Study Health Plans Ease Access to Essential Treatments

By Staff Report

Dec. 23, 2008

More health plans are reducing barriers to essential treatments in response to employers’ requests, according to the 2008 findings of the National Business Coalition on Health’s eValue8 tool, which coalition members use to assess the quality of health plans as part of the request-for-proposal process.

For example, for patients with diabetes, 27 percent of health plans waive co-payments, and 33 percent reduce co-payments, for essential drugs and equipment such as blood glucose monitors. For patients with asthma, 19 percent of health plans waive co-pays for essential drugs, and 32 percent reduce them.

For patients with hypertension, 20 percent of health plans waive co-pays for drugs and equipment, and 28 percent reduce co-pays for such treatments. In the area of wellness and health promotion, 43 percent of health plans waive co-payments for preventive health care visits.

Although employers are asking health plans to provide more detailed quality information to plan members so they can make better-educated decisions regarding provider selection and treatments, only 47 percent display such quality information, and only 16 percent enable plan members to search for physicians based on quality, the eValue8 RFP tool found.

And while employers are demanding that health plans adopt electronic medical records to improve information flow and patient safety and reduce gaps in care, so far only 25 percent of health plans indicate in their provider directories whether the physicians use electronic health records, according to eValue8.

The 2008 eValue8 findings also showed health plans need to do more to ensure plan members are receiving preventive treatment such as cancer screenings. For example, only 57 percent of health plans remind members about colorectal cancer screening, and only 53 percent of health plans tell members when their colorectal screening is overdue. Moreover, only 40 percent of the plans report to physicians if their patients have received colorectal cancer screenings.

For more information on the eValue8 tool and its findings, visit

Filed by Business Insurance, a sister publication of Workforce Management. To comment, e-mail

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