Regence responds to Senate Finance Committee vote on key health care legislation

Source: Regence.com

10/13/2009

PORTLAND, Ore. — The following is a statement from Mark Ganz, president and chief executive officer of Regence BlueCross BlueShield, regarding the Senate Finance Committee vote today on the America’s Healthy Future Act:

“Regence continues to be cautiously optimistic that an economically sustainable health care reform package will be adopted this year. Today’s vote is an important step toward ensuring long-term health care security and stability for all Americans. However, there is still more work to be done.

“Our company's deep commitment to improving the health care system is unwavering. In the coming weeks, we will continue our ongoing advocacy for these key reform elements: all Americans must have affordable coverage and access to quality care; insurers must drop pre-existing barriers to coverage, medical care must become more efficient; and the entire system must be simpler and more transparent.

“Regence will work tirelessly to achieve the critical pillars of reform that will ensure broader economic sustainability for our members and the nation as a whole.”

Regence Video Asks “What if Everything Worked Like Health Care?”

“45 Seconds to Share” illustrates health care system foibles

PORTLAND, Ore. — What if you could not find the price for anything at the grocery store, even the most basic items? What if the check-out clerk offered to mail you a bill, but could not tell you what your total amount would be?

Although that sounds ridiculous, that is exactly how our nation’s health care system often operates.

As the country’s health care reform debate charges forward, the unsustainable rise in health care costs remains a significant issue. Understanding the cost of medical care – from a doctor’s visit to a flu shot to knee surgery – is the key to controlling those costs. To illustrate the absurdity of not knowing what a procedure or office visit costs, unlike other sectors of our economy, Regence launched a video called “45 Seconds to Share,” part of the company’s WhatsTheRealCost.org campaign.

GHRI Receives $16 Million in Federal Funding for Cancer Research

Source: GHC.org

10/05/2009

SEATTLE — Researchers at Fred Hutchinson Cancer Research Center, Group Health Research Institute, and the University of Washington schools of Public Health and Pharmacy have been selected to lead four projects backed by approximately $16 million in federal stimulus funding for comparative-effectiveness research in cancer.

The grants establish Seattle as a national hub for conducting such research, which aims to objectively analyze cancer diagnostic tools, screening tests, and treatments to determine the optimal choices based on balancing benefits — including effectiveness — and harms, such as cost. Most of these projects involve extensive collaboration between these local institutions.

The American Recovery and Reinvestment Act has dedicated $1.1 billion to fund such research via the Grand Opportunities (GO) grants program of the National Institutes of Health, which supports high-impact ideas that lend themselves to short-term funding. The Seattle-led GO grants, each of which will fund two-year projects, account for approximately one-third of the National Cancer Institute's (NCI's) first investment in the burgeoning field of cancer-related comparative-effectiveness research.

"Cancer is one of the highest areas of health care spending," said Scott Ramsey, MD, PhD, an internist and health care economist who is leading a Hutchinson Center-based project that will lay the foundation for research to evaluate how various cancer genetic tests influence cancer care, outcomes, and costs. "We are spending multiple billions on cancer diagnostics and hundreds of millions on genetic tests, for example, but we're not certain what we're getting for all of that money. Are patients living longer? Are they living better quality lives? We just don't have that answer," he said.

The following Seattle-based comparative-effectiveness research projects aim to help provide some of those answers:

Cancer genomics: A $4 million project based at the Hutchinson Center and led by Ramsey, a member of the Center's Public Health Sciences Division and a professor of medicine at UW School of Medicine, will fund the development of an infrastructure to support the Center for Comparative Effectiveness Research in Cancer Genomics or CANCERGEN. This public-private consortium will design and conduct prospective, controlled clinical trials of promising cancer genetic tests working in close collaboration with the University of Michigan-based Southwest Oncology Group (SWOG), one of the largest NCI-supported cancer clinical trials cooperative groups. Researchers in the SWOG Statistical Center, co-located at the Hutchinson Center and the Seattle nonprofit Cancer Research And Biostatistics (CRAB), will design the statistical structure of the study and lead data management and analysis. CANCERGEN will develop the tools that help SWOG researchers determine which proposed trials will have the greatest clinical benefit for patients.

"Part of CANCERGEN's vision is to position SWOG as a national leader in cancer comparative-effectiveness research," Ramsey said. "Realizing that vision will go a long way to help achieve the health care reform goal of making cancer treatment more effective and less expensive," he said. Researchers at the UW School of Pharmacy and the Center for Medical Technology Policy in Baltimore will co-lead the effort.

Cancer diagnostics: A $4 million project based at the UW School of Public Health and led by Larry Kessler, ScD, professor and chair of the UW Department of Health Services, will fund research to evaluate the effectiveness of cancer diagnostics — from mammography and MRI to ultrasound, PET-CT, and blood- or tissue-based biomarkers — to determine the extent of disease and plan treatment.

"Over the past decade, the field of both medical imaging and laboratory-based diagnostics has taken a quantum leap forward. However, the evidence to determine how to best use these modern technologies in clinical practice hasn't kept pace with the technological developments," Kessler said. "Our research will help providers and patients make better decisions about the use of these technologies, which ultimately will lead to the best possible outcomes," he said. The project, called Advancing Innovative Comparative Effectiveness Research in Cancer Diagnostics or ADVICE, will be co-led by investigators from the UW schools of Pharmacy and Medicine, Group Health, Veterans Affairs, and the Hutchinson Center, which will serve as the study's data center.

