From the Washington Health Alliance
The Washington Health Alliance has announced results on the performance of six health plans in the state of Washington using eValue8TM, an assessment tool from the National Business Coalition on Health (NBCH).
The alliance found widespread differences among the performance of the six participating health plans on such issues as strategies to reduce waste, engage consumers and measure physician quality.
For the first time since the alliance began conducting eValue8 surveys in 2008, a Washington-based health plan achieved the best overall score in the nation. Group Health Cooperative’s HMO product, with 77% of the total points, scored higher than all other health plans participating in eValue8 nationally during 2016.
In addition to achieving best national performance overall, Group Health’s HMO product also achieved best national performance in two of eValue8’s eight modules: “Helping Members Get and Stay Healthy” and “Helping Members Manage Chronic Conditions.”
Every two years, the alliance joins together with employers and union trusts in Washington state to sponsor eValue8, a nationally standardized Request for Information managed by NBCH, a national organization of purchaser-led health care coalitions, of which the alliance is a member.
eValue8 asks health plans over 200 questions about health plan accreditation, how the plan measures and pays physicians and hospitals, how well the plan meets consumers’ needs for getting needed care and plan information, how well the plan engages and incents consumers to promote health and manage disease, as well as the plan’s strategies to reduce and eliminate waste, ensure patient safety and control costs.
Health plans as well as employers and union trusts receive objective scores enabling comparison of plans locally and against national benchmarks. Once scores are available, health care purchasers have a face-to-face discussion of findings with each health plan to learn what they each need to do to align their strategies, maximize the value of the health care investment and ultimately, improve health and quality of care for residents of Washington state. Employers and union trusts use the information to inform their decisions about which health plans offer the best service and quality.
Details of the 2016 eValue8 analysis
In 2016, six Washington-based health plans voluntarily agreed to participate in the eValue8 process. These six plans include: Aetna, Cigna, Group Health HMO, Group Health Options, Regence Blue Shield, and UnitedHealthcare. A seventh plan, Premera Blue Cross, was invited but they declined to participate in eValue8.
Cigna WA achieved best national performance in “Pharmaceutical Management,” one of eValue8’s eight modules. Aetna WA achieved best national performance in “Business Profile,” one of eValue8’s eight modules that largely reflects health plan accreditation, resource use and level of collaboration.
While each health plan differentiates itself with strong programs and results in select areas, the following represent some of the areas of opportunity to improve for most or all health plans:
- Increase the level of support for physicians for identifying and managing patients with depression, alcohol use, obesity and tobacco use
- Improve cancer screening and childhood immunization rates, including member reminders
- Improve tools available to consumers to select physicians and hospitals; ensure that the quality measures used are transparent and integrate quality and price information into the same tool
- Improve quality results for maternal and child health; take steps to lower the rate of C-sections
- Improve patient experience and satisfaction, especially on overall rating, getting needed care and shared decision-making