Friday, February 10, 2006

Kaiser Permanente Press Release 1/17/2006

Kaiser Permanente's Disease Management Expertise Now Available to All Large Employer Groups
Kaiser Permanente Healthy Solutions Offers Health Coaches, Help With Rising Costs
Oakland, CA (January 17, 2006) -Kaiser Permanente (KP) has launched a new disease management subsidiary, Kaiser Permanente Healthy Solutions, that will offer its award-winning disease management programs to large, national employers (10,000+ employees) with self-funded employee populations, as well as labor and trust unions, and government payors.
"KP Healthy Solutions has been created to encourage informed health care decisions by employers and their employees, and is a direct response to numerous requests from our large employer customers," explained Chris Stenzel, CEO of Kaiser Permanente Healthy Solutions. "Kaiser Permanente Healthy Solutions is an opportunity for purchasers and their benefits consultants to mitigate the drivers of health care costs, while offering employees and dependents improved care, and higher levels of satisfaction."
"Most large employers are looking for ways to improve quality and promote a healthier, more engaged and productive workforce," stated Al Weiland, MD, chief medical officer for Kaiser Permanente Healthy Solutions, and former medical director of the Northwest Permanente Medical Group. "Kaiser Permanente Healthy Solutions leverages the proven strategies used in caring for our 8.4 million Kaiser Permanente members to promote healthier lifestyles, create more informed patients, and utilize the best evidence to care for chronic illness."
KP Healthy Solutions' services will include features for three critical groups, employers, employees and their dependents, and physicians which can dramatically impact the overall effectiveness of the health care experience. The first is the employers who are providing health plan coverage. Employer-focused services include an initial assessment to identify areas of opportunity within the covered population to improve quality and outcomes. This information can then be used to create customized outreach campaigns to help employees and dependents become better-informed health care consumers. Employers can gauge the effectiveness of strategies through feedback on overall program performance.
Employees and dependents can take advantage of 24/7 telephone health coaching, and benefit from comprehensive support for their health concerns using web, video and print materials. Health education will be available for everything from nutrition, weight loss, smoking cessation, stress reduction, to self-care and decision support for chronic and preference-sensitive conditions.
Community physicians will be offered convenient access to tools and resources via a web portal, access to evidence-based knowledge and registries, feedback on their patient population, improved panel management and ability to meet pay for performance goals. "We can help improve the physician patient relationship, and we can become the trusted advisor for community physicians wherever Kaiser Permanente Healthy Solutions is offered," added Dr. Weiland.
Kaiser Permanente Healthy Solutions is a wholly owned subsidiary of Kaiser Permanente. Kaiser Permanente Healthy Solutions is headquartered in Oakland, California, with administrative offices in Atlanta and Los Angeles.
Kaiser Permanente is America's leading integrated health plan. Founded in 1945, it is a nonprofit, group practice prepayment program headquartered in Oakland, Calif. Kaiser Permanente serves the health care needs of about 8.4 million members in nine states and the District of Columbia. Today it encompasses the nonprofit Kaiser Foundation Health Plan, Inc., Kaiser Foundation Hospitals and their subsidiaries, and the for-profit Permanente Medical Groups.

