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 | State of Maine Bureau of Human Resources  Employee Health & Benefits *Newsletter - Fall 2009 |
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State Employee Health Commission Co-Chairs: Brett Hoskins Alicia Kellogg Members: John Bloomendaal Lauren Carrier Becky Greene Carol Harris Tom Hayden Richard Hodgdon Kandi Jenkins Scott Kilcollins Jan LaChapelle John Leavitt Michael Mitchell Steve Moore Cheryl Moreau Ed Mouradian Carl Parker Kimberly Proffitt E. James Soucie J. Sam Teel Will Towers Freeman Wood Executive Director: (Ex-Officio) Frank Johnson Staff: Tanya Plante Editor/Layout: Patrick E. Paradis Contributors: Bill McPeck Guida Libby Jane Paxton Earle Pease Heather Sargent/Plante |
The State Employee Health Commission has announced that Anthem Blue Cross Blue Shield has been selected to provide coverage for Medicare retirees under the Maine State employee health plan. Anthem will be providing a Medicare Advantage Private Fee-for-Service (PFFS) effective January 1, 2010. The Commission selected Anthem from among eight proposals to replace Coventry’s Advantra Freedom plan. While the Commission is still negotiating contract terms with Anthem, the monthly premium is expected to be no more than Anthem’s quoted price of $269.28 – this was the lowest bid among the eight vendors. The Office of Employee Health & Benefits is working with Anthem to schedule a series of informational meetings at numerous sites across the state beginning in November. Members will also be receiving written communication from Anthem within the next several weeks. Back in 2006 when the tiered hospital benefit was introduced the State Employee Health Commission told members that the objectives were to: encourage Maine hospitals to publicly report their performance, incent members to use high-quality providers, and drive quality improvement. So what has happened over the past three years? We can point to strong evidence that the safety and quality of Maine hospitals has improved both individually and collectively. When the tiered hospital benefit was introduced only half (18 of 36) of Maine’s hospitals scored well enough in the Medication Safety survey to indicate that the hospital “has made good early stage effort in implementing recommended safe practices”. In 2005 the average score on the Medication Safety survey was 14. By August 2009 all 36 Maine acute care hospitals earned a blue ribbon in Patient Safety. The average score in 2009 increased to 73. Each year the Medication Safety survey has gotten tougher at the insistence of hospital pharmacists yet hospital performance continues to improve. Maine hospitals arguably have among the safest medication practices in the country. One of the other key measurements has been how Maine hospitals have performed on Centers for Medicare and Medicaid (CMS) indicators compared with national results. CMS reports on hospital performance in four clinical areas: treatment of heart attack, of heart failure, pneumonia and surgical infections. From the very beginning of the tiered benefit Maine hospitals on average performed better than the national average. As national averages have increased, Maine hospital performance has continued to improve. The most recent Maine average performances for the treatment of heart attack and surgical infections are only slightly below the performance of the top hospitals in the country. |
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How to Reach Us WORKERS’ COMPENSATION 207-287-6655 1-800-422-4503 EMPLOYEE BENEFITS 207-287-6780 1-800-422-4503 WELLNESS CENTERS Wellness CenterAugusta: 207-287-9059 Bangor: 207-941-4774 Hours: Monday - Thursday 6:00 a.m. - 7:00 p.m. Friday 6:00 a.m. - 2:00 p.m. Saturday 8:00 a.m. - 2:00 p.m. (September - May) POINT-OF-SERVICE Anthem Member Services 1-800-527-7706 TTY: 1-888-671-4333 27/7 Nurse Call Line: 1-800-607-3262 MEDICARE RETIREES Anthem Smart Value First Impressions: 1-866-657-4970 TTY/TDY: 1-800-425-5705 Employee Assistance Plan Contact us TOLL FREE at 1-800-451-1834 |
In the most recent reporting period four Maine hospitals (Inland, Maine Medical Center, Maine General Medical Center, and Parkview Adventist) each scored among the top hospitals in the country in selected categories for rates readmission and mortality. The actual performance for these outcomes measures found these four Maine hospitals performing in the top 1.8% to 5% among nearly 5,000 hospitals reporting nationwide. While the State Employee Health Commission certainly cannot take credit for the outstanding performance of Maine hospitals, we do believe that public reporting and the tiered benefit design have contributed to ongoing improvements. We will continue to work with the Maine Health Management Coalition and Maine hospitals to expand the measures for hospital performance and to share that information with State employee health plan members. It is the Commission’s objective to provide members with the information and incentives to select the highest value care. The State employee health plan is offering members with certain chronic conditions the opportunity to save money and improve the management of their illness. For several years the State Employee Health Commission has offered the Telephonic Diabetes Education & Support (TDES) program. TDES provides one-on-one telephonic contact with a diabetic educator to help set goals and give you the tools to better manage your disease. As an incentive prescription drug copays for diabetes medications and supplies are waived while you participate in TDES. In January 2010 the TDES program will be expanded to include members who have a diagnosis of diabetes and cardiovascular disease. The same incentives on prescription drug copays will apply. Look for your invitation to participate later this fall.
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The State of Maine member copay is a $15 Specialty copay at a Walk-In-Center as compared to $75 at an ER. |
Open enrollment for medical care and dependent care (day-care) spending accounts will be held from November 16 through December 18, 2009) (More details to follow ...) The Department of Administrative and Financial Services (DAFS) has listed the following state government colsure (shut-down) days for the remainder of the fiscal year 2010.
Thursday, December 24
Friday, January 15
Tuesday, February 16
Friday, March 12
Tuesday, April 20
Friday, May 28 Due to space limitations in this issue, we were unable to include the guide, “How to Read Over the Counter Drug Labels.” It will appear in the Winter issue… |
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The maximum annual amount you may contribute to the State of Maine Deferred Compensation Plan will be $16,500 in 2010. If you qualify for Special Age 50 or Older Catch-Up Contributions, you may contribute up to an additional $5,500 for a total annual contribution of up to $22,000. If you are nearing your Normal Retirement Age, you may be eligible to make pre-retirement Plan Catch-Up Contributions up to an additional $16,500, for a total annual contribution of up to $33,000. As you consider these contribution limits, ask yourself if you are doing all you can to save for retirement. Now is a good time to look at your savings and determine whether you are on track. If you have questions about Plan contribution limits, please consult your financial services organization (FSO) representative. Contact information for the representatives is available on the Deferred Compensation Plan website at: http://www.maine.gov/beh/DeferredComp/deferredComp_Index.htm |
