The 3 P’s to Becoming an Engaged Healthcare Consumer

Originally appeared in Life and Health Advisor
https://www.lifehealth.com/3-ps-becoming-engaged-healthcare-consumer/

Has your business or startup made a major purchase only to find out later you overspent significantly? How often are you making this same mistake with healthcare? Moreover, it’s likely that your employees are making this mistake every day, yet they may not even know they have an option. Unless you as an organization take ownership of educating your workforce, it’s likely your employees will continue to overspend. And remember, if they are overspending their own money then you can multiply that by 3-4 times for its financial impact on the company. For example, a simple surgery can cost your company $30,000-$40,000 more if the employee does not choose a Center of Excellence.

It’s very common that a hospital charges 60% more for the exact same procedure as a competing hospital directly across the street. To confuse this process even further, would you believe that the same exact doctor will operate on you at either of these hospitals? This is what happens when you are led to believe “your insurance will pay for it.” These are the six words that killed American healthcare.

Your insurance will not pay for it

When you buy a new car, do you compare features and price? When you buy a house do you shop neighborhoods, school districts and number of bedrooms? Of course you do. Why don’t you do the same when it comes to your personal health? Why are Americans afraid to ask a doctor for a second opinion of just an alternative when a high cost procedure is recommended?

Well, the short answer is that we have been led to believe that our insurance will cover the costs so it’s not important which facility we choose. But that’s dead wrong. Each time an employee chooses a higher cost provider, that costs is added in some form to the following years premium cost to your company, which in turn is passed on to you. Year after year. Its inflation by design! Not your design, but by the hospitals, insurers and pharma companies among others, who benefit from constantly increasing prices.

Become an EHC

It is critical that individuals become Engaged Healthcare Consumers (EHC). How do you personally become an EHC? Start by focusing on the 3P’s to becoming an EHC: Plan, Prevent & Personalize: Have a Plan that focuses on Preventative Care, as well as Personalized Care.

the short answer is that we have been led to believe that our insurance will cover the costs so it’s not important which facility we choose. But that’s dead wrong…

Here are a few steps toward becoming an EHC:
P #1 – Have a Plan
The first P is to take control of your health by creating a healthy living Plan. That plan includes your dietary goals, as well as fitness and lifestyle habits. Also, if you suffer from a condition or chronic disease that impacts your health, your plan should include specialized steps to specifically address those needs as well. Your plan should also include several Personalized and Preventative Medicine steps.

Update your plan at least annually, but daily monitoring and tracking of diet and fitness habits are critical in shaping this plan as well. There are plenty of tools available via mobile phone application to track both diet and fitness. Also, research mobile applications available to support you in disease management efforts for any chronic diseases you may have such as diabetes or hypertension.

P #2 – Personalized Medicine Tactics
A number of personalized medicine tactics should be considered including DNA testing and genome sequencing, as well as functional and integrative medicine tactics. The more you can learn about how your body differs from others, how your body metabolizes medication and food, and reacts in general to different foods, exercises and lifestyle habits, the healthy you will be. Implement these tactics into you Plan!

P #3 – Preventative Medicine Tactics
The second key component of your plan is to utilize the tools, resources and technology available to assist you in monitoring and improving health. From checking your blood pressure, to diabetic management to tracking exercise and dietary consumption, the second key component of your healthy living plan is Preventative Medicine tactics. It’s only a matter of years now before science will identify the exact medication that is best for your condition based on your personal metabolism, known as polygenic risk scoring. At present we are well on our way to that so utilize the tools presently available.

To date there has been little evidence suggesting any link between price and quality in healthcare. In fact, those doctors who engage in the discussion about fair pricing are often getting higher quality scores than the high cost provider. These doctors and facilities that offer lower pricing and higher quality are known as Centers of Excellence, often referred to as within the narrow network. Once you begin your journey to becoming an Engaged Healthcare Consumer, continue by shopping for healthcare Centers of Excellence. This will save significant dollars for both you and your employer.
So while corporate America has finally stepped up to lead the charge against hyperinflation in American healthcare, individuals can do their part by becoming Engaged Healthcare Consumers. The tactics listed above are simple, and will get start you down your EHC path.

