Audio CD and written materials of AIS's audioconference on October 11, 2006

Consumer-Directed Care and Chronic Conditions: How to Design Plans That Target High-Cost Members

Consumer-directed health (CDH) plans have little chance of succeeding without a wellness component or strategy that gives enrollees a financial stake in their own health. The high deductibles inherent to CDH plans give enrollees a huge financial incentive to forgo necessary health services, which can be devastating in the long run. A growing number of CDH plans are now targeting chronically ill patients by including financial incentives (in the form of additional health account dollars or lower premiums) that encourage enrollees to receive the preventive and maintenance health services they need. Get the details of how this wellness component can solve one of consumer-directed care's most serious potential problems.

Sponsored by Atlantic Information Services, Inc., publisher of Inside Consumer-Directed Care, Managed Care Week and Consumer-Directed Health Care Facts, Trends and Data.

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While health savings accounts (HSAs) and health reimbursement arrangements (HRAs) are key components of consumer-directed health (CDH) plans, they don't do enough to change employee behavior and in fact might provide the wrong incentives for chronically ill patients. Nearly half of all Americans have a chronic condition, and half of those have multiple chronic conditions. An effective CDH strategy must encourage healthy employees to stay healthy and chronically ill patients — who generate 80% of private health care spending — to manage their conditions effectively. CDH plan designs must be crafted to include the right financial incentives to compel enrollees adhere to treatment regimens.

Hear from three CDH innovators who are designing plans that effectively address their most expensive enrollees. Topics addressed include:

Speakers

MICHAEL PARKINSON, M.D., M.P.H, is chief health and medical officer at WellPoint, Inc.'s Lumenos division. He formerly was associate director of medical programs and resources for the U.S. Air Force. A retired colonel, he also served as deputy director of Air Force Medical Operations and was chief of preventive medicine. He served on the National Advisory Committee of the Robert Wood Johnson Foundation Health Care Purchasing Institute and is president-elect of the American College of Preventive Medicine. Lumenos has been a leading innovator of CDH plans for the past six years and was one of the first to see the positive effect account-based plans can have on the chronically ill.

FRED VOLKMAN, M.D., is chief medical officer with Fiserv Health's Avidyn Health division. Dr. Volkman's background includes more than 20 years of experience in practice, managed care and plan design. He has held senior positions at Humana Inc., CIGNA Corp. and WellPoint Blue Cross Blue Shield of Georgia. Most recently, he was a principal at MedAchieve, where he worked with health care payers on a variety of topics including pay-for-performance initiatives.

MICHAEL PARKER is director of human resources at Richmond Behavioral Health Authority (RBHA). He will explain how, just one year after launching a wellness program, RBHA trimmed $400,000 from the $1.2 million it paid in annual health insurance premiums. The organization saved an additional $200,000 the following year and saw a 45% drop in prescription drug use. You'll also hear how the program prompted RBHA's 420 employees shed more than 2,000 pounds.

Moderator: Steve Davis, managing editor of AIS's industry-leading biweekly newsletter, Inside Consumer-Directed Care.

 

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