Consumer Engagement Best Practices
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Transcript of Consumer Engagement Best Practices
Consumer Engagement Best Practices –A Profile of an Empowered PatientDavid Randall, Executive Director, CDHCiJohn Bull, Director CDH Product Strategy, FIS
Agenda
• David Randall, Executive Director, CDHCi– Consumer Directed Healthcare growth– Consumer engagement past and present– State of the market– Future trends and direction– Key metrics– Key metrics
• John Bull, Director CDH Product Strategy, FIS– FIS market perspective– Consumer needs/wants– The CDH lifecycle– A few real life examples– Solution imperatives
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Consumer Engagement Best Practices –A Profile of an Empowered Patient
Presented by:
David Randall, Ph.D. (A.B.D), Executive Director, David Randall, Ph.D. (A.B.D), Executive Director, CDHCi and The American Research and Policy Institute,
Washington, D.C.
What is Consumer Driven Healthcare?
• The application and use of tools, services and products that engage, inform and empower individual consumers of healthcare services to make healthcare choices in their own self economic and health interests.economic and health interests.
• CDHC removes the problem of Third Party Payment discussed by Tullock (1965, 1990), Friedman (1962,1975) and Herzlinger (2004).
• CDHC growth and adoption began after the passage of the Medicare Modernization Act of 2003 when Health Savings Accounts were created
4
Enrollment Growth in HDHP
8
10
12
8
10.1
HDHP Growth
0
2
4
6
8
2008 2009 2010HCHP Growth 6.1 8 10.1
6.1
HCHP Growth
AHIP
HRA Account Growth and Balances
• More than 5 million accounts as of 2009• Average account balance of $1,419• Average roll over balance of $1,295• Projected growth by 2014 at more than 10
AHIP
• Projected growth by 2014 at more than 10 million HRA accounts
• Projected growth of all CDHC accounts to be more than 22 million by 2014
Economic Downturn Driving Consumer-driven Healthcare Adoption
DoubleDouble--digit digit healthcarehealthcarecost increasescost increasesaverage cost average cost perper--employee employee of health of health benefits $9,660benefits $9,660
Employers Employers more more aggressive in aggressive in managing their managing their health care health care costscosts
Currently only 17% Currently only 17% employers offer a employers offer a full replacement full replacement CDH program AND CDH program AND a MAJORITY of a MAJORITY of Fortune 500 offerFortune 500 offer
benefits $9,660benefits $9,660
Implementing a Consumer Driven Healthcare program is one of the leading healthcare strategies for employers
Employers looking for options to decrease the cost per employee of health benefits
Number of Consumer Driven Healthcare programs to increase in 2010
* Towers Watson, Aon
Consumer Engagement: Past and Present
• Past government efforts• State-of-the-market: From PHRs to mobile
payment platforms• Transaction metrics, spending trends from • Transaction metrics, spending trends from
CDHCi data
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Evolution and Devolution:
• Center for Medicare and Medicaid Services (CMS) posts prices, industry follows
• Aetna Price Transparency Project• Personal Health Record (PHRs)• Personal Health Record (PHRs)• Online tools − Google and Microsoft• Price disclosure in post-PPACA environment
State of the Market:
• State-based efforts to encourage or require providers to post prices
• The rise of retail-based healthcare• The rise of retail-based healthcare• CDHC growth trends and
impediments
Future Trends and Health Care Reform:
• Impact of Health Insurance Exchanges before and after 2014
• Watch the states − where all the action will be!will be!
• A generational shift away from third-party payers to CDHC products and services
• Mobile applications
Key Data Metrics:
• CDHCi market data advisory• Transaction trends• Mobile payments• Mobile payments• Retail model growth
Our Target Consumer:
• Healthcare consumer − Lori S., age 48, white female
• She is used to low co-pays and has never seen a price list!a price list!
• Question − How to engage her?• The retail model!• Keep it simple and make it easy!
New Healthcare Retail Model
• Retail 1.0
• Minute Clinic/CVS
• Retail 2.0-3.0
• Minute Clinic/CVS• Nurse Lines• Use of PHRs• Lower utilization,
convenience
• Consult A Doctor• Use of Web-based
technologies, 24-7 access• Higher ROI, reduced
utilization
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CDHCi Market Data
• Beginning in June, 2010 CDHCi launches a Quarterly Data Advisory Service that will track account-based plans across a range of metrics, including:
− Account balances, spending patterns and − Account balances, spending patterns and healthcare utilization trends, and projections for future growth.
− Data published quarterly that provides valuable insight for a range of marketing and account use purposes.
CDHCi Market Data AdvisoryKey Data Highlights
• CDH accounts (specifically HSAs) within existing programs, grew 6.46 percent in Q1.
• Account balances were $592 in individual HSAs, a decrease from average balances in Q4 ’09. While the average balance in family HSAs reached $1,408 in Q1 ’10.
• 56 percent of employees in family HSAs contributed to their • 56 percent of employees in family HSAs contributed to their accounts, while only 49 percent of employees in individual plans contributed to their accounts.
• On average, both reimbursements and check transactions exceeded debit card transactions nearly 2:1 both in individual and family account spending.
