The Empowered Consumer

Today’s presentation was from Wayne Sensor, CEO, Alegent Health, who gave what he calls: A Marketer’s Call to Action.

Mixing metaphors, Wayne says our industry is “at a crossroads” and “facing a gathering storm:” rising cost of healthcare, number of uninsured and questions about whether not-for-profit hospitals are keeping up their end of the bargain. He says this will be the age of the consumer.

Consumerism isn’t new in America, but it is for health care…and it has reached its zenith in TiVo, iPods, consumer-generated Super Bowl ads and you/me being the Time Person of the Year.

He says our choice is whether we embrace or deny consumerism. We need to have Tools to empower consumers, Access Points (e.g. clinics in grocery stores) and Incentives for good behavior.

He discussed some of the drivers of rising costs, including pharmaceutical costs, defensive medicine, aging population, lifestyle choices and failure to practice evidence-based medicine.

He outlined solutions in three categories:

Tools – Reporting meaningful quality data, with composite scores based on CMS data. Alegent’s first set of quality ads showed performance data that were below the regional average. Now the scores have gone up because they focus on what creates the scores at monthly clinical practice meetings. They publish their scores on the web site, and report that they not only have surpassed regional competition but also national levels of some elite centers.

Another tool they are developing is a personal cost estimating tool. “Instead of a list price we provide the consumer with the ability to find out how much tests and procedures cost and how much they will actually pay.” The program asks the consumer to enter their insurance plan and checks the co-pays to give a bottom line estimate. This is another big blue button that says “My Cost” on the site.
Access — studies said consumers generally like the care they get (but can’t afford it), but it doesn’t look anything like what they would really want: quick, convenient, with easy-to-understand costs. They developed Alegent Health Quick Care to give care in grocery stores, for everyday illnesses such as sore throats, sinus infections, etc. Nurse practitioners provide the service for $24-$52.

Incentives: As more employers offer Consumer Driven Health Care, we will see consumerism take control. More premiums and co-pays are being pushed to employees, which makes them unhappy but doesn’t necessarily really engage them. Wayne says we need more than that to be truly effective. We need to have programs to encourage preventive care and lifestyle modification.

For Alegent Health’s 8,500 employees, 88 percent chose consumer-driven options. Here are some of the plan elements:
If it’s preventive care, it’s free. Use of preventive care among employees is now 40 percent above the national average.
Healthy Rewards: All employees get an opportunity to do a health risk appraisal, which kicks out a list of risk factors. They get $100 in their health savings account just for doing the HRA (although this may be only for those at higher risk), and if they have significant risks they get lifestyle coaching. If they get to within 10 percent of the healthy level on that risk factor, they get another $400 in their HSA.

Early results: those participating in the weight loss program have averaged 15 pounds lost, the workforce is healthier, and Alegent spent less on health care than the previous year. They also gave a $750,000 rebate of premiums to their employees because the goal was health improvement, not saving money. Sort of a “profit sharing” plan for health.

These are some interesting thoughts, especially in an environment in which we’re seeing double-digit cost increases. The quick clinic and employee health plan perspectives are particulary relevant for the Health Policy/Health Reform debate.

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Author: Lee Aase

Husband of one, father of six, grandfather of 15. Chancellor Emeritus, SMUG. Emeritus staff of Mayo Clinic. Founder of HELPcare and Administrator for HELPcare Clinic.

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