Breast imaging: A $4 million project led by Group Health will support comparative-effectiveness research of conventional and cutting-edge breast cancer imaging techniques to help determine which modalities are most effective for women according to individual patient demographics and risk factors. It will use data from the NCI's Breast Cancer Surveillance Consortium, a nationwide collaborative network of mammography, tumor, and pathology registries. With modeling experts from NCI's Cancer Intervention and Surveillance Modeling Network, the project will compare the effectiveness of various breast cancer screening strategies such as film-screen mammography, digital mammography and breast MRI.

"A growing body of evidence is showing that screening tests can sometimes do more harm than good," said Diana Miglioretti, PhD, a senior investigator in biostatistics at Group Health and one of the project's leaders. "This study will let us evaluate different strategies for breast cancer screening so we can inform women about the best screening choices for them, based on their own age, risk factors, and illnesses." The grant, Comparative Effectiveness of Breast Imaging Strategies in Community Practice, will be co-led by investigators at Group Health, the University of North Carolina at Chapel Hill, the University of California at San Francisco, the University of Vermont, and Georgetown University.

Cancer screening: A $4 million project based at Group Health aims to lay the groundwork for studies to improve the effectiveness of colorectal and cervical cancer screening and increase participation in such screening.

"How well cancer screening works in real-world settings depends not only on how well each screening test identifies cancer, but also on patients, health care providers, and the context and systems in which health care is delivered," said Diana Buist, PhD, MPH, an associate investigator in epidemiology at Group Health and one of the project's leaders. "Our grant will study how to deliver colorectal and cervical cancer screening most effectively to populations. The goal is to detect cancer better, decrease the rates of screening's adverse effects and, ultimately, to reduce death from cancer," she said.

The project, called SEARCH: Screening Effectiveness and Research in Community Based Healthcare, will be co-led by Chyke Doubeni, MD, MPH, an assistant professor in family medicine and community health at the University of Massachusetts Medical School. The project will be conducted in collaboration with seven other health-maintenance organizations in the NCI's Cancer Research Network, a consortium of 14 health plans across the U.S., to quickly and effectively translate and disseminate its findings directly into clinical practice.

Cancer treatment: In addition, Group Health is collaborating on a $4 million GO grant based at Dana Farber Harvard Cancer Center that will address two key issues: the costs and effectiveness of treating advanced cancer and the lack of population-based research on patterns and outcomes of cancer care in populations not covered by Medicare, such as those under 65 and the poor. The data from the study will be provided, in part, by the Cancer Research Network, a research-based consortium of health-maintenance organizations that is based at Group Health.

"Most cancer research is done in patients in the early stages of their disease, so we know relatively little about patterns of treatment among patients whose cancer has recurred or progressed," said Paul Fishman, PhD, an associate investigator at Group Health and co-investigator on the project. "This study will provide evidence needed to support better care for more patients. Our research will be based on a wide range of patients who receive care in the full range of clinical settings where Americans receive their cancer care."

These GO grants represent just a fraction of federal stimulus funding for biomedical research awarded to these Seattle institutions. In total, as of Oct. 1, the UW schools of Medicine, Public Health, and Pharmacy had received $79.6 million for 186 projects, the Hutchinson Center had received nearly $40.4 million for 60 projects, and Group Health had received more than $17 million for 15 projects.

Phone Therapy for Depression Found Cost-Effective

Source: GHC.org

10/05/2009

SEATTLE — When people get brief, structured, phone-based cognitive behavioral psychotherapy soon after starting on antidepressant medication, significant benefits may persist two years after their first session, with only modest rises in cost. Over two years, this treatment is cost-effective, according to a randomized trial in the October 2009 Archives of General Psychiatry.

"The most important reason to treat depression is to reduce suffering and improve daily functioning," said Group Health psychiatrist Gregory E. Simon, MD, MPH, also a senior investigator at Group Health Research Institute. "But our findings suggest that insurers or health care systems aiming to improve depression treatment in primary care should consider incorporating structured psychotherapy."

The Journal of the American Medical Association (JAMA) reported earlier results from the same 600-person trial, the largest to date of psychotherapy by phone and one of the largest studies of psychotherapy ever.

Over two years, phone psychotherapy plus care management led to a gain of 46 depression-free days, with only a $397 increase in outpatient health care costs. The incremental net benefit of phone psychotherapy plus care management was positive, even if a day free of depression was valued as low as $9.

By contrast, phone care management alone, with no phone psychotherapy, led to a gain of only 29 days free of depression, with a $676 rise in outpatient health care costs. The incremental net benefit of phone care management alone was negative, even if a day free of depression was valued up to $20.

The trial enrolled 600 Group Health patients whose primary care doctors diagnosed their depression and (as is usual in primary care) prescribed their antidepressants without psychotherapy. The patients were randomly assigned to receive either:

Usual primary care.
Phone care management: Usual care plus a phone-based care-management program including three outreach calls from a bachelors-level clinician (assessing patients' symptoms, antidepressant drug use, and side effects and referring to mental health specialty care if needed), with care coordination and feedback to the primary care doctor.
Phone psychotherapy: Usual care plus phone care management plus eight 30- to 40-minute sessions of structured cognitive-behavioral psychotherapy delivered by phone by a masters-level mental health clinician.

