EveryMove blog

The Traditional Health Assessment is Dead

By Russell Benaroya

I have a good friend, Andrew Sykes, who is a well-respected wellness actuary.  I’d say he is one of the sharpest guys in healthcare I have met and he is an advisor for our company.  We spend a lot of time talking about the consumerization of healthcare and how personalization is an imperative to align the right interventions to the right people at the right time.    The prevailing wisdom has been to first assess a person, figure out a bit more about them, and then propose something they should do.  The problem with the traditional assessment is that it is fraught with error.  Andrew Sykes wrote an article a few years back articulating why he believes this is the case and I wanted to share the high points.

What is a health risk assessment?  A health assessment typically consists of about 5-10 pages of questions that cover topics around exercise, eating, alcohol, biometrics, and more.  Many of you have probably filled one out (when you are going to get $100+ from your employer most likely).  Here are the problems with traditional assessments according to Andrew Sykes:

1.  Health assessments paint a biased picture of the population.  Most people that fill out health assessments are healthier than average so the data is skewed.  It is more worthwhile to just assume that your population maps to the general population of healthcare prevalence (why wouldn’t they?) and focus the attention (and incentive dollars) on programs.

2.  We have really poor memories.  I can’t even remember what I did yesterday so when the assessment asks questions about my physical activity or my nutrition I am likely going to recollect myself in a much better state (oh, of course I work out 5 days/week).  We have hindsight bias and wishful memories.

3.  We know we’re being observed.  We know the assessment is going to be collected and reviewed by someone, somewhere.  As a result, we alter our behavior because we are being observed.  And we know what the right answer should be so we’re inclined to overestimate our health too.  There is a term for this called the Hawthorne Effect.  Asking fewer questions with more frequency in a less intrusive way can glean more accurate information.

4.  We are programmed to misreport.  As humans we are already biased to misreport because anything less than “getting a good grade” is failure.  As a result, we tell “white lies” on health assessments that we skim through in as little time as possible. When the reports come back that we’re actually healthier than we really are, it only exacerbates the problem.

5.  Health assessments focus too much on risk factors, not health habits.  Health assessments ask questions to smoke out high risk individuals for intervention but that’s not how health assessments are marketed.  They are marketed to promote positive health drivers.  Improving health isn’t about merely being “not sick” but rather helping make someone their best selves.  If a health assessment is actually going to be useful, its content should be squarely focused on improving health drivers like exercise, nutrition and sleep.

6.  Health assessments actually drive up healthcare costs.  Health assessments give people a “free pass” to go visit their physician and get prescription medications which drive up healthcare costs.  Most people do not learn about the results from their health assessment and fundamentally change their behavior.  By going to the doctor with some new information, individuals can work to “treat” their health risks rather than reverse them with a change in lifestyle.

The traditional health assessment is dead.  Let’s stop spending money on it as soon as possible.  It’s not enough to say that it’s a good year over year benchmark because people aren’t truthful and healthcare is not getting improved because of the assessment.  There is a better way.  Learning about individuals is a process, not a 5-10 page questionnaire.  It is a process that directly accompanies engagement in actions and programs designed to improve health, not just treat the health risk. 

Posted on November 9, 2015 02:30 PM


Wearable Tech and Healthcare Week in Review -- Week of November 2, 2015

By Russell Benaroya

Summary: With health tracking platforms like Apple's HealthKit seeing increasing takeup, insurers are getting interested in the possibilities the devices represent. While health and fitness tracking platforms have long been popular with runners and quantified selfers, the arrival of Apple's HealthKit has caused a new group to get interested: insurers. Read more on this upcoming trend in this article from Jo Best. 

Summary: There’s some news for those who were questioning Fitbit’s entry into Corporate Wellness area. Reportedly, the number of businesses who started monitoring their employees’ wellbeing with Fitbit’s trackers have increased significantly in the last four months, when the program first started to take shape. Fitbit shares were up as much as 5%, as wearable device maker takes on 20 new enterprise customers in the third quarter, including Barclays PLC. Read more in this article from Smith Dalton.

