Participant Questions & Answers
Play videos below to view corresponding speaker presentations
Click on question bubble to view answer in drop down box
Defined by % below poverty in the census block group according to the 2000 census. For example, low-income was defined as living in a census block group with greater that 10% of households below the federal poverty level.
We linked members to their neighborhood (census block group) characteristics such as poverty level using Census 2000 data (geocoding).
Does this refer to contributions to premiums? Our studies cannot assess premiums or the relative contributions of employers / subscribers because this is proprietary information.
Two possibilities that are happening in the real world are income-proportional deductibles (i.e., lower-income members have low or no deductible) or health savings account contributions that are targeted to lower income workers.
The health insurance plans we study generally include a mix of non-HSA HDHPs (the majority of HDHPs) where pharmacy has a traditional 3- or 4-tiered copayment structure and HSA HDHPs where medications are subject to a general annual deductible.
The State of MN has maintained coverage of MTM consults from pharmacists at no cost to members. Drug co-pay discounts were expanded to a broader set of therapeutic classes (depression, cholesterol, etc.) than were included in the previous diabetes program.
We have not made these calculations based on our current experience with VBID; however, we expect the effect on premiums to be fairly modest overall.
SEGIP is not currently using diabetes quality measures to steer members to high quality providers, but Minnesota Community Measurement has been publishing quality scores on diabetes care for adults for several years. In the future, we may considering incentives to encourage members to seek care with high quality providers of diabetes care.
Advantage Value for Diabetes is a pilot program and is built on our previous diabetes medication therapy management programming which only covered adults.
We did not consider this concept in our development of Advantage Value for Diabetes, primarily due to the limited amount of time we had to implement the program. However, the concept is intriguing to employers who are looking to reward adherence.
While benefit design could be a tool to address some high-cost patients, a large share of high-cost patients in our population do not repeat as high-cost the following year. We work to provide disease and condition management services to high-cost patients and V-BID to our diabetic members to help them from becoming a high-cost patient due to their chronic condition.
Advantage Value for Diabetes covers medications across the diabetes, hypertension, cholesterol, and depression therapeutic classes, including several products to control A1C and cardio risks.
No, not at this time. However, we are exploring the connection with provider quality, as measured by following clinical guidelines, and potential ways to encourage members with diabetes to seek care with high quality providers.