Consumer Driven Healthcare

What comes first...?

  ...or rather, the high deductible health plan or CDH?

People keep debating the merits and weaknesses of Consumer Driven Healthcare, or CDH, and its flashy centerpiece, the Health Savings Account, or HSA.  The HSA is the best tax savings vehicle and the most flexible short or long term benefit there has ever been... who can complain about that?  Well, see, it's that pesky required High Deductible Health Plan (HDHP) that is the sticky point, and the basis of the argument that only the rich and healthy win. Valid arguments abound. But that is not the point of CDH.

Let's back up and talk about this high deductible health plan itself, out of the context of CDH, because whether people want to realize it or not, high deductible health plans along with other cost-sharing plans are and will continue to be on the rise.  According a recent (September 2008) Mercer study, "Well over half (59 percent) of employers taking action to reduce their 2009 cost increase will raise deductibles, copayments, coinsurance or employee out-of-pocket spending limits... Between 2003 and 2007, the median family deductible for in-network services... rose from $1,000 to $1,500"   

The fact is, whether we typical citizens want to be "consumers" of healthcare or not, we are going to have to be under any administration.  We're paying more of the bills, like it or not. This happens not because our employers think it would be a great socially conscious gesture to promote consumerism, but because they simply have to reduce benefits to contain costs.

So let's, regardless of party affiliation, focus on solutions that bridge that inevitable gap, including education, cost transparency, supplemental support options such as HSA or HRA (or whatever the powers that be dream up as the next best solution). That, I believe, is called CDH... at least for now.

Heather Andrews (handrews@lighthouse1.com) is a Product Consultant at Lighthouse1, LLC

Impact of Unemployment and the Economy on Single Payer System

The Healthcare Blog posted an interesting article on the impact of unemployment rates on the push toward a single payer / universal healthcare system. 

Hit the jump here: [The Healthcare Blog]

“Perfect Storm” to “Disruptive Innovation”: The CDHC Summit

Jackie Dornfeld

These are tumultuous times in healthcare today. A ‘perfect storm’ is what speakers told us at the October National Consumer Driven Healthcare Summit in Washington DC. They described the situation as a grim culmination of various disturbing trends:

• Uncoordinated care -- 20% of tests are duplicative

• Poor quality -- 100,000 die each year due to medical errors and hospital infections 

• Aging population -- 40-80 million seniors are living beyond 65, and most with chronic diseases

• Unhealthy behaviors -- $500 billion spent annually (25% of total medical expenditures) due to ‘behavioral habits’ including obesity, smoking, alcohol and non-adherence 

• Skyrocketing health care costs – over 9% premium increases for 5 consecutive years. $370 billion in unfunded medical liabilities among state governments alone. 

• Poor access – 40% of employers unable to afford offering health coverage. 47 million uninsured.

Indeed, an alarming situation. And worse yet, many ‘perfect storms’ often result in even further harmful disruption. This would be quite typical.

But, the consumer driven health space is not typical. Here, disruption is taking-on a different and much more positive form. What we’re seeing is “disruptive innovation” – the kind of new solutions that cause true change in how providers, insurers, consumers and the entire system behave.

Summit speakers talked about many examples of “disruptive innovation” happening in the marketplace today. For instance, we are seeing:

• Personal Health Records (PHRs) – web sites such as HealthVault and Google Health intended to help consumers store, manage and share their personal health information. 

• Medical Tourism – cost conscious consumers drawn to global destinations for health care services at an average cost of 20% less than in the U.S. 

• Value-Based Benefit Design (VBBD) – steerage of consumers to high performing providers applying evidence-based medicine techniques. 

• Online Individual Insurance – web sites such as eInsurance.com providing an end-to-end consumer experience from comparing insurance options, to underwriting approval, to immediate coverage.

• Wellness Programs – encouraging healthy behaviors such as weight loss, smoking cessation and preventive care through various incentive programs. 

• Voluntary Benefit Employee Associations (VEBA) – establishing tax-advantaged trust arrangements to cover future health care expenses for active and retired employees. 

• Consumer Activation – engaging consumers in their health decision-making with targeted messaging and innovative media/tactics such as text reminders, blogs, videos, and default enrollment.

So, how can each of us help move health care from the “perfect storm” to “disruptive innovation”? It all starts with identifying and investing in promising ideas that upset the status quo. And by aggressively transforming ideas into new and improved solutions. Only then will we have the kind of disruption impactful enough to change health care for the better.

Jackie Dornfeld (jdornfeld@lighthouse1.com) Director of Product Management at Lighthouse1