Wellness Programs - Wellness & Preventative Care

Posted on April 22, 2016 by zyniker — No Comments ↓

The video at right, shows what Mexico is doing. Click here for more information in English. Wellness programs are Mandated as an Essential Health Benefit Section I. Final Regulations will increase the greatest permissible reward under a health-contingent wellness program from 20 percent to 30 percent of the cost of health coverage, and that further increase the largest reward to as much as 50 percent for programs designed to prevent or cut tobacco use. ^{(Fact Sheet) Health Net Q&A 8.9.2013 Kaiser Health Reform Summary last page}Dubai is paying $40/pound of weight loss ^CNN

How will Covered California health insurance companies improve quality of care?

Covered California and each health insurance company selected are committed to ensuring high quality of care for all enrollees. Specifically, each health insurance plan must:

ensure that each enrollee has had a preventive health and wellness visit during the first year of enrollment
identify and proactively manage all “at-risk” enrollees [pre-existing conditions]
determine each enrollee’s health status and proactively develop a plan to manage their individual health care needs
promote the use of best practice models for continuity of care and care coordination that are proven to improve quality of care
be transparent about plan performance at the point of enrollment, specifically regarding standard measures of prevention, access and clinical effectiveness
be certified by the National Committee for Quality Assurance or URAC (formerly known as the Utilization Review Accreditation Commission) to meet quality standards ^{Covered CA Tentative Rate & Plan Guide Page 8}

Health Care Reform – MANDATES Chain Restaurants to provide calories on the Menu! ^{Page 455 Section 4205 HR 3590}Final Rule Wellness incentives can only be to encourage participation not penalize if goals are not met ^{bizjournals.com} democrat and chronicle.com

29 CFR 2590.702 Health Factors

View each companies Wellness Program

Resources

Functional Medicine & Neurology – Chiropractor Website

Healthy Living Magazine – by Torrance Hospital IPA THIPA

Technical Resources

Final Regulations

IRS Regulation 122707-12 Wellness Programs – Proposed
amendments to regulations, regarding nondiscriminatory wellness programs, clarifications regarding the reasonable design of health-contingent wellness programs and the reasonable alternatives they must offer to avoid prohibited discrimination.