Readiness of US health plans to manage cardiometabolic risk.
BACKGROUND
American health plans can make a substantial contribution to the control of cardiometabolic risk (CMR), a condition associated with both adverse health outcomes and increased cost of care. Our goal was to determine health plan interest in and ability to provide CMR control services.


METHODS
In January 2008, America's Health Insurance Plans, in collaboration with the HealthPartners Research Foundation, surveyed the chief medical officers of 74 member health insurance plans that offer commercial health maintenance organization, point of service, and preferred provider organization insurance. The response rate was 47%.


RESULTS
The 35 responding chief medical officers reported that their plans identify members with CMR through referral from case or care management (89%), health risk assessment data (86%), claims data (82%), and pharmaceutical use data (79%). Nearly all (97%) plans currently offer interventions for tobacco use, obesity/overweight, and nutrition. Ninety-four percent of plans offer interventions to increase physical activity. All plans offer health risk appraisal or assessment with feedback and education, 91% use Web-based tools, and 85% use health coaching to help plan members lower their risk. Perceived barriers to broader implementation of risk control programs included lack of resources (79%), limited available enrollee data (74%), and lack of reporting systems (79%). Few health plan officers viewed lack of purchaser interest to be a barrier to program implementation.


CONCLUSIONS
Health plans appear to be positioned to provide CMR control services that could improve health outcomes, reduce health care costs, and increase workplace productivity in the United States.
Kottke
Thomas E
TE
HealthPartners Research Foundation, 8170 33rd Ave S, PO Box 1524, MS 21111R, Minneapolis, MN 55440-1524, USA. Thomas.E.Kottke@HealthPartners.com
Jordan
Courtney O
CO
O'Connor
Patrick J
PJ
Pronk
Nicolaas P
NP
Carreón
Rita
R
D019090:Case Management; D044882:Glucose Metabolism Disorders / Q000150:complications / Q000517:prevention & control* / Q000628:therapy; D019538:Health Care Surveys; D006293:Health Promotion; D006331:Heart Diseases / Q000150:complications / Q000517:prevention & control* / Q000628:therapy; D006801:Humans; D008329:Managed Care Programs; D017410:Practice Guidelines as Topic; D014481:United States