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Volume
6: No. 3, July 2009
ORIGINAL RESEARCH
Readiness of US Health Plans to Manage Cardiometabolic Risk
| Program Type |
Provide Program for the Community, % |
Provide Program for Clinicians, % |
Provide Program for Employers, % |
Provide Program for Members, % |
| Other |
2.9 |
8.8 |
14.7 |
23.5 |
| Insulin resistance |
17.6 |
26.5 |
20.6 |
47.1 |
| Glucose intolerance |
17.6 |
47.1 |
44.1 |
58.8 |
| High triglycerides |
20.6 |
52.9 |
52.9 |
76.5 |
| Hypertension |
32.4 |
61.8 |
64.7 |
85.3 |
| Cholesterol control |
26.5 |
64.7 |
61.8 |
91.2 |
| Physical activity |
44.1 |
38.2 |
73.5 |
94.1 |
| Nutrition |
47.1 |
41.2 |
73.5 |
97.1 |
| Obesity/overweight |
50.0 |
41.2 |
70.6 |
97.1 |
| Tobacco use |
44.1 |
55.9 |
73.5 |
97.1 |
Figure 1. Percentage of health insurance plans with wellness, health promotion, or prevention programs/activities for members, employers, clinicians, and communities, by program type, 35 members of America’s Health Insurance Plans, United States, January 2008.
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| Strategy |
Used by Health Insurance Plan, % |
Ranked as Among 3 Most Effective, % |
| Other |
2.9 |
0 |
| Disparities-reduction initiatives |
58.8 |
0 |
| Pharmacy consultation |
52.9 |
2.9 |
| Fitness classes |
61.8 |
2.9 |
| Community-based services |
67.6 |
2.9 |
| Nurse advice lines |
70.6 |
2.9 |
| Behavioral health programs for stress, depression, and/or substance abuse |
73.5 |
2.9 |
| Reduced co-pays/cost sharing |
26.5 |
5.9 |
| Drug therapy |
61.8 |
5.9 |
| Nutrition counseling |
79.4 |
8.8 |
| Tobacco use cessation programs |
82.4 |
11.8 |
| Health education classes |
73.5 |
14.7 |
| Web-based tools and resources |
91.2 |
14.7 |
| Patient educational materials/brochures |
91.2 |
14.7 |
| Physician counseling |
35.3 |
17.6 |
| Phone-based services |
55.9 |
17.6 |
| Worksite services |
82.4 |
17.6 |
| Incentives |
76.5 |
23.5 |
| Referrals to case management |
91.2 |
29.4 |
| Feedback from health risk assessment or appraisal |
100.0 |
35.3 |
| Health coaching |
85.3 |
58.8 |
Figure 2. Percentage of health insurance plans that use strategies to help enrollees manage cardiometabolic risk and percentage of health insurance plans that rank the strategy as among the 3 most effective, by strategy, 35 members of America’s Health Insurance Plans, United States, January 2008.
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| Strategy |
Used by Health Insurance Plan, % |
Ranked as Among 3 Most Effective, % |
| Disparities-reduction initiatives |
35.3 |
0 |
| Patient educational materials at provider offices |
55.9 |
2.9 |
| Referral to specialists |
38.2 |
2.9 |
| Incentives for e-visits, e-mails |
14.7 |
2.9 |
| Other |
2.9 |
2.9 |
| Specialized training for providers and/or their office staff |
26.5 |
5.9 |
| Consultation/referral to tobacco use cessation services |
58.8 |
23.5 |
| Pharmacy programs |
64.7 |
23.5 |
| Information technology tools to providers |
52.9 |
38.2 |
| Care coordination |
79.4 |
38.2 |
| Pay for performance |
64.7 |
41.2 |
| Feedback to providers |
88.2 |
52.9 |
| Evidence-based practice guidelines |
97.1 |
55.9 |
Figure 3. Percentage of health insurance plans that use strategies to assist clinicians evaluate and/or manage enrollees’ cardiometabolic risk and percentage of health insurance plans that rank the strategy among the 3 most effective, by strategy, 35 members of America’s Health Insurance Plans, United States, January 2008.
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| Barrier |
Named by Health Insurance Plan, % |
Ranked as Among Top 3 Barriers, % |
| Lack of performance measures |
35.3 |
5.9 |
| Lack of purchaser interest |
23.5 |
5.9 |
| Lack of guidelines |
17.6 |
8.8 |
| Lack of codes |
26.5 |
11.8 |
| Lack of evidence |
14.7 |
11.8 |
| Lack of provider interest |
35.3 |
11.8 |
| Lack of enrollee interest |
61.8 |
35.3 |
| Poor or unknown return on investment |
55.9 |
35.3 |
| Lack of reporting systems |
79.4 |
41.2 |
| Lack of enrollee-level data |
73.5 |
44.1 |
| Resources (staff, funds) |
79.4 |
55.9 |
Figure 4. Percentage of health insurance plans that face barriers to addressing cardiometabolic risk and percentage of health insurance plans that rank the barrier among the top 3, by barrier, 35 members of America’s Health Insurance Plans, United States, January 2008.
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