Ethical Marketing Dilemmas
Cigna Causing Tidal Waves Among Members, Employers
Corporate relations professionals at Cigna HealthCare Mid-Atlantic are busy handling the backlash from members, employers and physicians due to its recent decision to drop hundreds of Washington, D.C., area doctors from its preferred provider organization run by National Capital PPO (NCPPO), a Springfield, Va., firm.
Some doctors, patients and corporate employee benefits managers are up in arms because of the tough ultimatum Cigna has imposed on 12,000 people that were enrolled in the NCPPO plan: find new doctors or pay more to stay with their favored physicians. But the corporate relations department headed by Mark Di Giorgio, Cigna's director of corporate relations, is fielding these anxious concerns by focusing on the positive aspects of the aggressive corporate move by highlighting these benefits:
- Cutting out NCPPO now creates a seamless national network that will avoid delays in paying claims.
- Directly contracting with doctors through its new PPO network increases the number of patients to doctors because their national employer clients will have access.
- The new PPO network enhances the quality of direct communications to physicians.
- To respond to physician complaints about their reduction in fees (15 to 20 percent), Cigna maintains that they are using the industry's standard for physician compensation, the Resource Based Relative Value Scale (RBRVS).
So far, about 75 percent of Cigna's 3,153 NCPPO doctors have signed contracts to join the new network, falling short of Cigna's internal goal of 90 percent physician retention. (Cigna, 860/726-5848)
Innovative Targets
Humana Rolls Out Plan to Fill Niche Between HMOs and PPOs
To address mounting consumer concerns about rising healthcare costs and limited physician access, Louisville, KY-based Humana Inc. recently launched "HumanaFreedom Plans," a family of new open access products that let members seek specialist care without a referral. The plans will be marketed as the cost-effective compromise between HMOs and PPOs.
Humana's new plans allow members to visit any participating physician - primary care or specialist - without designating a PCP or getting a referral. "We believe there are a significant number of Americans who, in their personal outlook, fall somewhere in between those options. We built HumanaFreedom for them," said Greg Rotherman, Humana vice president for marketing.
For in-network providers, the plan delivers marketable customer service benefits and preventive care features, according to Humana. The plans are being introduced in Daytona, Fla., all of Texas and Kentucky. (Humana, Inc., 800/558-4444, ext. 5725)
College Grads Targeted For Short-Term Medical Insurance
Many of our nation's college grads, who are uninsured, shutter at the thought of becoming seriously ill. But Cleveland-based KeyCorp Insurance Agency, Inc, an affiliate of Key Education Resources, has made short-term insurance to this group a uniquely affordable possibility.
Targeting recent grads through a national direct mail campaign, Key Corp is aggressively educating and marketing the importance of health insurance to a target that typically does not place a high priority on health insurance. Monthly premiums run as low as $20. The KeyCorp insurance plan (underwritten by Time Insurance Co.) offers short-term medical coverage between one to six months and is affordably priced for recent college grads with new or temporary jobs. (KeyCorp, 216/689-7195)
New Enterprise
Two Financially Distressed N.Y. Hospitals Get $2 Million Loan
The New York healthcare job market just got brighter. The New York City Investment Fund (NYCIF), an entity developed to create jobs and promote economic growth in the five boroughs, recently committed a $2 million loan to support Jamaica Hospital and Brookdale University Hospital, two financially distressed hospitals in the state.
The loan will help capitalize the two managed care companies (Neighborhood Health Providers, LLC and Royal Health Care, LLC) created as a joint venture by the two hospitals and is expected to generate 850 marketing, clerical and administrative jobs over the next five years.
In the past two years, Brookdale and Jamaica established the two for-profit companies to make them more competitive in a growing managed care market. Profits generated by Neighborhood Health Providers, LLC and Royal Health Care, LLC are intended to provide important resources to the two financially distressed hospitals during a period of reduced public funding. NYCIF will now proved the financing that will allow the project to proceed. (NYCIF, 212/493-7551)
Marketing To Children
Prozac's Hot Young Target of Children May Be Ethical Taboo
Soon, when little Suzie feels sad, instead of asking for her Teddy Bear, she might ask for a peppermint-flavored Prozac pill, if Eli Lilly & Co. has its way. Pending FDA approval this summer, the household drug for depression and low-risk prescription is primed and ready to target childhood depression, which psychiatrists say is a pervasive and increasing problem.
But medical scientists aren't sure that antidepressants work the same way in children as they do in adults; some question their effectiveness altogether. No one knows yet how Prozac-like drugs, which alter levels of the brain chemical serotonin, might affect a growing child.
Despite the extensive body of data and anecdotal evidence on Prozac's effectiveness for adults, pediatric research is lacking, in part, because drug companies are reluctant to conduct research on children due to its ethical and costly challenges. In this case, the few studies that have been done on children have found anti-depressants no more effective than placebos in treating depression.
But Eli Lilly, encouraged by a potentially lucrative market of 8- to 15-year-olds, has recently conducted the largest controlled pediatric study on Prozac involving 96 children, 8 to 18 years old. The results were promising: 56 percent of those on Prozac and 33 percent of the placebo said they felt much or very much better. (Eli Lilly, 317/276-2000)