savings Accounts: For Better or Worse?" Davis notes that nearly two of five (38%) adults with high-deductible health plans report experiencing one or more of four cost-related access problems, compared with just over one-quarter (27%) of those with lower-deductible plans. The findings are based on new analysis of data from the Fund's Biennial Health Insurance Survey.
Davis suggests some legislative fixes for HSAs that could help prevent medical access problems and burdensome medical debt:
Reduce deductible for lower-income families.
Exempt effective services and medications for patients with chronic conditions.
Require provider discounts for uninsured low-income families.
Cap income eligibility for tax-sheltered savings accounts—similar to Individual Retirement Account provisions.
Prohibit discrimination in favor of high-wage employees in funding health savings accounts by employers.
Methodology: The Commonwealth Fund Biennial Health Insurance Survey was conducted from September 2003 through January 2004 by Princeton Survey Research Associates International. The survey consisted of telephone interviews among a nationally representative sample of 4,052 adults ages 19 and older living in the continental United States. Researchers examined where the public stands on financing broader coverage, the stability of Americans' health insurance coverage, the quality of their health benefits, and whether they can afford the health care that they need and pay their medical bills.
The Commonwealth Fund is a private foundation supporting independent research on health and social issues.

Wednesday, January 25, 2006

CareFirst Press Release 1/23/2006

CareFirst BlueCross BlueShield Marks First Anniversary of CareFirst Commitment
Initiative Focuses on Affordability, Accessibility and Quality
OWINGS MILLS, MD (January 23, 2006) - In the first year of its $112 million CareFirst Commitment initiative, CareFirst BlueCross BlueShield set out to help thousands of people in its service area by stabilizing premiums for members and launching programs designed to offer more accessible, better quality health care to the communities it serves. By contributing to nonprofit health care organizations in Maryland, Washington, DC, Northern Virginia and Delaware, as well as partnering with organizations to create new health care programs, CareFirst took steps to benefit not only its members, but the community at large.
Launched mid-January 2005, CareFirst Commitment encompasses three components:
Ensuring health care affordability and improving access by reducing costs;
Raising the bar on standards of care for CareFirst members and non-members alike; and
Closing gaps in health care delivery, by addressing health disparities in the diverse communities CareFirst serves.
"We have dedicated more of our resources than ever before to help fund nonprofit organizations, but CareFirst Commitment goes well beyond our charitable contributions. In just one year, we made significant strides in addressing these key mission-related objectives," says William L. Jews, President and Chief Executive Officer of CareFirst BlueCross BlueShield.
CareFirst BlueCross BlueShield this month will issue a special year-end Report to the Community, documenting the first-year milestones of CareFirst Commitment's three components including:
Ensuring Affordability
CareFirst reduced its operating earnings for 2005 by $60 million, and redirected the money to moderate and, in some cases, lower premiums. The company also opted to absorb a newly enacted 2 percent tax on HMO premiums rather than pass it on its 345,000 HMO members in Maryland, a decision that saved members nearly $20 million in taxes in 2005.
In addition, CareFirst launched a variety of low-cost, flexible products for the under-65 individual market. Included were lower premium offerings BlueChoice Saver and BluePreferred Saver, a no-deductible Health Maintenance Organization (HMO) and a higher deductible Preferred Provider Organization (PPO), respectively, and BlueFund, a suite of health plans combining a PPO with an employer-funded reimbursement plan or health savings account.
Closing the Gaps
In 2005, CareFirst Commitment moved aggressively to address health disparities facing the Hispanic, Asian and African American communities. The company partnered with D.C.-based La Clinica Del Pueblo in an effort to improve diabetes care among the local Latino community. The company launched a new Web site (, along with educational materials and brochures in Spanish. CareFirst also partnered with Boat People SOS in Fairfax, Virginia to fund a program designed to raise awareness and improve screening rates of cervical cancer in Vietnamese women, a group that has the highest risk of the disease.
CareFirst also contributed $250,000 to the Governor's Wellmobiles, run by the University of Maryland School of Nursing, for the four mobile health units to bring nursing care and bilingual outreach to 6,000 people in underserved Maryland communities. Another $50,000 contribution dispatched the units to Gulf Coast hurricane disaster zones.
Raising the Bar
CareFirst launched a three-year pilot program called Bridges to Excellence, a national pay-for-performance initiative that rewards physicians who take specific, measurable steps to improve the quality of their patient care. Twenty primary care physician practices serving 50,000 CareFirst members have been certified through the program to date.
Throughout 2005, CareFirst equipped 500 high-prescribing primary care physicians with personal digital assistants (PDA) and the software needed to send prescriptions electronically to pharmacies in an effort to improve patient safety. The program not only streamlined the prescription process, but it alerted doctors to potentially harmful drug interactions and patient allergies.CareFirst partnered with the Delmarva Foundation for the Maryland Patient Safety Center's local launch of the national 100,000 Lives Campaign, which aims to improve life-saving measures in intensive care units and operating rooms in the region. Initial results of the program show a significant reduction in infection rates in 45 participating intensive care units.
CareFirst Commitment's first year also marks CareFirst's most generous charitable giving year to date. CareFirst contributed approximately $2.7 million to nonprofit programs in Maryland, D.C., Delaware and Northern Virginia, including:
$500,000 to D.C.-based Whitman Walker Clinic for its mobile HIV testing services and operation of its food bank
$70,000 to children’s charities through Ks for Kids programs with area major and minor league baseball teams.
$300,000 to the Greater Washington Board of Trade's Wellness Works program, focused to encourage regular exercise for employees around D.C. Ninety-five employers representing 60,000 employees participated in the program
$100,000 for Hurricane Katrina relief.
Plans for the Future
"CareFirst Commitment is multi-year initiative. We are proud of our achievements in 2005, and we consider our work to be just beginning. In 2006 we will see the expansion of existing programs and new investment to yield more positive results," said Michael R. Merson, Board Chair of CareFirst, Inc.
CareFirst Commitment plans for 2006 include:
Continued involvement with La Clinica del Pueblo and Boat People SOS
A new $185,000 pilot program to address cardiac care in the African-American community.
A training program to help primary care physicians better work with ethnically diverse patients
An investment of up to $1 million in technology initiatives to improve quality and efficiency of care
A continued goal of donating 2 percent of net operating income to corporate giving
In its 70th year of service, CareFirst, an independent licensee of the Blue Cross and Blue Shield Association, is a not-for-profit health care company which, through its affiliates and subsidiaries, offers a comprehensive portfolio of health insurance products and administrative services to more than 3.3 million individuals and groups in Northern Virginia, the District of Columbia, Maryland and Delaware. Through its CareFirst Commitment initiative and other public mission activities, CareFirst supports efforts to increase the accessibility, affordability, safety and quality of health care throughout its market areas.