Group Health drops Medicare rates by as much as 77 percent

October 20, 2009 — 11:00 am

Affordable rates  expand access to hiqh-quality care for seniors

SEATTLE — Group Health has significantly reduced premium rates for its Medicare Advantage members. The new rates go into effect Jan. 1, 2010.


“Group Health is able to lower premiums as a result of several converging factors including favorable projected cost trends and benefit changes to the plans,” said Pam MacEwan, executive vice president for public affairs and governance.


Group Health currently offers four Medicare Advantage HMO plans, called Clear Care, in the 13 Western and Eastern Washington counties mainly served by Group Health Medical Centers. Starting January 1, 2010, it is adding a fifth Clear Care HMO plan. Two of the HMO plans will have $17 monthly premiums.


“We are very excited about being able to reduce our Medicare plan premium payments, one by as much as 77 percent, or $58 a month,” MacEwan said. “Our strategic direction is to provide affordable excellence to all our members. These lower rates will attract thousands of new patients.”


Group Health has served Medicare patients for more than 30 years — longer than any other health plan in Washington. Thirty percent of the state’s Medicare Advantage enrollees receive their care through Group Health — more Medicare patients than any other health plan in the state.


“Our coordinated approach to care and our focus on prevention make us well-suited for meeting the healthy aging and chronic care needs of seniors,” MacEwan said.


Also in January, Group Health will offer two new Clear Care PPO (preferred provider organization) plans in Benton, Franklin and Yakima counties in Central Washington, and in the eastern parts of Clallam and Jefferson counties on the Kitsap Peninsula.


“We look forward to serving our state’s growing number of retirees,” MacEwan said. “We have a long tradition of seniors being actively involved in our governance. We know that the Baby Boomers are savvy about their health and their health care, and we know from experience that we can give them the care that they both need and want, for a very affordable price.”


For more information click on Medicare Advantage Plans on www.ghc.org, or call 800-446-8882, ext. 100.

PLAN
 2009 Premium

 2010 Premium Percentage drop
Clear Care Basic HMO
 $75 $17 77%
Clear Care Essential HMO
 $168 $116 31%
Clear Care Optimal HMO
 $225 $208 8%
Clear Care Sound HMO (King and Pierce counties only)
 $175 $108 39%
Clear Care Vital HMO
 NA $17 NA

Group Health offers new Medicare plans in five Washington counties

— 10:55 am

Affordable options allow Medicare members to keep their own doctors

SEATTLE — Group Health is offering two new Medicare Advantage plans in Benton, Franklin and Yakima counties in Central Washington, and in the eastern parts of Clallam and Jefferson counties on the Kitsap Peninsula. Consumers may sign up for the plans Nov.15, 2009 through the end of the year. Coverage will start Jan.1, 2010.

The PPO (preferred provider organization) plans, called Clear Care PPO, allow members to benefit from Group Health’s extensive expertise in caring for seniors without having to switch doctors. The Clear Care Elite PPO will cost $78 a month in premiums and the Clear Care Prestige PPO is priced at $37 a month.

Pam MacEwan, Group Health’s executive vice president for public affairs and governance, said the organization is able to offer these plans as a result of several converging factors including rising numbers of retirees living in the five counties, and favorable projected cost trends.

“We are very excited about offering affordable Medicare plans to the people of Benton, Franklin, Yakima, Clallam and Jefferson counties,” MacEwan said. “Group Health has served Medicare patients for more than 30 years — longer than any other health plan in Washington. Thirty percent of the state’s Medicare Advantage enrollees receive their care through Group Health — more Medicare patients than any other health plan in the state. Our coordinated approach to care and our focus on prevention make us well-suited for meeting the healthy aging and chronic care needs of seniors.”

While participating PPO doctors will have access to Group Health’s chronic care management expertise and continuing education programs in gerontology and healthy aging, PPO members will benefit from Group Health’s comprehensive preventive care checkups, mail-order pharmacy, 24-hour consulting nurse, supplemental dental plan, and a wealth of information about health and healthy aging offered at MyGroupHealth.org,

Group Health will continue offering Medicare Advantage HMO plans, called Clear Care HMO, in the 13 Western and Eastern Washington counties mainly served by Group Health Medical Centers. (more…)

Study finds domestic violence leads to many health problems

October 15, 2009 — 10:07 am

Group Health/Ohio State research in Archives of Internal Medicine

SEATTLE—Women abused by intimate partners suffer higher rates of a wide variety of doctor-diagnosed medical maladies compared to women who were never abused, according to a new study of more than 3,000 women at Group Health. The Archives of Internal Medicine published it on October 12, 2009.

Many of these health problems are not commonly understood as being associated with violence, such as abdominal pain, chest pain, headaches, acid reflux, urinary tract infections, and menstrual disorders.

“Roughly half of the diagnoses we examined were more common in abused women than in other women,” said Amy E. Bonomi, PhD, MPH, lead author of the study, an associate professor of human development and family science at Ohio State University and affiliate investigator at Group Health Research Institute in Seattle. “Abuse is associated with much more than cuts and bruises.”

Compared with never-abused women, victims had an almost six-fold increase in clinically identified substance abuse, a more than three-fold increase in receiving a depression diagnosis, a three-fold increase in sexually transmitted diseases and a two-fold increase in lacerations.

Dr. Bonomi led the study, co-authored with researchers from the Group Health Research Institute and the University of Washington in Seattle. Their research examined data from 3,568 randomly selected women patients at Group Health Cooperative. All women in the study consented to giving researchers confidential access to their medical records.

Women in the study were surveyed by telephone about whether they experienced any physical, sexual, or psychological abuse from intimate partners, including husbands and boyfriends, within the past year. Researchers checked their medical records from the past year to see the diagnoses they had received from doctors in primary, specialty, and emergency care settings.