The trial excluded people who were already seeing a therapist or intending to do so. The patients and mental health clinicians never met face to face, only over the phone. The mental health clinicians followed a structured protocol for psychotherapy. They encouraged the patients to identify and counter their negative thoughts (cognitive behavioral therapy), pursue activities they had enjoyed in the past (behavioral activation), and develop a plan to care for themselves.

Few of the patients who received phone-based therapy — and even fewer than those who did not receive it — sought in-person therapy. Phone-based therapy is more convenient and acceptable to patients than in-person psychotherapy, said Dr. Simon.

Depression symptoms, including feeling discouraged and avoiding other people, can prevent people from seeking help, he added. Nationally, only about half of insured patients receiving depression treatment make any psychotherapy visit, and less than a third make four or more visits. By contrast, in this trial, three in four patients completed at least six phone therapy sessions.

The National Institute of Mental Health funded the trial. The other authors were Evette J. Ludman, PhD, senior research associate, and Carolyn M. Rutter, PhD, senior investigator at Group Health Research Institute.

Group Health Research Institute

Founded in 1947, Group Health Cooperative is a Seattle-based, consumer-governed, nonprofit health care system. Group Health Research Institute changed its name from Group Health Center for Health Studies on Sept. 8, 2009. Since 1983, the Institute has conducted nonproprietary public-interest research on preventing, diagnosing, and treating major health problems. Government and private research grants provide its main funding.

LifeWise Health Plan Waives Out of Pocket Costs for H1N1 Vaccinations

Source: LifewiseWa.com

10/1/2009

MOUNTLAKE TERRACE, WA – (October 1, 2009) – LifeWise Health Plan of Washington today announced actions to provide peace of mind to its members by waiving certain out-of-pocket costs that would otherwise be associated with the administration of the H1N1 vaccine.

“LifeWise has been planning and preparing for scenarios related to H1N1 flu since the issue arose this spring,” said Dr. Roki Chauhan, LifeWise’s Chief Medical Officer. “We are actively engaged with our associates, our members, and our network of healthcare providers to meet their respective needs on this issue.”

LIFEWISE WAIVES MEMBER COSTS FOR H1N1 VACCINE

LifeWise of Washington is waiving certain out-of-pocket costs that would otherwise be incurred by members receiving the H1N1 vaccine. LifeWise will cover the cost of administration of the H1N1 vaccine for all members in fully insured groups, including those who have reached their preventive care benefit maximum or whose plan does not include an immunization benefit.

This action is part of our efforts since April, when H1N1 came to the attention of the health community, to be prepared to provide continuous service to its providers and members in the event of a major flu outbreak. The decision to waive certain out-of-pocket expenses related to the administration of the H1N1 vaccine until further notice is based on LifeWise’s recognition of the unique nature of this flu virus and the company’s desire to encourage appropriate member access to the vaccine.

“We want LifeWise members to have peace of mind knowing that receiving the H1N1 vaccine will not require payment of out of pocket costs for administration of the vaccination,” Chauhan added.

“We urge our members in at-risk groups as defined by the CDC to receive vaccinations recommended by that agency. In the meantime, we strongly encourage everyone to follow common sense steps to help minimize flu transmission,” Chauhan concluded.

The CDC currently recommends individuals in the following groups receive the H1N1 vaccine:

Pregnant women
People who live with or care for children younger than 6 months of age
Healthcare and emergency medical services personnel
Persons between the ages of 6 months through 24 years
People ages 25 through 64 years who have chronic health disorders or compromised immune systems.

LifeWise remains actively engaged in monitoring and preparing for all appropriate steps to support its associates, members, and network of healthcare providers during the upcoming flu season.

More information regarding the flu and the H1N1 virus, including links to relevant health organizations, is available at our “The Flu And You" page.

Regence to cover administration costs of H1N1 vaccine for fully-insured groups, individuals this flu season

Source: Regence.com

09/23/2009

Portland – To remove financial barriers associated with administration of the H1N1 vaccine and to encourage members to seek vaccination, Regence BlueCross BlueShield will provide coverage for the costs associated with the administration of the H1N1 vaccine during the 2009-2010 flu season, waiving co-pays and deductibles for all members covered by its insured plans. Regence will strongly encourage self-insured employers to cover the full cost to ensure that the greatest number of people are protected.

Working to prevent and contain the spread of H1N1 is an important priority at Regence. This includes educating members on facts about the virus, prevention of illness and information on the vaccine.

Regence will coordinate its efforts with state and federal authorities to ensure the widest possible administration of the vaccine in an effort to mitigate the potential consequences of an H1N1 pandemic.

