Paying for Health Care Reform with Medicare/Medicaid Savings

Here in Asheville North Carolina, health insurance reform is a huge issue as our local population consists largely of retirees, many of whom are becoming increasingly concerned about the cost sustainability of their Medicare and their North Carolina health plans. As health care costs continue to rise, reform is something the Obama Administration earnestly hopes to include in the 2010 Fiscal Budget. President Obama has identified savings which could constitute a reserve fund for the proposed health care reform plan. Approximately half of the funding would come from proposals to generate revenue, while the rest would come from Medicare and Medicaid savings.

Based on White House projections, the Medicare savings proposals would reduce beneficiary premiums for physician and outpatient services by about $33 billion over the next decade. As a result of these proposals, beneficiaries would also see an improvement in the quality of their Medicare services. The reserve fund includes a host of Medicare/Medicaid savings proposals, some of which include:

- Improving the accuracy of Medicare and Medicaid payments. The Centers for Medicare and Medicaid Services (CMS) would have to strengthen their integrity efforts in order to address flaws that have led to billions in overpayments and fraud each year.

- Reducing Medicare overpayments to private insurers would save taxpayers roughly $177 billion over 10 years, as well as reduce Part B premiums. This would be accomplished through the establishment of a competitive system in which payments are based on an average of plans' bids submitted to Medicare.

- Reducing hospital readmission rates and improving post-hospital care. The idea here is that a combination of incentive payments and penalties would lead to better care and fewer readmissions, which would save approximately $25 billion over 10 years.

- Expanding the Hospital Quality Improvement Program to improve quality of care for beneficiaries. This would be done by tying a portion of Medicare payments for acute in-patient hospital services to hospital performance on certain measures of quality. As a result of this effort, Medicare would save around $12 billion over 10 years.

- Cutting waste, abuse and fraud. When it comes to care, patients need quality, not quantity. Unnecessary treatments are not only expensive, but can also pose risks to patient health. To prevent physicians from ordering unnecessary treatment, the Administration proposes increasing scrutiny (through a pre-payment review process) in high-risk areas or for those physicians who order an excessive amount of high-risk services.

For residents of North Carolina, health insurance, Medicare and health care reform are no doubt important topics. As citizens directly affected by these potential changes in policy, it's important that you stay abreast of the facts, beware of misinformation surrounding health care reform, and show your support for legislation that speaks to your needs (which are probably not unlike those of many other Americans). If you are satisfied with your Asheville North Carolina health plans, rest assured in knowing that under Obama's plan, you would be able to keep your private insurance and continue seeing the doctors you trust.

BCBSNC Customers Save Millions and Stay on Medications with Free Generics Program

Chapel Hill, N.C. – Blue Cross and Blue Shield of North Carolina (BCBSNC) is helping customers save money and stay on their medications with the generic copay waiver program. BCBSNC customers saved at least $15 million in out-of-pocket expenses since the program started January 1, 2009. The program will run until June 30.

The generic copay waiver program is in effect until the end of the year for eligible customers taking generics to treat chronic conditions such as hypertension, congestive heart failure, high cholesterol and diabetes.
“In this tough economy, the generic copay waiver program allows BCBSNC customers to control out-of-pocket costs by using generic drugs,” says Ron Smith, PharmD, BCBSNC vice president of employer health and corporate pharmacy. “The savings our customers see through the program reaffirms that the generic copay waiver program helps people to better manage their health and not be forced to choose between medication and paying their bills.”
The 2009 generic copay waiver program applies to nearly 1 million BCBSNC customers and eliminates customer copays for covered generic drugs. Eligible BCBSNC customers include:

· Blue Advantage customers (once they meet their annual prescription deductible, if applicable).
· Medicare Supplement customers who have prescription coverage on their policies (once they meet their annual prescription deductible, if applicable).
· Members of insured employer groups (if their employer group has pharmacy benefits through BCBSNC).
· Members of self-funded employer groups (if their employer group has pharmacy benefits through BCBSNC and has chosen to participate in the program).

Generic drugs are equivalent to corresponding brand name drugs in active ingredients, dosage, strength, safety and performance, but they cost a fraction of their brand name counterparts. Since prescription drug costs are a key driver of rising medical costs, the long-term increased use of generics also impacts future premiums for the benefit to BCBSNC customers.

With or without the copay waiver, generic medications cost less out-of-pocket than brand-name medications. Generic copay waiver programs increase those savings and highlight the benefits of generic medications.

BCBSNC Encourages Awareness, Prevention on Swine Flu

Chapel Hill, N.C. (April 29, 2009) - Blue Cross and Blue Shield of North Carolina (BCBSNC) is monitoring swine influenza (swine flu) concerns and assures customers it has plans in place to meet customer needs in the event of a public health emergency.

In 2006, BCBSNC created a pandemic subcommittee and prepared detailed plans for responding to the varying levels of intensity of a pandemic.

