Thursday, March 23, 2006

BCBS of Michigan & Partnership for Michigan's Health Complete IT Inventory

The following press release outlines the inventory of health care information technology, conducted by Blue Cross Blue Shield of Michigan along with the Partnership for Michigan's Health...

Blue Cross Blue Shield of Michigan, Partnership for Michigan's Health Complete Inventory of Health Care Information Technology

DETROIT, March 22, 2006 - Blue Cross Blue Shield of Michigan and the Partnership for Michigan’s Health, comprised of the Michigan Health & Hospital Association, the Michigan State Medical Society and the Michigan Osteopathic Association, today released the findings of a statewide inventory on the use of health care information technology (IT) as it relates to fully capturing patient health records electronically. The study identifies current efforts of Michigan’s health care providers to adopt electronic health records (EHR) and barriers to EHR development. As demand for efficiency in health care continues to grow, the expanded use of EHR is imperative in reducing health care costs and errors.

The findings of this study show that efforts to acquire, expand or even replace current record systems for most health care organizations in Michigan are under way. They also showed that Michigan was ahead of the national average for adoption of computerized physician order entry, a building block of EHRs, and the delivery of safer patient care at the bedside. Among the recommendations in the study:

Identify the information required to support patient care and safety.
Continue development of infrastructure to support a regional/statewide EHR in the state.
Encourage physician buy-in, as it is an essential element to success.
Involve physicians, payers and hospitals to promote collaboration within the region.
Target e-prescribing as a fundamental building block to EHR.
Define guidelines, standards, formats and infrastructure model and approach.
Conduct a financial assessment and identify potential funding alternatives.
Develop incentives to adopt and use technology.

The study also identified barriers to EHR development, including varying computer systems, a mix of nonstandard data elements, inconsistent code sets and medical vocabularies, the need to promote more e-prescribing and pharmacy integration, and the need for development of unique patient identification solutions. The study will assist efforts recently launched by the Michigan Health Information Network and CyberMichigan as they look to build a statewide health information network. “The research will help us obtain better understanding of the IT capabilities of hospitals, health systems and physician practices and how we can work together to improve information exchange,” said Daniel J. Loepp, executive vice president and CEO designate at Blue Cross Blue Shield of Michigan. “The results will be shared with various stakeholders to help leverage efforts to promote adoption of electronic health records in Michigan.”

“This research identifies how IT is being used to benefit patients by assisting practitioners in managing critical patient information during every aspect of the health care delivery process,” said Kevin A. Kelly, executive director of the Michigan State Medical Society. “As hospitals and health systems invest in necessary improvements, it is imperative that we move toward common standards that prevent costly redundancies,” said Spencer C. Johnson, president of the Michigan Health & Hospital Association. “Key to this is sharing of health care information and the interoperability of EHRs.”

“It is critical that we invest in systems that interrelate,” said Dennis Paradis, M.P.H., executive director of the Michigan Osteopathic Association. “This inventory can help us identify some common directions to go in the future.”
Major vendors of health care information technology solutions were asked to identify organizations in Michigan with the most widespread adoption of EHR among study participants. From this process, 37 of Michigan’s 144 acute (hospital) sites and also 54 ambulatory (outpatient) sites were identified. In-depth interviews were completed and scored according to the EHR criteria established for the study.

Some of the areas examined in the study include:
Live interfaces with pharmacies and laboratories
Patient monitoring interfaces
Systems that archive radiology pictures
Live electronic health records (inpatient and ambulatory settings)
Percentage of physicians using electronic signatures and e-prescribing
Medication dispensing when nurses use barcode scanning
Total computerized physician orders done electronically

The report identified five large acute care (inpatient) sites with the most active EHR initiatives as Trinity Health (Novi/Farmington), Hurley Medical Center in Flint, Munson Healthcare in Traverse City, Spectrum Health in Grand Rapids and Detroit Medical Center. For smaller acute care (inpatient sites under 200 beds), the institutions identified with most active IT initiatives were Pine Rest Christian Mental Health Services (Grand Rapids), Schoolcraft Memorial Hospital (Manistique), Central Michigan Community Hospital (Mount Pleasant), Memorial Healthcare (Owosso) and Holland Community Hospital.
The report also looked at the IT capabilities of large ambulatory (outpatient) sites with more than 25 physicians and midsize sites with six to 25 physicians as well as smaller sites with one to five physicians. The five large outpatient sites identified with the most active EHR initiatives were Trinity Health (Novi/Farmington), Michigan State University (Kalamazoo), Michigan Heart (Ann Arbor), Spectrum Health (Grand Rapids) and Michigan State University (East Lansing). The five midsize ambulatory sites were Lakewood Family Medicine (Holland), Orthopedic Associates of Grand Rapids, Michigan Heart and Rhythm Group (Troy), Silver Pine Family Medicine Child Health (Sterling Heights), and Michigan Multispecialty Physicians (Ypsilanti). In the one-to-five physician size, the most active EHR sites were the Center for Women’s Healthcare (Carson City ), Holt Family Practice (Holt), Grand Valley Internal Medicine (Grand Rapids), PrimeCare of Novi, and Associates of Family Medicine (Rochester Hills ).

