NOTE: Group Health is now Kaiser Permanente. Group Health Cooperative (HMO) is now Kaiser Foundation Health Plan of Washington. And Group Health Options, Inc. (PPO) is now Kaiser Foundation Health Plan of Washington Options, Inc.
Recently, the Washington Health Alliance announced performance results of six health plans in Washington state. The plans included a mix of local and national carriers: Aetna, Cigna, Group Health Cooperative (HMO), Group Health Options, Inc. (PPO), Regence Blue Shield, and UnitedHealthcare. (Premera Blue Cross declined to participate.) Not only did Group Health HMO post the best overall score in the state, it achieved the best overall score in the nation.
In becoming the top-performing health plan in the country, Group Health’s commercial HMO achieved the nation’s highest rating in two of eight modules used for evaluation:
- Helping members manage chronic conditions
- Helping members get and stay healthy
Chronic conditions: A drain on productivity
For employers, these are two particularly important areas. First, chronic conditions. Gallup reports that absenteeism related to chronic conditions costs companies more than $153 billion a year in lost productivity. Medical issues such as diabetes, high cholesterol, hypertension, obesity, back pain, and more take their toll on your employees—and your bottom line.
The good news is that the Rand Corporation reports that 87 percent of employers’ health care cost savings come from chronic condition management programs. And Group Health has a robust approach that eValue8 considers the best in the nation. Key elements include baseline risk assessments, timely outreach, the closing of care gaps, complex care management, and more.
Employee health: The holy grail
With health care costs seemingly always on the rise, companies are doing everything they can to help lower their health care spend. Tactics include sharing costs with employees, high-deductible health plans, and defined contributions. Wellness programs have received a great deal of interest, too. The thinking goes that if employees are healthier, health care costs for companies and workers will go down.
One approach employers may be missing is the quality of care their employees receive. Group Health focuses on preventive medicine to help keep your workers from getting sick in the first place. Wellness visits, immunizations, active outreach programs, and more all play a part.
If care is needed, Group Health relies on proven treatments to get your employees back on the job as soon as possible. With occupational services, we even help injured employees get back to work as soon as they’re able. It’s a powerful and effective combination that earned our HMO eValue8’s highest rating for helping members get and stay healthy.
A case in point
Group Health worked with a local union SEIU 775 to help their employees improve their health and help the union to reduce health care costs. Employees were offered preventive incentives to select a primary care doctor and make a wellness visit, take a health risk assessment, and use alternative avenues of care such as our Consulting Nurse Service or walk-in clinics. The results were impressive:
- Emergency room visits: Down 36%
- Inpatient hospital admits: Down 13%
- Inpatient hospital stays: Down 21%
The value of Group Health HMO
By encouraging employees to choose Group Health HMO, employers and workers alike can take advantage of our most efficient, lowest total cost health plan. It works like an Accountable Care Organization with a not-so-narrow network focused on superior care management.
Part of that efficiency and cost-effectiveness comes from accessing care from Group Health Physicians, the highest-ranked medical group in the state per the 2015 Community Checkup from Washington Health Alliance.
By way of example, Newport Children’s School, with five campuses in east King County, offered their employees both Group Health HMO and Access PPO. After observing that most of their employees accessed Group Health doctors, the school went to a single plan, choosing our HMO. In so doing, they saved nearly 15 percent in health care costs.
The top-performing plan in the country and the highest-ranked medical group in the state: Two good reasons to consider Group Health HMO for your company.
About the ratings
Managed by the National Business Coalition on Health, eValue8™ is an evidence-based resource created by business coalitions and employers like Marriott and General Motors to measure and evaluate health plan performance. Every two years, the Washington Health Alliance joins together with employers and union trusts in Washington state to sponsor eValue8, a nationally standardized Request for Information managed by the National Business Coalition on Health. eValue8 breaks down its assessment into eight modules, including hospital management, managing acute conditions, managing chronic conditions, and pharmaceutical management.