COLUMBUS, Ohio, May 21 /PRNewswire/ -- The Ohio Association of Health Plans (OAHP) announced this week at it’s annual convention the 2004 Pinnacle Award winners, recognizing the efforts of Ohio’s health plans to improve the quality of health care throughout the state.
“Health plans have been a vital element in Ohio’s health care industry for many years,” said Kelly McGivern, OAHP President and CEO. “Not only are these companies the source of a growing sector of jobs for Ohioans, they also create and implement numerous initiatives to improve the health status of Ohioans and the efficiency of providing health care benefits. Unfortunately, the value health insurers provide to Ohio have remained largely unrecognized, so we established the Pinnacle Awards in 2002 to help showcase the industry’s best practices.”
This year’s winning programs included initiatives that provided ease of use and understanding complex Power of Attorney documents for consumers, partnered with the American Cancer Society to provide information about breast cancer to diagnosed patients, and educated asthma patients to reduce emergency room utilization and inpatient stays. The winners of the awards were as follows:
Category: Improvements in Business/Operational Performance Winners: Paramount Care, Inc. -- Can We Talk? CareSource -- Skill-Based Customer Relationship Management Category: Community Outreach and Partnerships Winners: Nationwide Health Plans -- Breast Cancer Management Nationwide Health Plans -- Search Your Heart Category: Health Care Programs Winners: SummaCare, Inc. -- Asthma Disease Management CareSource -- Partners With Hospitals
OAHP invited all member plans to participate in the competition, which provided an opportunity for health plans to demonstrate what they are doing to provide exemplary care and service for their members and community. A panel of experts representing hospitals, doctors, businesses, regulators and state officials judged the 18 submissions and selected the winners.
“After reviewing the programs outlined in the submissions, it is clear that health plans are not only playing a major role in, but are also creating innovative solutions for providing quality health care benefits for Ohio’s citizens,” McGivern said.
For a detailed description of each winning program, please see below.
OAHP is a statewide trade association of companies providing health care benefits to over 6 million Ohioans. The mission of the OAHP is to promote and advocate quality health care and access to a variety of affordable health care benefits for all consumers in Ohio.
2004 Pinnacle Award Recipients Business/Operational Performance Pinnacle Award: Paramount Care, Inc. -- Can We Talk? A licensed social worker screens, reviews and encodes information regarding complex Power of Attorney documents used for both financial and health-related situations. This eliminates research time to determine disclosure limits and improves consistency of information provided by staff to callers while assuring regulatory compliance relating to Protected Health Information.
Meritorious Award: CareSource -- Skill-Based Customer Relationship Management
CareSource implemented Skill-Based Customer Relationship Management to streamline calls to its Service Center. Representatives were split into two categories: Tier 1, to handle routine requests, and Tier 2, to handle grievances. Improvements to customer service were immediate, including a much shorter average speed to answer and much lower call abandonment rate. Community Outreach/Partnerships Pinnacle Award: Nationwide Health Plans -- Breast Cancer Management In an attempt to provide more support and information to our membership, Nationwide Health Plans (NHP) partnered with the American Cancer Society (ACS) in 2003 to disseminate program and educational materials available for women with breast cancer. Our goal is to enhance the case management services we provide, and to help the ACS evaluate the effectiveness of their programs and services for this specific population. Meritorious Award: Nationwide Health Plans -- Search Your Heart NHP and the American Heart Association (AHA) provides an innovative faith based education program, “Search Your Heart.” As central Ohio’s sole health plan sponsor of the program, NHP serves as a community leader in the fight against heart disease. Search Your Heart is designed for African-American congregations. The program informs individuals about risks, and is making positive impacts on those who have or are at risk for cardiovascular disease, high blood pressure, and stroke. The partnership works because the AHA has established a level of trust and credibility in the community, thus encouraging healthy lifestyle behaviors. Health Care Programs Pinnacle Award: SummaCare, Inc. -- Asthma Disease Management SummaCare reviewed utilization daily to inform case managers of activity and identify new candidates, mailed educational materials to candidates, provided peak flow meter if needed and published member/provider newsletter articles about asthma disease management, resulting in a 40 percent reduction in emergency room utilization in 1st quarter 2003 (vs. 1st quarter 2002) and a 72 percent reduction in inpatient days for same time period. Meritorious Award: CareSource -- Partners With Hospitals CareSource worked with Miami Valley Hospital in a pilot project to identify members who overuse the emergency department. Whenever one of these members visited, Miami Valley Hospital called CareSource, which could contact the member within 48 hours. By working in real time, CareSource and MVH reduced the number of emergency department visits by targeted members by 50 percent.
Ohio Association of Health Plans
CONTACT: Kelly McGivern, President and CEO of Ohio Association of HealthPlans, +1-614-228-4662, or kmcgivern@oahp.org
Web site: http://www.oahp.org/