About Blue Cross Blue Shield of Michigan
Blue Cross Blue Shield of Michigan, a nonprofit corporation, provides or administers health care benefits to just over 4.7 million members through a variety of plans: Traditional Blue Cross Blue Shield; Blue Preferred, Community Blue and Healthy Blue PPOs; Blue Choice Point of Service; Blue Care Network HMO, and Flexible Blue plans compatible with health savings accounts. Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.

Tuesday, March 21, 2006

CareFirst NCQA Ratings

CareFirst BlueCross BlueShield's HMO-PPO Earns New NCQA Quality Plus Distinction...Insurer is an early adopter of "Member Connections"

OWINGS MILLS, MD (February 9, 2006) – CareFirst BlueCross BlueShield's managed care plans – CareFirst BlueChoice HMO and CareFirst BluePreferred PPO – have been awarded Quality Plus Distinction from the National Committee for Quality Assurance (NCQA) by adopting innovative practices that make health care more accessible and easy to understand for the health plans' members. One of the first insurers in the nation to receive the NCQA Member Connections Quality Plus Distinction, CareFirst BlueChoice, the company's Health Maintenance Organization (HMO), and CareFirst BluePreferred, its Preferred Provider Organization (PPO), achieved high scores for providing easy connections for members to information such as care options and prescription drug costs.

In addition, the plans were evaluated on the measures taken to help members understand their benefits, self-manage certain chronic medical conditions and check the status of their claims. CareFirst voluntarily went through in 2005 the NCQA's Member Connections Quality Plus accreditation process, which will be required for all health plans seeking NCQA accreditation beginning in mid-2007. NCQA, an independent, non-profit organization dedicated to measuring the quality of the nation’s health care, created Member Connections as the first part of its new Quality Plus program. "We obviously are very proud to be one of the first insurers to achieve this distinction," said Jon Shematek, M.D., CareFirst Vice President of Quality and Medical Policy. "We are very serious about keeping our members informed, whether that means helping them more easily navigate the health care system to receive proper care or using our Web-based tools to learn about their prescription drugs."

Member Connections Standards are focused on four areas:

Support and Administration
Functionality of Claims Processing
Pharmacy Benefit
Self management

NCQA is a private, non-profit organization dedicated to assessing and reporting health care quality. NCQA accredits and certifies a wide range of health care organizations and manages the evolution of HEDIS®1, the performance measurement tool used by more than 90 percent of the nation's health plans. NCQA is committed to providing health care quality information through the Web and the media in order to help consumers, employers and others make more informed health care choices.

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.

Sunday, March 19, 2006

Medica Unites with Eau Claire YMCA

MINNETONKA, Minn., March 1, 2006 — Medica members in the Eau Claire area will have a new opportunity to improve their health and save money. Effective March 1, 2006, the YMCA of Eau Claire joins Medica’s Fit Choices by Medica network.The program, the first of its kind in Minnesota, is designed to help members improve their health and save membership and health care dollars.

Fit Choices by Medica members get a $20 monthly membership credit just for exercising at a participating YMCA eight or more days per month.“We are delighted to partner with the YMCA of Eau Claire,” said Dr. Ted Loftness, M.D., Medica’s vice president of regional health services. “This is an important addition to the Fit Choices by Medica program because it provides easy access to our members in the Eau Claire area and the YMCA is very supportive of our mission to engage our members in greater amounts of physical activity and fitness programs.”Studies show that helping people stay healthy not only saves lives, it controls health care costs.

An estimated 70 percent of all illnesses are due to lifestyle-related causes such as obesity and physical inactivity, and one-half of all medical costs are attributable to illnesses that could be prevented. Fit Choices by Medica is now a standard component of Medica’s offerings to fully insured employers and is being offered as an option for self-insured groups.

About Medica:Medica is Minnesota’s largest HMO, largest PPO and leading non-profit and independent provider of health plans. Medica has 1.3 million members and 24,000 providers in a regional health care network service area that includes 98 percent of Minnesotans and a growing number of adjoining counties in Wisconsin, North Dakota and South Dakota.

Medica also offers national network coverage to employers who also have employees outside the Medica regional network.Medica has the highest accreditation status, Excellent, from the National Committee for Quality Assurance (NCQA®) for its Minnesota and North Dakota Medicaid HMO plans and commercial health plans.

Medica’s vision is to become the community’s health plan of choice, trusted for its integrity, respected for its service, and admired for its commitment to innovation and efficiency.