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AIS's Health Business Daily
Featured Story March 8, 2010
Health Plans Can Save Significant ‘Green’ When Members Opt to Give Up Paper EOBs Reprinted from HEALTH PLAN WEEK, the industry's leading source of business, financial and regulatory news of health plans, PPOs and POS plans. In health plan parlance they’re known as “e-adopters,” those members who’ve “gone green” by opting out of receiving paper explanation of benefits (EOB) documents and other correspondence. And they’re saving plans lots of a different kind of “green,” which at least one — Humana Inc. — has turned into living green trees.
In 2009, Humana donated $60,000 to the Arbor Day Foundation, which says that’s equal to 60,000 trees — long-leaf pines, to be exact — planted in the Manchester State Forest in South Carolina as part of a drought rehabilitation project.
“For each member who selects to receive their communications electronically, we donate a dollar, and that dollar plants a tree,” Chris Nicholson, who oversees Humana’s member communications, says of the program, which began last February. Humana’s goal this year is to donate $100,000 and have 100,000 additional members “go green.”
Financial institutions may have been the first, but health plans are also prompting their members to green up. For health plans, like other businesses, it’s a win-win: They can cut down on paper and printing costs and help shrink their carbon footprint. Some even sweeten the deal for members by offering a donation as thanks.
HPW asked Humana, Aetna Inc. and UnitedHealth Group to describe some of their green initiatives related to members and any savings derived from them; only Humana was willing to talk dollars and cents. A $1 donation to charity for every person who switches to electronic communications isn’t a bad return on investment.
For each person who goes paperless, the plan will save $3 to $6 per member per year by not sending paper EOBs, and as much as $10 to $12 per member per year for those who are high utilizers of medical care.
Humana puts a message about going green on its correspondence with members, which states, “Make a change that will grow into a difference,” with the word difference embedded in a drawing of a tree. It has also has trained its call-center staff to promote the use of online EOBs and explain that members “can get access to more documents online,” Nicholson says.
Moreover, call-center staff can switch members over to paperless status if they have registered online already and — if asked — they can even tell members details about the forest where the trees will end up.
Like Humana, “Aetna is a strong supporter of online communications as a way to reduce our environmental impact and streamline and simplify communications with our constituents,” says spokesperson Sherry Sanderford. “We offer a variety of ways for members, providers and plan sponsors to get information online.”
In 2004, the first year Aetna offered the paperless option, fewer than 5% of members chose electronic EOBs; by 2006, 29% of members using the secure Web site chose to forgo paper EOBs.
“As of year-end 2009, approximately 68% of people using our secure member Web site get their EOBs online,” says Sanderford. She adds that between 60% and 65% of Aetna’s medical members are registered for the site.
Plans Push Paperless EOBs
Aetna also tries to prod members to give up paper. “We periodically reach out to our members who aren’t receiving electronic EOBs and remind them of the option. We have tried incentives as well, such as the charitable promotion,” Sanderford tells HPW. Aetna seems to have had less success than Humana with dangling charitable contributions as an incentive, though its program was short-lived. To encourage members to switch, between September and December 2009, Aetna pledged to donate $1 to one of five charities chosen by the member. The venture raised $12,710. But many members see benefits beyond a charitable donation, Sanderford says.
“The electronic EOBs are available for up to 24 months, and most members find that once they try it, they realize they don’t need the paper to be mailed,” she tells HPW.
Humana and the other health plans aren’t actually e-mailing EOBs. “We cannot send protected health information in e-mail, but we send them an e-notification when those documents are available online. We have a PDF version of the document posted in a communications section of the secure Web site,” explains Nicholson.
United did not provide information to HPW about how many of its members have gone paperless. Spokesperson Will Holman says United’s “paperless communications involve all aspects” of its business, including online EOBs, claims letters, bills, eligibility information and “online banking reports for [members’] health accounts.” In addition, brokers’ commission statements and pricing information are online, and physician can also obtain remittance advice, electronic payments and real-time adjudication online.
“UnitedHealth Group is committed to improving the health of the environment and the communities it serves through numerous green initiatives, including the use of paperless communications, workplace conservation and environmental stewardship,” Holman says.
According to focus groups Humana convened, some 10% to 12% of members are just never going to be comfortable getting information online, or do not have Internet access. For them, plans are looking for ways to mail paper EOBs less often — and make them more useful.
Health plans can’t arbitrarily limit the frequency or method of delivering EOBs for all members. Medicare doesn’t permit online-only communications, for one thing. Aetna has gone to monthly EOBs for enrollees in its HealthFund product, “but they also get EOBs for claims as they are adjudicated. There are state and ERISA guidelines that impact this — we need to ensure members receive timely information about how we handled their claims,” Sanderford says.
Humana also recently implemented monthly EOBs for some groups — whether they want this or not. “We have it in production for our self-funded groups and for Humana [employees]. The way we have to roll it out is state by state,” Nicholson says. “So far, more than 100,000 members are receiving the monthly EOBs.”
The plan also offers some members quarterly “SmartSummary” statements, which list flexible spending account activity; prescriptions by name, date, and coverage amounts, and medical claims received and amounts paid.
Another target for reduced paper is plan sponsors, who, in Sanderford’s words, “have shown increasing interest over the last few years in encouraging their employees to go paperless.”
This is especially evident during open-enrollment season. A survey of 347 employers’ 2009 open-enrollment activities by benefits consulting firm Towers Watson found that just 69% of employers mailed printed materials to employees’ homes, compared with 76% in 2008. The question was not asked in previous years’ surveys.
Employers predicted that number would grow. The survey found 22% of plan sponsors intend to eliminate paper-based communications this year. Nearly 90% put materials on a company intranet or the Internet, while 76% communicated through e-mail, according to the survey, released Dec. 1.
This idea is also catching on with some federal agencies. Some health plans that offer coverage through the Federal Employees Health Benefits Program, for example, will eliminate all 2011 open-season mailings for federal retirees unless the member requests them. The Government Employees Health Association (GEHA) is offering all its members the option of getting open-enrollment materials online, not just retirees.
“GEHA is trying to soften our impact on the environment by going green in a number of ways, and we need your help. We’re offering members the option of receiving open season plan materials online,” the plan says on its Web site, noting that to do so “is a small step toward going green.”
“Reducing the number of printed materials reduces transportation costs and reduces landfill waste. Online materials help GEHA control costs,” the health plan says. “We are very careful with your premium dollars and remain committed to maintaining low administrative overhead costs, including printing and postage.” |
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