Based on its analysis of the current situation, The CDC's Advisory Committee on Immunization Practices has recommended prioritizing the following population segments to receive the vaccine:

pregnant women
caregivers for children younger than 6 months of age
health care and emergency medical services personnel
children and young adults from 6 months through 24 years old
persons aged 25 through 64 years who have underlying health conditions that might increase their risk for flu-related complications

There are steps everyone can take to prepare. Keep a supply of food and medicines on hand in case you have to stay home, and practice good public health measures like frequent hand washing and staying home when sick. For more good information, visit one or more of the following resources:

US Flu Web site: http://www.flu.gov

CDC: http://www.cdc.gov/h1n1flu/

CDC Information in Spanish: http://www.cdc.gov/h1n1flu/espanol/

World Health Organization: http://www.who.int/csr/disease/swineflu/en/index.html

State H1N1 Flu Web Sites: http://www.astho.org/Programs/Infectious-Disease/H1N1/State-H1N1-Flu-Information/

Local Health Department Links: http://www.naccho.org/about/LHD/

US Flu Web site: http://www.flu.gov

LifeWise Health Plan Announces Expanded Benefits for Individuals:
Prescription Coverage Grows As Prevention Pays Off

Source: LifewiseWa.com

09/17/2009

MOUNTLAKE TERRACE, WA – (September 17, 2009) – LifeWise Health Plan of Washington is announcing the following expansion of individual health-plan benefits to provide consumers with more choices and greater coverage:

A new comprehensive plan with lower out-of-pocket costs.

WiseChoices Prime will offer comprehensive coverage coupled with a reduced annual coinsurance maximum, reducing potential out-of-pocket costs for consumers by up to $2,000.

A market leading catastrophic plan that adds prescription drug coverage.

WiseEssentials Rx will provide consumers seeking catastrophic coverage the additional benefit of up to $3,000 in prescription drug coverage. No other catastrophic plan in Washington State combines multiple office visits, preventive tests at no cost, and now prescription drug coverage.

Access to a national network of healthcare providers to better serve members.

All LifeWise individual members will have access to a nationwide network as of January 1, 2010. Partnership with PHCS/Multiplan will provide members with access to more than 500,000 unique practitioners and 5,500 hospitals and ambulatory services across the country – in addition to the extensive LifeWise provider network in Washington, Oregon, and Alaska.

“This is a big step forward,” said Jeff Roe, President & CEO of Lifewise Health Plan of Washington. “Three years ago we made a commitment to providing first-dollar coverage of preventive care for our members. This was the right thing to do, and we have indications that commitment may also be contributing to an improved cost trend. We’re very happy to be offering expanded benefits while keeping rate increases below the rest of the market.”

The issue of trends in rising healthcare costs is important. Steady increases in the cost of medical care have resulted in double-digit rate increases across the individual market in recent years, from health plans across Washington State. LifeWise recently filed for a much lower increase of 7.4%, significantly below recent trends in the marketplace. While by no means an indicator that the problem is solved, this is a positive sign that steps to control costs – including by emphasizing the value of preventive care – can have an impact.

LifeWise is offering opportunities now to take advantages of these benefit improvements taking effect January 1, 2010. Customers purchasing LifeWise products during October, November, and December will be able to transition to equivalent new and improved product offerings without the need for additional underwriting as is otherwise standard in the individual marketplace. This will provide even more value to LifeWise customers.

Finally, LifeWise members will also soon be able to access enhanced online features, allowing them to manage their benefit dollars and health in one location. LifeWise expects to announce more about these online features in coming weeks.

Please call 1-800-592-6804 for more information on these expanded benefits and options for consumers.

National Survey Shows Consumers Prefer Agents When Shopping for and Purchasing Individual Medical Insurance

Source: AssurantHealth.com

07/23/2009

Milwaukee, WI- National Survey Shows Consumers Prefer Agents When Shopping for and Purchasing Individual Medical Insurance

Those who bought through an agent were significantly more satisfied with their health plans than those who purchased insurance online
Independent study confirms that consumers want agents to help them understand their options and recommend a plan tailored to their needs

A recent online survey of more than 1,000 consumers found that those who purchased individual medical (IM) insurance through a professional agent were significantly more satisfied with their health plans than those who bought IM insurance online.

The independent study was commissioned by Milwaukee-based Assurant Health, a leading national provider of Individual Medical, Small Group and Specialty health insurance products. Some of its other key findings included:

64% of those who bought through agents used the word “helpful” to describe their experiences while only 36% of online purchasers used this term.
91% of those who purchased through an agent bought the plan their agent recommended.
31% of those shopping online described the experience as “time-consuming.”
Despite the recent proliferation of Web-based insurance brokerages, 62% of the survey respondents bought their insurance through an agent.
In addition, consumers who purchased through an agent were significantly more satisfied in regard to how easy it was to understand their options and choose a plan that gave them the best coverage tailored to their needs than those who purchased online.
After being presented with information on how agents can help, and advised that purchasing through an agent does not increase their costs, nearly one out of four of those who purchased online reported that, if they were going to purchase IM insurance today, they would buy it through an agent.

“This study confirms our long-held belief that independent insurance agents play a vital role in educating consumers and helping them make informed decisions about their health plans,” said Don Hamm, President and CEO, Assurant Health. “It also shows that consumers greatly value agents’ personalized services and recommendations.”

“Assurant Health hopes this survey brings attention to agents’ numerous contributions to consumers and our entire health care system.”

