echnology and the Health Care Consumer - Henry …：技术和医疗保健消费-亨利….ppt

2006 Keenan & Associates, Inc. All Rights Reserved. Confidential Client Use (License No. 0451271),1,“Technology and the Health Care Consumer”,Managed Care Executive Group Clinical Integration/Interoperability to Improve Quality Presented by: Henry Loubet Chief Strategy Officer, Keenan Monday, March 27, 2006 , 2006 Keenan & Associates, Inc. All Rights Reserved. Confidential Client Use (License No. 0451271),2,Table of Contents,Introduction Market Opportunity & Size Business Case for Consumer Directed Health Plans (CDHPs) CDHP Results Engaged Consumer, 2006 Keenan & Associates, Inc. All Rights Reserved. Confidential Client Use (License No. 0451271),3,“Refusal to adopt health IT contradicts the Hippocratic Oath, since its use would help them make better medical decisions, achieve better results and make their patients happier.” Source: Craig Barrett, Intel Chairman, HIMSS 2006 “To above all else do no harm.” - Hippocrates, 2006 Keenan & Associates, Inc. All Rights Reserved. Confidential Client Use (License No. 0451271),4,About Keenan,Keenan is a California based full service brokerage and consulting firm, dedicated to meeting the risk management, employee benefits, workers compensation and property & liability needs of public entities, health care systems and high-tech firms. Formed in 1972 Largest privately held brokerage firm in California 6th in the nation - privately held 17th in nation of the 40,000 Brokers/Consultants/TPAs 600+ employees 9 offices Owns and operates 3 TPAs Employee Benefits, Workers Compensation and Disability Management, 2006 Keenan & Associates, Inc. All Rights Reserved. Confidential Client Use (License No. 0451271),5,Market Opportunity & Size, 2006 Keenan & Associates, Inc. All Rights Reserved. Confidential Client Use (License No. 0451271),6,The State of Health Care,$3,907,$4,276,$4,713,$5,427,$6,187,$6,857,+76%,Health Care Costs,Source: Hewitt Health Value Initiative (HHVI), 2006 Keenan & Associates, Inc. All Rights Reserved. Confidential Client Use (License No. 0451271),7,The State of Health Care,$1,054,$1,231,$1,311,$1,641,$2,126,$2,377,+126%,Source: Hewitt Associates,Employers Respond With Cost Sharing,Annual Employee Contribution, 2006 Keenan & Associates, Inc. All Rights Reserved. Confidential Client Use (License No. 0451271),8,Consumer Directed Health Plans (CDHPs),Source: Forrester Research, Inc., 2006 Keenan & Associates, Inc. All Rights Reserved. Confidential Client Use (License No. 0451271),9,HSA & HRA Market Projected Trends 2005-2010,Data Source: Information Strategies, Inc. Publication: Analysis of HSAs and HRAs Where Theyve Been and Where Theyre Going, March 2, 2006, 2006 Keenan & Associates, Inc. All Rights Reserved. Confidential Client Use (License No. 0451271),10,Current Adoption,By the end of 2004 CDHP enrollment was estimated at 4 million nationally; 600,000 with an HSA As of March 2005, more than 1 million people were covered by High Deductible Health Plans with an HSA When offered as an option: Up to 65% of participants enroll 20% is average 20% - 30% of new hires select Increasingly offered as full replacement More than 90% of employees re-enroll Employee surveys show high levels of satisfaction Employer and carrier analysis show positive financial results,National Institute for Health Care Management (NIHCM) Americas Health Insurance Plans (AHIP), 2006 Keenan & Associates, Inc. All Rights Reserved. Confidential Client Use (License No. 0451271),11,Business Case for Consumerism, 2006 Keenan & Associates, Inc. All Rights Reserved. Confidential Client Use (License No. 0451271),12,“We have established ourselves as an innovative leader in many areas, particularly consumerism Staying ahead of the pack will require us to continue to focus on what got us this far: focusing on the customer.” Source: Interview with Ron A. Williams, Newly Appointed Aetna CEO, February 2006, 2006 Keenan & Associates, Inc. All Rights Reserved. Confidential Client Use (License No. 0451271),13,Impact on Consumers,Projected Consumer Health Premium Expense Compared to Other Living Expenses,The Consumer Market is Born,Sources: Kaiser Family Foundation, Bureau of Labor Statistics 2002 National Compensation Survey, Health Research and Educational Trust,Bureau