payers & providers midwest edition – march 8, 2011

8/7/2019 Payers & Providers Midwest Edition – March 8, 2011

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As the U.S. healthcare system graduallymigrates toward letting consumers assumemore responsibility for overseeing their careand paying for it, patients and families are

going to need tools to help them gure outhow to work through some immenselycomplicated decisions. Sarah Wilcox thinks she’s got one piece of the answer. She and a partner have founded aweb site, MyHealthandMoney.com, that aimsto guide consumers in learning to makehealthcare decisions with their pocketbooks inmind, without losing sight of quality andaccess considerations.

The web site offers“wellness deals” as well asdiscounts on condition-related expenses, such as

diabetes products orhearing aids.

“Our mantra is ‘takecontrol,’” Wilcox said in theof ce of her Chicagostartup. “Cost is becoming afear for consumers,” whodon’t always understandthat “you can makedecisions, you cannegotiate with providers.”

The site offers advice onhow to talk to doctors andhospitals about what of ce

visits and procedures arelikely to cost, how to ndout about discounts onprescriptions or recurringexpenses, and how to nd the appropriatelevel of care for what ails you.

Her web site is designed to benetemployees who have been switched into ahealth-savings account or similar consumer-driven plan, but who may not have thewherewithal to navigate the system ontheir own.

“As consumers, we have to gure out

the role of providers in our lives,” she said.“Doctors say patients are asking what thingscost, more than ever,” especially with highdeductibles and copays. “Affordability is a

concern even for the insured because of out-of-pocket costs. And a statement of benets isbeyond most people’s comprehension.”

Her web site is one of several that havebeen developed in recent years to respond toconsumer demand for more information.HealthGrades.com, for example, rateshospitals, nursing homes, and physicians byquality stars. HospitalCompare.hhs.gov gathers quality information for Medicare

patients. HealthcareCoach.comgives patients advice onhow to understand their

insurance and solvebottlenecks with thesystem.

For consumer-direct-ed healthcare tofunction at all, peoplehave to have inform-ation and the ability tomake decisions, saidPaul Fronstin, directorof the health researchand education programat the Employee BenetResearch Institute in

Washington.“Web sites can be

good for that, and theycan be bad for that,” he

said, depending how useful they are forconsumers.

“We are on the verge of being in a placewhere we give people the real-timeinformation they need to make decisionsabout quality, access, and treatment options.”

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[email protected]

the details of your event, or call(877) 248-2360, ext. 3. It will be

published in the Calendar section,space permitting.

Midwest Edition

Experience + Price = Best Choice?Startup Web Site Helps Patients Switched into HSAs

Continued on Next Page

Sarah Wilcox, CEOMyHealthandMoney.com

http://www.ilruralhealth.a25hourdaysites.com/f/IRHA_2011_Conference_Brochure_Final1.pdf









http://www.mnruralhealth.org/









http://www.wha.org/education/physicianleadership.aspx














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In Brief

Kansas LegislatorsComplain BioscienceAuthority Overpays

Employees

The Kansas Bioscience Authority isunder attack for paying highsalaries to its employees. Twelve of the agency’s 21 employees earnmore than $100,000, according toa report completed by the SenateCommerce Committee.

“The Board has been irrationallyexuberant in awarding excessive,extravagant entertainment andexecutive bonuses,” said state Sen.Chris Steineger, a Republican fromKansas City. He said the legislatorswant their money to be spent indirect investments, not expenses.

University of Cincinnatito Buy Jewish HospitalCampus in Avondale

UC Health, part of the Universityof Cincinnati, will purchase theJewish Hospital Medical Campusfrom the Jewish Foundation of Cincinnati.

Included in the transaction arethe former Jewish Hospital, anoffice building a garage, and otherparking facilities. James Kingsbury,CEO of UC Health, said hisorganization is discussingdeveloping the campus withCincinnati Children’s Hospital.

The value of the transaction wasnot made public. The closing isexpected within two months.

