We've listened…and are pleased to be offering several new BlueOptions® plans – the consumer choice series – with enhancements that reflect your feedback! Plus, we have added flexibility to make offering more than one health plan even easier. All of this is available for large and small groups beginning May 1 with July 1 effective dates.
Not only have we made benefit and contract enhancements, our collateral materials are now easier to understand and more user-friendly! The new member communication is designed to help educate members about self-service tools and point out the lower-cost choices for services based on the type of care and the location of care received. Now, back to the plans.
In the consumer choice series of BlueOptions plans, there are several new plans which will provide clients with a choice in products ranging from plans with predictable costs to lower- cost plans to help with affordability issues (including those that are HSA-compatible). The new plans include enhanced benefits such as no caps on in-network adult wellness, increased benefits for ambulance, lower cost for therapy in a outpatient hospital setting and more.
Current large group, small group and individual under 65 BlueOptions members will also receive some enhancements to their existing plan at no cost, effective July 1. We will be notifying members and group benefit administrators (BAs) of these no-cost upgrades starting in May, so there's no work required on your part!
We'd like to give you all of the details here, but we wouldn't have enough room! Please contact your BCBSF representative to hear more about these improvements.
On March 29 you received a Breaking NewsfromBlue email providing you with details on the continued rollout of our new, magnetic stripe ID cards. Please click here to read this update!
We also thought you would enjoy the Mr. BlueSky animated video that helps to explain how our new magnetic stripe ID card and the CareCalc member cost estimating tool work together! Click here to review and be sure to have on your volume.
We're highest in customer satisfaction! Blue Cross and Blue Shield of Florida has been ranked "Highest Member Satisfaction among Commercial Health Plans in the South," in part because of our ability to communicate with members, our network of physicians, hospitals and pharmacies, and health benefits, according to the J.D. Power and Associates 2007 National Health Insurance Plan Satisfaction StudySM.
We scored 779 points out of a maximum 1,000 points. In contrast to us, other major health insurers scored below the region's average (746 points).
The inaugural study identifies coverage and benefits, choice of doctors, hospitals and pharmacies, and information and communication as the most significant factors in driving member satisfaction. Additional factors examined in the study include approval processes, insurance statements, customer service and claims processing.
For more details on the study, see the J.D. Power and Associates press release at: http://www.jdpower.com/corporate/news/releases/pressrelease.asp?ID=2007041.
How does the BlueOptions® benefit work when a member receives a Gardasil (HPV, human papillomavirus) vaccination?
The Gardasil® vaccine is FDA-approved for females between the ages of 9 and 26. Gardasil is administered as three injections over a six-month period. With BlueOptions, the Gardasil vaccination benefit works as follows:
- For members between the ages of 17 and 26, the costs will be applied to their Adult Wellness benefit maximum limitation. Members are responsible for 100% of costs that exceed the annual benefit maximums.
- Members between the ages of 9 and 16 will have benefits applied under Well Child. Since there is no well child benefit maximum with BlueOptions or a calendar year deductible for well child visits, members will simply be responsible for the applicable copayments or coinsurance based on the location of service.
Click here to view a listing of providers that have recently joined NetworkBlueSM.
Health Coaching Improves Our Performance
Health coaching is an important component of our Blueprint for Health® program, assisting members in many ways no matter where they are on the health spectrum. Results just received from periodic program measurements1 show health coaching results in positive outcomes and significant improvements in our financial return on investment (ROI), member satisfaction levels and quality of care.
More than 1.6 million members had access to Health Dialog® programs and services in 2005, which resulted in:
- A year-two ROI of 4.1%, which is an increase of 1.8% over year one
- Member satisfaction levels with Health Dialog programs and services exceeded 95%
- Improvement in quality of care trends for patient adherence to clinical standards for managing diseases such as coronary artery disease and diabetes
These results prove that everyone wins when we can help our members make the right decisions and take the right actions for the sake of their good health.
