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HAP’s Enhanced Medicare Advantage Offers Huge Savings on Insulin through Innovative CMS Pilot Program

October 14, 2020

Pilot program helps to ensure HAP members can afford life-saving drug

DETROIT – Health Alliance Plan (HAP), a Michigan-based nonprofit health plan, is offering redesigned Medicare Advantage plans that feature the Centers for Medicare and Medicaid Services’ (CMS) Part D Senior Savings Model, which caps the copay cost of insulin at $35 per 30-day supply throughout the benefit year. HAP is one of the only health plans in Michigan participating in the pilot program which could help its members see average out-of-pocket savings of $446 a year.  Open enrollment begins on October 15. The program begins in January 2021.

“Our goal has always been to remove barriers to care for our members across Michigan,” said Michael Genord, MD, HAP president and CEO. “Through our ongoing analysis of member spend patterns we learned that a significant portion of members are controlling diabetes through insulin and would benefit greatly from a program that offers lower-cost insulin.  Offering these savings to our members through this CMS program was a no-brainer.”

The model is a partnership between CMS and the nation’s three largest insulin makers – Eli Lilly, Novo Nordisk and Sanofi – and will include both pen and vial dosage forms for rapid-acting, short-acting, intermediate-acting and long-acting insulins. HAP believes we have a social responsibility that members should not have to make heart-wrenching decision between taking their life saving medications as prescribed or paying for food and taking care of your family’s needs.  HAP is here to help; we are a phone call away.

Diabetes can impact an individual’s life in devastating ways. People with diabetes suffer from complications such as eye disease, kidney failure and nerve damage, and are two to four times more likely to have a heart attack or stroke than those without.  According to the American Diabetes Association (ADA), more than 23 million American adults have been diagnosed with diabetes and experts estimate that an additional 7 million have the disease but don’t know it. The ADA also reports that diabetes disproportionately affects African Americans and older adults as the risk of diabetes is 77% higher among African Americans than among non-Hispanic white Americans and approximately 25% of Americans over the age of 60 have the disease.

By significantly increasing the affordability of a routine drug to help manage diabetes, HAP’s participation in the pilot program will help improve members’ health outcomes and family budgets. 

Best-in-class ratings

HAP’s participation in the pilot program is the most recent effort to provide members with exceptional insurance coverage and customer service.  HAP’s efforts are reaping benefits as indicated by a three-year positive trend in the Consumer Assessment of Healthcare Providers and Systems (CAHPS) ratings.  In the most recent ranking for 2019, which was adjusted to account for the pandemic year, HAP logged the highest customer service satisfaction score of any Michigan-based Medicare Advantage HMO plan, and a highly competitive national ranking.  CAHPS surveys patients directly, asking them to report on and evaluate their experiences with health care. These surveys focus on aspects of quality that only consumers can assess, such as the communication skills of medical professionals and ease of access to health care services. HAP’s strong performance in Medicare Advantage CAHPS measures results from solid, collaborative relationships with health care providers, benefit programs designed to support member health and exceptional attention to customer service. In a separate survey, nine out of 10 new Medicare Advantage members prefer HAP’s coverage to the coverage of their previous health insurer.

Consumers looking to compare Medicare plans (visit www.medicare.gov)  will find that CMS has ranked HAP’s three Medicare Advantage plans as the top three plans offered in Wayne County.  HAP’s MA plans also earned the number one spot among Medicare plans in West and Southwest Michigan, both relatively new markets for HAP.  CMS uses a formula based on a plan’s yearly premiums and drug costs and ranks plans accordingly to assist consumers in making plan choices. 

In addition to the strong showings in CMS plan rankings and CAHPS, HAP also recorded an elite net promoter score (NPS) of 59, which is an excellent score regardless of industry, and certainly for health insurance. NPS is calculated based on responses to a single question, “How likely is it that you would recommend our service to a friend or colleague?” HAP’s NPS puts it in an elite customer satisfaction category comparable to Apple or Amazon.   HAP conducts more than 600 surveys monthly to track member satisfaction.  The resulting data is used to develop its NPS score. The survey not only provides data for NPS but allows HAP to address individual member’s questions and issues identified through the survey.

For more information on HAP’s product offerings in Michigan visit www.hap.org.

About Health Alliance Plan

Health Alliance Plan (HAP) is a Michigan-based, nonprofit health plan that provides health coverage to individuals and companies of all sizes.  For 60 years, HAP has partnered with leading doctors and hospitals, employers and community organizations to enhance the health and well-being of the lives it touches.  HAP offers a product portfolio with six distinct product lines: Group Insured Commercial, Individual, Medicare, Medicaid (through HAP Empowered Health Plan), Self-Funded and Network Leasing.  HAP excels in delivering award-winning preventive services, disease management and wellness programs, as well as personalized customer service.  HAP is an operating unit of Henry Ford Health System, one of the nation’s leading health care systems.  For more information, visit www.hap.org

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Health Alliance Plan (HAP) has HMO, HMO-POS, PPO plans with Medicare contracts.  HAP Empowered Duals (HMO SNP) is a Medicare health plan with a Medicare contract and a contract with the Michigan Medicaid Program. Enrollment depends on contract renewals.

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