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 News & EventsEncouraging Adolescents’ Use of Recommended Health Care ServicesNIHCM Foundation invites you to participate in a webinar "Encouraging Adolescents' Use of Recommended Health Ca... NIHCM Award Winners Announced!The winners of our annual Health Care Research, Print Journalism, and Television and Radio Journalism Awards have been select... Understanding the Uninsured: Tailoring Policy Solutions for Different SubpopulationsNIHCM Foundation has released a new report, Understanding the Uninsured: Tailoring Policy Solutions for Different Subpopulati... Robert Greczyn, CEO, Blue Cross and Blue Shield of North Carolina, Addresses Chronic ConditionsOn March 25, 2008, the Alliance for Health Reform hosted a briefing, "Helping 125 Million Americans: Improving Care for ... NIHCM Has Accepted Entries for its 2008 Health Care Research and Journalism Awards.NIHCM Foundation has accepted entries for its Fourteenth Annual Health Care Research and Journalism Awards and its First Annu... Connecting the Electronic Dots Among Disparate Health ProvidersBarriers to sharing patient clinical data among unaffiliated hospitals, doctors and other health care providers remain high... |
SpotlightMCAH Spotlight: Sharing Health Plan Initiatives on Maternal & Child HealthOn March 25, 2008, NIHCM Foundation hosted a Health Plan Foundation Leadership Roundtable entitled “Priorities in Children’s Health: Access to Health Care Services and Insurance.” The meeting was an opportunity for health plans’ foundations to share best practices being used in their communities to improve access to health care services and coverage for children and families. Participants included representatives from eight health plans and foundations. WellPoint Foundation described its company-wide Uninsured Initiative to ensure universal coverage for children and provide new and more attractive options for the working uninsured. Blue Cross Blue Shield of Massachusetts Foundation discussed its role in advancing health reform in Massachusetts and the company’s experiences as a Commonwealth Choice provider. Horizon Blue Cross Blue Shield of New Jersey discussed it’s participation in the new state buy-in program, NJ FamilyCare Advantage, that makes available health insurance to New Jersey families who do not qualify for the traditional Medicaid or SCHIP benefits. Blue Cross and Blue Shield of Florida highlighted the success of its retail stores that sell low-cost products. Other health plan participants included BlueCross BlueShield of North Carolina Foundation, BlueCross BlueShield of Tennessee, Blue Cross Blue Shield of Western New York, and Highmark Foundation. Two experts were also invited to share their knowledge on the topic. Genevieve Kenney, PhD, The Urban Institute, presented on the role of public programs in addressing the uninsured problem in the United States and Jack A. Meyer, PhD, Health Management Associates, presented on effective community-based efforts to increase access. A new Maternity Depression Program, launched by Blue Cross of California (BCC), will provide new mothers with information and screening tools, and identify members at high risk for depression. Beginning in May 2007, BCC mailed over 13,000 educational packets to new mothers about the program. New mothers who screen positive can share results with their physicians or contact a Behavioral Health clinician for additional screening or referrals. Women who enroll in the program receive follow-up calls from clinicians, education on depression and treatment options, and support to obtain appropriate care. Behavioral Health staff also helps coordinate care with the member’s medical team. Additionally, through clinician focus groups, BCC learned that members have a deep level of trust in their providers. Consequently, BCC developed and mailed over 10,000 physician toolkits, which include Continuing Medical Education course material, educational handouts for patients, and sample screening tools. BlueCross BlueShield of Tennessee (BCBSTN) hosted a Youth Conference to address health and quality of life issues. BCBSTN invited 25 local teens to help plan, promote and host a free conference for 600 local youth aged 13 to 20 years . The five-hour conference included a general session; choice of 10 breakout sessions; free health screenings for cholesterol, blood pressure and diabetes; and an educational display area for participants to pick up health information. The teen-selected topics covered during the day included obesity, healthy relationships, substance abuse, teen pregnancy, sexually transmitted diseases, suicide, media influences, peer pressure, stress/depression and gang violence. Special adult sessions were offered to parents and covered exercise and nutrition, gang violence, and alcohol and drugs. More information is available at www.teenhealthexplosion.com. The Wellmark Foundation awarded $574,147 in grants to 10 organizations. Three projects, under the priority area of “Health Literacy,” are aimed at developing health education curriculum in local schools. Sanford Health Foundation will create a coordinated health education curriculum to be used in South Dakota schools after an initial pilot within the Brandon Valley School District. Sioux Falls School District will implement a health literacy education project including lessons on nutrition, oral health, mental health, immunizations and safety, aimed at both elementary school students and their families. Finally, for students with developmental disabilities who have diabetes or are at risk for the disease, the University of South Dakota will implement a nutrition education project that will include education materials at appropriate readability and literacy levels to educate these students on healthy lifestyle choices. On February 1, 2007 Highmark Foundation awarded $1.3 million in grants to five local organizations. Three of the five grantees will focus specifically on improving maternal, child and adolescent health: Butler Memorial Hospital (Butler County, Pennslyvania) will contribute funds toward a Maternal Services Program that provides medical, nutritional, home health and follow-up care free of chare to low-income and uninsured women and their children from 0-5 years of age; Sudden Infant Death Services (S.I.D.S.) of Pennsylvania (Allegheny County) received a three-year grant to hire a community services coordinator to expand the Cribs for Kids safe sleep education