“It’s not only what you measure, but making sure those things you measure matter to the marketplace,” says Stump of Blue Cross and Blue Shield. “EValue8 helps us ensure we are counting what counts most to the customer.”
EValue8 Performance Areas The areas covered in the eValue8 online health plan survey include: • Health Information Technology—Plans are asked if physicians and nurse practitioners have access to personal digital assistants and computer software to order patient prescriptions and prevent drug conflicts; also, what information technology is used to process claims and communicate claim costs to employers by disease categories. • Consumer Engagement and Support—Asks plans if they offer 24/7 nurse advice/health coaching, automated “push” e-mails based on a member’s disease or condition, and online enrollment in disease management programs. • Provider Measurement: Incentives and Rewards—Plans are asked if they partner with other health plans in the community on patient safety programs, and what they do to track and report performance for both doctors and hospitals through projects such as Minnesota Community Measurement. • Primary Prevention and Health Promotion—Plans are asked about the extent of their community education efforts regarding cancer screening, immunizations, tobacco, weight management, and work site health. • Chronic Disease Management—Plans must document the programs they use to help their members suffering from asthma, cardiovascular disease, and diabetes to manage their conditions. Asks if phone calls are used to remind these patients, and what specific triggers prompt the plan to contact the patient. • Behavioral Health—Plans are asked if they promote established clinical guidelines and best practices for depression management and alcohol disorders. The plans report whether they measure provider performance results in behavioral health and the extent of their patient support and education programs. • Pharmacy Management—Plans report on their relationships with pharmacy benefit management firms, how they manage costs through generic equivalent prescriptions, whether or not they have programs to address specialty pharmaceuticals, and the steps they take to maximize pharmacy safety at the prescribing and patient level. —Excerpted from “BHCAG Minnesota Purchasers Health Plan Evaluation: eValue8” |
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