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WellPoint official addresses healthcare costs, quality, reform


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WellPoint, the parent company of Blue Cross of California, will continue investing in programs that improve members' health and care and provide more consumer information in response to consumers' demands, the organization's chief medical officer said Thursday.

"Improving service is a focus area now, and healthcare quality — we're focused on that, " said Dr. Samuel Nussbaum, executive vice president for clinical health policy and chief medical officer for the Indianapolis-based health insurance provider.

"Our mission is to improve the lives of our members and the health of our community," he said.

WellPoint serves 34 million people in 14 states, including 8.3 million in California. Nussbaum was in the state this week to meet with 200 of the company's senior executives and with the media to talk about healthcare cost, quality and reform.

"California is extremely important to us," Nussbaum said. "This is a vital state for us."

California has become a testing ground for new programs, including a recent move to provide financial incentives to member physicians who provide better care. By April, Los Angeles area members, including those in Ventura County, will have access to a Zagat survey tool they can use to rate their experiences with doctors and find out about others' experiences, Nussbaum said.

New efforts such as the 360 Health Program are designed to emphasize prevention and minimize or manage risk factors so members have better health outcomes, a move that benefits the member as well as the plan.

"We're helping empower consumers to take care of themselves," said Shannon Troughton, a spokeswoman for WellPoint.

The company also is developing a "member health index" that compares the kind of care consumers receive with the standards of care for their medical status or situation to expose gaps that could be improved.

Filling such gaps was a goal of the company last year, and employee bonuses were partially tied to it, Nussbaum said.

"You can identify savings by improving care, not denying it. If you have diabetes, are you getting the necessary care; is it being managed optimally?" he said. "We actually surpassed some very aggressive targets we set" toward closing such gaps.

WellPoint also has watched closely the efforts by Gov. Arnold Schwarzenegger and others to reform the state's healthcare system — which failed earlier this week in a Senate committee — but could not support it.

The proposal would have put health coverage out of reach for people who have access now, Nussbaum said.

Still, with 6.6 million uninsured people in California, reform is necessary, he said.

"There needs to be solutions. We want to be part of that," he said, "but don't create solutions that make insurance unaffordable for people who can afford it now."

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