The researchers then compared the diagnoses of the 242 abused women with the remaining women who had never been abused.

While other research has found a link between intimate partner violence and health, this is among the first major studies that has not relied on self-reports by women about their health status.

“We were able to go to the medical records and find out what abuse victims had been formally diagnosed with in the past year,” Dr. Bonomi said. “These women are not just saying they are depressed or have cuts and bruises,” she stressed. “They are going to the doctor and having their problems diagnosed.”

In addition, the study improves on past work because it includes a random sample of women enrolled in the health plan, and not just women who were already seeking some kind of health services.

Dr. Bonomi noted that many of the doctors involved in treating these women probably didn’t know of their abuse history. “For most women, abuse likely never enters into the conversation with their doctors,” she said.

The results suggest that physicians should use a “targeted screening” approach with their female patients to determine if they are being abused. Any women who come to the doctor with complaints of depression, substance abuse, sexually transmitted disease, or cuts and bruises should be interviewed about the possibility of abuse. (more…)

Group Health supports a yes vote on Referendum 71

October 6, 2009 — 3:25 pm

Group Health Cooperative’s Board of Trustees voted to support a yes vote on Referendum 71—which asks Washington state voters to re-confirm the expansion of domestic partnership rights in Washington.

“Our position is consistent with past Group Health positions on antidiscrimination and equal rights legislation, and with our Human Resources statement on diversity,” said Pam MacEwan, executive vice president for Public Affairs. “As an employer—and as a health care system—we work to provide the same benefits and opportunities for all of our staff and our patients. This philosophy extends beyond medical care and treatment, to focus on the health of the whole person— including the health and well being of the communities we serve.”

Group Health joins other major employers including Boeing, Microsoft, Nike, Real Networks, Vulcan and Puget Sound Energy, in supporting the measure. The Greater Seattle Chamber of Commerce and The Seattle Times have also endorsed yes on Referendum 71.

Opponents of the new law put Referendum 71 on the ballot in hopes of overturning it. However, when a measure that is already signed into law is put up for a referendum, voters are asked to approve the law or reject it.

Group Health’s public policy agenda and positions are guided by the Cooperative’s social mission and purpose—to create better health. The Board of Trustees periodically takes positions on initiatives or referendum measures when Group Health’s clinical, social, or economic interests would be significantly affected and/or enhanced.

Organized phone therapy for depression found cost-effective

October 5, 2009 — 1:00 pm

Randomized trial at Group Health finds significant benefit with modest cost

SEATTLE—When people get brief, structured, phone-based cognitive behavioral psychotherapy soon after starting on antidepressant medication, significant benefits may persist two years after their first session, with only modest rises in cost. Over two years, this treatment is cost-effective, according to a randomized trial in the October 2009 Archives of General Psychiatry.

“The most important reason to treat depression is to reduce suffering and improve daily functioning,” said Group Health psychiatrist Gregory E. Simon, MD, MPH, also a senior investigator at Group Health Research Institute (formerly called Group Health Center for Health Studies). “But our findings suggest that insurers or health care systems aiming to improve depression treatment in primary care should consider incorporating structured psychotherapy.”

The Journal of the American Medical Association (JAMA) reported earlier results from the same 600-person trial, the largest to date of psychotherapy by phone—and one of the largest studies of psychotherapy ever.

Over two years, phone psychotherapy plus care management led to a gain of 46 depression-free days, with only a $397 increase in outpatient health care costs. The incremental net benefit of phone psychotherapy plus care management was positive, even if a day free of depression was valued as low as $9.

By contrast, phone care management alone, with no phone psychotherapy, led to a gain of only 29 days free of depression, with a $676 rise in outpatient health care costs. The incremental net benefit of phone care management alone was negative, even if a day free of depression was valued up to $20.

The trial enrolled 600 Group Health patients whose primary care doctors diagnosed their depression and (as is usual in primary care) prescribed their antidepressants without psychotherapy. The patients were randomly assigned to receive either: (more…)

$16 MILLION IN FEDERAL STIMULUS FUNDING ESTABLISHES SEATTLE AS A HUB OF COMPARATIVE-EFFECTIVENESS RESEARCH IN CANCER

— 10:00 am

SEATTLE – Researchers at Fred Hutchinson Cancer Research Center, Group Health Research Institute and the University of Washington schools of Public Health and Pharmacy have been selected to lead four projects backed by approximately $16 million in federal stimulus funding for comparative-effectiveness research in cancer. The grants establish Seattle as a national hub for conducting such research, which aims to objectively analyze cancer diagnostic tools, screening tests and treatments to determine the optimal choices based on balancing benefits – including effectiveness – and harms, such as cost. Most of these projects involve extensive collaboration between these local institutions.

The American Recovery and Reinvestment Act has dedicated $1.1 billion to fund such research via the Grand Opportunities (GO) grants program of the National Institutes of Health, which supports high-impact ideas that lend themselves to short-term funding. The Seattle-led GO grants, each of which will fund two-year projects, account for approximately one-third of the National Cancer Institute’s first investment in the burgeoning field of cancer-related comparative-effectiveness research.

“Cancer is one of the highest areas of health care spending,” said Scott Ramsey, M.D., Ph.D., an internist and health care economist who is leading a Hutchinson Center-based project that will lay the foundation for research to evaluate how various cancer genetic tests influence cancer care, outcomes and costs. “We are spending multiple billions on cancer diagnostics and hundreds of millions on genetic tests, for example, but we’re not certain what we’re getting for all of that money. Are patients living longer? Are they living better quality lives? We just don’t have that answer,” he said.

The following Seattle-based comparative-effectiveness research projects aim to help provide some of those answers: (more…)