Medica dives into electronic services with health scorecards and e-prescribing

Medica, a regional nonprofit health insurer serving 1.6 million members in Minnesota, Wisconsin, North Dakota and South Dakota, has made significant strides over the past two weeks to ramp up its digital-age offerings for members. First, the Minnetonka, Minn.-based company partnered with HealthInsights in Minneapolis to offer Medica's commercial customers a value-based benefit program that will allow members to create their own personalized health scorecards. The scorecards set member-specific health actions focused on preventive care and chronic condition management, as well as tracking how well members comply with their assigned actions.

Medica began marketing the program in June. "It's too early to speculate on a sales forecast for 2011," Medica spokesman Greg Bury told FierceHealthPayer. However, initial results are promising. "Our first customer sale for Jan. 1, 2011, included nearly 5,000 members," he explained. "In addition, nearly every one of our 2011 large-group prospects have asked to learn more about our new value-based benefit program with HealthInsight."

The level of interest generated by the program isn't surprising given the "culture of health" that is emerging among U.S. employers, according to the study, "The Road Ahead - Emerging Health Trends 2010," from Hewitt Associates in Lincolnshire, Ill. More than half (53 percent) of employers already have a disease management or health improvement program, and of the ones that don't, 86 percent plan to add a program within the next three to five years. In addition, 77 percent of employers reported targeting at least one specific health condition for their employees. Diabetes, cardiovascular disease and asthma are the perennial favorites, but weight and obesity programs are the newest stars, with 47 percent of employers offering these programs in 2010 compared to 7 percent in 2009. Less than 25 percent of employers reported that they didn't target any conditions.

Medica expects the program to benefit all members, not just those with chronic health conditions. "The program is flexible and customizable, allowing employers to shape the benefit to fit their health improvement and financial goals while offering something of personal value to their employees," said Bury. "For example, if an employer has a higher than average population of diabetics, the program can place an emphasis on behaviors that prevent diabetes and/or improve management of the disease.  If an employer's employee population is healthy for the most part, the emphasis can be placed on behaviors that maintain health."

Compliant members who meet their target actions will qualify for financial rewards under the program. The employers "will determine the reward strategy for their employees," said Bury. "Some possible examples include gift cards, financial account contributions, premium credits or plan design changes."

Medica already has a standard (i.e., human-based) coaching service, and essentially this new electronic-based program offers another avenue to provide an even wider array of members with coaching-type services. "It is definitely an adjunct to our human-based coaching service," said Bury. "Medica believes very strongly that the one-to-one support is crucial to some people obtaining their health goals."

Medica expects the program to reap "heightened activity in engagement and prevention activities," said Bury. "For example, a major New Jersey-based hospital system with 2,500 employees began a partnership with HealthInsight in 2008 and has experienced a 17 percent cost reduction among employees who participated in the program. Additionally, the percentage of individuals screened for colon cancer increased by 27 percent, while the number of females screened for breast cancer increased by more than 20 percent."

In other news, Medica has become the first of Minnesota's three largest health insurers to make e-prescribing available to all members--meeting a new state mandate for e-prescribing that takes effect Jan. 1, 2011, reports the Minneapolis/St. Paul Business Journal. The state's other two dominant insurers, Blue Cross and Blue Shield of Minnesota and HealthPartners, have yet to fulfill the state requirement.

Medica offers an "enhanced version" of e-prescribing, according to Dr. Thomas Becker, medical director. For example, physicians can find out whether a patient has Medica pharmacy benefits, look up which drugs are covered by a patient's prescription drug benefit plan and which drugs require prior authorization, and see what medications a patient is taking even if the drugs were prescribed by other providers.

To learn more:
- read these Medica press releases: release 1 and release 2
- access the Hewitt report here
- read this Minneapolis/St. Paul Business Journal article

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