Summary: The Consumer Electronics Association (CEA) this week released a set of voluntary guidelines for use by organizations designing tools and devices based around health and wellness. Providing consumers with clear, straightforward information on security is especially important as many remain wary about the privacy of their health information. Read more in this article from Katie Dvorak.

Summary: The success of Apple's ResearchKit platform in the clinical trial space has caught the attention of the U.S. Food and Drug Administration. In an Oct. 29 notice published in the Federal Register, the FDA is seeking input on how mHealth technology might be used to improve clinical trials. The agency is particularly interested in how healthcare providers and other parties are using consumer-generated data, how they're reaching out to consumers, and whether the data being collected is useful and reliable. More in this article from Eric Wicklund.

Summary: The smartphone has graduated from simply being a communication device to one that is capable of being used as a health tool in our daily lives. A veritable digital health revolution is brewing, with a plethora of health apps coming to market that go beyond simply tracking your daily steps and caloric burn. Nonetheless, while many companies and tech giants (eg, Apple and Google) are growing this niche, many health care practitioners are still trying to deduce how to use such data for daily practice and patient care. More in this paper published by Timothy Dy Aungst and Steven Khov on Pharmacy Times.

Summary: It should come as no surprise that we're losing the battle to improve global wellness.  But, there are rays of hope. As digital technologies like the Web and mobile have gained in popularity, some have used these tools to nudge people to engage in healthier behaviors. Read more in this article from Fard Johnmar.

Posted on November 9, 2015 12:10 AM


How the Affordable Care Act Unlocked the Entrepreneur in Healthcare

By Russell Benaroya

We may have different views on the Affordable Care Act (ACA), its desired effects and practical realities, but one thing is clear:  The ACA has triggered massive market disruption and created a treasure of new businesses and business opportunities.  Established players are shifting their strategies toward a future where money and customers flow in new ways.   By no means have we reached a panacea of solutions that actually work (or even help lower costs…yet) but the path to change for the better is afoot.  Many companies will not survive.  Some will and they will be transformative.  Here are some categories that have been created and/or benefitted from the ACA:

Risk Coding.  The public insurance exchange is complicated.   Health plans have little control over the health risk of people that purchase their insurance in the online marketplaces (e.g. www.healthcare.gov).  The government has agreed that if a health plan assumes risk that is greater than some market average then the government will facilitate payment for that additional risk through a vehicle called risk adjustment (low risk health plans pay money to higher risk health plans).  Risk coding is the act of a physician properly diagnosing a patient and the insurance company submitting that coding to the government to get paid more for that risk.  If an individual with assumed risk (e.g. a diabetic) is not coded then the insurance plan doesn’t get paid but they still incur the costs of providing expensive care.  Companies like Arrohealth are making a big impact in this market by providing coding services for health plans.  They actually will go to physician practices, look at their charts and make sure they are coded correctly.  There is big money in risk coding.  In fact, it is the result of poor risk coding that has many health plans licking their wounds in the Exchange.

Wellness.  We all know it’s important to create a culture of prevention and hundreds of companies have jumped in to serve this market.  Why?  Well, employers are spending more money (estimated at $6 billion/year) on employee wellness to control costs, build culture and improve productivity.  Additionally, the ACA created more incentive for companies to offer premium differentials (up to 30%) for participating in a wellness program.  There are a lot of rules (and conflicting rules) around HIPAA and the ADA but the market is big.  Companies like Limeade, Redbrick, Welltok, Jiff, and Virgin Pulse, are taking the higher end of the self-insured market.  Many of these companies are positioning themselves as the “platform” where they integrate other app content and manage a broader suite of services like benefits, reporting, analytics, and incentives.

Individual Insurance.  The launching of the individual public exchanges created a tectonic shift with the prospect that many small employers will send their employees to the exchange to source benefits in a 401K style contribution fashion.  When this happens at scale, the broker community that sells insurance to these groups will need to find a new purpose.  So brokers are working to become more relevant to their customers.  Companies like Maxwell Health have built a benefits management platform that brokers can offer their customers.  Zenefitsis completely disrupting the small group market by giving away their human resource management platform and making money as an online broker when companies buy insurance through them.  Gravie is helping employees that are moving to the individual market figure out how to have a better shopping experience.  Speaking of better shopping experience, there are exchange companies like Array Healththat are developing the shopping platforms and big consultancies like AON Hewitt are launching their own individual private exchanges.    The world is moving the individual marketplace and companies are positioning for that growth.

