CDHC onus falls on health plans

October 1, 2007

Consumers tend to seek the best combination of price, features and quality when shopping for medical services, just as in other market transactions. Today, employers are relying on health plans to fill the value-information void with Web-based decision support tools.

Consumers tend to seek the best combination of price, features and quality when shopping for medical services, just as in other market transactions. Today, employers are relying on health plans to fill the value-information void with Web-based decision support tools.

At a minimum, patients should have accurate and detailed information on a physician's location, specialty, practice and hospital affiliations. However, often the accuracy of what is provided is lacking.

Patients should also have information about the age and disease profile of the physician's patient base. Does a certain neurologist, for instance, specialize in multiple sclerosis in women aged 18 to 39?

Is it more cost effective in the long run to have surgery or to take pharmacotherapy? Soon, consumers will have the tools to perform cost/benefit analyses, and, with the help of their physicians, they'll be able to consider cost when choosing between treatments.

Until then, health plans can use the information they have to educate consumers on the value of healthful behaviors, explaining the costs associated with not seeking treatment or not following a prescribed treatment regimen.

For the promise of CDH to be realized, consumers must have easy access to accurate, detailed, integrated and user-friendly information to make wise purchase decisions. While many plans are making forays into the "information business," they must continue to make progress as more information and consumer-friendly tools become available. To support their members in making smarter healthcare decisions, health plans will need to seek out new types and presentations of information.

David MacDougall is account director, payer solutions, and Michael DeSimone is director, payer solutions at IMS Health, which combines information, analytics and industry expertise to deliver intelligence on the practice and consumption of healthcare services.