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Julie Miller was the former Managed Healthcare Executive Editor in Chief until May of 2014.
Outlining future costs for HDHP members would encourage more prevention and care compliance.
The industry must figure out the answer quickly because HDHPs are becoming employers' design of choice.
According to several sources, HDHPs are no longer the "better than nothing" benefit designs they once were. America's Health Insurance Plans reports a significant trend with enrollment growing from 1 million in 2005 to 13.5 million in 2012.
WHAT TO DO, WHAT TO DO?
So as the enrollment continues to trend up, what are some immediate solutions to manage the inevitable, growing problem of members skipping high-value care?
Obviously, members don't really want to skip the care itself; what they want to avoid is paying the cost. Managed care's challenge comes in making the HDHP's higher out-of-pocket costs manageable and rational in the eyes of the members.
Recently, several of the largest health plans improved their online cost-estimating tools to reflect not only an individual's benefit design but also the up-to-date deductible balance. It's a fantastic feature. Previously, most cost tools provided a range of estimates for a limited list of services and rarely considered contracted rates or an individual's actual out-of-pocket costs.
UnitedHealthcare's new tool also includes care paths, which provide a comprehensive view of what the member might expect to pay throughout a course of treatment, from the first visit up through testing, procedures and any necessary follow-up care.
While the upgraded tools will help HDHP members make more cost-conscious choices, consider going a step further. Most families plan well in advance when making a major consumer-product purchase, such as a new television or a car, but are blindsided when healthcare costs crop up.
Managed care must redesign estimators not only to provide comparative information for immediate health events but for future costs as well. For example, one-year health portfolios might include recommended preventive care and expected events based on historic data to help families plan for the year ahead.
A diabetic member might receive a one-year portfolio that lists an annual retinal eye exam and the estimated costs of current prescriptions-nothing too extreme, just the clearly expected care needs. Now he or she has a basic cost outlook for the year and knows what to expect.
Think of the possibilities. You can help your members plan financially while also encouraging prevention and care compliance. Sure, there would be a long list of caveats when trying to present future healthcare needs in a way that can be responsibly shared with consumers, but it's doable.
Especially now that managed care has to shift to a more retail, consumer-centric model, such value-added services can help make a difference. Don't miss this opportunity to put costs in perspective.
Julie Miller is editor-in-chief of MANAGED HEALTHCARE EXECUTIVE. She can be reached at firstname.lastname@example.org