IN THIS ISSUE:
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What’s the Buzz in the Trade Press?
? Business Insurance Compares CD Health to Growth of Managed Care
? Business Insurance Touts Aetna Results
? Business Insurance Debunks Selection Concerns
? Business Insurance Editors – CD Health Has Promising Start
? Employee Benefit News Drills Down on HSAs
? Employee Benefit News – HSAs are Logical Next Step
? KC Business Journal – CD Health Looks Favorable
? KC Business Journal – HSAs Provide Big Push
? Sacramento Bee – Early Signs are Positive
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What’s the Buzz in the Trade Press?
What’s the buzz in the executive suites about consumer driven health? One way to find out is to read the same publications CEOs, CFOs, and HR executives read. The trade publications are full of encouraging news. Some examples:
Business Insurance Compares CD Health to Growth of Managed Care
“Business Insurance” has run a steady stream of articles, mostly positive. The February 16 issue includes an article by Joanne Wojcik that compares the roll out of consumer directed health with that of managed care in the 1970s. She says CD has been slower, but the comparison is a bit strained since HMOs had a long-standing presence in the market long before the 1973 federal HMO Act, and she dates the beginning of CD health to the launch of Definity in 2000. Also, the advantages given to HMOs included federal seed money and a dual-choice mandate on employers — advantages consumer driven health neither wants nor needs. The article says HMO enrollment climbed from 3 million in 1971 to 10 million by 1980. If we start the clock ticking with the clear guidance from the IRS in June, 2002, I don’t think there is much doubt that consumer driven health care enrollment will far exceed HMO enrollment of 10 million nine years later.
SOURCE (subscription required): http://www.businessinsurance.com/cgi-bin/article.pl?articleId=14164&a=a&bt=Aetna
Business Insurance Touts Aetna Results
The same edition of “Business Insurance” included an article by Roberto Ceniceros touting Aetna’s experience with its HealthFund program. Aetna kept track of 14,000 enrollees from 19 different companies after nine months of participation in the HealthFund and compared this with their experience in the nine-month period a year earlier in traditional plans. Aetna found medical costs increased by only 1.5% for people enrolled in HealthFund, compared to double-digit increases for similar populations in other plans. Pharmacy costs dropped 6.5%, while the use of preventive services rose sharply.
Business Insurance Debunks Selection Concerns
In the February 23 edition of “Business Insurance,” Ms. Wojcik had an article reviewing Galen’s Capitol Hill briefing. She wrote, “Enrollees in consumer-directed health plans are more likely to be older and sicker, not young and healthy, as many benefits experts had expected, according to evidence presented at a recent Galen Institute briefing in Washington. Furthermore, the utilization of preventive services increases by as much as 60% for those enrolled in these new plans.” She added that “patients chose generic prescription drugs up to 50% more often and satisfaction and re-enrollment rates are high, up to 98%.”
SOURCE (subscription required): http://www.businessinsurance.com/cgi-bin/article.pl?articleId=14195&a=a&bt=consumerdriven
Business Insurance Editors – CD Health Has Promising Start
BI’s editors also weigh-in, saying that while “we wouldn’t hang our hats on one study ? the outcomes reported by the study do seem on target. Consumer driven plans, in striking contrast to other plan designs, we think, encourage more careful and better employee use of health care services.” The editorial goes on, “Certainly consumer driven plans do not address all the forces — like the near-monopolistic power medical providers enjoy in some communities – which have driven up health care costs. But we think they are a promising start and we eagerly await more research to better determine their ability to keep costs under control.”
SOURCE (subscription required): http://www.businessinsurance.com/cgi-bin/article.pl?articleId=14185&a=a&bt=Aetna
Employee Benefit News Drills Down on HSAs
“Employee Benefit News” has been even more focused on consumer driven health. The February issue included an in-depth article headlined “HSAs Give Clients New Option for Consumer-Driven Health” by John Hickman and two fellow attorneys at Alston & Bird. The article is a dispassionate review of the provisions of the new law, with an emphasis on cafeteria plan funding, which opens “a whole new avenue for funding consumer-driven health care.” The authors say, “This combination of a tax-advantaged HSA with salary reduction funding should prompt more discussions between employers and benefits advisers and accelerate the growth of consumer-driven health care.”
Employee Benefit News – HSAs are Logical Next Step
The same edition features an article by Steve Brown entitled, “Initial HSA Offerings Solidify Trend Toward CDH Products.” The article quotes Mohit Ghose of AAHP/HIAA, Susan Relland of the American Benefits Council (ABC), Paul Fronstin of EBRI, and representatives of Aetna and Humana to conclude, “Industry watchers say the HSAs are the logical evolution in the market trend toward consumer-driven health care.” The article concedes larger employers will take a while to adopt the approach, largely because they “had already closed their open enrollment periods for 2004.” But “small businesses and partnerships appear eager to jump on HSAs.” Ms. Relland says, “We’re hearing from partnerships that they are interested in implementing them right away, even as early as this month, because this is the first time any kind of partner medical benefits can be paid pretax.” The article says, “Experts expect such enthusiasm to permeate as time passes.”
KC Business Journal – CD Health Looks Favorable
It isn’t only in the executive suites that consumer driven health has become mainstream; small business is learning more about it every day. The “Business Journal of Kansas City” ran two articles in its February 20 edition. The first, by staff writer Lola Butcher, is a straight news piece that begins, “Kansas City’s pioneers into the world of ‘consumerism’ in health care give this scouting report: This is uncharted territory, but the landscape looks favorable so far.” The article mentions that Humana, the local Blues, and Coventry Health Care are all offering CD health plans in the local area, and Children’s Mercy Hospital is one of the first local companies to offer it as a benefit. The article says that “Some people expected that healthy young singles would flock to the plans.” But that is not the experience of Children’s Mercy. VP of Human Resources at the hospital, Dan Wright, says, “The best generalization is that folks who typically in the past have taken more of an active interest in managing their health care are the ones who went for this.”
KC Business Journal – HSAs Provide Big Push
Accompanying the news article is an opinion piece by James Clay, a principal of The Resource Group of Overland Park. He says it is rare for the government to move as quickly as it has on HSAs. He adds, “HSAs provide a big push to employers and the health insurance industry to move from predominantly employer-defined benefit health care plans to defined-contribution approaches where individuals can save money in tax-favored accounts.” He expresses some concern about regulatory confusion and the adequacy of the insurance industry’s offerings, but “the real hope is that it spurs an evolutionary change where individuals no longer are insulated from the reality of how their behavior directly affects health care costs.”
Sacramento Bee – Early Signs are Positive
Local dailies are touting the approach, too. A recent edition of the “Sacramento Bee” included an article by Daniel Weintraub, “Early Signs are Positive for Consumer-Directed Care.” He references Galen’s recent Hill briefing and cites the experience reported by Definity and Aetna in utilization changes, cost savings, and – importantly – the fact that there has not been the favorable selection predicted by some. He concludes, “Anything that takes the management of our care away from employers and insurers and gives choice and control back to the individual is bound to be good for our health, and our economy.”
This is what decision-makers are reading. The positive evidence is mounting and is overwhelming. This is the kind of buzz that moves an idea out of the pioneering stage and well into the mainstream.
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The views expressed in this newsletter are the opinions of the authors and do not necessarily reflect the views of the Galen Institute or its directors.