UnitedHealthcareLoses Tricare Contract

Minnesota-based UnitedHealthcare has lost a contract to handlemilitary healthcare that it won two

Continued on Page 3

NEWS

Care + Cost Consumer Web Site (Continued from Page One)

And, he added, “It needs to be written at athird grade level. Healthcare is not easy forpeople. Half the adult population is health

illiterate. They have trouble understandingbasic health concepts.”A Towers Perrin study released in May

2007 concluded that “compared totraditional health benet plan participants,account-based health plan members are lesscomfortable with the level of nancial risktheir plan exposes them to, less likely tounderstand how the plan works, lessfavorable about how easy it is to use the plan,less favorable about the clarity of commun-ication around benet change, and lesssatised with the basic elements of theirplans."

Wilcox believes her background inhospital administration and healthcaremarketing gives her insights into how tospeak to consumers. She has an MBA fromthe Kellogg School of Management atNorthwestern University, and was a seniorexecutive at advertising powerhouse DraftFCB before starting her own venture twoyears ago.

“We have of oaded on the Americanpublic in a very short period of time decisionsthey are not qualied to make,” she said. If aperson is diagnosed with diabetes, forexample, she has no way of knowing whether

this is a $20,000 a year responsibility, or a$2,000 a year responsibility.

“How do I do nancial planning for theyear if I have an HSA? If we’re going to makepatients bear the cost, we have to help peoplebe compliant and monitor themselves.”

MyHealthandMoney.com lets patientslook up both diagnostic and proceduralprices. Women in west suburban St. Louisseeking a mammogram, for example, canenter their zip code (63105 for Clayton) andget a list of 18 providers within 10 miles.Prices range from $500 at St. LouisConnectCare to $46 at Forest Park Hospital.

Barnes Jewish charges a at $180, with nouninsured discount offered, while Des Perescharges $164 but will take 40% off if youhave no insurance.

Patients needing heart bypass surgerywithin 25 miles of downtown Cleveland (zip44101) have their choice of 10 medicalcenters, whose charges for insured patientsrange from $58,322 (Metro Health MedicalCenter) to $26,333 (Parma CommunityGeneral Hospital).

But in a side column, the site advises:“Experience + Price = Best choice.” It lists thethree hospitals with the highest volume of

procedures, with Cleveland Clinic, at 875, atthe top, with an estimated charge of $44,404.Then comes Hillcrest Hospital, with 345

cases, at $32,140, and nally FairviewHospital, with 201 cases, at $36,722. Parma,it turns out, does only 143 cases, and SaintVincent Charity Hospital does just 39. Theinformation is supplied by HealthGrades.com

“The quality information isn’t enoughanymore,” Wilcox said. “We have to marry upcare and cost.”

The web site also offers discount cards forchiropractic services, dentistry, and hearingaids, as well as access to coaching andguidance for those too afraid to ask directquestions of their doctors.

The target market of the product is mid-size

employers offering high-deductible healthplans, and self-insured employers. Shecurrently has 10 small companies, withseveral hundred employees, signed up ascustomers.

“We thought this would be of real value inhelping our employees,” said George Mutert,president and CEO of Franklin Display Groupin Belvidere, Ill., one of Wilcox’s customers.His family-owned business, with about 85workers, switched to self-insurance severalyears ago.

“It’s a big line item on our P&L, it’s a bear,”he said. “Anything we can do to save costs.”

He likes the idea of helping employees “haveone-stop shopping for services. We’re trying toincentivize them accordingly.”

His company has subscribed to the website for a year. “There hasn’t been a lot of traction yet. We’re hoping it will help us get agrip on our costs.”

The premium for companies purchasing theweb site is $2.50 per member per month,Wilcox said. For $5.50, they get the “Ask theExperts” service, which connects them toproviders who can respond to specicconcerns at lower cost than a doctor’s of cevisit.

For individual consumers the price is $6.99a month, or $10.99 a month for the expertfeature. Wilcox is working through large thirdparty administrators and general brokerages tosell the product.

The price point is too low to establish adedicated sales force, she said.

