There were two themes I heard repeatedly at the America's Health Insurance Plans (AHIP) conference in San Francisco last week:
Sander Domaszewicz, senior consultant at Mercer Human Resources Consulting in Newport Beach, CA, said consumer-directed healthcare isn't about forcing employees to pay a greater share of their healthcare bills. A CDH plan design will fail without consumer tools like physician and hospital quality data and funding sources such as health savings accounts or health reimbursement accounts.
Domaszewicz said health plans have an opportunity to help educate their members. Though studies show that patients trust their physicians more than health plans and employers, Domaszewicz said 70% rely on family and friends for healthcare advice, half admit they haven't followed their doctors' advice, and nearly half of people reject care management program offerings.
“There is a disconnect between what is the best thing for them and their families, and what they're doing,” he said.
The challenge is engaging those people, changing their minds and behaviors, and making them part of the healthcare team. Simply creating a health plan with deductibles and health savings accounts as a way to pass healthcare costs onto employees is not the way to make an educated consumer—or a happy employee.
Dennis Schmuland, U.S. health plans industry solutions director at Microsoft, told me health plan member portal traffic has been lower than hoped because the portals are too stagnant.
Microsoft's entry into the personal health record market last year was met with anticipation. Microsoft's personal health record, HealthVault, allows people to populate a PHR and share the information with third parties to create health, wellness, and fitness services. The technology giant added to its offerings last week with a new consumer health platform to help payers connect services like HealthVault and Windows Live, which Microsoft says will allow the user to help manage health through continuity of care documents, prescription medication lists, health histories, hospital discharge summaries, and lab test results.
Schmuland says the patient portal is an important channel, but is only one way to reach members. Health plans must provide a multi-channel approach if they expect to impact their members' health and lower costs.
“That's really where health plans need to go—to go where the consumer goes,” says Schmuland.
What can you do?
That these two topics were so prominent at AHIP should not be surprising. Both go to the heart of one of the major challenges in the health plan industry: to produce products and services that engage the member. Simply creating programs, such as a PHR or CHD will not work—consumers have shown us that.
Both have not impacted healthcare as hoped, and a reason for that is there simply isn't enough interactivity. Look at it this way: Millions of Americans don't stay up-to-date with their personal financial records like balancing checkbooks. So why would healthcare expect consumers to log in to their PHRs? You must give them a compelling reason.
The solution is to offer them valuable information that interests a member's specific needs and find out how and by what means to best reach that individual. That could mean a phone call, e-mail, instant message, interactive Web site, text messages, or any other emerging form of technology to create a multi-channel approach.
Health plans need to find ways to make valuable connections to members in order to remain competitive in this increasingly technologically-advanced marketplace. Simply transferring costs on members and uploading a PHR onto a Web site doesn't cut it.