ActiveHealth Management Researchers Receive Health Care Award

Researchers honored by National Institute for Health Care Management for Value-Based Insurance Design paper; selected as best health services research of the year

NEW YORK, NY .— ActiveHealth Management (ActiveHealth) announced today that three of its executives were among a team of nine researchers who received the National Institute for Health Care Management (NIHCM) Foundation Health Care Research Award. The award was presented to the researchers for “Impact of Decreasing Copayments on Medication Adherence Within a Disease Management Environment,” published last year in Health Affairs.

Selected unanimously by a panel of independent judges as the best health services research of the year, the paper was co-authored by ActiveHealth’s Stephen Rosenberg, MD, senior vice president for outcomes research, Iver Juster, MD, senior vice president for informatics and Arnold Wegh, senior informatics analyst, as well as researchers from Harvard University and the University of Michigan. The study described in the paper evaluated the impact of selectively lowering co-pays for certain classes of drugs used in the treatment of chronic medical conditions. ActiveHealth’s patented clinical decision support technology, CareEngine® System, identified individuals from a large employer who would benefit from essential medications, and communicated the co-pay reduction. The results showed a significant increase in compliance with four of five drug classes studied, compared to a control group. The study is the most rigorous, controlled trial to-date of a concept called value-based insurance design (VBID).

"Research has proven that co-pays, even very small ones, can serve as financial barriers to accessing needed care. This leads to costly and avoidable hospitalizations and emergency room visits. Our study demonstrated that reducing or eliminating co-pays significantly increases compliance with potentially life-saving medications. A VBID program can reduce a significant barrier to compliance resulting in improved quality care and lower costs,” said Stephen Rosenberg, MD. “We are honored by this award and hope our research promotes plan designs focused on both quality and value.”

ActiveHealth’s CareEngine creates a personal health profile for each individual using claims and other data, and compares the profile to the evidence-based literature. If the CareEngine identifies an opportunity for better care, it issues a clinical alert, called a Care Consideration, to the patient and the physician. As part of its analysis, CareEngine identifies people who are eligible for reduced co-pays. Individuals currently taking essential medications are notified that they will pay a reduced fee when they refill their prescriptions. The CareEngine also identifies individuals who may benefit from an essential medication that they are not currently taking. These individuals are notified about the co-pay reduction and the importance of the medication. Whenever the CareEngine identifies a contraindication for a medication, it alerts the prescribing physician and patient to the potential danger involved.

ActiveHealth’s value-based insurance design program, Active Benefit DesignSM, can be integrated with its disease management program, called Active Disease ManagementSM. The combined offering helps improve clinical outcomes by encouraging targeted individuals to participate in nurse coaching and removing a financial barrier to medication compliance.

The Health Affairs article [27(1): 103-112], was authored by Michael E. Chernew, PhD, Mayur R. Shah, MA, Arnold Wegh, MS, Stephen N. Rosenberg, MD, MPH, Iver A. Juster, MD, Allison B. Rosen, MD, ScD, Michael C. Sokol, MD, MS, Kristina Yu-Isenberg, PhD, RPh, and A. Mark Fendrick, MD.

Established in 1993, the NIHCM awards program recognizes talented researchers and journalists who serve as catalysts for positive change by advancing and informing the health care policy debate.