Consumer Tools and Services
The ACA is a catalyst for the growth in Consumer Directed Health Plans (CDHP’s).  CDHP’s are high deductible health plans which means that consumers bear a significant out of pocket obligation before their insurance kicks in.  It is estimated that by 2017 a majority of employers will be offering CDHP’s and it is an example of how risk is being transferred to the individual.    As the consumer bears more out of pocket expense, market forces take over which means that consumers want to know how they can reduce that expense and employers want to make sure they aren’t just passing along costs without the ability to offset.  It is a reason that devices like Fitbit, fitness applications like EveryMove, telehealth companies like Teladoc, and price transparency tools like Healthcare Bluebook are taking off.  In other words, consumers have access to an increasing number of services that will help them better manage their health (and the costs of the services they incur) because there is real financial risk if they don’t. 

Population Health Management
Speaking of transferring risk, providers are being asked to take more responsibility for the health outcomes of their patients.  Health plans are partnering with providers to deliver tools and innovative reimbursement strategies that are tied to managing a patient’s health rather than just billing for a visit (known as fee for service).  In order to better manage risk, providers need more insight into which patients are at risk.  Population health software companies have landed on the market in a big way.  Companies like ZeOmega, Deerwalk, Caradigm, Truven, Verisk, and Amplify Health have all found a way to wedge in with their analytics capabilities.  As they say, you can’t improve what you don’t measure and population health is helping to measure along the guidelines that health plans are subscribing to, such as HEDIS and Medicare Stars rating systems.

By no means is this an exhaustive summary.  Check out companies like Rock Health and StartUp Health that have been formed to cultivate many of these innovative ideas through funding, mentorship, and collaboration.    While many new entrants might look at a healthcare start-up opportunity as a “no brainer”, it is critical to get very specific on the problem that you are solving, how you are going to reach your target customer and finally, who is going to pay you for it.  Now get after it!

Posted on October 2, 2015 06:29 PM


Wearable Tech and Healthcare Week in Review -- Week of 9/14/15

By Russell Benaroya

CBG Opportunity Required Fields Grid
Summary: Linking wearable biometric data to electronic health records and other material such as nutrition information offers additional value to wearable products. The insurance industry is racing to quantify the impact of wearables throughout the product and customer life cycle. More details in this article from LifeHealthPro.

Summary: mart wearables, such as the Apple Watch, will surpass basic wearables, such as Fitbit activity trackers, in shipments by 2018, a new report by research firm IDC predicts.  Smart wearable devices, mostly smartwatches, will make up about 31.5% of total wearables shipped this year, up from 18.1% in 2014. More details on this and additional industry forecasts in this article from IBDinvestors.

Summary: Fitness trackers of all kinds have become extremely popular in urban India, helping people to manage their physical activity and calorie intake and stay in shape. Device makers see significant opportunity due to growing interest in the connected health and fitness market. Sudhir Chowdhary writing for Financial Express gives more details in his article.

Summary: Wearable technologies have gained increasing traction in recent years, particularly with the much hyped launch of the Apple Watch in April. Approximately six million people are expected to own a wearable device by September 2015, according to YouGov’s Wearables tracker research 2014, published in October 2014. Furthermore, almost a fifth (18%) of employees in Europe have access to some form of wearable technology at work, according to research by human capital management provider ADP. it is in the health and wellbeing space that wearable devices are having the biggest impact, and perhaps the greatest potential, for organizations and their staff. Read more in this article from Louise Fordham.

Summary: Baby Boomers recognize the importance of being both physically and financially healthy, but according to a recent John Hancock survey they could be living healthier lives which would potentially make them more prepared for their financial future. What if by living a healthier life you could get discounts on your life insurance premium?  This is leading Corporates to include wearable technology in their corporate wellness programs. Read more on this in this article from Casey Dowd with Fox Business.

