Consumer Directed Healthcare

Health Savings Accounts are clearly not just for the “young and healthy”.
MINNEAPOLIS (April 23, 2007) – Individuals enrolled in a consumer-driven health (CDH) plan receive needed care at rates equivalent to, or in many cases higher than, members of traditional plans, according to data released today by UnitedHealth Group (NYSE: UNH).

This new data illustrates how these plans are creating much more informed health care consumers who are better able to understand and navigate through important health decisions. It also helps alleviate concerns over whether consumer-driven plans will induce the chronically ill to forgo necessary treatment, or the healthy to avoid preventive care.

UnitedHealth Group, through its Definity Health business, analyzed 2004 and 2005 data for 250,000 of its consumer-driven plan members and compared it to an external, national benchmark population of 10 million traditional health plan members. The study examined consumer usage of preventive care services such as cancer screenings and well child care, as well as adherence to evidence-based care among individuals with chronic conditions, including diabetes, asthma, coronary artery disease and congestive heart failure.

According to Miles Snowden, M.D., UnitedHealth Group’s senior vice president of Health Advancement Solutions, the analysis confirms that when consumers are given the proper ongoing support and tools to help them understand and navigate important health decisions, they continue to seek needed and appropriate care.

UnitedHealth Group is the largest provider of consumer-driven health plans in the country with more than 2 million members. The company analyzed claims data to determine utilization rates of preventive and evidence-based care using measures recommended by renowned national organizations such as the U.S. Preventive Services Task Force, the National Committee for Quality Assurance, the American Diabetes Association, and others. Key findings include:
Preventive and Well Child Care
Compared to the benchmark population, CDH members were:

• 16 percent more likely to have a cervical cancer screening.
• 10 percent more likely to receive a cholesterol screening.
• 16 percent more likely to receive a prostate screening.
• 8 percent more likely to have well child visits.
• As likely to receive a colon cancer screening.
• As likely to receive mammograms.

Diabetes
Compared to the benchmark population, CDH members were:

• 16 percent more likely to receive HbA1c tests. HbA1c testing is among the most important steps in monitoring diabetes and provides an average of an individual’s blood glucose control over a six to 12 week period.
• 36 percent more likely to see their physician.
• As likely to receive eye exams.
• No more likely than the benchmark population to be admitted to the hospital or visit the emergency room for diabetes.

Congestive Heart Failure
Compared to the benchmark population, CDH members were:

• 41 percent more likely to receive creatinine tests, an important test of kidney function for those on heart medication.
• 26 percent more likely to receive potassium tests.
• 6 percent more likely to use ACE inhibitor medications, which block an enzyme that contributes to narrowing of the blood vessels.
• As likely to receive an electrocardiogram.

Coronary Artery Disease (CAD)
Compared to the benchmark population, CDH members were:

• 22 percent more likely to receive lipid tests
• As likely to visit a physician

Asthma
Compared to the benchmark population, CDH members were:

• As likely to have a flu shot, a critical preventive measure for asthmatics.
• No more likely to be admitted to the hospital or visit the emergency room for asthma.

“This data confirms that individuals are continuing to receive important health services and are not compromising the quality of their care,” said Dr. Snowden. “Combined with other recent studies that show how CDH plans are successfully being used as a savings mechanism, we are beginning to develop a much more compelling and fact-based view of how consumer-focused strategies are working to support both health care affordability and quality.”

This quality of care research is the third in a series of studies from UnitedHealth Group over the last nine months, creating a solid body of evidence illustrating that CDH plans are delivering positive changes in health care behaviors and costs for both employers and consumers:

• A July 2006 study found that CDH plans constrain costs and utilization over time.
• A January 2007 study found that Health Savings Accounts encourage saving among all consumer segments, including low-income populations as well as white-collar professionals.
• This study of preventive and chronic-care services confirms that the above gains do not come at the expense of vulnerable populations or discourage individuals from seeking needed care.

For more on the story please see www.unitedhealthcare.com.

Popularity: 23% [?]

The need for healthcare pricing transparency is the hottest conversation right now in the world of consumer directed healthcare. (www.galen.org) There are initiatives forming at the state, local, regional and government levels.

In a March 14 speech, Mike Leavitt, secretary of the Department of Health and Human Services (HHS), announced his intention to create transparency in quality and price. The federal government makes up 46% of the entire payer market, according to HHS but has not been a participant in the efforts to control cost. (www.managedhealthcareerexecutive.com).

A Pennsylvania lawmaker proposed a price transparency bill for pharmacies and Hospitals (www.medicalnewstoday.com). The intent was to create a way for consumers to view the top 150 most popular prescription drugs. The pharmacies would update their drug list monthly and could change prices at any time as long as their in-store price list are updated at least once a week. The bill also calls for the creation of a hospital payment registry. The registry would be updated annually and include payments received by hospital for the 150 most common admission diagnoses and most often dispensed drugs.

These conversations are not surprising. Studies indicate the patients are 58 percent more likely to switch to a more cost-effective prescription drug or a lower-cost pharmacy channel when they can comparison shop for drugs. The analysis conducted by Medco Health Solutions, Inc, found that patients are willing to price shop on prescriptions drugs when presented with clear information on their clinical alternatives, channel options and overall savings. (www.medcohealthsolutions.com)

The notions of consumer-driven healthcare and price transparency are going to fundamentally change how Hospital and Pharmaceutical marketing takes place. Price transparency and consumer-driven healthcare will force marketers to engage with consumers healthcare as never before. With the media reporting issues surrounding hospital and drug charges nearly every day, price is an increasing important portion of the marketing mix.

The next phase in price transparency must come directly for physicians who need to voluntarily post their prices so consumers can know directly and up front the full cost of a visit or procedure. One of the forces driving this will be consumer directed healthcare where consumers will want to get the best cost and quality as they spend their deductible dollars.

Popularity: 17% [?]