News Releases - April 20, 2004
FOR IMMEDIATE RELEASE
Contacts:
Deb Wiethop
314.923.4767
deborah.wiethop@wellpoint.com
Andover, MA. – UniCare Life & Health Insurance Company (UniCare) has received awards in the categories of "Best Health Plan Initiative for Consumer Directed Health Care" and "Best in Show" from this year’s Consumer Directed Health Care Conference and Expo (CDHCC) for a program designed to provide participants with information on improving their health care while reducing their out-of-pocket expenditures.
Constance Williams, M.D., associate medical director, UniCare, said that the awards for the pilot program were gratifying. "Our client, The Group Insurance Commission, challenged us to develop a program for our members that would encourage them to get the most value out of their health care benefit," she said. "I thank the CDHCC for awarding our initial efforts. We are excited to offer this pilot program and look forward to returning next year to share the results of our outcomes assessment."
Earlier this year, UniCare announced that, under a multi-year agreement with Resolution Health, Inc. [RHI], it launched a customized version of RHI’s new Direct-To-Member™ Program ("DTM") for Massachusetts state employees who receive health insurance through the Massachusetts Group Insurance Commission [GIC]. There are approximately 3,000 people participating in the pilot program. All of these individuals are enrolled in the Commonwealth Indemnity Plan, which is administered by UniCare and covers over one-half of GIC beneficiaries.
The DTM program is designed to provide participants with information they can use to improve their health and health care and to reduce their out-of-pocket expenditures. The program is simple to use, and the information it provides is personalized and easy to understand.
"Our goal is to improve quality of care and help patients live healthier lives and take better advantage of the programs we offer at the same time that we help both the GIC and its beneficiaries save money," said Robert Sorrenti, M.D., UniCare Vice President and Medical Director. "By providing patients with personalized information to help them make decisions about the health care they receive, and by providing their physicians with information to improve coordination of care in an otherwise fragmented health care system, we can help employees and employers achieve their goal of obtaining affordable high quality care."
The initial mailing of the Direct-to-Member™ program occurred in October 2003. Going forward, on a quarterly basis each DTM program participant will be sent a Member-Direct Guide™, which is a personal health care statement that contains health improvement and cost reduction suggestions, information regarding disease management / wellness programs from which they might benefit, and discounts on special programs and over-the-counter products that might be of interest. The suggestions and recommendations are based on a highly sophisticated computer analysis of each member’s medical and prescription claims data from the preceding 24 months.
Also included in the quarterly mailing is a "For My Doctor™ Analysis," which participants are encouraged to give to each of their physicians at their next office visit. The "For My Doctor™ Analysis" is designed to improve coordination of care provided to patients who have multiple chronic conditions and who typically see more than one physician. It provides a concise summary of a patient's recent prescriptions, office and hospital encounters, tests, procedures and other care events. It also brings specific quality of care observations, derived from the patient’s claims history, to the attention of the patient's physician.
This is a first-of-its-kind pioneering effort that, on a broad, population-wide basis, provides patient-specific clinical guidance, personalized cost-reduction recommendations, a concise chronology of the member’s recent health care activity, and personalized information about resources that directly apply to the participant. Because it is a simple mailing, it is a very cost-effective way to get this information into the hands of each participant.
The program is well-suited to address many of the key current trends in health care: the movement toward more patient-directed health care decisions, the need of patients for more specific information about their own care, and the growth in demand caused by the baby boomer generation reaching an age where chronic conditions become far more prevalent.
The initial response to the Direct-to-Member™ program has been positive, and there is an ongoing program of gathering feedback and suggestions for improvement from the pilot population and their physicians.
UniCare also offers PREMIER Health Management, a disease management program for people with Asthma, Diabetes, Congestive Heart Failure, Coronary Artery Disease and related chronic conditions.
UniCare
UniCare serves 1.7 million medical members and is the national operating subsidiary of WellPoint Health
Networks Inc., the nation’s second largest publicly traded health care company. WellPoint serves
the health care needs of more than 15 million medical members and approximately 46 million specialty
members. WellPoint offers a broad spectrum of quality network-based health products including
open access PPO, POS and hybrid products, HMO and specialty products. Specialty products include
pharmacy benefit management, dental, utilization management, vision, mental health, life
and disability insurance, long term care insurance, flexible spending accounts, COBRA administration,
and Medicare supplements. UniCare can be found on the web at
www.unicare.com.
