This panel has representatives from a care management vendor (Health Dialog), a staff model integrated system (GHCPS) and a big insurer (United).
Shorter George Bennet, Health Dialog — You make $3 for every 88 cents you spend on care management when you get the doctors involved. So the answer is to get care management companies to pay doctors to deliver information therapy, and pay them based on how well their patients can answer simple questions.
Best joke (from James Hereford at Group Health Cooperative of Puget Sound) — you know you’re west of the Mississippi when the agenda has both a Holstein and a Hereford on it.
Shorter James Hereford– Group Health is a provider that takes risk (a la Kaiser), and we don’t think like other insurers (and so it has hired a recovering mathematician to improve its consumer health systems). They’ve decided that the use of the web is to integrate and spread information, based around a clinical information system (Epic) and a messaging system. They had a business case for driving integration using technology–but most organizations don’t. Their payback for their $40m investment is in five years, and some facilities have done more eVisit (touches) than actual visits for their secure messaging. Now they have one in three of their patients using it. And they saved $1.4 million in transcription costs. In addition, they believe that with each email they are replacing a phone call, which costs $16-18 or a visit which obviously costs more.
Shorter Bob Tavares, UnitedHealth Group: If you want Information Therapy and consumer portal web sites, you’d better have some goals as to what you’re trying to achieve. United’s consumers site had no goals and Bob has just been hired to figure out what they are! So create some goals about the impact web-based therapy has on for example replacing inpatient care with outpatient procedures (and BTW saving United some cash). Consumers want benefit, costs and treatment outcomes/ quality information all in one place.
Matthew- the $3 for every $1 data– and I would like to have access to the real data is exactly what the group “Bridges to Excellence” reports. The presentation by BTE, however, makse it appealing— identify “best practices”, currently PROCESS measures, not OUTCOMES– then bonus doctors for meeting process measures and also consider bonusing patients for process measures as well. According to Jeff Hanson, who is leading BTE, this approach is yileding $3 in savings of health expenditures for every $1 spent on bonuses.
Very attractive concept, and one not based on punsihing doctors.