HealthNet Adds Services to Rebranded Managed Care Plan

Say good-bye to the Bronze Age. Health Net Inc., the Woodland Hills-based managed care company, launched a major rebranding strategy of one of its largest managed care plans, adding new services like acupuncture, more tightly aligned providers and an incentive for patients to share their health data with the company. The change affects the company’s Bronze HMO, which has been rebranded SmartCare. The move comes as Health Net looks to continue to expand its “narrow networks,” plans which save employers as much as 25 percent off the cost of broader HMO products by working more closely with doctors and limiting the number of doctors in a plan. The name-change is also meant to eliminate confusion ahead of health care reform, which will introduce health insurance exchanges and tiered pricing that goes by bronze and platinum levels. “The health insurance exchanges will be using the metallic colors, so we are changing to a name we find better suits our plans,” said Larry Tallman, chief sales officer/large groups for Health Net. SmartCare will actually have more providers than the original Bronze HMO, Health Net said. The company was able to negotiate agreements with more physician groups, including HealthCare Partners Medical Group of Torrance, which has 400 doctors. “We were able to come together, sit down and agree on goals and tactics,” said Health Net Spokesman Brad Kieffer. “In doing so, we were able to arrive at arrangements that offer benefits at a savings of up to 25 percent less.” SmartCare will also cover new ancillary services for the first time, such as chiropractic care and acupuncture, and an incentive for members to visit their primary care doctor and fill out a questionnaire about their health, such as their weight and blood pressure. Patients will receive a $50 gift card from a major retailer for their trouble. “Our studies show that everyone wants greater health and wellness, but they need incentives to be engaged,” Tallman said. “We believe this will give them the incentive to have a higher level of engagement with their providers.” Consumers in the plan will also have access to online tools to monitor their health, as well as health coaches available by phone. But the most important feature of the plan is the close alignment between Health Net and providers. The parties hope to drive down health care costs by collaborating, sharing patient data and emphasizing preventive care. Healthcare Partners CEO Dr. Robert Margolis said the collaboration with Health Net will involve the creation of an accountable care organization, or ACO, a model of care in which doctors’ fees are tied to quality metrics and a reduction in the total cost of care. Doctors often wind up sharing in the risk of taking care of patients under such a model. “Our collaboration with SmartCare…aligns us with Health Net in a way that helps promote affordable benefits and enhanced health outcomes,” he said in a statement. For employers and patients covered under the narrow network plans, the risk is fewer available physicians and the possibility that a patient will not have access to the right doctor at the right time. Health Net argues those risks are minimized because the provider network has sufficient doctors to meet the need and patient care is more tightly coordinated. And now with SmartCare, the firm argues, there are actually more providers. The lower cost structure, they argue, actually increases access to health care because employers who would not otherwise be able to afford health insurance can afford these products. The company has even tighter networks in Northern California, where the managed care company contracts with Sutter Health exclusively to deliver care to members. Tallman said a partnership with a single provider was not feasible in Los Angeles because of the large geographic footprint of the region. “Sutter is a premier quality provider in Northern California with little competition,” Tallman said. “They had the geographic coverage. The greater Los Angeles area is miles and miles. We needed to have multiple providers.” As of year-end 2011, the narrow networks accounted for 31 percent of Health Net’s commercial risk membership, compared with 23 percent for the year-ago period. Some 46 percent of the company’s California capitated membership was enrolled in these products.