About the Survey
The research commissioned by Assurant Health was conducted in May/June 2009 by the Chicago firm of Beall Research & Training, Inc. One-thousand-three (1,003) consumers who purchased individual medical (IM) insurance within the past two years were surveyed about their shopping and purchase experiences. The respondents were recruited from a representative online panel of Americans. All differences noted are statistically significant at the .05 level.

Group Health Researchers to Test H1N1 Flu Vaccine

Source: GHC.org

07/22/2009

SEATTLE — Scientists at Group Health Research Institute, along with a network of medical research institutions across the United States, are set to begin a series of clinical trials to gather critical data about influenza vaccines, including two candidate H1N1 flu vaccines.

The research will be under the direction of the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

After the isolation and characterization of the virus, the U. S. Centers for Disease Control and Prevention (CDC) generated and distributed a 2009 H1N1 seed virus to vaccine manufacturers for the development of vaccine pilot lots for testing in clinical trials.

"Now, NIAID will use our longstanding vaccine clinical trials infrastructure — the Vaccine and Treatment Evaluation Units or VTEU — to help quickly evaluate these pilot lots to determine whether the vaccines are safe and to assess their ability to induce protective immune responses," says NIAID Director Anthony S. Fauci, M.D. "These data will be factored into the decision about how and if to implement a 2009 H1N1 flu immunization program this fall."

Group Health expects to begin its trials by the end of August 2009. Initial studies will look at whether one or two 15 microgram doses of H1N1 vaccine are needed to induce a potentially protective immune response in healthy adult volunteers (aged 18 to 64 years old) and elderly people (aged 65 and older). Researchers also will assess whether one or two 30 microgram doses are needed. The doses will be given 21 days apart, testing two manufacturers' vaccines (Sanofi Pasteur and CSL Biotherapies). If early information from those trials indicates that these vaccines are safe, similar trials in healthy children (aged 6 months to 17 years old) will begin.

Volunteers Needed

Volunteers for these and other vaccine studies are being recruited from the Group Health population and the general public. For more information about vaccine trials for people aged 18 and older, call Group Health Research Institute, formerly the Center for Health Studies, at 206-287-2061 or 1-866-883-6772. For information about vaccine trials for those aged 17 and younger, call 206-884-1100.

A concurrent set of trials will look at the safety and immune response in healthy adult and elderly volunteers who are given the seasonal flu vaccine along with a 15 microgram dose of 2009 H1N1 vaccine. The H1N1 vaccine would be given to different sets of volunteers either before, after, or at the same time as the seasonal flu vaccine. If early information from those studies indicates that these vaccines are safe, similar trials in healthy children (aged 6 months to 17 years old) will start.

"The H1N1 flu virus has the potential to cause significant illness in the fall and winter flu season," said Lisa Jackson, MD, MPH, principal investigator of the VTEU at Group Health Research Institute. "Vaccines are a proven method for preventing a flu epidemic. The results of these studies will help us make the best use of H1N1 vaccine in Washington state and around the world."

A panel of outside experts will conduct a close review of the safety data from these trials to spot any safety concerns in real time. Information from these studies in healthy people will help public health officials develop recommendations for immunization schedules, including the optimal dosage and number of doses for multiple age groups, including adults, the elderly, and children. Data may also be used to support decisions about the best recommendations for people in high risk groups, including pregnant women and people whose immune systems are weakened or otherwise compromised.

The trials are being conducted in a compressed timeframe in a race against the possible autumn resurgence of 2009 H1N1 flu infections that may occur at the same time as seasonal influenza virus strains begin to circulate widely in the Northern Hemisphere.

The VTEU network consists of eight university research hospitals and medical organizations across the United States that provide a ready resource for conducting clinical trials that evaluate vaccines and treatments for a wide array of infectious diseases.

Group Health is collaborating with the University of Washington (UW) Department of Medicine, the UW Division of Allergy & Infectious Diseases, and Seattle Children's Hospital Research Institute to operate the VTEU in Seattle.

An important strength of the VTEU is their ability to rapidly enroll large numbers of volunteers into trials and to immunize the volunteers in a safe, effective and efficient manner. This rapid-response capability is especially important for testing vaccines designed to counteract emerging public health concerns. Results are expected to be available weeks after the trials begin.

NIAID's Vaccine and Treatment Evaluation Units include the following:

Baylor College of Medicine, Houston
Children's Hospital Medical Center, Cincinnati
Emory University, Atlanta
Group Health Cooperative, Seattle
Saint Louis University, St. Louis
University of Iowa, Iowa City
University of Maryland School of Medicine, Baltimore
Vanderbilt University, Nashville, Tenn.

Co-investigators for the Group Health VTEU are Dr. Anna Wald, professor in UW's Department of Medicine and Division of Allergy & Infectious Disease, and Dr. Janet Englund, professor of pediatrics in the Department of Infectious Diseases at Seattle Children's Hospital Research Institute.

Group Health expects to begin recruiting volunteers for these studies from its membership and the general public beginning in early August. For more information on influenza, visit www.flu.gov for one-stop access to U.S. government information on avian and pandemic influenza. Also, see www3.niaid.nih.gov/topics/Flu/.

Group Health Research Institute

Founded in 1947, Group Health Cooperative is a Seattle-based, consumer-governed, nonprofit health care system. The Group Health Research Institute, formerly the Center for Health Studies, is Group Health's research arm. For 25 years, GHRI has conducted nonproprietary public-interest research on preventing, diagnosing, and treating major health problems. Government and private research grants provide its main funding.

