Control Costs and Increase Employee Engagement With Consumer Advantage

Transcription

1 Control Costs and Increase Employee Engagement With Consumer Advantage

2 Engage Employees Faced with rising healthcare costs, employers are turning to consumer-driven strategies to provide more cost-efficient health insurance plans to employees. Because these plans require employees to play a larger role in their healthcare decision-making, it s critical to provide solutions that help them make informed decisions. Empower employees to make informed decisions, such as: Selecting the right health insurance plan Maximizing participation in and contributions to taxadvantaged accounts Getting the right preventive care and recommended care for chronic conditions Learning about relevant health topics Monitoring out-of-pocket expenses Understanding potential savings opportunities Maximizing health benefits Evaluating and selecting the right treatment Choosing the right provider Engagement is the process of helping employees become more involved and better informed in the critical issues affecting their health. The Consumer Advantage suite of solutions from Truven Health Analytics helps activate employees by giving them the information and resources they need to manage their health throughout the year. As a result, you ll see improved outcomes and lowered costs. Engage With Personal Information People respond best to information that is personal and relevant to the issues they face. Traditionally, employers have implemented health education portals as part of a well-intentioned effort to inform employees about healthcare topics. These tools are underutilized by employees who find the portals impersonal and irrelevant to the specific questions they have at a particular point in time. Alternatively, our Consumer Advantage solutions are designed to provide the right information at just the right time and to do so in a way that is engaging and informative. From open-enrollment decision-making to postenrollment health management, Consumer Advantage delivers highly relevant, personalized information designed to help employees make good decisions. Guide individuals to their best-fit plan Help plan for out-of-pocket expenses Engage at Every Stage Help consumers manage their care Assist with provider selection Provide resources to evaluate and select the right treatment

3 Start Open Enrollment Off Right During open enrollment, Consumer Advantage Informed Enrollment helps employees identify their best-fit health insurance plan by reviewing their actual cost and use data from the previous year and guiding them through a series of interview questions about their healthcare needs in the upcoming year (Figure 1). The interactive website also helps employees determine how much money to contribute to a healthcare spending account. In addition, it generates a preventive care checklist for every member of the family, to help ensure the right care is received at the right time. Figure 1: Informed Enrollment Consumer Advantage Informed Enrollment delivers highly relevant, personalized information designed to help employees make good decisions. Informed Enrollment helps employees identify the lowest-cost plan based on their own personalized data.

4 More than data. Answers. At Truven Health, we re dedicated to delivering the answers our clients need to improve healthcare quality and access, and reduce costs. Our unmatched data assets, technology, analytic expertise, and comprehensive perspective have served the healthcare industry for more than 30 years. Communicate Throughout the Year Consumer Advantage Personal Health Insights builds a personalized activation schedule that proactively contacts employees at key points throughout the year. A web-based program helps them keep track of outof-pocket healthcare expenses, review claims detail, and learn more about relevant health topics (Figure 2). Figure 2: Personal Health Insights Independent and unbiased 2,200+ employees, including 75+ PhDs, 65+ clinicians, and 200+ data managers and analytic consultants We are obsessed with data we process 220,000+ files from 450+ suppliers, and 50+ types of data per month We house the industry s largest, longest-running claims benchmarking database, with 175 million unique patients Our 95-percent customer retention rate shows we re happy only when you re happy Personal Health Insights helps employees monitor their health throughout the year. The program also sends tailored, personalized messages by mail, , web, or text alerting employees about potential health issues, reminding them of preventive care opportunities, and suggesting ways to save money by making small behavioral changes (Figure 3). Figure 3: Personalized Messaging Personalized messages are available in print, web, , or text messages.

5 Provide Resources to Evaluate and Select the Right Treatment Wrong treatment decisions cost, on average, $235 each. And not only are they costly, they re less effective than the right treatment.* Engaging consumers at the point when they are making treatment choices can mean substantial cost savings and healthier consumers with treatments proven to work better for their conditions, their insurance coverage and their financial situations. Our partner, Wiser Health, provides a personalized online treatment evaluation and decision-making solution. Wiser Health allows users to engage, explore, and customize treatment options via one easy-to-use tool. It quickly delivers personalized treatment options based on multiple factors including: Overall clinical outcome and effectiveness data Clinical effectiveness specifically for people with similar demographic and condition characteristics Overall popular preferences Individual consumer s personal preferences Benefits and insurance coverage Personal financial parameters Consumer Advantage solutions help people evolve from passive participants to active healthcare consumers by: Guiding individuals to their best-fit plan Helping them manage their care Providing resources to evaluate and select the right treatment Assisting with provider selection Helping plan for out-of-pocket expenses Wiser Health enables users to choose the right treatment for better health outcomes and lower cost overall. The Treatments Bullseye shows treatments with Highest Patient Satisfaction at the center. The treatments with Highest Patient Satisfaction balance treatment effectiveness, cost, speed, and side effects. *Source: WiserTogether research, wisertogether.com, accessed April 7, 2014.

