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Rebecca E

CareFirst BlueCross BlueShield plans new healthy incentive product


By: Health Insurance
Submitted: 2009-12-19 10:42:07 | Word Count: 559


CareFirst BlueCross BlueShield Inc. plans to roll out an incentive program to encourage people to live healthier.

Chet Burrell, president and CEO of the Owings Mills, Md.-based insurer, announced the plan during a one-on-one interview with Washington Business Journal Editor Doug Fruehling.

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The health insurance product, which is expected to be available by next year, is called Healthy Blue.

About 100 business people tuned in to hear the interview Tuesday morning at Gensler’s D.C. office, which also featured Kenneth Samet, president and CEO of MedStar Health.

Following a lengthy discussion on the state of health care and legislature, an audience member asked if there was anything individuals or businesses could do to influence better reform in the future. Burrell responded by discussing the new product.

People who sign up for Healthy Blue receive a health risk appraisal at CareFirst’s expense. It includes reviewing blood work and drug and prescription histories.

“If you look good and healthy we will give you up to a $300 health debit card or put that deposit into your [health reimbursement arrangement (HRA)] or [health savings account (HSA)],” Burrell explained. “If you don’t look so good but you mitigate those factors and improve them we will give you that award as well.”

If the person gets sick, they would have to pay a deductible for care. If they agree to have their care guided by CareFirst, the insurer would mitigate that deductible.

If a patient opts to have it guided, CareFirst would set up a care plan through the patient’s primary and nurse practitioner.

“We would help you [navigate it] and make it financially worth your while,” he said.

Burrell said under the Healthy Blue program, CareFirst pays for fitness club memberships and primary care and preventive screenings in full without any co-payment or deductible.

“In other words, put no barrier to the access to primary care services,” Burrell said. “And when you do get really sick, have your care coordinated and mitigate your cost-sharing for that.”

He said a problem with the general population is that even if one took prescription drugs alone — let alone an overall care plan — compliance with what patients are asked or told to do is in the 30 percent to 40 percent range. Healthy Blue’s financial incentives are expected to help patients adhere more to what they are asked to do.

Healthy Blue is currently filed with Virginia, Maryland and D.C. regulators and awaits approval.

“As soon as it is available to sell, we will sell it,” Burrell said. “We expect thousands of people to be interested, small employers and individuals. From a price standpoint it’s not the lowest possible price you could ever get.”

He points out that it can’t be sold at a super-cheap price, considering all the primary care services the program provides.

“Usually the rock bottom price is obtained by a massive shift of cost to the member,” he said. “ We don’t want to do that.”

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