“Our primary concern is helping our customers stay informed and healthy, and our preparations will ensure that in the event of a pandemic, we will be able to provide the customer service our members want and need,” said BCBSNC Chief Medical Officer Don Bradley, M.D. “A key part of our preparations include making sure our business remains financially solvent and that we are able to cover customers’ medical expenses over an extended period of time during a pandemic. BCBSNC’s financial reserves are there for just such an emergency.”

While no cases of swine flu have been confirmed in North Carolina residents are urged to take the same preventive measures they take during any flu season, including:

·Cover your nose and mouth when you cough or sneeze.

· Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol- based hand cleaners are also effective.

·Avoid touching your eyes, nose or mouth since bacteria can live on surfaces you handle.

·Avoid close contact with sick people.

·If you become ill with flu symptoms, call your doctor for advice, and stay home from work, school or other public events.

· Try not to touch surfaces that may be contaminated.

· Get plenty of sleep.

· Manage your stress through exercise and plenty of rest.

· Drink plenty of fluids.

· Eat healthy, nutritious food.


According to the Centers for Disease Control and Prevention, swine flu has not been shown to be transmitted to people through eating properly handled and prepared pork (pig meat) or other products derived from pigs. The virus is killed by cooking temperatures of 160°F/70°C, corresponding to the general guidance for the preparation of pork and other meat.

A variety of reliable resources are available to help answer questions about the Swine Flu:

Centers for Disease Control and Prevention (CDC)
World Health Organization U.S. Department of Health and Human Services www.pandemicflu.gov
North Carolina Department of Health and Human Services

BCBSNC customers with the Health Line Blue benefit can talk to a nurse about possible symptoms. Customers should check their benefit book or online account to determine if they have this benefit and for the Health Line Blue telephone number.
“In previous emergencies, such as hurricanes and ice storms, BCBSNC demonstrated flexibility in order to assist our customers and our employees. We would bring that same kind of flexibility and customer focus to a pandemic,” said Bradley.

Swine flu is a respiratory disease of pigs caused by type A influenza that regularly causes outbreaks of influenza among pigs. It can be transmitted from pigs to humans through contact with live pigs, and cases of human-to-human spread of swine flu viruses have been documented.

About BCBSNC:

Blue Cross and Blue Shield of North Carolina is a leader in delivering innovative health care products, services and information to more than 3.7 million members, including approximately 900,000 served on behalf of other Blue Plans. For 76 years, the company has served its customers by offering health insurance at a competitive price and has served the people of North Carolina through support of community organizations, programs and events that promote good health. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Access BCBSNC online at www.bcbsnc.com.

BCBSNC adopts policies to improve hospital patient safety, reduce medical errors

Chapel Hill, N.C. – Blue Cross and Blue Shield of North Carolina (BCBSNC) today announces the adoption of a formalized policy to improve hospital patient safety and quality as well as reduce costly medical errors.

Under this policy, hospitals will not be reimbursed for adverse patient events identified by the National Quality Forum if the error was preventable by the hospital. Such events include procedures that are performed on the wrong side of the body, at the wrong site, or on the wrong person.

The policy on medical error billing was developed after consultation with the North Carolina Hospital Association (NCHA) and the North Carolina Quality Center and incorporates principles promoted by those organizations for hospitals. “These new guidelines will effectively move us forward to improve the quality and safety of medical services for patients throughout North Carolina,” said Don Bradley, M.D., Chief Medical Officer, BCBSNC.

BCBSNC, the State’s largest health insurer, provides a portion of the financial support for the North Carolina Quality Center, helping fund a number of patient safety initiatives. These initiatives include efforts among more than 100 North Carolina hospitals to implement quality improvement measures and improve patient safety. The Center is also working on an initiative for hospitals to confidentially report adverse patient events under the new federal Patient Safety Organization regulations. The Center will analyze these events to assist hospitals in developing best practices to improve systems of care and patient safety.

About BCBSNC:
Blue Cross and Blue Shield of North Carolina is a leader in delivering innovative health care products, services and information to more than 3.7 million members, including approximately 900,000 served on behalf of other Blue Plans. For 76 years, the company has served its customers by offering health insurance at a competitive price and has served the people of North Carolina through support of community organizations, programs and events that promote good health. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Access BCBSNC online at www.bcbsnc.com.

BCBSNC Named to DiversityInc. 25 Noteworthy Companies

Blue Cross and Blue Shield of North Carolina was named to the DiversityInc 25 Noteworthy Companies. These are companies DiversityInc. believes are rising diversity-management leaders and are close to earning spots on The DiversityInc Top 50 Companies for Diversity® list.

"Competitive companies such as Blue Cross and Blue Shield of North Carolina have switched from trying to move the status quo to establishing a new one," said Luke Visconti, CEO of DiversityInc. "Smart companies see increasing diversity efforts in an economic downturn as a way of beating less-adept competition that will pull back."

Both the DiversityInc Top 50 list and the 25 Noteworthy Companies list were unveiled March 12 in New York City.