Tuesday, February 07, 2006

HHS Press Release 12/22/2005

More Than 21 Million Medicare Beneficiaries To Be Covered For Prescription Drugs As of January 1, 2006
More than 21 million seniors and people with disabilities will get prescription drug coverage as of Jan. 1, 2006, HHS Secretary Mike Leavitt said today. The number includes more than one million Americans who signed up for the new stand-alone coverage in the first 28 days it was offered. Another 500,000 are expected to be enrolled by the end of January.
“The new prescription drug benefit is off to a strong start,” Secretary Leavitt said. “With more than 21 million participating in coverage as of January 1, we are well on the way of meeting our goal of 28-30 million enrolled in the first year of the program. While there is still much work to do, we are encouraged by the early results.”
“Interest in the drug coverage is strong, and these numbers do show that people are getting questions answered and making decisions. For people who have decided they want coverage, they should go ahead and enroll now so they can take advantage of this important new protection,” said Centers for Medicare & Medicaid Services Administrator Mark B. McClellan, M.D., Ph.D.
Dr. McClellan noted the especially strong response from employers and unions who are planning on keeping their retirees in their current coverage. “We expected an initial spike in enrollment, but the participation in Medicare’s new support for retiree coverage is even better than many predicted,” Dr. McClellan said. “With more than 11 million retirees keeping the good coverage they have now, the support for retiree coverage provided in the Medicare drug benefit is working.”
Medicare beneficiaries will be getting their drug coverage in various ways, including from existing federal and/or military programs. The enrollment figures as of Dec. 13 are:
Stand-alone Prescription Drug Plans: more than 1 million.
Medicare/Medicaid: 6.2 million (including 600,000 in Medicare Advantage plans).
Medicare Advantage: 4.4 million (plus 600,000 Medicare/Medicaid beneficiaries).
Retiree coverage: About 5.9 million retirees are enrolled in the Medicare retiree subsidy, with an additional 600,000 in process. Also, about 1 million retirees are in employer coverage that incorporates or supplements Medicare’s coverage. Another estimated 500,000 retirees are continuing in coverage that is as good as Medicare’s. (See Attachment A.)
TRICARE/ FEHB retirees: 3.1 million.
“The holidays are a great time for families to have a conversation with a loved one about signing up for the new prescription drug coverage,” Secretary Leavitt said. “The new benefit is the biggest improvement in health care for seniors and Americans with disabilities since Medicare began 40 years ago. We encourage all eligible beneficiaries to enroll so they can start saving right away on the prescription drugs they need to stay healthy -- now and in the future.”
The Centers for Medicare & Medicaid Services will be releasing drug coverage enrollment data monthly.

Retiree Drug Subsidy (qualified to date): Includes retirees determined to meet the applicable standard for their drug expenses to be claimed for retiree subsidy payments by their plan sponsors.
Retiree Drug Subsidy (still being processed): Includes additional retirees expected to meet applicable standard
Federal retirees: Includes retirees receiving coverage from the Federal Employees Health Benefits (FEHB), TRICARE (military health care) and TVA.
Coverage that incorporates or supplements Part D coverage, includes retirees in:
“direct contract” plans, where the employer or union itself becomes a Part D plan for just its retirees, and
“employer group waiver” plans, where a plan contracts with just one employer or union to create a plan for just that organization, and
separate employer/union maintained plans that “wrap around” Medicare Part D
Note: Since tax-exempt entities do not benefit from the retiree subsidy not being excluded from federal taxation, these approaches may be more attractive to tax-exempt entities.
Other: Includes retirees that will receive coverage from non-calendar year plans that have not yet come into the retiree drug subsidy program, as well as plan sponsors covering relatively small numbers of retirees that decided the administrative cost of implementing an MMA option outweighed the saving available.

Plan sponsors can be either:
employers or unions applying on their own behalf, or
entities providing coverage to multiple employers or unions, such as a state retirement system
Sponsors can submit multiple applications if they offer multiple plans, so the total number of applications submitted will be greater than the total number of unique sponsors listed in the table
It is too early to provide a reliable count of total applications, since some sponsors may split or consolidate applications before the application process is complete
In some cases a single entity has applied as the plan sponsor for retirees in a plan covering multiple employers or unions, so the number of employers and unions providing coverage to qualified retirees is higher than the total number of unique sponsors listed in the table.
Because the application only captures information about the plan sponsor, we do not have data on the actual number of individual employers and unions that will be receiving retiree subsidy payments.
Table include only those retirees already determined to be eligible for their sponsor to receive retiree drug subsidy payments
CMS is still processing additional retiree lists and expects the final total to be about six million qualified retirees.