I get emails from PR companies all the time pimping this or that client, but they don’t get a lot stranger than this one. (I‘ve hidden the names to protect the guilty):
Subject: Top 3 Reasons Why Health Insurers Are On Your Side…
Hi Matthew,
Health plans are typically portrayed as the evil empire, bent on raising premiums and squeezing every shred of patience out of their members. But, what if I told you that in reality, that isn’t the case?
Here are the top 3 reasons why your health plan really is in your corner and why it is in their best interest to keep you healthy:
1. The healthier you are, the more profitable it is for your insurance provider. Therefore they should go out of their way to keep you healthy with preventative care recommendations.
2. Your health insurer is in a position to get you access to the providers and specialists you want, when you want them. A plan biggest differentiator and selling point is its provider network. It benefits both the plan and the member to have the most skilled, sought after providers a part of the network.
3. Health plans have a 360 degree view of every member’s care. Unlike individual healthcare professionals, plans know every touch point their members have with providers and can make care recommendations.
How about a story that looks at why plans get a bad rap, and actions they are taking that are in their members’ best interests that aren’t typically publicized?
I can put you in touch with REDACTED of HEALTH IT VENDOR who can elaborate on the top 3 reasons and discuss steps that plans are taking to improve the flow of information between plans and providers and plans and members leading to more efficient and effective care.
What do you think?
Regards,
REDACTED
I thought that the careful THCB reader might come up with some interesting analysis about whether health plans are actually doing what this PR maven thinks they’re doing. And I’m sure one or two other THCB readers may not be convinced that insurers are “on your side”
Categories: Matthew Holt
Nice post
was this really sent by someone hired by insurers? This sounds way to corny and off base to be written by someone that has worked more then a week in insurance.
Which is the most honest response:
A. Yes, yes, yes, Matthew, I will still love you, in the morning!
B. This won’t hurt but it will be just a little uncomfortable.
C. The check is in the mail.
D. No, you don’t look fat in that dress.
E. All of the above.
Restating it:
1) We do not offer a proactive wellness program, even though it might make business sense to do so. Instead, we will send daily or weekly e-mails with reminders about how to take care of yourself better so we don’t have to shell-out as much for your care.
2) We have a long list of practitioners who have signed our reimbursement contract. However, we do not publish any ratings from their patients. We are also not responsible for their quality of care nor how long it takes to get an appointment. Good luck.
3) Because we already have your healthcare data, HIPAA allows us to target-market our providers’ services to you, some of which we may cover. So if your health improves, it increases our profit.
Yes, it’s true most health care companies want healthy populations and have provided wellness programs, online support, prevention information, newsletters and emails in an effort to help members before illness takes place. Once an illness sets in, there are disease management programs and care coordination provided to navigate an expensive system. There are two pools to consider – individual and group. There are subgroups within the group pool. Each pool has accountability to keep a benefit to care ratio that is typically 72-75% and stay profitable. The questions are: how much savings are these programs generating and where is the savings going? For the majority, premiums are going up, and benefits are going down and the savings, well it may be lining executive pockets for keeping the benefit ratios in line.