Summary: When it comes to health and wearable technologies, most people are only familiar with fitness tracking armbands, but counting steps is just the tip of a fast-approaching iceberg.  In the not-so-distant future, wearable technology and big data will completely revolutionize our approach to health care, according to Tom Emrich, founder of the Toronto-based wearable technology meet-up and advocacy group, “We Are Wearables”. Jared Lindzon writes more on this in his article. 

Posted on September 21, 2015 03:35 PM


Wearable Tech and Healthcare Week in Review -- Week of 9/7/15

By Russell Benaroya

Summary: The use of wearables is clearly on the rise. A report released in April 2015 by IT staffing firm Robert Half Technology shows that 81 percent of the 2,400 U.S.-based CIOs surveyed expect wearable computing devices such as watches and glasses to become common tools in the workplace. So companies must consider the benefits and challenges of allowing employees to use these devices at work. A detailed discussion on this topic is available in this article from Bob Violino. 

Summary: One of the greatest challenges the U.S. healthcare system faces is a growing population of sedentary individuals. As a result of working long hours and accommodating busy school schedules, many families lack the time (and the energy) to prepare healthy meals and to exercise regularly. Still, most families want to be healthier; they simply lack the information and motivation needed to maintain healthy habits. That seems to be changing with the wearables. Taylor Mallory Holland provides more insights to this.

Summary: Corporate wellness programs used to involve lackluster participation, a pedometer and potentially fudged numbers on a spreadsheet. But FitBit is changing the way HR departments implement corporate wellness programs -- and the results may surprise you.  More in this article from Sarah K. White.

Summary: As time goes by, employers have realized the importance of having healthy and happy employees in the improvement of the company's performance and productivity. The benefits of these wellness programs are undoubtedly clear but the problem is how to make the employees participate in them. FitBit comes in to solve this predicament. See how, in this article from Evangeline Alfeche with CruxialCIO.

Summary: The global wearable technology market is already worth more than $20 billion, 74% of that value comes from mature categories: the wristwatch, earphones, and even blood glucose test strips. More numbers in this article from Techvibes NewsDesk.

Summary: One great tool for companies to reduce health expenses? Software that encourages employees to get moving. Williams Cos., in collaboration with Limeade, a fast-­growing software startup, has the data to prove it. Read further in this article from Heather Clancy.

Summary: Wrist-bound wearables are so last month, which is why one company is introducing an old concept with a new twist. Launched by fitness and health company Health o meter, a new line of products called “nuyu” is a full suite of tools to help users get and stay in shape. For those of you who don’t want to be weighed down by a watch-like device, try clipping nuyu’s tracker on your belt, or better yet, tie it to your shoelaces.  Read more in this article from Lulu Chang with Digitaltrends.

Posted on September 15, 2015 01:30 PM


By Russell Benaroya

Healthcare is undergoing major transformation that is changing the way individuals engage with their care, how providers are reimbursed, how health insurance companies interact with consumers and how employers are providing benefits.  I’d say that’s pretty major.  Any disruptive force, regulatory or market driven, requires a new way of thinking about solving problems.  It requires innovation.  The problem is that health plans that set up “Innovation Departments”, "Innovation Labs”, or invest in "Start-up Accelerators" may be missing the big point.

Why is leadership pursuing these tactics?  If you believe that we are motivated by fear or greed I think this one is fear driven.  First executive leadership knows they need to be in the “innovation” game and the easiest thing to do is segment off a group of people to head it up.  It may check the box but won’t transcend the organization.  Second, there is a concern that innovating across the health plan will disrupt the core insurance “bread and butter” business so the appropriate thing to do is keep innovation out of there in order to protect the base.  Courageous and vulnerable leaders know that this is not going to drive the next generation of organizational success.