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What this all means
• Increasing Demand!
40.0
60.0
16.023.1 27.3
Mill
ions
of A
ccou
nts
CDH Accounts
Forrester views adoption Forrester views adoption of CDH as stronger than of CDH as stronger than predicted predicted –– calling out HSAs calling out HSAs as the growth engine.as the growth engine.
0.0
20.0
40.0
2007 2008 2009 2010 2011
16.5 17.3 16.8 16.3 15.5
3.7 7.0 10.9 12.9 12.33.99.3
16.023.1
Mill
ions
of A
ccou
nts
FSA Enrollees HRA Enrollees HSA EnrolleesSOURCE: BearingPoint
Thank You!
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Consumer Engagement Best PracticesJohn Bull, Director CDH Product Strategy, FIS
Consumer Engagement Best Practices
FIS Market Perspective − Consumer
Market Observations• CDH benefits can be complex, confusing and designed a la carte• Hands on information is a must• HSAs and HRAs will continue to grow in the future• Incentives are still drivers
Technology Needs• Online experience must be intuitive, fun and quick• Online banking is the barometer for success• Mobile is the future• Health Management and Integrated claims must be provided
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Before technology solves everything…
• We need to ask (and answer)…What does the consumer really want to know?– What plan should I enroll in?
– What’s the difference between an HSA and an HRA?
– Have my claims been paid?
– What’s my balance? – What’s my balance?
– What services does my account cover?
– What incentives do I have that I should be aware of?
– How can I save money on healthcare?
– How much is my healthcare going to cost me?
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So, how do we answer these questions…
• There are really just a few ways to answer the questions:1. Online2. Phone call to customer service3. IVR4. E-mail 5. Online chat5. Online chat6. Mobile7. Ask HR8. Finally, tell them before they think to ask
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Tell the before they ask….???
• How do we tell consumers what they want to know before they even ask?• The social media world of Facebook and Twitter make pro-active communication an
everyday and expected activity.• Messages are pushed based on your likes and who you follow. Advertising is
embedded into everything.• Can we do this for CDH? Absolutely!• Can we do this for CDH? Absolutely!
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Education
Driving information relies on understanding the CDH life cycle
Enrollment
Incentives
Wellness
Price & Quality
Claims
Payments
Year End Management
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Let’s take Jane…
• Jane’s 40 with two children• She has choices at enrollment − an HSA Plan with a deductible of $4,800 or a lower
deductible plan with a funding account.• How will she decide what to enroll in?
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Jane’s decision making process…
• Jane receives notice from HR as well as an e-mail about enrolling in an HSA• Jane goes online to learn more about HSAs and which plan is right for her• She views an interactive video on HSA for someone like her – Sarah who is married,
40 years old and has two children
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Jane’s decision making process…
• Jane likes what she hears, but she wants to forecast what plan is right for her so she uses the “Which plan is right for me?” planning tool.
1. She enters in her plan information
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Jane’s decision making process…
• Jane likes what she hears but, she wants to forecast what plan is right for her so she uses the “Which plan is right for me?” planning tool.
2. She enters in her medial expected services
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Jane’s decision making process…
• Jane likes what she hears but, she wants to forecast what plan is right for her so she uses the “Which plan is right for me?” planning tool.
3. She enters in her tax information and expected HSA Contributions
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Jane’s decision making process…
• Jane likes what she hears but, she wants to forecast what plan is right for her so she uses the “Which plan is right for me?” planning tool.
4. Based on her unique situation, the HSA looks right for Jane
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Jane’s ready to enroll, but she’s still not sure…
Jane reads through the FAQsNow, she’s ready to enroll…
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Now that Jane is enrolled, she can access her account online or on her mobile device
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Jane not only needs to manage her HSA, but she needs to manage her overall health
• Jane needs wellness tools, incentives and a personal health record − all in one place, through one, online experience
Mobile WellnessPHR
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Wellness tools and Health Risk Assessments
Now, it’s time to communicate!
E-mails and texts• Opt-in/out of
communications• Open enrollment• New claim received• Payment made
Online/mobile self-service capabilities• Claim submission• Enrollment• Bill payment for HSAs• Funding of HSAs
Online and mobile presentment requirements • My deductible status• My HRA rollover rules• My HSA contribution
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• Payment made• Debit card mailed• Deductible met• Incentive completed/
funding received• Time to refill• Preventive care notices• And more
• Funding of HSAs• Transfers out for HSA• Incentive-based
communications• Mobile balances• Upload of claims• Save receipts• Fun incentives• Health savings and
spend forecasting• Pricing analysis
• My HSA contribution status
• My claims status and payments
• Personal health records• Wellness information
and programs• Interactive education
To make the consumer engagement a reality, you need the strong technical and market-focused foundation
• First, you need technology that is real-time, dependable and integrated.
• Second, you need to respect the different communication channels demanded by consumers.
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demanded by consumers.• Third, you need to allow
users to manage their communication preferences
• Finally, you need an administrative and social media engine for driving the CDH messages.
Questions and AnswersQuestions and Answers
Thank You Thank You John Bull, Director CDH Product Strategy, [email protected]
David Randall, Executive Director, [email protected]