St@teside

New Hampshire Governor John Lynch recently signed legislation to enact HealthFirst, a program designed to make coverage more affordable to small businesses by emphasizing wellness, prevention, and chronic disease management. The state will convene an advisory group to work out the details of implementation, but the general requirements of the program includes the following:

• The price of the plan will be set at 10 percent of the median wage – currently $262 in New Hampshire[i] – and will include limits on out-of-pocket spending.
• All carriers with 1,000 members in the small group market need to offer the product. At least one carrier needs to meet the target premium, or a hearing is held to determine the reasonability of the target with proposed benefits. Depending on the hearing, all carriers may be required to offer the product at the target premium.
• The Insurance Commissioner will need to certify that the HealthFirst wellness plans create incentives for consumers, health care providers, employers and/or health carriers to:
  • Promote wellness;
  • Promote primary care, preventive care, and a medical home model;
  • Manage and coordinate care for persons with chronic health conditions or acute illness;
  • Promote the use of cost effective care; and
  • Promote quality of care by the use of evidence-based, best practice standards and patient-centered care.