Controlling Corporate Healthcare Costs

Originally posted on Total Industrial Plant Solutions

After working on his own as an independent healthcare insurance broker for several years, Ryan recently took a job with a bigger brokerage. When he broke the news to his wife that the company he joined did not offer a traditional PPO or HMO insurance plan, she wasn’t thrilled. After all, Americans have been conditioned to these models for years.

A few weeks later, Ryan’s wife woke up and found one of their three children not feeling well, and she immediately grew frustrated as she knew what that meant: she would have to cancel her plans for the day and arrange alternative plans to carpool her other two children to school so she could take her sick child to the doctor. She immediately went to the mobile app on her phone to schedule an appointment at her child’s doctor’s office, only to learn that a telehealth consult with a physician could be scheduled remotely within the hour. So she gave it a try.

Ten minutes later, from the couch in her living room, a physician conducted a telehealth appointment remotely via Ryan’s wife’s mobile phone. After asking a few questions of the mother and child, the doctor advised that he had written a prescription for the child and it would be available for pick up within 30 minutes at her regular pharmacy.

It turns out mom didn’t have to cancel her carpool schedule at all, nor re-arrange her schedule for the day. That was it.

The irony of this story? The American healthcare delivery model is fragmented and broken, yet our innate desire to resist any sort of change keeps us clinging to ineffective plans such as a PPO’s or HMO’s. Stories like this exemplify how inane that resistance to change truly is.

New Alternatives

New alternative approaches to providing employees and employee family member’s healthcare are sweeping the country. But you are not likely to ever hear about them unless you ask your broker. Why? Your broker is like a realtor, the more money you pay, the more they make.

So, it’s time to ask! When you do ask, you will learn that the more employees that engage in smart healthcare decisions, the more your company and the employee both stand to save. So creating a work environment that encourages smart, engaged healthcare decisions is key. Many of these corporate offerings are turn-key and simply require your organization to contract with an organization and move forward! Here is a list of several offerings that could provide improved care and access to your employees, while drastically reducing your company’s overall healthcare costs.

1. Telehealth options

As discussed above, when used as an alternative to a primary care visit, both telehealth and 24-hour call lines can reduce wasteful spending and eliminate unnecessary delays in care.

2. Disease Specific Programs

The old saying that 10 percent of your employees account for more than 90 percent of your overall spending is never truer than in healthcare. Expenses on chronic diseases like diabetes can be reduced drastically if your company invests in and offers a prevention program for employees at risk for diabetes.

3. DNA Testing

Companies offering voluntary DNA testing or genome sequencing for employees are finding that the potential to save thousands on unnecessary medications and preventable chronic diseases has a swift return on investment. DNA test identify which medications are ineffective on an individual and also identify those who are pre-disposed to acquire several forms of cancer.

4. Integrative, Functional or Naturopathic medicine consults

The reemergence of natural methods to live healthier and prevent increased likelihood of chronic disease by better understanding each individual’s body composition has proven to be a quick return on investment as well.

5. Local Medical Tourism

Employees who choose a Center of Excellence, or in-network provider may save a few thousand dollars, but your company can save anywhere from $40,000 to $80,000 on major procedures. Making sure employees understand that the quality of care at both facilities is comparable often is enough to convince them to choose the in-network provider. And if not, why not offer to pay their personal co-pay if it saves the company $20,000 or more?

Simple Tactics, Quick Results

Companies all over the country are proving that simple tactics like this can produce quick results. Not only will the employee and employer save significant dollars in year one, but you are also likely to see enhanced access to care, improved quality and an increase in overall employee morale as a result.

Keep in mind that you don’t even need to tackle all of these tactics in the first year. Many companies have had great success starting with two or three of these tactics and adding others later.

Of late, companies like Walmart, Disney, Apple, Amazon, JP Morgan and Berkshire Hathaway have all declared war on healthcare costs. Isn’t it time that your organization declare your tipping point on wasteful and excessive healthcare spending?