CYPRESS, Calif., June 23 /PRNewswire-FirstCall/ -- PacifiCare Health Systems, Inc. has received the 2004 National Exemplary Practice Award from the nation’s largest health insurance trade association for its diabetes program in Oregon and Washington. The PacifiCare program has led to improved care and treatment outcomes for its plan members with diabetes, ranging from 15 to 122 percent across standardized measures of comprehensive diabetes care.
America’s Health Insurance Plans (AHIP) announced its award recipients on June 17 at ceremonies held in Chicago. AHIP, based in Washington, D.C., represents nearly 1,300 member companies providing health insurance coverage to more than 200 million Americans. The National Exemplary Practice Awards recognize member companies for their successful efforts to improve chronic care management through innovative models of care.
AHIP awarded PacifiCare for its “Taking Charge of Diabetes” program that addresses the complexities of managing diabetes with co-morbidities such as coronary artery disease and congestive heart failure.
Diabetes is a prevalent, high-cost disease. Recent data indicate that 17 million people in the United States have diabetes, and 7.5 percent of PacifiCare’s plan membership in Oregon and Washington have been diagnosed.
PacifiCare’s “population-based” Taking Charge of Diabetes program, established in 1997, emphasizes member lifestyle and disease risk management. Its leading components include:
* A registry to track members identified with diabetes. * Interactive educational materials and tools to help members “take charge” of their health. * Individual physician reporting on patients with diabetes who are missing exams. * Public reporting of medical groups’ comparative performance on diabetes measures through PacifiCare’s QUALITY INDEX(R) Provider Profile reports. * Distribution of diabetes guidelines and other decision-support materials to physicians. Case-based Program Added in 2001
In 2001, PacifiCare expanded its Diabetes Program with “case-based” programs to address co-morbidities that are frequently associated with diabetes and build upon the population-based care and treatment interventions.
“The PacifiCare Diabetes Program models our belief that a quality-driven, consumer-centric health plan should focus on improving and maintaining the health of its members in every stage of their life -- whether they are sick, well or in-between,” said Sam Ho, M.D., senior vice president and chief medical officer of PacifiCare.
“The impact of our multi-pronged Diabetes Program has led to improvement in care and outcomes, evident in PacifiCare of Oregon’s and Washington’s overall high scores in the HEDIS* diabetes measures,” said Ho. “Furthermore, the adaptability of the program has been demonstrated across all of the PacifiCare health plans nationwide, since these multiple interventions -- both population-based and case-based -- have been replicated with similar success in all our markets.”
About PacifiCare
PacifiCare Health Systems is one of the nation’s largest consumer health organizations with more than three million health plan members and approximately nine million specialty plan members nationwide. PacifiCare offers individuals, employers and Medicare beneficiaries a variety of consumer-driven health care and life insurance products. Currently, more than 99 percent of PacifiCare’s commercial health plan members are enrolled in plans that have received Excellent Accreditation by the National Committee for Quality Assurance (NCQA). PacifiCare’s specialty operations include behavioral health, dental and vision, and complete pharmacy and medical management through its wholly owned subsidiary, Prescription Solutions. More information on PacifiCare Health Systems is available at http://www.pacificare.com/.
* The Health Plan Employer Data and Information Set (HEDIS) is a set of standardized performance measures designed to ensure that consumers have the information they need to reliably compare the performance of managed health care plans. HEDIS is maintained by the National Committee for Quality Assurance (NCQA), a not-for-profit organization dedicated to improving health care quality.
PacifiCare Health Systems, Inc.
CONTACT: Cheryl Randolph of PacifiCare Media Relations, +1-714-226-3441,cheryl.randolph@phs.com
Web site: http://www.pacificare.com/