Assurant Health Extends Patient Care Health Care Advocacy Services to All Permanent Policyholders at No Additional Cost

Assurant Health and Patient Care contract is the first and only of its kind in the United States

Source: AssurantHealth.com

07/15/2009

Assurant Health and Patient Care announced that as of July 1, 2009, all Assurant Health permanent policyholders have access to health care advocacy services from Patient Care at no additional cost, to help them navigate through the health care system and become better health care consumers. In July 2008, Assurant Health became the first national carrier to offer Patient Care for new individual and small group medical plans. The contract extension between Assurant Health and Patient Care to all policyholders is the first and only of its kind in the United States.

“Assurant Health has always had a strong belief in clarifying health care for all of our customers” said Debbie Kramer, Senior Vice President, Marketing. “Contracting with Patient Care offers us yet another way to show our commitment to helping them get the information they need to make smart choices for their families,” Kramer continued.

Patient Care President and CEO Jane Cooper agreed, “Assurant Health and Patient Care are very strong partners.’ Cooper continued. “Patient Care Advocates are at the crossroads of consumers, providers and insurers – no one else offers that guidance, perspective and expertise.” Cooper said.

Patient Care’s Health Care Advocates Help Save Money, Time, Stress

Patient Care’s health care advocacy services are especially beneficial for people with high deductible health plans and/or health savings accounts (HSAs), since it lets them compare cost and quality data for up to three network providers. For example, consumers can call Patient Care 15 days before a recommended test or surgery to get quality information along with the estimated cost after network discounts for each provider.

Patient Care is automatically available to customers with qualifying plans and requires no additional paperwork by the agent. Patient Care advocates are experienced health insurance professionals who also can assist customers by:

Explaining health care bills, claims and benefits
Answering questions about HSAs and how to use them
Resolving issues regarding claims or billing
Identifying lower-cost drug options
Handling all of the necessary pre-authorization approvals.

For more information on Assurant Health insurance products and services, please visit www.eQuoteAssist.com. For more information on Patient Care, visit www.patientcare4u.com.

LifeWise Encourages Awareness, Prevention on Swine Flu

Source: LifewiseWa.com

05/01/2009

MOUNTLAKE TERRACE, WA – (May 1, 2009) – LifeWise Health Plan of Washington is actively monitoring developments around the swine flu and is working with our providers, employer groups, and members to address the situation as events warrant. In the meantime, we continue to be focused on providing our members peace of mind about their healthcare coverage, and we are also working with our own employees to take appropriate preventive steps to maintain a healthy and safe working environment so we can continue to address our customers’ concerns and needs.

We urge our customers to take the same preventive measures they take during any flu season, including:

Cover your nose and mouth when you cough or sneeze
Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective
Avoid touching your eyes, nose or mouth since bacteria can live on surfaces you handle
Avoid close contact with sick people
If you become ill with flu symptoms, call your doctor for advice, and stay home from work, school or other public events
Try not to touch surfaces that may be contaminated
Get plenty of sleep
Manage your stress through exercise and plenty of rest
Drink plenty of fluids
Eat healthy, nutritious food

Additional Information

For the most up-to-date information, preventive care tips, frequently asked questions and more, please refer to the CDC or WHO Web sites.

Centers for Disease Control and Prevention (CDC) http://www.cdc.gov/swineflu/
World Health Organization http://www.who.int/en/

A variety of other reliable resources are available to help answer questions about the Swine Flu:

U.S. Department of Health and Human Services http://www.pandemicflu.gov/
WA DOH: http://www.doh.wa.gov/swineflu/
Alaska DOH: http://www.hss.state.ak.us/
Oregon DOH: http://www.oregon.gov/DHS/index.shtml
Arizona DOH: http://www.azdhs.gov/
Health and Human Services: http://www.hhs.gov/
Government Pandemic planning site: http://www.pandemicflu.gov/

Swine Flu Outbreak: Group Health Responds

Source: GHC.org

04/26/2009

Group Health is working with state, local, and federal agencies to understand and limit the spread of the swine flu virus. A Group Health team headed by David Grossman, MD, preventive care chief, is reviewing the local and national situation daily to make sure that Group Health can respond appropriately.

The U.S. Department of Homeland Security, on advice of the Centers for Disease Control and Prevention, has declared a "public health emergency" in response to a growing number of flu-like illnesses caused by the swine flu virus.

The outbreak was first reported in Mexico, where several hundred have become ill and more than 60 people have died of the new influenza virus since March. There are now at least 40 people who have been confirmed as having the swine flu virus in the United States; all have recovered.

Protecting Yourself and Others

Swine flu is a respiratory illness that is spread in much the same way as seasonal flu. The best ways to keep from becoming ill are to:

Wash your hands frequently
Use hand-sanitizers
Avoid contact with people who are ill

If you are ill, please stay home to avoid spreading the illness to others. If your children are ill, they should stay home from school or day care.

More Cases Expected

As the Centers for Disease Control and Prevention (CDC) continues its investigation into this disease in the United States, experts predict that more cases will be reported in the next days and weeks. Because so many people travel, it is likely that there will be cases reported in the Northwest.