But the proof isn't only in the numbers. It's also in the personal stories of members who have improved their health by taking advantage of Blueprint for Health services, like health coaching. Take Sarah2, for example. Here's her story as told by her health coach:
"I first met Sarah when she called the Health Dialog health coaching line to learn what she could do to relieve her joint pain. We talked about the risks and benefits of different treatment options for the discomfort she was feeling, and she agreed to talk with her doctor about which one was right for her.
"Over the next six months, Sarah and I talked regularly about her other health issues – including how she could better manage both her diabetes and her heart condition.
"I am happy to report that today Sarah is doing great. She is using what she has learned through our conversations to make a real difference in her health.
"Sarah's hard work has paid off: Her diabetes is well under control, and she's learned to manage the fluid issues that are a part of heart failure. Sarah can't believe what a difference the Health Dialog health coaching program has made in her health and in her ability to enjoy life."
Health coaching is a great example of how Blue is helping people every day.
2 This story is based on a real person's experience with Health Coaching, but her name and identifying information has been changed to protect her privacy.
Subimo tools now in Spanish
We are pleased to announce Subimo'sTM full suite of health care decision support tools is now available in Spanish!
The Hispanic population is one of our primary market segments and is increasing at three times the rate of the general population in Florida. By seeking out and offering additional tools in Spanish, we are demonstrating our commitment to improving the quality of care and service our members receive.
The following Subimo tools are now available in Spanish:
- Healthcare AdvisorSM includes more than 150 medical conditions and procedures, suggested questions to ask a physician, or benefit plans regarding managing a condition or preparing for a procedure. It also includes links to resources including Web sites organized by health care topic.
- Physician Selection AdvisorSM provides members the ability to research and compare physicians on attributes such as demographics, education, training, affiliations, certifications and sanctions.
- Hospital AdvisorSM allows members to find and compare hospitals side-by-side for specific procedures or types of care based on clinical quality, experience and outcomes, patient safety standards, reputation and characteristics.
- Treatment Cost AdvisorSM provides estimates for the cost of specific health care services including medical conditions, diagnostic tests, prescription drugs, inpatient and outpatient procedures and treatments and office visits.
In March, NetworkBlueSM providers received notification that, beginning July 2, authorizations will be required for advanced imaging services, such as CT scans, MRIs, MRAs, PET scans and nuclear cardiology. Our new Advanced Imaging Utilization program requires the provider to initiate the authorization process and if they do not, the member is not responsible for the cost of the services.
The program is part of our ongoing efforts to address quality of care, patient safety and health care affordability. It is designed to effectively manage non-emergency radiology services in an office or independent diagnostic testing center (IDTC) and ensure evidence-based imaging protocols are met. Diagnostic imaging quality of care concerns, especially related to unnecessary exposure to radiation, are rising and costs for advanced diagnostic imaging are trending at 15 to 20 percent annually, second only to pharmacy.
Prior to scheduling the advanced imaging procedure for our BlueOptions members:
- Providers will be required to call our radiology management vendor.
- Based on a determination of medical necessity, the vendor will provide an authorization number once the procedure is approved.
- Before performing the procedure, providers will need to verify that prior authorization has been obtained for each identified advanced imaging procedure.
- Verification can be obtained by calling the radiology management vendor via numerous contact methods.
A follow-up letter with detailed program requirements and processes will be sent on May 1 to the same providers and IDTCs. Other external communication components will include member notification, which will also be mailed in May, articles in BlueLine® and office visits from a BCBSF representative.
Appointment scheduling at all Florida Quest Diagnostics® owned and operated Patient Service Centers is now available! Patients can now schedule appointments 24/7—reducing the wait time upon arrival. Follow this link www.questdiagnostics.com/appointment to view the new scheduling website, select your center location site and click on the right to schedule an appointment. It's that easy! Patients can also call 1-888-277-8772 to reach Quest Diagnostics new voice-activated appointment scheduler. To view and print a handout containing details, please click here.
That you may be hearing what we are doing in the marketplace in an effort to always be a superior marketing company! We will be contacting various businesses to gain a better understanding of their needs and thus provide service and products to better meet these needs. Of course we will share this valuable information back with you and our internal sales force as it becomes available. So stay tuned…