program, an educational media campaign, to rural and underserved communities throughout Southwestern Pennsylvania; Somerset Hospital (Somerset County, Pennsylvania) received funding to support a program that provides concussion screening and athletic training for students in grades 7-12. On December 5, 2006, Horizon Blue Cross and Blue Shield of New Jersey launched an innovative program that uses phone-based, speech-enabled outreach and mailings to increase the rate of eligible women’s mammogram and cervical cancer screenings. The telephone call program, developed by Eliza Corporation, uses speech recognition technology and claims history to: 1) identify women who have not had their recommended mammogram or cervical cancer screenings and 2) call and conduct an interactive conversation with women to discuss their plans to receive the screenings. During the call women are provided education and support and can request a transfer to a radiology scheduling line. The call also prompts a personalized follow-up letter to the member that references the initial call and provides information on the importance of screenings. Finally, as an incentive, women who schedule their screenings are given gift cards redeemable at hundreds of retailers around the country. The program recognizes that screenings are often forgotten in the pace of today’s womens' lives. Blue Cross and Blue Shield of North Carolina (BCBSNC) launched a pilot program aimed at decreasing childhood obesity by empowering families. A survey of 1874 BCBSNC parent members revealed a discrepancy on parental perceptions of their children’s health: 29% of member children are overweight or at risk of overweight, however 59% of those children's parents thought their children’s weights were "about right." The pilot program, set to begin January 1, 2007, aims to: reduce children's computer and TV screen time to less than two hours per day, increase their fruit and vegetable consumption to at least five servings per day, increase their physical activity to 60 minutes or more per day, and to reduce their consumption of sugared beverages. Through the program, BCBSNC will cover children for up to six visits to network nutritionists, phone access to a nurse health coach, and up to four physician visits a year for the evaluation and treatment of obesity. In addition, BCBSNC will provide tools to help families care for children of all ages from toddlers to adolescents. Invited participants will include families in eligible BCBSNC plans with at least one child diagnosed as diabetic or asthmatic and survey participants who indicated a desire for family lifestyle changes. BCBSNC covered families can also request to join the program through the company's Member Health Partnershipssm. On September 14, 2006, Highmark, Inc. announced its “Healthy High 5” initiative that provides $100 million dollars over a five-year period to improve the health and wellbeing of children in Pennsylvania. Specifically, the grant will be used to address five important children’s health issues: nutrition, physical activity, self-esteem, grieving and bullying. By collaborating with various local, state, and private organizations, Highmark will draw from a wide range of experts to promote education, communication, volunteerism, and programming efforts that target children’s health. To spread awareness of children’s health issues, Highmark released a Public Service Announcement to be aired across Pennsylvania and has developed a website to help adults, children, and communities learn about children’s health issues and ways in which to lead healthier lifestyles. WellPoint, Inc. has developed TONIK, a health coverage plan now available in California and Colorado that has been designed for and marketed to young adults (ages 19-29). TONIK's premiums run from about $64 to $123 a month and carry relatively high initial deductibles ($1,500, $3,000 or $5,000 depending on the plan), and there is very high catastrophic coverage. It also includes vision and dental coverage, which may provide additional levels of access to care for young adults. This type of low-premium plan is starting to get buy-in from young adults. Since the launch of TONIK in November 2005 in California, more than 40,000 applications have been received, 50% from young adults. As of January 2006, Blue Cross Blue Shield of North Carolina (BCBSNC) has extended individual and family plan coverage for dependents to age 25, regardless of whether or not the dependent is enrolled in college full-time. This is a departure from the coverage offered to most young adults through their parents’ insurance, which for the most part only covers a dependent while they are enrolled in school full-time or until age 23. BCBSNC has also developed health savings account (HSA) products for those enrolled in both group and individual insurance plans. HSAs offer young adults an alternative, more affordable insurance option by giving them control over their health care spending. Incremental reforms may help support more affordable (or even subsidized) private products targeted towards young adults. The Caring Program is a program of the Highmark Caring Foundation, an affiliate of Highmark Blue Cross and Blue Shield, representing the largest health insurer in Pennsylvania. Their special focus on Children with Special Health Care Needs emerged as they recognized the significant unmet needs among this population, including the lack of coordination among providers, their lack of knowledge regarding services offered by other providers, the lack of communication regarding care plans among providers and the families being served, and the marginalization of parents by physicians in the care of their children. Additionally, providers felt that they did not have enough information about the specific conditions of the children they were serving, the community support services available, the lack of time to serve the population, and the lack of adequate reimbursement. Program Components: In 2005, the Highmark Caring Foundation implemented the Caring Program: Care Coordination for Children with Special Health Care Needs and Their Families, designed to provide community-based care coordination for children enrolled in the Children’s Health Insurance Program (CHIP), administered by Highmark Inc. Children with Special Health Care Needs who reside within the Highmark 49-county service region are provided with two types of support:
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