For More Information

CDC: www.pandemicflu.gov
WHO: www.who.int/en/

Assurant Health Helps People Keep Their Insurance

Individual Medical Policyholders Can Swap Plans When Economic Situation Changes

Source: AssurantHealth.com

03/24/2009

Milwaukee-based Assurant Health, a leading national provider of Individual Medical, Small Group and Specialty health insurance products, is allowing policyholders to change their health coverage if they face economic hardship.

“In these challenging economic times, it is more important than ever for individuals to maintain health care coverage,” said Scott Krienke, senior vice president, Product Lines, Assurant Health. “We are working with our customers and giving them options to continue health care coverage, including changing to a lower cost plan in our portfolio of affordable plans, if they experience economic difficulties.”

Individuals, for example, can opt-out of a low deductible plan and choose a higher deductible plan that has a lower monthly premium. Customers can, within six months, reinstate the low deductible plan without additional underwriting when their economic situation improves.

More and more people are losing health insurance as job losses mount and employers cut back on coverage. Many others are foregoing or cutting back on insurance in order to meet rising household expenses, especially those with adjustable rate mortgages. All are at risk of more serious economic troubles if they were to have a health crisis.

“It’s vital for individuals to maintain a level of heath coverage and we’re offering them flexibility to do just that,” said Krienke.

According to the U.S. Department of Labor, the number of U.S. workers drawing state unemployment benefits scaled another record high in March, underscoring the difficulties of getting new jobs in the recession-hit economy. Since December 2007, over 4 million jobs have been lost, with the unemployment rate at 8.1 percent, the highest level in 25 years.

Policyholders can learn more about their options by contacting their independent insurance agent.

Assurant Health Gives Residents of Washington State More Choices for Individual Medical Health Plans

Leading provider of individual medical insurance now offering various plans; coverage includes HSAs with tax benefits

Source: AssurantHealth.com

11/19/2008

October 20, 2008 – Today, residents of the state of Washington will be able to buy individual medical insurance from Assurant Health, which has been a leading national provider of individual medical, small group and specialty health insurance products for more than 115 years.
In addition to plans that offer comprehensive and catastrophic coverage, consumers can enroll in plans with HSAs, a consumer-managed, tax-favored alternative to traditional health insurance. HSAs can often save families with annual medical expenses of about $1,500 as much as $6,000 a year.
“We believe everyone benefits when consumers have more choices,” said Scott Krienke, Senior Vice President, Product Lines, at Assurant Health. “In a state where residents have had relatively limited options for individual medical insurance, our various health plans give them more ways to get affordable coverage with the protection they need.”
Assurant Health has nearly one million customers nationwide. It also offers Washington residents short-term health plans and other products.
Those interested in Assurant Health’s individual medical plans or its other products and services should contact their independent agent.

$27 Million In Higher 2008 Medical Bills Are The Chief Factor In A 22.5% Rate Increase For LifeWise Individual Members

Long-Term Solution is Increased Emphasis on Prevention and Evidence-Based, Cost-Effective Care

Source: LifewiseWa.com

11/01/2007

MOUNTLAKE TERRACE, WA (November 1, 2007) – Noting “it’s imperative we develop long-range solutions to slow the rate of medical-care cost increases,” LifeWise Health Plan of Washington announced today that it projects paying an additional $27 million in medical bills for its members in 2008.

Rising medical-care costs are the chief factor driving a 22.5 percent rate increase for LifeWise individual products, effective January 1, 2008. Notifications to LifeWise’s nearly 90,000 members are being mailed this week.

About $22 million of the higher 2008 medical bills will result from higher prices for medical treatment, and increased use of prescription drugs, doctor visits, hospitalizations, and new medical technology.

Another $5 million in higher medical bills will be driven by a new state law requiring expanded coverage for mental health treatment. The first phase of this new law takes effect January 1, 2008.

“We understand that this rate increase puts a strain on our members’ pocketbooks,” said Jeffrey Roe, president and CEO of LifeWise Health Plan of Washington. “Rate increases are an unfortunate part of healthcare today, and we are not pleased about having to raise premiums to this extent.”

Roe noted these medical-cost increases are occurring in an environment of very slim health plan profits. “The vast majority of the premiums we collect go to pay for our members’ medical bills,” said Roe. “Profits from our LifeWise individual business have been 2 pennies on the dollar over the past five years.”

Smaller, contributing factors include commissions, premium taxes and high-risk pool assessments, operating and disease management expenses and an adjustment for premium adequacy.

“The rate increase is a symptom – not the cause – of the dramatic increase in medical-care costs,” he said. “We need to focus on a long-term solution to curb rising healthcare costs. We believe that long-term solution is a combination of healthier lifestyles, and more cost-effective medical treatment when medical care is required.”

LifeWise’s approach is consistent with the direction set by Governor Gregoire and the Blue Ribbon Commission on healthcare. In its January 2007 report, the commission concluded, “No other strategy can compare to healthy lifestyles in terms of improving health and stretching our healthcare dollars.”

The commission also recommended “a system in which every dollar spent goes only toward the most appropriate, highest quality treatment delivered in the most cost-effective way.”

Roe identifies innovative product design as one part of the solution. “Our product portfolio, introduced in January, includes first-dollar coverage designed to encourage regular preventive care and reward healthier lifestyles,” he said.

