Managed Care Report
• Aetna U.S. Healthcare (Blue Bell, PA) is rolling out a program to get corporate employees who are out on disability to return to work sooner, according to a Wall Street Journal report. The company’s plan, called HealthWorks, would combine elements of its managed healthcare plans with those of its disability-insurance lines. It could reduce employers’ disability costs by up to 20%. The plan would mostly work by speeding disabled workers’ return to work. Aetna said it could do that primarily by identifying potential cases early in the process and then having its case managers work with the employee’s doctor and supervisor to work on a schedule for rehabilitation and return to work. In other news, the company has received approval from the Department of Insurance to begin marketing its new USAccess plan in Florida, giving members more choice and flexibility in their managed care plans. USAccess offers three tiers of benefits that range from in-network, referred coverage, to complete freedom to self-refer and choose any participating or non-participating physician or hospital. While the costs to the employer remains the same no matter which tier of coverage the employee chooses, out-of-pocket costs for the employee will vary based on those decisions.
• HIP Health Plan of Florida (Hollywood, FL) has named to new executives. Ronald Platt has joined HIP as vice president for medical affairs. Platt, a pediatrician, was previously medical affairs director at HIP Health Plan of New York. Edwin Pont has been named associate medical director. Pont is a specialist in internal medicine and was previously chief medical officer of Healthplan Southeast (Tallahassee, FL).
• Cigna HealthCare of North Carolina (Raleigh, NC) plans to reward doctors who have endured several cost-cutting initiatives that the company has launched in the past year, reported the Raleigh News & Observer. Starting Oct. 1, Cigna will pay its network of nearly 10,000 doctors an average of 8% more for patients’ office visits, the Observer reported. The higher fees are partly a bid to appease doctors frustrated with Cigna’s new cost-cutting programs and the additional paperwork and administrative headaches they’ve created, reported the Observer.
• PacifiCare of Texas (Dallas) and PacifiCare of Oklahoma (Oklahoma City) last week announced the debut of a regional advertising campaign for Secure Horizons, its Medicare+Choice product, in its Southwest markets. The two distinct but complimentary campaigns are geared toward Medicare eligible consumers in Dallas, San Antonio, Beaumont, Port Arthur, and Orange, TX, and in Oklahoma City and Tulsa, OK.