Employers shape progress

May 1, 2005

Healthcare consumers and purchasers finally are getting what they've wanted for years: online information about health plans and hospitals. But is it data they need and can use to make good healthcare decisions? Employers say, "not yet."

The Centers for Medicare and Medicaid Services (CMS) launched a new Web site March 30 that compares hospital quality using 17 widely used measures for treating heart ailments and pneumonia. Hospital Compare includes data reported voluntarily by nearly all of the nation's 4,200 general hospitals.

And for the past two years, the Agency for Healthcare Research and Quality (AHRQ) has published "The National Healthcare Quality Report" on behalf of the U.S. Department of Health and Human Services (HHS). The report sizes up providers using a set of healthcare measures across four dimensions of quality (effectiveness, safety, timeliness and patient centeredness), plus additional measures focusing on effectiveness in nine targeted clinical condition areas (cancer, diabetes, end stage renal disease, heart disease, HIV/AIDS, maternal and child health, mental health, respiratory diseases, and nursing home and home healthcare). The purpose of the report, according to AHRQ and HHS, is to track the state of healthcare quality for the nation on an annual basis.

The uptick in privately and publicly available tools to measure health plans and healthcare quality can be directly tied to two trends: the emergence of Consumer-Directed Health Care (CDHC) plans, and the continuing push from employers for tools to measure the quality of the healthcare benefits that cost more each year.

Recent research from the National Business Group on Health (NBGH) and Watson Wyatt Worldwide projects that employee participation in CDHP plans tripled between 2003 and 2004. Although CDHP enrollment is still low (first-year enrollment ranges from 1% to 33% for employers offering competing plans), growing interest in these plans will require more and better e-based tools for consumers to make wise healthcare choices.

For its recent report, Health2 Resources surveyed employer healthcare coalitions (representing more than 21 million covered lives) and large businesses (representing more than 2.3 million covered lives) about their current and planned use of e-health tools to manage employee health benefits.

Health2 Resources also introduced the Health I-CUE concept in the report as a rubric for determining how employers evaluate and select health benefit IT vendors, based on their ability to offer:

Information to Choose-individual providers, hospitals or care networks, health plans, benefit programs, physicians and systems of care;

Information to Use-tools that allow interactive claims management, enable chronic disease and care management, educate them about best practices for chronic conditions and acute care needs, offer research and evidence-based treatment options and caregiver options;

Information to Evaluate-tools that measure outcomes, safety, quality, cost, customer service and patient perception.

Coalition executives said that over the coming year, both "disease and care management" and "educate my employees about their health/diseases" would be nearly equally effective tools for managing healthcare costs.