The innovative benefits include 100 percent coverage of preventive screenings such as pap smears, cholesterol screenings, blood glucose tests, and bone density tests on most plans. The deductible is waived for mammograms on all plans and for office visits on most plans. Coverage for alternative care, including acupuncture and naturopathy is available on all plans. All LifeWise members are eligible for health and disease management programs and use of the 24-Hour NurseLine.

In addition to collaborating with its members, LifeWise advocates working with physicians, hospitals, employers and legislative leaders to identify and standardize “best practice,” cost-effective medical care.

“More care doesn’t necessarily mean better care,” said John Castiglia, M.D., chief medical officer for LifeWise. “Across the country there is research demonstrating a high degree of variation in the cost of care without differences in outcomes or customer satisfaction. We are working with physicians and hospitals to implement evidence-based best practices that deliver the highest value for customers.”

“LifeWise has been active in this effort,” he said. “Through our Quality Score Card, pharmacy programs, and elsewhere, we are working closely with physicians in Washington to promote prevention, and when care is needed, the most cost-effective and high quality treatment.”

LifeWise Health Plan Delivers Solutions for People Without Health Coverage

58% of New Individual Members were Previously Uninsured

Source: LifewiseWa.com

04/28/2005

MOUNTLAKE TERRACE, WA – (April 28, 2005) – Innovative benefit plan designs for individuals and families with difficulty affording more traditional health plans are also improving access to health coverage for the uninsured, based on the experience of LifeWise Health Plan of Washington.

In the first quarter of 2005, the company enrolled more than 12,458 new individual members -- a 79 percent increase over first quarter 2004. In the first quarter of 2005, 58 percent of those new enrollees reported they had been without health coverage for at least two months at the time they applied. This is up from 42 percent of new members in the first quarter of 2004.

Uninsured consumers are responding to new benefit-design options launched in 2004 by LifeWise Health Plan of Washington.

In April 2004, the company rolled out a range of high-deductible individual plans coupled with tax-advantaged Health Savings Accounts (HSAs). More than half (51%) of new members buying HSA plans in the first quarter of 2005 were previously uninsured.

In October 2004, LifeWise launched its Essentials™ family of products with a variety of different deductibles, member cost-sharing, and first-dollar coverage options that include cancer screening in some plans, and multiple office visits in others. Through March 2005, 61 percent of new Essentials members were previously uninsured.

“We’re seeing a marked gain in new individual members, and it is clear that these new members see these plans as successful alternatives to going without health coverage,” said Gubby Barlow, Chairman of LifeWise Health Plan of Washington. “By offering a diversity of affordable choices, we’re clearly reaching people we couldn’t reach before.”

LifeWise of Washington individual membership grew by 29 percent in 2004, from 49,000 to 67,000 -- “in large part by creating better access to affordable health coverage for people without insurance,” Barlow said. “That’s clearly good for our members, good for LifeWise, and good for physicians and hospitals because it helps reduce the amount of uncompensated care.”

Essentials 25™ is characterized by very low monthly premiums (roughly $50 per month for a member in their 20’s), and deductibles of $1,500 or $2,500 with 25 percent co-insurance. Unlike typical catastrophic plans, Essentials 25 also covers three office visits per year, as well as cancer and cholesterol screenings.

“For years, consumers have asked for a plan that protects against catastrophic risk, while providing some meaningful up-front benefits at a price they can afford,” said John Mychalishyn, Director of Consumer Sales and Marketing for LifeWise Health Plan of Washington.

Another Essentials product, called Essentials 50™, offers deductibles from $500 to $2,000, with 50 percent coinsurance and out-of-pocket maximums (including deductible) from $2,000 to $4,000. All Essentials 50 plans waive the deductible for cancer screenings, and maternity care is available with the lower-deductible options.

“Interest in these products is clear,” said Fred Green of GreenFinancial.com in Kirkland, WA. “People are attracted by the significantly lower premium costs and the needed protection for catastrophic health problems. These plans are popular with the self employed -- real estate agents, contractors, mechanics, architects, and more. Economically, it works for many people,” Green said.

“The Essentials 25 plan also is being selected by employees who are finding the group premiums they are required to pay for their families are too expensive. It can be the difference of $700 to $800 a month to cover four dependents on a company plan, or $190 with Essentials 25,” Green said.

“One size does not fit all, and a diversity of benefit options can appeal to a wide variety of people,” noted Sheri Ferguson, who heads up the individual insurance department for The Meacham Group in Kirkland, Washington. Ferguson observes that the Essentials 25 plan has special appeal for people in their twenties “who think they don’t need insurance, and will live forever.” In many cases, Ferguson said, parents are behind the choice -- and are paying the premiums after their children are no longer eligible for dependent coverage.

John Stupey, owner of the Stupey Agency in Everett, Washington, says the Essentials 25 design appeals to people who can’t afford to go unprotected. “It’s also appealing to people who have either lost coverage at work, or whose employer coverage doesn’t cover spouses or children,” he said. “The real key is being able to see the doctor a few times. That’s very appealing in a catastrophic plan. The approach allows some leeway for people to protect themselves. The bottom line is that you don’t have to hang on to an illness until you’re really sick.”