“Let’s stop pointing ngers. It’s soexhausting,” Wilcox said. “Healthcare is aplace you can have an impact, but it also tellsyou what kind of community you live in.

“Let’s create a community of informedpatients and consumers. This is denitely apassion.”



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NEWS

In Brief

years ago but never startedadministering. Humana MilitaryHealthcare Services Inc. won thefive year contract, which covershealth services for soldiers in theSouthern states.

The Humana subsidiary had hadthe contract earlier, but failed in its

bid to continue the work in 2009.Military contracting officialsmoved the contract to aUnitedHealth subsidiary.

Humana appealed thatdecision, and was supported by theGovernment AccountabilityOffice.

Kansas InsuranceDept.to Hear Testimony

on Medical Loss Ratio

The Kansas Insurance Department will conduct a hearing next week to

examine the impact of the medicalloss ratio provision in the federalhealth reform law on local insurancecompanies.

“I am concerned about the impactof this new provision on the insurancecompanies operating in Kansas, andany potential disruption of theinsurance market as a whole,” saidInsurance Commissioner SandyPraeger in announcing the fact-ndingevent.

The Accountable Care Actmandates that insurers spend aminimum of 80% of premium revenueon claims in the individual insurancemarket. This measure goes into effect

this year. If insurers don’t meet thisrequirement in 2011, they may haveto provide refunds to customers nextyear.

The individual market comprises176,000 people in Kansas, or 6.5% of the population.

Praeger, a Republican, said Kansasinsurance agents requested thehearing. Her department will compilethe hearing results, and if necessary,ask the federal government to alter theMLR percentage requirements.

More details are available atwww.ksinsurance.org/gpa/news .

The chief of the Illinois Department of Insurance may soon be named to head thenew Federal Insurance Of ce, according tonews reports late last week. The new post,which has no actual regulatory power, wasestablished under the Dodd-Frank Wall StreetReform and Consumer Protection Act. Michael T. McRaith, 45, of Chicago, wasappointed insurance director in 2005 by then-Gov. Rod Blagojevich. Before that he was anattorney in private practice for 15 years,representing nancial and insurance clients.

McRaith is Secretary/Treasurer of theNational Association of Insurance

Commissioners (NAIC) and was previouslychairman of the NAIC’s Midwest Zone.

A Reuters article said McRaith was thefrontrunner for the new federal job, created to

appease those who oppose allowingWashington to regulate the insurance industMcRaith was very aggressive in helping

move the federal health reform forward on tlocal level, according to the Illinois Observea political blog.

In a conversation on Feb. 24 with Payers Providers, he argued strongly for maintaininthe course on implementation of the Obamahealth reforms. “The people arguing againstgovernment involvement in healthcare are thsame people arguing against the (individualinsurance) mandate,” he said. “The mandatepreserves the private insurance market. In th

absence of that, we are headed toward whatthose people opposed to the mandate don’twant: a single-payer government controlledsystem.”

Trinity Health, the country’s fourth-largestCatholic health system, announced on Fridaythat it will acquire Loyola University Health System from Loyola University Chicago.

The Loyola system includes a large teachinghospital in Maywood, Ill., Gottlieb MemorialHospital in Melrose Park, Ill., plus 28 primarycare and specialty facilities in the Chicagoregion.

Trinity is based outside Detroit, in Novi,Mich., and has $7.1 billion in revenues and48,000 employees at hospitals in nine states,according to a statement on its web site. In theMidwest it runs hospitals in Michigan, Iowa,

Ohio, and Indiana. Trinity was formed in 2000through the merger of the Holy Cross HealthSystem and Mercy Health Services.

The Loyola University Health System hasabout $1 billion in revenue and about 6,800employees. It trains more than 450 medical

residents. The university would retain controof its medical school and research efforts.

President Michael J. Garanzini, S.J., of Loyola University said it had been trying tond a partner for the medical center for somtime. The health system lost $32 million inscal 2008 and $43 million in scal 2009. Ithe most recent year it earned $400,000 onoperations.

