Anthem, Buckeye Health Plan Named 2018 Pinnacle Award Winners
Date: 05/18/18
Annual Accolades Recognize Innovation and Best Practices Among Health Insurers
The Ohio Association of Health Plans (OAHP) recently recognized a pair of Ohio health plans for taking innovative approaches to addressing challenges in today’s health care landscape. The awards were given in conjunction with OAHP’s 2018 Annual Convention that was held May 15-16 at the Renaissance Columbus Downtown Hotel in Columbus, Ohio.
Anthem Blue Cross and Blue Shield and Buckeye Health Plan, a Centene company, were named the 2018 OAHP Pinnacle Award winners at this year’s convention.
“Health plans continue to lead and innovate when it comes to ensuring that quality health care is affordable and accessible to Ohio’s employers, the state and the many Ohioans that are purchasing health insurance on their own,” said Miranda Motter, President and CEO of the Ohio Association of Health Plans. “As Ohio’s health care system and health insurance markets continue to evolve, Ohio’s health plans have responded with a series of innovative, out of the box approaches to address the health care and insurance needs of Ohioans.”
Pinnacle Awards are given on an annual basis to OAHP member health plans who have launched initiatives that have become “best practices” in addressing the challenges of a shifting health care environment. The programs claiming to 2018 honors are:
Anthem’s Care Transition Intervention Program for Medicare Members– Anthem initiated a pilot program in 2016 in NE Ohio intended to improve transitions of care and reduce hospital readmissions. Targeting high risk members with multiple chronic conditions, Anthem implemented the evidence- based Coleman Care Transitions Intervention® (CTI).
Anthem’s Transition Coaches were trained and certified by Dr. Eric Coleman, the founder of the CTI model. Their role is to encourage both the patient and family caregiver to assume a more active role in the member’s care. The Transitions Coach does not fix problems and does not provide clinical care, though Anthem’s staff possess clinical skills. During the home visit the Transitions Coach models and facilitates new behaviors, skills, and communication strategies so that the members gain confidence to successfully respond to common problems that arise during care transitions.
A recent statistically significant program evaluation found Anthem CTI participants had approximately 18% fewer 30-day readmissions in comparison to other members with similar acuity, diagnoses, and demographics. Member engagement rates for this population was above 50%. Significant improvement in the number of post discharge appointments was found. In addition, the evaluation showed CTI participants had a total health care savings of $247.60 PMPM. Because of the program’s positive outcomes, it has since been expanded to additional areas of Ohio and five other states.
Buckeye Health Plan’s BuckeyeRxPlus – In 2017, Buckeye Health Plan piloted an innovative customized prescription management program called BuckeyeRxPlus that successfully improved medication adherence, reduced overall medical costs and improved health outcomes for members who take more than 10 medications daily or have a high-cost chronic disease. BuckeyeRxPlus identifies these Buckeye members, then triages them for in-home assessment and follow-up care management to achieve five core objectives: improve medication adherence, simplify medication reconciliation, decrease polypharmacy, medication education, and decrease overall medical costs.
Adherence rates for BuckeyeRxPlus patients were close to 100% due to transferring patient medications to one pharmacy and sending compliance packaging to patients monthly. Medical outcomes were improved as measured by a decrease in inpatient stays and emergency department visits along with cost savings of approximately $500 per member per month for members using the service. A recent study of 442 patients enrolled in BuckeyeRxPlus illustrated the substantial impact this comprehensive model had on member and health plan outcomes.
“Not only are these programs inventive, but they are addressing two areas affecting Ohio today – the unsustainable cost of drugs and transitions of care," Motter said. “Both BuckeyeRxPlus and Care Transition Intervention Program are proof that health plans are dedicating research and resources to the challenges that are most directly impacting Ohio's health care delivery system."
Contact:
Gretchen Blazer Thompson, Director of Government Affairs
614-228-4662
The Ohio Association of Health Plans (OAHP) represents 15 member plans providing health insurance coverage to more than 9 million Ohioans. Ohio’s health plans include commercial insurers, Medicaid managed care plans and Medicare Advantage Plans. As the statewide trade association for the health insurance industry, our core mission is to promote and advocate for quality health care and access to a variety of affordable health benefits for all Ohioans