Health 2.0 and Healthcare: Innovative Ideas

Of all the areas of business that I have dealt with during my career the issue of healthcare has been one I keep returning to over and over again.  As an employer and someone who has worked with insurance carriers and healthcare providers I have to admit that the amount of innovation that is occurring in the area of the internet and healthcare is rather disappointing; but I do realize that this is easily explained by the fact that our healthcare system is a dysfunctional system.

Now we are beginning to see an interest on the part of technology start ups and VC firms to fund innovation to improve, or at least simplify healthcare from a variety of fronts.  Here are a few very interesting and promising products:

SIMPLEE  


Simplee helps with medical bills by tracking medical expenses, managing health care costs, helping you pay medical bills, and finding the right medical plans and medical services for the consumer and their family.  While the focus has been on the ever increasing cost of health insurance, with premiums that have doubled in the last decade, we have not noticed that consumers are paying an additional 15% for the services that they use, even with insurance!  This "nickle and diming" costs the consumer an additional $3,000 a year on average and these additional costs and fees have increased by 50% in the last 4 years alone!

HEALTH TAP

Health Tap is a program that allows one to gain accurate, timely, and personalized information so that consumers can begin to make better evidence-based healthcare decisions for themselves and their family.

ZOCDOC

ZocDoc is basically a service that allows you to find doctors in your local area and book appointments on line.

PRACTICE FUSION

This new development is focused primarily on serving healthcare professions but allowing for the sharing of medical records on the internet.  I think it is innovative in the fact that it will allow medical practices to spend more time with patients, ensure that records are up to date and improve communications.  

CASTLIGHT HEALTH

This is the one innovation that I hope succeeds because it benefits both the employer and the employee.  Employers and health plans can now lower the cost of providing health care benefits, while offering employees and plan members a consumer-friendly way to get the most for their out of pocket costs.  From their website:

Castlight Health offers companies the following opportunities:
*   Reduce health care costs—guaranteed—so savings can be applied to other programs or                                                          to the bottom line

*  Successfully implement innovative benefit designs, including Consumer-Directed Health Plans, Reference-Based Pricing, and shared savings models

*  Make smart health care shoppers out of employees and plan members—empowering them to get the most for each dollar spent

Then, you can also review this slide show and note that their are some new applications where you can use your cellphone to monitor your blood pressure, check to see if a spot on your skin is cancer, or to remind you to take your medications!


While I have no experience with any of these programs and or products I do like to see that innovation is beginning to enter healthcare and hopefully eventually lead to empowering consumers, employers, and health care professionals!

Employees and Employers: Hostages Of Healthcare

I was reading an article today about internet start ups in Israel and how this portion of their GDP was almost as much as health care was; then I noted that health care was something like 6.8% of their GDP.

In the United States health care represents 17.3% of our GDP.  Now, the government, through Medicare and Medicaid, accounts for half of this amount, but the reality is that this is a huge number! 

Oh, and Israel has universal health care coverage that is mandatory.  In 2009, 61% of non elderly Americans had health insurance through their employers; which was down from 69% in 2000.

Now, I am not going to get into the politics of the Affordable Care Act or "Obama Care" as it is commonly known, but I believe that Winston Churchill pretty much said it all when he stated, "You can always count on Americans to do the right thing - after they've tried everything else." 

For clarification, I believe that we would have been better served if we had implemented the Swiss Health-Care Model; it basically takes the employer out of the health care system. Over the course of the last 20 years I know the importance fringe benefits play in attracting and retaining employees; the reality is if we had not been self funded, or our own health care insurer in 1994, we would have fell victim to NAFTA, but we benefited by being our own health insurer and having a reputation of having great insurance.

Employers, especially small employers, find themselves held hostage by health insurers.  They have to offer health insurance, which requires a decision that most small employers are ill equipped to make.  Then they have to administer the insurance, and the performance of the insurer reflects on the employer.  At renewal, employers always find themselves facing a rate increase and left with the options of reducing coverage or switching insurers; kind of like trying to carve a stick of wood with an axe rather than a pocket knife.

I found this article about the demise of Google Health, which was a platform that Google attempted to launch to provide individuals with a vehicle to centrally store and manage their health care information online.

The reality is in the American health care system there is no consumer. 

"The theoretical appeal of such a service (Google Health) is that people can make better decisions about health care when they have all of their health information readily available. 
After a very successful pilot test with 1,600 patients of the Cleveland Clinic, Google Health launched a little over three years ago. It joined similar consumer-driven offerings from Microsoft, Dossia and Indivo. While none of these other services have outright failed, they cannot be considered home-run successes. 

Why not? Why hasn’t the Internet empowered consumers to manage their personal health information the same way it has better informed them about medical conditions?

The answer is the same as why Health Savings Accounts (HSA) have never achieved the interest that they should have:  Individuals are not the consumers of health care. 

The rates charged are established by the insurance carrier; providers when asked what a procedure costs have to know who your insurance carrier is first.  In turn, doctors are directed by ones health insurance on how to treat a patient; under one health insurance contract the carrier may have agreed to 'bundling' of certain services by CPT code and another might not have.

In more and more cases, particularly with BC/BS - Anthem, more and more medical providers are finding that Medicare actually pays more for some services than insurance companies do, and the federal government is mandated by law to pay all undisputed claims in 30 days; there is no such mandate with health insurance companies.

For employers, I do have the following recommendations, until sanity returns to our dysfunctional health care system:

• Join The Employer Health care Network
• If you have over 150 employees look into self funding
• Bring employees into the decision making process; get their input
• Demand experience data, note where your health care dollars are going.
• Find ways to educate your employees and get them thinking about changing bad lifestyles habits

Think of health care as an employee/employer partnership.  You will find that besides the long term cost savings you will enjoy you will also notice improvements in employee morale and employee retention.