Methodology

The DiversityInc Top 50 Companies for Diversity list is a purely editorial process with no connection to business done with DiversityInc. It is determined entirely by a statistical analysis of responses to our 200-question survey. There is no fee to enter. DiversityInc Top 50 companies demonstrate consistent strength in four areas: CEO Commitment, Human Capital, Corporate and Organizational Communications, and Supplier Diversity. The list itself covers 19 industries, from consumer-facing companies to B-to-B's to industrial businesses. They range from small regional companies to global giants.

For more detailed information on the methodology, please visit www.DiversityInc.com/top50.

About DiversityInc.

Launched in 1997, DiversityInc. is the leading business publication connecting diversity and the bottom line, with 1 million unique monthly visitors. DiversityInc.com includes the largest diversity job board in the nation. DiversityInc also produces events and conducts benchmarking, custom research and consulting.

Key findings from The 2009 DiversityInc Top 50 Companies for Diversity:

In the United States, the DiversityInc Top 50 hire 41 percent Blacks, Latinos, Asians and American Indians, compared with the U.S. work force, which is 32 percent Black, Latino, Asian and American Indian (BLS)
25 percent of DiversityInc Top 50 companies' managers are Black, Latino, Asian and American Indian, compared with 17 percent nationwide (BLS)
DiversityInc Top 50 boards of directors are 23 percent Black, Latino, Asian and American Indian, compared with 13 percent nationally
DiversityInc Top 50 boards of directors are 24 percent female, compared with 15 percent nationally
One-third more DiversityInc Top 50 chief diversity officers now report to their CEOs than four years ago (28 percent vs. 18 percent)
88 percent of DiversityInc Top 50 CEOs personally sign off on executive compensation tied directly to diversity initiatives, compared with 72 percent in 2005
All of the DiversityInc Top 50 companies now have employee-resource groups for their LGBT employees, 70 percent have groups for employees with disabilities, and 40 percent have generational resource groups. DiversityInc benchmarking customers seek data on employee-resource groups more than any other subject
In 2005, less than 1 percent of DiversityInc Top 50 philanthropy went to multicultural groups; today, almost 25 percent does
There has been a 50 percent increase in companies including supplier diversity in their RFPs (requests for proposals) since 2004 (60 percent vs. 90 percent)

About BCBSNC

Blue Cross and Blue Shield of North Carolina is a leader in delivering innovative health care products, services and information to more than 3.7 million members, including approximately 900,000 served on behalf of other Blue Plans. For 76 years, the company has served its customers by offering health insurance at a competitive price and has served the people of North Carolina through support of community organizations, programs and events that promote good health. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Access BCBSNC online at www.bcbsnc.com.

ePrescribe Bringing Increased Accuracy to North Carolina Physicians and Patients

BCBSNC doubles the number of providers using electronic prescribing
More than 87 percent of North Carolina pharmacies use ePrescribe

Chapel Hill, NC – More North Carolinians will benefit from increased prescription accuracy and safety because of the growing popularity of ePrescribe, a statewide electronic prescribing initiative of Blue Cross and Blue Shield of North Carolina.

The latest ePrescribe results show the number of doctors using electronic prescriptions in the last quarter has now doubled to more than 2,000. In addition, more than 87 percent of North Carolina pharmacies now use electronic prescribing to meet customers’ prescriptions needs.

“Our results show steady growth and adoption of electronic prescribing for both North Carolina physicians and pharmacies,” said Dr. Ron Smith, BCBSNC vice president of Employer Health and Corporate Pharmacy. “This is good news for patients. ePrescribe puts patients’ medical and drug histories at physicians’ fingertips, so they can see at-a-glance any possible drug interactions. They also can see the patient’s health plan formulary and can discuss the cost implications of various drug choices while their patient is in the office.”

As patients take a more active role in managing their health care costs, understanding drug treatment options is becoming increasingly important. Electronic prescribing allows physicians and patients to explore and discuss medication choices and costs at the point of care, before the prescription is written. It also prompts consideration of generic drugs where appropriate, which can save consumers between $15 to $30 per prescription compared to the brand name equivalent.

BCBSNC is the first insurer in North Carolina to actively support the use of electronic prescribing. Since BCBSNC launched the pilot ePrescribe program in 2006, more than 7.8 million electronic prescriptions have been written.

BCBSNC began the ePrescribe program through a partnership with Community Care of North Carolina (CCNC) and North Carolina Medicaid to improve prescription accuracy and increase patient safety. BCBSNC will continue to promote electronic prescribing for all North Carolina providers and will continue to work with CCNC to encourage electronic prescribing.

In addition, BCBSNC is making an electronic prescribing solution available on the BCBSNC web site to help every licensed provider in its network start electronic prescribing. The web site requires no downloading and no new hardware. The BCBSNC web portal is safe, secure and accessible from any web-enabled computer, handheld device or cell phone.