of Labor Statistics Consumer Expenditure Report, 2003,285% Increase,15% Increase,24% Increase, 2006 Keenan & Associates, Inc. All Rights Reserved. Confidential Client Use (License No. 0451271),14,Business Case for Consumer Directed Health Plans (CDHPs),The Theory: Employees make rational and efficient health care purchasing decisions if they have the financial incentives and tools to do so Consumer Directed Health Plans Bring: Financial incentives and accountability Full cost transparency Education and self-care resources Decision support tools, 2006 Keenan & Associates, Inc. All Rights Reserved. Confidential Client Use (License No. 0451271),15,Business Case for Consumer Directed Health Plans (CDHPs),CDHPs are different from traditional health plans: The amount of general and targeted information required to empower consumers is significantly greater The number of plan partners and integrations is greater Websites and on-line tools MUST be used to achieve the promised trend reductions The consumer web experience must integrate all channels of communication and provide easy-to-access support systems, 2006 Keenan & Associates, Inc. All Rights Reserved. Confidential Client Use (License No. 0451271),16,Typical CDHP Plan Design,Employer provides PPO coverage above the gap,Employee is responsible for $1,000 gap,Employer deposits $500 into an employees account,Health Plan Coverage $1,500/year deductible 90%/70% coinsurance to out-of-pocket maximum,Gap $1,000,“Spending Account” $500,Preventive care covered at 100% (does not count against account) Pharmacy may (HRA) or must (HSA) be included within medical design Family design maximums may apply, but one family member can use entire account amount Unused funds roll over into next year, 2006 Keenan & Associates, Inc. All Rights Reserved. Confidential Client Use (License No. 0451271),17,Business Case for Consumer Directed Health Plans (CDHPs),Holds cost or minimizes increases in year 1 Minimizes premium trend going forward Continues to provide comprehensive, high quality medical benefits Better manages utilization Supports recruitment and retention goals Provides incentives for employees to become partners in managing health care costs, 2006 Keenan & Associates, Inc. All Rights Reserved. Confidential Client Use (License No. 0451271),18,Business Case for Consumer Directed Health Plans (CDHPs),IT Infrastructure Consumer-facing decision support tools are key Cost comparison for medical procedures and drugs Plan comparison tools for enrollment decisions Provider/Hospital quality comparison tool Self-care resources and educational information Keep web site design simple and clean Secure buy-in from marketing and key sales staff at each phase of development Assign dedicated IT and product development resources to keep project on track, 2006 Keenan & Associates, Inc. All Rights Reserved. Confidential Client Use (License No. 0451271),19,CDHP Results The Engaged Consumer, 2006 Keenan & Associates, Inc. All Rights Reserved. Confidential Client Use (License No. 0451271),20,Consumer Directed Health Plans and New Technology,In the framework of Consumer Directed Health Plans, new and improved ways to communicate and share information results in: Better Utilization A CDHP 2 year study showed: 15.9% decrease in ER use 6.7% decrease in Inpatient Admissions 49.8% rate of Generic drug utilization, 2006 Keenan & Associates, Inc. All Rights Reserved. Confidential Client Use (License No. 0451271),21,Consumer Directed Health Plans and New Technology,Improved Member Engagement Navigator, member web site experienced a 38% increase in log-ons among their 2nd year members Enrollees: Log on to Navigator 11% more often Use DocFind 13% more often Use HealthWise almost twice as often Use wellness content 48% more often Use Price-a-DrugSM and performed formulary searches almost twice as often Source: Aetna Health Plan, 2006 Keenan & Associates, Inc. All Rights Reserved. Confidential Client Use (License No. 0451271),22,Consumer Directed Health Plans and New Technology,Better Cost Containment Keenans CDHP, ConsumerAdvance, had better results when compared to PPO plans Medical Cost Amount Paid Per Member: ConsumerAdvance $1053 PPO $1986, 2006 Keenan & Associates, Inc. All Rights Reserved. Confidential Client Use (Licens