News
GE and health insurer test plan to reward chronically ill patients who follow treatment plans
Business Week
A few years back, Dr. Robert S. Galvin was desperately searching for new ways to control medical costs at his company, General Electric. Galvin is GE’s chief medical officer. It’s his job to keep the company’s 323,000 workers healthy. But he was growing frustrated with the challenge: Too many employees with chronic illnesses such as diabetes were not taking their medications or following other prescribed treatment plans, and that led to serious—and expensive—complications. “I said, ‘We need to innovate around managing costs,’” Galvin recalls.
One of GE’s major benefits providers, UnitedHealthcare, was thinking along the same lines.
So last year, United introduced the Diabetes Health Plan, a first-of-its-kind benefit now in pilot testing at GE and two other companies. Fifteen more workplaces plan to roll it out in 2010.
This is far more than a “disease management” program where patients sign up to receive, say, discounts on medications but are left to fill the prescriptions themselves.
The diabetes plan requires patients to adhere to treatment and drug guidelines and to agree to be tracked by the company to ensure they are compliant. Those who stick with it receive significant discounts on out-of-pocket expenses such as co-pays for diabetes-specific treatments. Those who don’t are kicked out of the program and put back into their company’s standard plan.
Harsh as it sounds, it’s exactly the type of plan that’s likely to catch on as the country debates health-care reform. No matter which of the many proposals knocking around Congress actually passes, there’s no doubt companies and their insurers will be expected to hold down the costs of caring for chronically ill people.
