I Have A Better Idea, Mr. President

by George Pantos

President Obama has repeatedly challenged Americans who disagree with his approach to health reform to off their alternatives, most recently at his televised White House Health Reform Summit. “You got a better idea? Bring it on,” he has said.

Here’s a suggestion. Why not focus on streamlining health costs by harnessing technology that allows companies to take control of their healthcare expenses?

Businesses generally lack the data necessary to measure and manage their health costs, even though health care represents one of their biggest expenses. Executives have a better sense of how much money they spend on office supplies than where their health dollars are going. But with the cost of health benefits projected to increase 7 percent in 2010 — and to double over the next seven years — businesses can no longer afford to be unaware.

Some firms have a stake in preserving the costly status quo. Consider the insurance industry, whose top five companies recently announced profits up 56 percent from last year. Insurers’ business models are largely based on keeping firms in the dark — that is, preventing them from analyzing their own healthcare data and using the results to find alternative benefit structures that offer better outcomes at lower cost.

Companies have tackled customer relations and supply chain management with technology-driven strategies. Why not do the same for health benefits?

Such “Healthcare Performance Management” business strategies can alert companies to expensive problems within their benefits programs — and help them find ways to implement money-saving fixes. The innovative technology for doing so exists. It just needs to be adopted on a grand scale.

Although benefits are growing ever-more expensive, most firms employ a limited number of tactics for trimming health costs. They may adjust the level of benefits employees receive, force workers to pony up a bit more, or switch to a different provider. But these primitive approaches yield only marginal savings.

Healthcare Performance Management offers employers an alternative. With HPM data, managers can gain insight into what is happening in their benefits plans — insight that used to be the exclusive property of insurers.

For instance, on an aggregate basis, businesses could turn to HPM data to find out how many times the employee population had visited the doctor in the past year and correlate it with treatment data to ensure that their employees were following their doctors’ orders. Using that information, management could use tested software tools to respond to patient risks — and achieve real savings in the process. 

Imagine if a segment of a company’s workforce suffered from serious but treatable conditions like high blood pressure or high cholesterol. Many of these patients don’t take their medications appropriately. Companies can use real-time dashboard features to manage these risk factors preemptively — to the benefit of both workers and their bottom line.

Employers can also link their workers with specialized “coaches” to help them pursue personalized treatment regimes. These mentors can inform patients about lower-cost medicines or even prepare them to ask the right questions at the doctor’s office.

Critically, technology-driven HPM strategies also allow for strict protection of employee privacy. Employers simply aggregate data and lean on third-party healthcare providers to engage their employees. Companies pay the bills, but private medical decisions are handled exclusively by doctors and patients. Executives don’t need to know who’s at risk — they just need to know that a risk exists.

President Obama came into office promising the most technologically savvy administration in history. Yet his healthcare reform plan virtually ignores common-sense money-saving technologies that we use in all other aspects of our lives. It’s about time that changed.

George J. Pantos, Esq., is Executive Director of the Healthcare Performance Management Institute.


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