Reports surfaced in December that Loyowas seeking a merger partner for its healthsystem. The arrangement with Trinity ensurethat Loyola will remain a Roman Catholicinstitution.

The merger must be af rmed by the boaof trustees of both the university and Trinity. also must gain regulatory approvals. Financiterms were not made public. The universitysaid it would develop a new research centerwith the proceeds of the transaction.

Trinity Health Expands into ChicagoCatholic System Acquires Loyola Medical Center

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Illinois Insurance Director to DC?McRaith Seen as Nominee to New Federal Post

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Payers & Providers Page

To meet the participation guidelines and goalsof healthcare reform and to access additionalsources of revenue such as shared savings, itwill be essential to follow the principles of aPatient-Centered Medical Home (PCMH). Theuse of evidence-based medicine, a focus onprevention and managing chronic disease, andcare coordination are the mechanisms toimprove the health of the population andreduce the cost of care.

Achieving those goalsrequires a departure fromtraditional of ce-based medical

care. Here are 10 factors thatpayers and providers shouldconsider in evaluating providerreadiness for Medical Home. Culture. Medical homesrequire a culture change forproviders and patients. Theprovider culture should acceptand/or reward standardization of of ce and clinical practices andenforce consequences fornoncompliance. Patients mustalso understand their role asactive participants in

maintaining their health. Connectivity with Accountability. To trulycoordinate patient care, health informationneeds to be comprehensive, timely, andavailable at the point of care. Data exchangeacross the continuum is essential, ideally withthe electronic medical record as thefoundation, but other mechanisms can be used.Once the data is received, acting on it iscritical.

Care Team Works at Top of Qualications.A care team is physician-led and may includemedical assistants, nurses, and physicianextenders. Care team members must be

prepared to delegate patient needs to theappropriate team member and reserve thephysician for more complicated clinical issues. Care Coordination Infrastructure.Providers need to ensure that patients followthrough on referrals they make and reach out topatients with a pattern of avoidable ER visits ormultiple admissions. Technology can aid carecoordination, and many of these functions canbe performed by care managers who are eitherembedded in the practice or a shared resource.

Evidence-based Medicine. Treatment forcommon or high-risk conditions should be

guided by the use of clinical guidelines that hbeen established by nationally recognizedorganizations. By receiving comparative dataabout their outcomes and performance, provican identify gaps in care that need to beaddressed, including mental health issues, whare signicant drivers of poor outcomes.

Population Management. To improve thehealth of a patient population, providers not o

need disease registries, but thealso need tools to remind themwhen preventive services are and alert them when test resu

fall outside the norm.Access. Patients should bseen when and how they wanbe seen. Access, direct orelectronic, should be exible on the patient’s terms. Thereshould also be a mechanism tobtain care after hours and onweekends.

Patient Self-management.Patient self-management andpatient responsibility are keyhealth promotion andmaintenance. Manual and

online tools can be employed to engage patieabout their health and encourage compliance Leadership. Strong clinical leadership iscritical for adoption of clinical guidelines,reinforcement of practice standards, anddelegation to practice staff. In addition, leadeneed to make the case for investment in trainiresources, care coordination staff, and techno! fundamental pillars of the PCMH model. Patient-centeredness. The PCMH model patient-centered; therefore, systems must beorganized to meet the needs of patients, notproviders. Patients should also have thecapability to access their health information a

care team as well as communicate with theirpractice through a variety of means, includingphone, email, and web portal.

It should be evident that a transformation oof ce-based practice will be required to achiethe goals of PCMH.

OPINION

The Medical Home: Are You Ready?How to Start Thinking About Raising Your Game

B Claire F. Heideman

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Op-ed submissions of up to 600 words are

welcomed. Please e-mail proposals to

[email protected],

Claire F. Heideman, FACHE, is senior consultant

The Camden Group in Chicago.



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MARKETPLACE/EMPLOYMENTPayers & Providers

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payers & providers midwest edition – march 8, 2011

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