As previously discussed in Beyond Benefits, the Centers for Medicare and Medicaid Services (CMS) announced new requirements in late 2008 for all health plans to gather additional personal information about group plan enrollees. CMS intends to use this data to coordinate benefits for people who have both Medicare and group health plan insurance to ensure Medicare is not paying claims that should be paid by insurance plans.

HealthPartners will fulfill this requirement and will need your help in gathering key data. We will begin testing data files with CMS between April and July 2009.

All employers will receive further communication in the near future about when HealthPartners will be gathering this information.

• For groups who had HealthPartners coverage prior to January 1, 2009, we will be gathering this information during 2009 Open Enrollment. At that time we will need a Tax ID Number, total number of employees (total number of people employed - not just full-time employees or health plan eligible employees) and social security number or health insurance claim number for all employees.

• For groups whose coverage began January 1, 2009 or later, we will need to gather this information as soon as possible or by July at the latest. We need you to provide us with a Tax ID Number, total number of employees (total number of people employed - not just full-time employees or health plan eligible employees) and social security number or health insurance claim number for employees, spouses/ex-spouses/domestic partners and Medicare-eligible enrollees.

This data will be collected through HealthPartners existing eligibility and open enrollment channels. HealthPartners will be providing ongoing reports to help identify missing information. Please watch for additional information in the near future.

HealthPartners commercial pharmacy trend for 2008 is just 0.33 percent. HealthPartners saved over $100 million dollars in generic utilization alone in 2008.

By the end of 2008, generic medications accounted for 72% of all prescriptions filled. The greatest potential for pharmacy savings is through the promotion of generics. HealthPartners rate of generic use continues to rise – in 2008 the rate increased six percent over the previous year. As a result, 14 of the top 15 medications by volume are generics. The only brand name medication still making the list is the cholesterol-lowering medication, Lipitor, which fell to fifth by volume. Simvastatin, a generic alternative for Lipitor, is HealthPartners number one medication by volume.

We will continue our focus on increasing the use of generics. Look for these new generics in 2009 (anticipated dates only):

• January: Sumatriptan Succinate (Imitrex), oral tablet used for migraine headaches
• March: Topiramate (Topamax), an anticonvulsant used for seizures, migraine headaches and chronic pain
• April: Adderall XR, for Attention Deficit Hyperactivity Disorder (ADHD) (sixth medication by cost for HealthPartners commercial business)
• November: Lansoprazole (Prevacid), capsules for reflux
• December: Valacyclovir (Valtrex), an antiviral

HealthPartners uses targeted communications to members and physicians to help control pharmacy trend and to support quality, compliance and safety. In 2008, HealthPartners sent over 64,000 targeted letters to members. These letters addressed safety concerns, generic alternative promotion, savings opportunities, Preferred Drug List updates and transition information for new groups. 

To learn about HealthPartners pharmacy tools and resources, please visit healthpartners.com/pharmacy.

As part of our continued efforts to provide transparency to consumers, HealthPartners recently introduced an online tool where members can find and compare prices of nearly 100 healthcare services offered by 500 clinics and hospitals in the Twin Cities metro area.

HealthPartners gives more provider-specific cost information than any other plan in the region. Members can now look up and compare the provider costs of services in these common categories:

• Office visits
• Lab services
• Immunizations/vaccines
• X-Ray
• MRI/CT scans
• Pregnancy/delivery

This tool will quickly compare up to three providers at a time, so it’s easy for members to get a clear view of their healthcare costs and out-of-pocket expenses, plan their healthcare budgets and save money. This tool is especially helpful for members who have plans with a deductible, coinsurance or an account (HSA, HRA or FSA).

This tool is an enhancement to the cost information already available to members. To find out more or to try it out for yourself, simply log on to healthpartners.com and click on “Compare providers based on cost.”

Now is a great time to consider offering your employees HealthPartners Voluntary dental plans. If you’re puzzled about how to convince employees that this is a good idea, the best argument is that it pays for itself.

HealthPartners Voluntary dental plans include 100 percent coverage for dental checkups, teeth cleanings and x-rays each year. And by taking advantage of tax savings and discounted fees at network dentists, your employees can save on the cost of their dental visits.

Regular Care Approximate Costs

• Routine exam: $44 X 2 per year =   $88
• Teeth cleaning: $85 X 2 per year  =  $170
• Bitewing x-rays: $55 X 1 per year  =  $55
• Total cost without insurance: $313
• Total cost with insurance: $0

Tax Advantage (actual tax savings may be greater)

• Monthly tax savings: $33.25 x 32.05% = $10.66
• Monthly cost after tax savings: $33.25 - $10.66 = $22.59
• Cost per paycheck (24 paychecks): $22.59 / 2 = $11.30 (OR weekly cost = $5.64)
• Annual premium after tax savings: $271.08

Bonus Round

• Sealants: Approximately $47 per tooth (cost with insurance=$0)
• Fluoride treatments for children: Approximately $37 (cost with insurance=$0)

For example, if an employee had a dependent who received routine care, got sealants on eight teeth and a fluoride treatment, it would cost $726 out-of-pocket, but with HealthPartners Voluntary dental it would cost $271. It’s dental insurance that pays for itself … and then some.

Plus, HealthPartners Voluntary dental plans offer coverage for other dental services. Here are some typical costs for those services:

• Crown: $1,000
• Root canal: $1,084
• Filling: $107

For more information about HealthPartners Voluntary dental plans, talk with your HealthPartners sales executive or your broker.

A new case study of HealthPartners worksite clinic at the Hennepin County Government Center in Minneapolis found that the average cost per patient visit was nine percent less than traditional medical clinics.

The study, which analyzed insurance claims one year prior to the worksite clinic opening in November 2006 through its first year of operation, also found that there was an eight percent increase in the number of employees seeking basic healthcare services during the clinic’s first year of operation.

The report also found that wellness coaching services available to employees through HealthPartners at the Hennepin County Government Center contributed to:

• 47 percent increase in the number of employees who met or exceeded the Surgeon General’s guideline of 30 minutes of moderate physical activityfive or more days each week
• 18 percent decrease in the number of employees who made poor quality food choices
• Five percent decrease in the number of employees at high risk of being diagnosed with diabetes or heart disease

Learn more about onsite clinics available through HealthPartners.