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Generics and physician incentives are on the rise according to managed care survey Posted: November 18th, 2010

By Maryalene LaPonsie

The 2010 eValue8 survey provides a new look at how health insurance companies are doing business in the United States. Conducted by the National Business Coalition on Health, data was collected from 64 health plans, which collectively represent 100 million American subscribers.

While health insurance companies are providing incentives to improve patient care, relatively few subscribers with chronic conditions are signed up for disease management programs. In addition, the use of diagnostic testing varies widely across providers.

The detailed findings of the survey include the following:

  • Generics constitute 75 percent of prescriptions dispensed for HMO plan participants and 68 percent of prescriptions for PPO plan participants. Some plans reported dispensing rates as high as 85 percent for generic drugs.
  • The use of diagnostic testing, such as cardiac stress tests, ranged from a low of 2 per 1,000 members to a high of 99 per 1,000 members.
  • 67 percent of plans reported offering incentives to physicians to improve performance, and 58 percent provide financial incentives that are based on measures such as clinical outcomes.
  • Patient participation in disease management programs was reported at less than 5 percent for alcohol-related problems and less than 20 percent for depression.

Using criteria, such as consumer engagement, physician performance and prevention and health promotion among others, the National Business Coalition on Health also named its five top performing health plans.

For 2010, the top performers are:

  • CIGNA New York
  • HealthPartners Minnesota
  • Kaiser Permanente Northern California
  • Kaiser Permanente Northwest
  • Kaiser Permanente Southern California