Among the businesses eyeing the growing market for employer self-funding is one of Colorado's health systems, the University of Colorado Health. Starting in January, the University of Colorado Health is going to start offering a range of self-funded plan options to employers with at least 75 workers, under a new division called UCHealth Plan Administrators, formed through the merger of two legacy plan administrators in the state, Medical Network and United Medical Alliance. With six hospitals and a number of clinics and pharmacies across the state, the University of Colorado Health is billing itself as one of the only health systems in the Rocky Mountains to offer administrative and benefit design products for employers looking to self-fund. “Employers are beginning a new era of directly providing coverage and care for their employees, and our focus is on helping them navigate this efficiently and simply,” Kathy Major, executive director and VP of UCHealth’s new division, said in a media release. “In addition to the cost savings, we’re bringing these businesses and employees into a network of physicians and nurses that is among the best in the country,” Major said, noting self-funding savings estimates of 10 to 20 percent for many employers. The two merged administrators forming the new division handle enrollment, claims processing and other administration for part of the University health system and for 19 other large employers with about 19,000 individual and family members. With the new offerings, UCHealth is hoping to attract new businesses from greater Denver and northern and southern Colorado. Major, who previously worked for Colorado’s largest third party administrator, CNIC Health Solutions, said a key part of their goal is to “customize a benefit approach designed to meet each individual employer’s needs, balancing cost with quality,” with self-funded administrative services for high deductible plans, health savings and reimbursement accounts and prescription drug plans, along with stop-loss insurance. Plan members will also have their electronic medical records available to them remotely. “That means people can see their own test results as soon as they become available, monitor their health histories, request appointments and email their physicians 24/7, thus taking control of their own care,” Major said. In addition to avoiding a number federal benefit regulations and the premium excise tax, UCHealth noted in a media release than self-funded plans don’t have to pay Colorado state insurance premium taxes. Story Shared From HEALTHCARE PAYER News: http://www.healthcarepayernews.com/content/colorado-health-system-gets-self-funding-biz

Colorado insurers are doing more to test the obesity levels of state residents but pushing less for workers to get cancer screenings, according to a new report released Tuesday by the Colorado Business Group on Health (CBGH). The 14th annual “Health Matters Quality Report: Health Plans” (see the full report here) also lauded Rocky Mountain Health Plans HMO for having the highest consumer satisfaction ratings in the state, while scoring Kaiser Permanente highest among insurers for attaining top scores on clinical quality measures. Overall, said CBGH Executive DirectorDonna Marshall, Coloradans should feel good about the care they are able to receive through employer-offered health plans. “The fact that we’re above the national average on so many measurements and we’re at or above the 90th percentile on so many other measures shows we have the opportunity as Coloradans to get top-notch care,” Marshall said. The report compared results from Colorado health plans to state average of health plan data, the national average of health plan data and the benchmark score set by the top 10 percent of plans nationally. As employee wellness has become a bigger issue for companies, Marshall noted the report found that more and more are offering employee body-mass index testing and covering it with insurance. That is an important first step to cutting down on obesity, she said. However, Colorado has paralleled national trends by having a significant drop-off in the percentage of employees that get testing for cancer, especially breast cancer, the report also found. Insurers all offer preventive care in the area of breast cancer now, but she is worried they are not pushing clients enough to get important screenings. Written by: Ed Sealover Reporter - Denver Business Journal

