Connecticut Health Enhancement Program

  • Connecticut’s aggressive program for employee health accountability

    State of Connecticut employees overwhelmingly selected this fall a health plan that, in exchange for lower costs to them, makes them more financially accountable for their health management.  Some 96% of employees elected the more accountable plan option during plan enrollment in September. State officials had expected a 50% election rate.  The traditional BCBS plan is expected to cost households an additional $1,200.

    This is an important milestone because public employee health plans have lagged behind corporate health plans in using dollars to incent households to be more accountable for their health status.

    I applaud the state of Connecticut on using a more firm hand of trying to manage the cost of care by having the employees take greater responsibility of healthcare choices including providers.  If successful, this will no doubt reduce medical cost.

    On May 17, the state of Connecticut’s employee health plan introduced a sweeping “value based insurance design” program, the Health Enhancement Program, which covers a raft of preventive and other medical services.   This plan begins to introduce sensible financial incentives, in a limited way, to induce more personal accountability.

    The agreement was ratified, and the enrollment period for 2011- 2012 ended September 15.

    Specifically, the state told its employees, “When you enroll in the Health Enhancement Program, you and your enrolled family members will need to get age-appropriate wellness exams and immunizations, early diagnosis screenings (such as colorectal cancer screenings, Pap tests, mammograms, and vision exams).

    Those enrolled in the dental plan must also get annual dental cleanings. All of the plans cover up to two cleanings per year. Annual dental cleanings and unlimited periodontal care are included in the Health Enhancement Program.

    “If you or any of your enrolled family members have 1) Diabetes (Type 1 or 2), 2) asthma or COPD, 3) heart disease/heart failure, 4) hyperlipidemia (high cholesterol), or 5) hypertension (high blood pressure), you or that family member may be required to participate in a disease education and counseling program for that particular condition. They will receive free office visits and reduced pharmacy co-pays for treatments related to their condition.”

    The state told its employees, “ Unless you enroll in the Health Enhancement Program, your premiums will be $100 per month higher and you will have an annual $350 per individual ($1,400 per family) in-network medical deductible…..If you do not enroll in the Health Enhancement Program, an additional $46.16 will be deducted from your paycheck bi-weekly.”

    For more information about Connecticut’s program, go here.

     

    0 comment December 14, 2011