6 Provide Price Transparency Tools The Consumer Advantage Treatment Cost Calculator solution also allows your employees to get cost and quality information on various medical procedures. Cost estimates are shown at the provider level and are personalized based on the employee s benefit plan options. Employees can see upfront which portion of the procedure is covered and which portion they will be responsible for (Figure 4). Deliver Reliable Data Consumer Advantage leverages a variety of reliable data sources to provide relevant, personalized information to employees. Rather than using only selfreported data that is often incomplete and inaccurate, Consumer Advantage uses the family s medical and pharmacy claims data as its foundation, and adds other data sources to fill in the details. This model allows Consumer Advantage to assemble a holistic picture of the employee s health history information that is then used to help them make informed decisions about their healthcare. Figure 4: Treatment Cost Calculator The Treatment Cost Calculator helps employees see estimates based on benefit information to calculate out-of-pocket costs.

7 For example, when faced with choosing the right health plan during open enrollment, having a comprehensive, easy-to-understand picture of the previous year s healthcare-related expenses can help determine whether Plan A or Plan B is the lowest-cost option. Similarly, reliable medical claims information can be used as the basis for determining if an employee is overspending on brand-name drugs versus a generic alternative. Analysis of the claims data can also determine if an employee is overdue to receive care recommended for chronic conditions such as asthma, coronary artery disease, and diabetes. Consumer Advantage alerts employees to the care they should be receiving, reminds them why it s important, and provides links to relevant health education information. Claims data is also an integral part of the Consumer Advantage solution for price transparency purposes. Ninety percent of our estimates are accurate within 10 percent of the actual price. The reason for this precision is due to the fact that we have such a robust set of supporting claims data that goes into the creation of the estimation process. Nine Keys to Employee Activation 1. Be relevant provide interactive sites and messages with pertinent, personalized information 2. Get personal supply health information specific to each employee 3. Integrate offer a holistic view with integrated clinical and financial information 4. Make it actionable give people a to-do to emphasize opportunities to improve their health 5. Highlight ways to save provide information on potential savings based on current healthcare use 6. Engage reach out to consumers to help them manage conditions and control costs 7. Remind provide dynamic reminders throughout the year when care is missing 8. Educate incorporate health content to inform employees while they re engaged 9. Make it understandable translate medical terms into more common terminology

8 Clients using Consumer Advantage have seen results such as: Plan Optimization Migrated 59 percent of employees from a PPO to a CDHP plan Enrolled 66 percent of employees in an HSA Reduced number of overinsured employees by 14 percent Savings Account Adoption Added 1,000+ new participants to a healthcare savings account program Preventive Care Adherence Increased adherence of colorectal cancer screenings by 22 percent Increased adherence to breast cancer screenings by 7 percent See Clear Results Every aspect of Consumer Advantage is designed to help employers understand how their employee populations are performing relative to important measures of cost-containment. We begin the process by conducting a baseline assessment before solution implementation. Our assessment shows how the employee population is performing: What health plans are most subscribed to? What is the average contribution rate to an HSA? How are different segments of the employee population adhering to recommended care guidelines? How do these metrics compare with industry norms? Are consumers shopping for lower-cost healthcare solutions? As the Consumer Advantage program is rolled out to the employee population, these baseline metrics are continually monitored to see how behavior is being affected. For example: What percentage of employees moved to a lower-cost plan? What percentage of employees opened an HSA? What percentage of employees received preventive care after receiving tailored health communications? What percentage of employees received recommended care for their chronic conditions after viewing the alerts and related health education information? What percentage of employees elected to pursue a lower cost provider? Our solution provides a comprehensive set of analytic reports to measure consumer engagement, including information about healthcare cost, utilization, preferences, risk, and use of information. The ability to understand and assess the effectiveness of health benefit programs gives employers a competitive edge helping them achieve healthcare objectives and refine benefit programs for better efficiency. For more information consumer@truvenhealth.com, call , or visit truvenhealth.com/consumer. ABOUT TRUVEN HEALTH ANALYTICS At Truven Health Analytics, we are dedicated to delivering the answers our clients need to improve healthcare quality and reduce costs. We are a healthcare analytics company with robust, widely respected data assets and advanced analytic expertise that have served the global healthcare industry for more than 30 years. These combine with our unique perspective from across the entire healthcare industry to give hospitals, clinicians, employers, health plans, government agencies, life sciences researchers, and policymakers the confidence they need to make the right decisions, right now, every time. With our healthcare-specific expertise and tools for managing complex and disparate data, we understand how to implement and integrate tailored analytics that drive improvement. Truven Health Analytics owns some of the most trusted brands in healthcare, such as Micromedex, ActionOI, 100 Top Hospitals, MarketScan, and Advantage Suite. Truven Health has its principal offices in Ann Arbor, Mich.; Chicago; and Denver. For more information, please visit truvenhealth.com. truvenhealth.com Truven Health Analytics Inc. All rights reserved. All other product names used herein are trademarks of their respective owners. EMP