Media Contact: Jon Pushkin Telephone: 303-733-3441 Email: [email protected] Quality Report on Colorado Health Plans Now Available New report from Colorado Business Group on Health helps consumers make informed decisions when choosing a health plan DENVER – December 17, 2013 – Rocky Mountain Health Plans HMO scored consistently highest on consumer satisfaction ratings while Kaiser Permanente stood out for attaining top scores on most clinical quality measures in 2013. Overall, most Coloradans are getting better than average care when compared to the country as a whole, according to a report released today by the non-profit Colorado Business Group on Health (CBGH). The 14th annual Health Matters Quality Report: Health Plans was developed to provide Coloradans with reliable information about health care quality and consumer satisfaction. The report uses 27 Health Effectiveness Data and Information Set (HEDIS®) measures, a gauge of health plan effectiveness created by the National Committee for Quality Assurance (NCQA), as well as independent data from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) satisfaction survey. “Most people don’t think about health plans driving good clinical quality in addition to service quality,” said CBGH Executive Director Donna Marshall, MBA. “But health plans set up incentives to encourage doctors to provide quality care and for patients to take care of themselves. That’s why it’s important for consumers shopping for coverage to carefully examine health plan rankings.” Aetna, Cigna, HMO Colorado (a subsidiary of Anthem Blue Cross Blue Shield), Kaiser Permanente, Rocky Mountain Health Plans and UnitedHealthcare of Colorado are profiled. Report Highlights Regarding health plan quality, the report compares plan results to three metrics: • The Colorado average of health plan data; • The national average of health plan data; and • The benchmark score set by the top 10th percentile of plans nationally. Established by the NCQA, this score sets the bar for the performance that separates the highest scoring plans from every other plan. The good news is that members of Colorado health plans are likely to get better than average care when compared to the country as a whole, the report found. Further, many insured Coloradans get superior care, as measured by being enrolled in plans that score near or above the 90th percentile scores for many of the health conditions measured. Additional findings: Obesity The most marked improvements this year were in obesity and weight management. The majority of Colorado health plans have significantly increased the number of members whose body mass index (BMI) was documented and who received counseling on physical activity and nutrition. All but two Colorado plans exceeded the national average and two plans beat the national benchmark for BMI measurement. Prenatal care and infant immunizations All Colorado plans exceeded national benchmark rates for timely prenatal care and infant immunization rates. Cancer screening rates For the majority of Colorado plans, performance in cancer screening has unfortunately remained stagnant over the last several years. Only one-third of plans met or exceeded the national average of 69 percent of members screened for breast cancer. Heart Health Almost all Colorado plans report that the majority of their members who smoke have been advised to quit. While the rate of cholesterol screening has dropped in the last few years, Colorado plans show results that are well above the national average when it comes to helping members control cholesterol after a heart attack and helping members control high blood pressure. About CAHPS and HEDIS Overseen by the U.S. Agency for Healthcare Research and Quality, the CAHPS survey asks patients and enrollees to report their personal experience with health plans. The survey asks questions about access to care; overall rating of care; if medical claims are handled quickly and correctly; and the ease of getting needed care, tests, or treatment. The Health Matters Report summarizes data from over 3,000 Coloradans. HEDIS is a set of standardized performance measures that help purchasers and consumers distinguish between health plans based on comparative quality. Used by more than 90 percent of America's health plans, HEDIS makes it possible to compare plans on an apples-to-apples basis. About the Colorado Business Group on Health We are committed to changing the way employers buy health care. Through education, pilot projects and practical purchasing tools, we help forward-thinking Colorado employers get more value for their health care dollars. Our goal is to reduce the upward cost spiral and improve employee health. For more information: www.coloradohealthonline.org.

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Hospitals are the most powerful players in a health care system that has little or no price regulation in the private market. According to economists quoted in this article, “costs” are highly discretionary, and are not related to the quality of care that patients receive. “If you pay hospitals more, they spend it. If you pay them less, they adjust. The only way to pay less for health care — is to pay less for health care.” - Dr. Robinson, Berkeley health economist To read the full article, please visit http://www.nytimes.com/2013/12/03/health/as-hospital-costs-soar-single-stitch-tops-500.html?ref=todayspaper&_r=0&smid=pl-share

“The reason the richest country in the world doesn’t have the best health is because it takes more than health care to make a country healthy.” The authors of “The American Health Care Paradox” explore why the richest country in the world doesn’t have the best health and why it takes more than health care to make a country healthy. To read more, please visit http://well.blogs.nytimes.com/2013/11/21/spending-more-and-getting-less-for-health-care/?smid=pl-share

ValuePort™ is a new tool developed by the National Business Coalition on Health (NBCH). It enables purchasers to better understand their data to identify and implement strategies to improve health and control costs. In Colorado, CBGH is working with four employers during this year’s pilot phase . Read a recent article about this online decision support and planning tool at http://www.sacbee.com/2013/11/19/5925672/new-nbch-tool-helps-employers.html