Clayton Christensen invented the idea of disruptive innovation and the “innovators dilemma”.  The “innovator’s dilemma” is the difficult choice an established company faces when it has to choose between holding onto an existing market by doing the same thing a bit better, or capturing new markets by embracing new technologies and adopting new business models.  A good example is NetFlix moving from shipping DVD’s to OnDemand or IBM moving to start making PC’s even though it’s bread and butter was in mainframes.  Health plans face the classic innovator's dilemma. 
In order for health insurance companies to embrace disruptive innovation, consider the following:
  1. Change your Mission Statement.  There is nothing wrong with changing your mission to align with the realities of your business.  Consider Microsoft.  For many years their mission was “a computer on every desk and in every home."  In 2015, the new CEO, Satya Nadella changed it to, “Empower every person and every organization on the planet to achieve more.”  This is the one of the most valuable companies in the world that changed their mission.  It's okay.  Changing the mission was a signal to the market and the organization that things are going to be different.

  2. Acknowledge Physics.  Change the Mass.  It is simple physics according to Newton’s Second Law that Force = Mass x Acceleration.  The larger the mass the larger the Force (innovation) that will be required.  Unfortunately acceleration needs to be company wide which means that its application to the entire mass (the organization) will require a huge amount of force.  Unless, that is, you decrease the mass or change its construction.  A mass that has been in steady state for 20+ years may be resistant to change.  Change the mass.

  3. Be Courageous.  Well known scholar and author, Brenè Brown, recently wrote Rising Strong: The Physics of Vulnerability.  If you want to be in the arena (and all current CEO’s of health plans are playing in the new arena of healthcare) and you want to dare greatly you are signing up to get your ass kicked.  And when we sign up for that we can choose comfort or courage.  We can’t choose both.  There are cheap seats in the arena for people that don’t venture on to the floor.  Venture on to the floor.  It will take special leaders to navigate this change.
Innovation in healthcare is not a department and it is window dressing to believe that making it so will position the largest healthcare organizations for the revolution afoot.  Those leaders that align their mission with the market, acknowledge the physics of force, and are courageous, will realize they are not alone when their entire organizations line up to play in the arena.

Posted on September 8, 2015 01:30 PM


Wearable Tech and Healthcare Week in Review -- Week of 8/31/15

By Russell Benaroya

Summary: Once every few years, the Healthcare domain undergoes a transformation. Trends of Healthcare in 2015 point towards the popularity of Telemedicine, E-Health and Smart Wearable Medical devices. The emergence of these trends indicate a new wave in the Healthcare domain; more commonly known as Healthcare-IT.   The Wearable technology had so far been most popular in the Fitness segment. However, the healthcare application of the technology is the segment with the maximum potential. Soumya Rajan discusses more on the current trends in her article.

Summary: Intel exec says while wearables have yet to bring healthcare oraganizations analytics, other use cases exist. Healthcare organizations may have to wait a while before they can leverage data from wearables for predictive analytics, Christopher Gough, lead solutions architect for Intel Health and Life Sciences, mentions in a blog. Scharon Hardingdiscusses more on Christopher Gough’s blog post

Summary: Wearables have emerged for fitness tracking, medical condition management, wellness monitoring, and personal safety assistance, among other use cases. Wearable devices and their apps offer new means for consumers to manage their health and wellness. More details on the current trends and market overview in the article from Jennifer Kent

Summary: Wearables have emerged for fitness tracking, medical condition management, wellness monitoring, and personal safety assistance, among other use cases. Wearable devices and their apps offer new means for consumers to manage their health and wellness. More details on the current trends and market overview in the article from Megan Williams with Bsminfo.com

Summary: According to Grant Hughes, Co-founder and COO of FocusMotion, a wearables-first motion technology and application company, it will not be gyms or gym equipment manufacturers who will lead the fitness innovation charge because while they have many strengths, they have no core competency in technology. Also, their longstanding business models aren’t front loaded with the margins required to sponsor robust R&D efforts. Wearables are slowly revolutionizing the fitness industry. More on this discussion with Grant Hughes and the author from Sporttechie.com

Posted on September 8, 2015 01:20 AM


Wearable Tech and Healthcare Week in Review -- Week of 8/24/15

By Russell Benaroya

How Wellness Programs Must Evolve
Summary: Last month a diverse group of experts gathered in New York for a roundtable discussion on “redefining workplace wellness.” The group spanned academia, the health professions and corporate America and while their conclusions weren’t necessarily groundbreaking, they were nonetheless insightful and thought-provoking. The Global Wellness Institute organized the meeting and they’ve just released a report summarizing the discussion. Andrew Mcilvaine includes some of the highlights in his blog, including the impact and future of wearables and health technology.

