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BUCKEYE HEALTH PLAN, CARESOURCE NAMED 2017 PINNACLE AWARD WINNERS

Date: 06/01/17

Annual Accolades Recognize Innovation and Best Practices Among Health Insurers.

COLUMBUS – The Ohio Association of Health Plans (OAHP) recently recognized a pair of Ohio health plans for taking innovative approaches to addressing challenges in today’s health care landscape. The awards were given in conjunction with OAHP’s 2017 Annual Convention that was held May 16-17 at the Renaissance Columbus Downtown Hotel in Columbus, Ohio.

Buckeye Health Plan, a Centene company, and Caresource, a nonprofit health plan headquartered in Dayton, were named the 2017 OAHP Pinnacle Award winners at this year’s convention.

“The national healthcare landscape has undergone a tremendous amount of change in recent years,” said Miranda Motter, President and CEO of the Ohio Association of Health Plans. “That level of change has brought along great number of new challenges, and Ohio’s health plans have responded with a series of innovative, outside-the-box approaches to addressing the health care needs of Ohioans.”

Pinnacle Awards are given on an annual basis to OAHP member health plans who have launched initiatives that have become “best practices” in addressing the challenges of a shifting health care environment. The programs claiming to 2017 honors are:

  • Buckeye Compassionate Connections - Truly innovative and evidence-based, Compassionate Connections is an in-home palliative care program that identifies members needing additional supportive services. The program utilizes care managers and nurse practitioners to improve quality of life, address end-of-life planning, and reduce costs. Largely serving the dual eligible and aged, blind, and disabled populations, the program eliminates barriers that commonly impede access to palliative care.

To identify potential participants, Buckeye Health Plan developed an algorithm evaluating multiple data sources to pinpoint members who may need additional services or end-of-life care. The algorithm has demonstrated an 80 percent success rate in identifying program candidates, while also streamlining processes and complementing the ongoing work of Buckeye's care managers.

Having just launched in 2016, early results for Compassionate Connections have indicated a more than 50 percent reduction in emergency room visits, as well as per member per month (PMPM) cost reductions of more than $1,300.

  • CareSource MED Letters - The MED Letters program was launched to favorably influence opioid risk management for members and providers. The initiative achieves this through a provider education program that includes coordinated outreach to providers treating members who are prescribed high volumes of opioids. As a result of MED Letters, providers have reduced the daily morphine equivalent dose (MED) by 13 percent.

Leveraging claims data, the CareSource pharmacy team designed and implemented the MED letters program to provide data to prescribers regarding members at risk for an adverse event (such as overdose), diversion, or development of a substance use disorder. Over the course of six months and two letters sent to prescribers, the overall dose reduction experienced is the equivalent of over 4 million MED, or over 271,000 Hydrocodone 15 mg pills.

“Not only are these programs inventive, but they are addressing two areas affecting Ohio today - our aging population and the opioid crisis," Motter said. “Both Compassionate Connections and MED Letters are proof that health plans are dedicating research and resources to the challenges that are most directly impacting Ohio's health care delivery system."

The Ohio Association of Health Plans (OAHP) represents 15 member plans providing health insurance coverage to more than 9 million Ohioans. Ohio’s health plans include commercial insurers, Medicaid Care Coordination Plans and Medicare Advantage Plans. As the statewide trade association for the health insurance industry, our core mission is to promote and advocate for quality health care and access to a variety of affordable health benefits for all Ohioans.

Sam Rossi, Director of Government Affairs
614-228-4662 | srossi@oahp.org