Creenaght Health Plans is partnering with employers to offer an outcome driven plan that actually rewards people for going to the doctor when they should, and provides incentives to make people want to stay healthy.   This is an effort to infuse personal responsibility and healthy choices at the member level and as a result, lower the demand for healthcare services, which in turn will lower healthcare costs.

Brian Hefferan, the founder and CEO of Creenaght Health Plans, has been offering a self-funded version of this plan for approximately 6 years, but began putting together a fully-insured plan in Delaware about 4 years ago.  The Delaware plan stemmed from businesses asking Carol Everhart, head of the Rehoboth Beach-Dewey Beach Chamber of Commerce, for help. "Those small businesses basically said, 'Find something that will help us save money so that we can continue to offer our employees insurance,'" Everhart said. 

She and other Delaware Chambers of Commerce began working with Brian Hefferan. Hefferan is a strong advocate of affordable health care, and his company developed the unique program.  The fully-insured program is now available to any organization with a Delaware business license that belongs to a state or local Delaware chamber of commerce.  The new plan, which includes about 40 businesses, went into effect on October 1st, 2006. 

Hefferan explained that the plan has two pathways that an employee can follow in receiving benefits.  The core plan that the employer purchases is a $2000 high deductible plan.   However, employees can choose to follow the Health Corridor route instead.   This is a richer benefit option with a $20 co-pay and 100% coverage after that. 

In order to remain eligible for the Health Corridor path, the member must go through an initial biometic testing processing, including a blood draw, and complete a self-assessment application.  The member is then given the results,. Quite often the results show potentially undiagnosed conditions or risk factors that the member was not aware of.  Hefferan says that 6 out of 10 people that go through the process are found to have risk factors and 3 out of 10 members had no idea that they were at risk or that they had an existing health condition. 

After the results are shared, the member then commits to working with a physician and is offered ongoing tools, coaching and resources to address current conditions or eliminate potential risk factors.  The member’s ongoing participation in the Health Corridor plan is then monitored through self-reports, provider interactions, follow-up screenings and through claims data analysis which tracks physician visits, medication refills and other diagnostic codes that indicate the member is working on their issues.  At any time during the year, the member can choose to drop to the core plan if they are no longer making healthy choices or don’t want to continue addressing their conditions.

Hefferan explains that he believes that the current state of healthcare in the U.S. is a socialistic model in that two insured people with the same condition, but who choose to live in different ways (one doing everything right to address their condition and the other doing nothing and making unhealthy decisions) still get the same benefit and pay the same amount under most health care plans.  However, the person making poor decisions is going to have an increased demand for healthcare services and therefore, costs will increase to cover that person.  Creenaght is hoping to change that model by putting personal responsibility and free market principles back in to healthcare.

The company is currently in the process to make their fully-insured plan available in several other states and hopes to have those become effective July 1st.  The plan is also now available to self-funded groups nationwide.  For more information, you can contact Creenaght through their website at www.creenaght.com or by calling 302-644-6545.