Fitness Trackers: Trend or Tool?
Summary: Move over, wristwatch, there’s a new accessory in town and it’s sleek, functional and wildly popular. Wearable fitness devices—think FitBit, Garmin, Jawbone, Apple Watch—are strapped around the wrists of people everywhere, tracking their every move. University of Rochester’s Lori Barrette’s discussion with UR Medicine family physician Dr. Michael Mendoza, she asks if they’re a trend, a status symbol, or a useful wellness tool.

NeuroMetrix's forthcoming app may require FDA approval
Summary: The Food and Drug Administration has said it doesn’t want to get involved with health-related apps. A forthcoming product from NeuroMetrix, the maker of the Quell device, might change that. Quell, an over-the-counter device that uses electrical nerve stimulation to manage pain. More details in this article from Erika Morphy.

Digital health: Moving toward a healthcare revolution
Summary: Runners were the first to discover the potential of wearable devices several years ago. They started using watches and pedometers to measure steps, location and heart rate. As technology became increasingly sophisticated, early technology adopters and fitness enthusiasts followed suit. Today, nearly 75 percent of adults are using a fitness tracker. And, it is projected that about 120 million wearable devices will be sold by 2018. The eventual future of healthcare is one in which most patients will be hyper-connected to a network of devices and generating an astounding amount of data. More details in this article from Ryan Beckland.

Apple Debuts at the Number Two Spot as the Worldwide Wearables Market Grows 223.2% in 2Q15, Says IDC
Summary: In its first appearance in the wearables market, Apple finds itself within striking distance of the established market leader, Fitbit. Anytime Apple enters a new market, not only does it draw attention to itself, but to the market as a whole. The article from BusinessWire provides more details on the current trends and market share in the wearables industry

Can digital fitness trackers get you moving?
Summary: The study’s researchers wanted to see if digital fitness trackers would increase physical activity among older women. Heidi Godman discusses the results of this study by American Journal of Preventive Medicine (AJPM).

Wearable devices pose data security problems
Summary: While wearables have become quite popular, they do pose some risk to employers regardless of the company’s stance on wearables. If an employer will issue wearables to some or all employees, questions are being asked on what they plan to do with the data that is collected and how will they keep it secure? Jeffrey Labarge with Rochester Business Journal discusses this in more detail.

Posted on September 1, 2015 03:46 PM


Wearable Tech and Healthcare Week in Review -- Week of 8/17/15

By Russell Benaroya

Novant Health Connects Patients and Doctors Through Wearable Technology
Summary: Beginning this month, Novant Health patients will be able to share data from their fitness tracker with their doctor through Novant Health's electronic patient portal, MyChart. Novant Health's more than 430,000 MyChart users will be able to submit data from personal fitness devices, such as smart scales and wearable fitness trackers, directly to their doctors. More on this from Novant Health

Fitness Wearables are taking off across the globe, but for how long?
Summary: Fitness wearables are in the news with the success of Fitbit’s IPO, which launched on June 18th this year at USD20 per share and reached nearly USD48 per share by August 3rd. Is this really the valuable market that many people obviously believe it to be? It’s certainly crowded, with a range of products at all price points. Margaret Ranken discusses more on this in her article.

Wearable market to see most growth in North America
Summary: The global wearable technology market was worth US$749-million in 2012, according to Hexa Research, and is expected to grow in coming years at the CAGR of 40.7% from 2012 to 2018. Working with synchronization of human actions, wearable technology is growing rapidly due to increase in market of various applications such as advertising, cycling, running, surgery, remote patient monitoring, sports brain and project planning. In 2018, the wearable technology is expected to reach around US$5-billion globally. More details in this article from Stephen Law.

