Disease Management

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These executive summaries were compiled from EMPLOYEE BENEFITS INFOSOURCE database, a source for information on employee benefits and human resources.


Health Care Cost Control : Industry Approaches and Attitudes.
Natchek, Sally M.; vi, 57 pp 2009; book

Availability : International Foundation of Employee Benefit Plans
Abstract : The International Foundation surveyed its members on the approaches their organizations are taking to contain health care costs and to assess the success of various initiatives. Respondents were also asked for their opinions on health care cost trends, cost-containment strategies and government reform efforts. Responses are organized by employment sector: corporations, public employers, multiemployer plans and professional service firms.
[0155469]

CDH, Version 2.0: Compliance-Driven Health.
Robbins, McLean; Employee Benefit News; v22 no14 pp 48, 50 Nov 2008; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Consumer driven health has morphed into compliance driven health, Aaron C. Davis of NextLogical Benefit Strategies told attendees at an Employee Benefit News benefits forum. The concept reflects compliance with prescribed treatment as a responsible patient and working to maintain health and wellness as a responsible plan member. Consumer driven health plans have not succeeded for a variety of reasons. But a plan focused on patient and member compliance, removing all barriers to appropriate care, will succeed. It requires management support and a long term strategy geared to developing culture of informed wellness.
[0155246]

Employer Brings Simplicity to Specialty Pharmacy Benefits.
Bridgeford, Lydell C.; Employee Benefit News; v22 no14 pp 44, 46 Nov 2008; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : The University of Michigan's Keith Bruhnsen discussed strategies for handling specialty drug benefits at an Employee Benefit News benefits forum. The university spends $70 million annually on prescription drugs, carved out from the medical plan. They aim for the best drug prices and ensuring treatment compliance. Avoiding coverage duplication between medical and drug benefits is key, with cases requiring close therapy management best handled under medical benefits. Balancing cost sharing and assigning drugs to one of three tiers is challenging, since experience shows a $50 copayment becomes unmanageable. Specialty drug prices are forecast to rise at twice the rate of traditional drugs.
[0155245]

Five Pharmacy Benefits Trends Affecting Union Trusts and Plan Sponsors.
Solow, Brian K.; Benefits & Compensation Digest; v45 no11 pp 34-39 Nov 2008; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Employers today are challenged with a range of issues affecting their pharmacy benefit programs. While some programs have proven successful at managing costs, new challenges are on the horizon. The goal for plan administrators must be to maintain and increase programs that control costs, while bringing greater value and satisfaction to plan members. To achieve cost saving and member satisfaction goals, benefits administrators should examine the needs of their plan, as well as the workplace and societal trends that will continue to affect their benefit design. There are specific steps administrators can take to develop an effective pharmacy benefit program.
[0155036]

Hope for Tomorrow.
Chordas, Lori; Best's Review; v109 no7 pp 66-68 Nov 2008; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Autism is a devastating neurobiological disability that can easily wipe out a family's finances. Education and therapy cost about $18,000 annually, but insurance covers only the medical aspects. Some insurers such as Wellpoint and Highmark Inc. are adding some coverage but are unsure what benefits to extend. Cigna has created a special care management team, and some employers have increased limits on flexible spending accounts. Fifteen states require some coverage, with more working on a mandate, but America's Health Insurance Plans opposes any requirement for autism coverage, citing higher costs overall and the absence of evidence of specific treatment effectiveness.
[0155237]