Will Total Health Become a Total Bust?

Study looks at effectiveness of new health insurance approach that combines preventive care and wellness programs

(RxWiki News) The Federal Agency for Health Research and Quality's recently launched study of a unique benefits program for Group Health Cooperative employees (known as Total Health) will analyze the program's effectiveness over a four-year period.

Total Health, launched in January 2010, is part of an ongoing trend aimed at integrating care, insurance and wellness programs into one package based on research findings. The goal is to manage healthcare costs while promoting healthy lifestyles for enrollees.

Vaccinations, cancer screenings and other preventive measures, for example, are available for free or low cost to members. Copayments are reduced for doctor's visits, and medications for chronic conditions are reduced. Meanwhile, expensive medical services such as unnecessary high-tech imaging and emergency room visits may come with heftier fees.

These evidence-based guidelines contrast with traditional insurance programs, which charge copayment and coinsurance fees without regard to how treatments, therapies and procedures affect enrollees' health. Total Health's three-prong mission is to curb so-called overtreatment (extraneous or unneeded treatments), manage chronic conditions and thereby prevent future chronic conditions, and encourage participation in health-promotion programs.

David Grossman, MD, MPH, Group Health's medical director of preventive care and a senior investigator at Group Health Research Institute, said purchaser interest in this multifaceted approach is gaining traction, which has officials planning new value-based insurance products for the market.

The first progress report from the study of Total Health's effectiveness is expected to be available in 2011.

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Review Date: 
December 28, 2010