The Latest Campus Fashion: Wearable Technology
Summary: As wearables hit the mainstream, campuses discover more than one way to tap the devices’ potential. Tarleton State is one of many higher education institutions that are taking advantage of wearable technology as a way to give students and employees better — and more healthful — experiences both in and out of the classroom. Read more in this article from Karen J. Bannan.

Why data protection will be key to wearable tech success
Summary: The next generation of health-focused wearables could revolutionise the way people live, but only if consumers can be certain that their data remains confidential. The author from AFP Relaxnews shares the industry facts and concerns around data protection.

Wellness programs will spur wearables adoption in workplace
Summary: A new Tractica report projects more than 75 million wearable devices will be deployed in enterprise and industrial environments between 2014 and 2020, with smartwatches leading the way. Judy Mottl gives more details on this report in her article.

Posted on August 24, 2015 03:25 AM


The Times They Are a Changin’ and We Need to Rethink our Jargon

By Russell Benaroya

The Times They Are a Changin’ said Bob Dylan on his 1964 album and there is no better example of that than in healthcare today.   The tectonic plates are shifting and everyone is a little unsteady as they seek to find solid ground.  Consumer, employers, physicians, hospitals, and health plans are all trying to find that magic synergy to bring the universe into order.  But at the epicenter of all of this change is the most fundamental force of all….the role of the consumer.

Many of have experienced our changing role, moving from a position on the fringe of healthcare (things happen to me and I have no clue how my care works) to the center (things happen because I make informed decisions based on data that is transparent and readily available).  Oh my, that is a change and all of us need to be ready for it. 

There are a number of examples here but consider services like telehealth that will give you immediate provider access for a small fee, price transparency that will help you see what services will cost, and even fitness apps and devices that will help you manage/monitor your own wellness.  These aren’t just “neat” advances.  They are fundamental imperatives because over the next 5 years, it is expected that 35% of us will have what are called consumer directed health plans (CDHP’s) and value based benefits (VBB’s) to help reward our smart choices?

“Consumer directed” what and VBB who?  Okay, now we’re getting to the heart of this article.  Unless we make it abundantly clear what is happening in the healthcare consumer transformation, we will continue to walk in a haze of lingo confusion.  We need to simplify our healthcare jargon in a way that is understandable to the consumer so they “get it”.  I’m not suggesting individuals aren’t smart but the most savvy media companies understand that they need to build content targeting an 11 year old education.  We like it simple and easy to understand.  Let’s get there in healthcare.

Well since I threw out the jargon, let me clarify those two terms. 

Consumer Directed Health Plans are simply health insurance products that require the individual to pay a lot more out of pocket before insurance kicks in.  It makes the cost of insurance less but it requires that individuals better manage their health because otherwise they will suffer higher up front out of pocket costs.   Many of these products are accompanied with a health savings account (a what?) or HSA which is a fancy term for a retirement account that can be funded pre-tax by an employer and be used to pay for these out of pocket costs. 

VBB  (Value Based Benefits) is another really good one.  VBB or VBID (value based insurance design) has been around for a long time.  The concept is that health plans want to direct and promote high value services to individuals that will lower healthcare costs (makes sense).  These are services like getting your physical, filling out a health assessment, getting a biometric test, being active, etc.  VBB is massively antiquated in its delivery and majorly underutilized because the technology delivery is poor and no one gets it.  Do you even know what benefits are available to you with your insurance?  I doubt it.  What we need to do is bring VBB into the consumer spotlight.  Give individuals an easy, engaging and fun view to see their benefits, how to achieve them, and the associated incentives.  And please, please don’t call it VBB.  Call it member rewards or consumer focused care benefits. 

I’m no naming expert but you get my point.  If health plans are truly going to embrace the consumer then we must stop with the antiquated jargon (I don’t even want start talking about ACO’s) and get a marketing agency to help develop better language that will not only help the health plan better connect with the individual but will also help the individual better connect with their health.

Posted on August 19, 2015 04:42 PM