HMOs Launch New Products

June 4, 2007
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GRAND RAPIDS—West Michigan’s two largest health benefits providers announced new products last week that aim to reduce costs by convincing employees to change their behavior.

If they do, the Priority Health and Blue Cross Blue Shield products offer cheaper co-pays and deductibles and predict double-digit savings on premiums.

Priority Health, based in Grand Rapids, introduced “HealthbyChoice Incentives” with four HMO and four PPO options.

Employees start the year with the same lower level of out-of-pocket costs. To keep those favorable terms, the employees and their spouses must complete an online health assessment and submit a form from their doctors that indicates whether they meet criteria for three chronic disease factors: tobacco use, excess weight and high blood pressure. The plan gives them a chance to repent before pushing them into a higher-cost category for co-pays and deductibles.

The result is a two-tiered benefit system with two premium levels, with the idea that the blended premium rate could save as much as 13 percent on premiums.

“It combines a health plan and wellness program into one product that offers a strong incentive for employees to make healthier choices while also lowering costs significantly for employers,” said Leon Lamoreaux, vice president of business development.

Blue Cross, meanwhile, is offering “Healthy Blue Incentives” starting in July for self-insured companies of at least 50 workers with a PPO program administered by the Detroit-based nonprofit.

Employees who participate in wellness programs receive savings in co-pays and deductibles that include a health risk appraisal; for high-risk individuals, four contacts per year with a BlueHealth Connection health coach; and for those with chronic conditions, participation in condition management programs. In some versions, the same would be required of a covered spouse.

Savings for employers could run up to 10 percent, Blue Cross estimated. The product is similar to Healthy Blue Living offered to Blue Care Network HMO customers. Healthy Blue Incentives is expected to expand to smaller employers and insured groups in 2008.

“Healthy Blue Incentives aligns with the proposition that if employees take better care of their health, businesses ultimately will be more productive and pay less in health care coverage,” said Daniel J. Loepp, Blues president and CEO.

Competition is heating up between Priority Health and Blue Cross as the Grand Rapids health plan moves into the Detroit area with the purchase of a health plan there and Blue Cross has beefed up its presence in the West Michigan market.     

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