Notes
Slide Show
Outline
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Health Benefits:
Decade of the Consumer
  • Jerry Burgess
  • President/CEO
  • HealthCare 21 Business Coalition
  • November 2005
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Chronic Disease
70—30 Rule
  • Diabetes
  • Asthma
  • Cardiac
  • Depression
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Diabetes
  • HbA1c
  • Eye Exam
  • Check Extremities
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Current Health Care Market
(not a Market)
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HC21 Promotes
  • Value Based Purchasing:
  • IMPROVING THE WAY WE PURCHASE HEATLHCARE
  • Evidence Based Medicine:
  • IMPROVING THE DELIVERY OF HEALTHCARE
  • Consumerism:
  • IMPROVING THE HEATLHCARE SYSTEM, EMPOWERING THE CONSUMER
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Consumers
  • Incentives
  • Involvement
  • Information


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Incentives
  • Discount on premium for non-smoking, weight management
  • Tax exempt $$’s in FSA, MERP, HRA, HSA
  • Mandatory health assessment integrated into screening, nurse visits, and disease management
  • Benefit Design (Pitney Bowes)
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Involvement
  • Representative employee committee
  • Train the Trainer
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Information
  • Enrollment
  • Continuous Stream
  • One on One
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Providers
  • Performance Measurement
  • Recognition, Reward and Accountability
  • Steer employees to the high performers


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Measurement
  • National Standards (NQF, Leapfrog, JCAHO, NCQA)
  • Local Initiatives (Hospital Study Group/VAP)
  • Data Cooperative (HC21)
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Recognition, Reward and Accountability
  • Consumer Guide
  • P4P
  • Tier and Steer
  • Exclude from Network
  • High Performance Networks
  • Fraud
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What Can You Do?
  • Be informed
  • Embrace change
  • Work collectively
  • Work collaboratively


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Why You?
  • You have the business model for change
  • Value through supply chain