Illinois | Summer | 2009 | Health Plan Analysis
Health plans have begun to put generic dispensing goals into their pay-for-performance packages with some health plans. Advocate Physicians, which works closely with its payors, instituted a focused generic dispensing rate program for some of its specialty groups. The organization, which has 2,900 doctors in the Chicagoland region and around the state, is focusing on drugs classes that treat hypertension, depression and oral contraceptives, where branded utilization is much higher than it should be. Health plans continue to focus on the individual member with copay waivers and the like. Meanwhile, the insurance market has divided between Chicago and the rest of the state. While Chicago continues to trend more toward self-insured membership, the rest of the state is moving back toward fully insured plans. Organizations such as Health Alliance are responding to the recession by launching short-term policies. In an effort to reestablish its strength in the national accounts business, Blue Cross Blue Shield of Illinois is waiving a residency rule, which required that the bulk of a client's members live in Illinois or an adjacent state.
