HealthLeaders-InterStudy, a leading provider of healthcare market intelligence, reports southwestern Ohio has been the site of several pilot programs initiated by health plans, moving toward the ultimate end of consumer-driven health. According to the new report entitled Dayton Market Overview, the pilot programs initiated by health plans range from pay-for-performance to e-prescribing to cost transparency.
"Health plans in the region are trying to find viable new markets for their consumer-driven plans," states Mark Cherry, HealthLeaders-InterStudy market analyst and author of the report. "With these pilot programs, they are reaching out to patients, physicians and hospitals to encourage efficiency and cost transparency."
In January 2007, Anthem Blue Cross and Blue Shield announced a program to equip 100 physicians in Dayton and Youngstown with e-prescribing technology, with the insurer paying for computer equipment and access to online tools. Participating physicians are eligible for incentives of 1 percent for using the e-prescribing software and more if they prescribe generic drugs. The program is designed to reduce medical errors, improve patient safety and increase efficiency. The health plan also selected Dayton as its launch site for CareCompare, which allows members to see cost estimates for 38 procedures at individual facilities. The site posts the minimum and maximum prices for procedures, based on claims Anthem paid over the previous year, as well as frequency of service.
Aetna also expanded the pricing information posted on its website on 5,000 physicians in Dayton, Springfield and Cincinnati, to include physician- specific quality and efficiency information. The Aetna Navigator Web site shows members actual negotiated fees for up to 30 common medical services including office visits, diagnostic tests and procedures, and notes whether a physician meets the insurer's standards for clinical performance and efficiency.
The consumer-driven movement is also getting a push from the state, which required that hospitals post its list prices - rather than the rates negotiated by health plans - on an Ohio Department of Health website for 60 procedures. The state also required hospitals to list their quality awards on the site.
Other news in the Dayton healthcare market: -- Health systems continue to voice concern over physician-owned hospitals, wanting physicians to work with them and not become competitors. The Medical Center at Elizabeth Place opened in September 2006 and another facility is proposed for the northern part of the market. -- The state's transition to mandatory managed care for Medicaid has been largely trouble-free, and in December 2006, the Ohio Department of Job and Family Services released figures stating that from July to October 2006, the state spent 5 percent less on Medicaid than during the first four months of the fiscal year. About Market Overviews
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