In the news
Value-based health plan targets Fresno
By Business Journal Staff, The Business Journal
November 5, 2009
SeeChange Health, a start-up health insurance company based in San Francisco, is targeting Fresno as the first area in state in which it will roll out its value-based health plan to small businesses.
The plan is a PPO covering outpatient services, hospital care, physical therapy, mental health and prescription drug benefits under which members will be incentivized to manage chronic conditions. Members can reduce their coinsurance to zero and reduce out-of-pocket expenses by meeting certain criteria, including seeing their physician for an annual wellness visit.
Self-insured businesses commonly utilize value-based insurance designs that benefit employees by lowering copays for drugs deemed most effective in treating chronic conditions, such as statins, which might be free for heart disease patients.
"We are starting to see more health plans incorporate value-based insurance options aligned with pharmacy benefits, but SeeChange is upping the ante by offering a full-service PPO that is actually built on this value-based insurance design model," said Chris Lewis, analyst with HealthLeaders-InterStudy, a provider of health care market data.
The company plans to introduce the plan to San Francisco and Los Angeles in the coming months and to Colorado and Illinois next year.
Source: http://www.thebusinessjournal.com/health/2904-value-based-health-plan-targets-fresno
