Much of the buzz in consumer-driven healthcare centers on the gaining momentum of health savings accounts (HSAs). Consumers currently are focused on reducing their premiums, making HSAs popular because they offer an acceptable response to the rising premium cost. However, as HSA balances increase, the focus will shift to investment options, returns and associated fees, so as the CDHC market evolves, you will need to service two groups—spenders and savers.
Much of the buzz in consumer-driven healthcare centers on the gaining momentum of health savings accounts (HSAs). Consumers currently are focused on reducing their premiums, making HSAs popular because they offer an acceptable response to the rising premium cost. However, as HSA balances increase, the focus will shift to investment options, returns and associated fees, so as the CDHC market evolves, you will need to service two groups-spenders and savers.
There are plenty of wants, should-haves and wishes related to HSAs. Health plans often make their offerings too complicated too early in the adoption curve. Sophisticated integration to multiple banks is not required to launch a plan, but a strategic banking relationship is important to help your customers get started.
Many plans have introduced high-deductible health plans (HDHPs) and are now faced with how to differentiate their offering in the market. Momentum matters-getting to market quickly to establish brand recognition and to gain experience working with HSA consumers is more important than launching all the bells and whistles on day one. Consumers are still learning about HSAs and are not extremely demanding-yet. But they will be soon. Health plans can win by offering an HDHP now and positioning the organization to leverage existing service expertise to cement relationships with the consumer.
Providers are concerned with the "chase-to-pay"-a fire drill that providers must go through to be compensated if patients don't pay their portion of the charges before they leave the provider's facility. This concern is driving much of the desire for real-time claims processing and payment-a vision that will drive fundamental change over time.
In response to the providers' concerns, "auto-pay" has become one of the hottest new buzz words. The best way to eliminate the chase-to-pay for providers is to automatically deduct the member's financial responsibility from the HSA, without any member involvement.
However, while that solution might be good for the provider, it takes the consumer out of the picture. Some consumers will not be comfortable with the idea that money will be deducted from their account without the ability to review the charges. Consumers should be given the option to auto-pay, manually pay or save for the future.
As you implement an HSA, it is important to keep all stakeholders in mind. It is critical to leverage and expand upon your existing service infrastructure. Customer service becomes critical because 80% of the challenges will come from the exceptions. With HSAs, customer service extends beyond a health plan's four walls. Business process planning must consider future growth, and the impact that changes will have on each stakeholder in the value chain. It is imperative to foster a strong partnership between the health plan, the consumer and external parties that provide HSA services (e.g., banks).
THINGS TO REMEMBER
Most of you have a HDHP product in the market and now you are faced with sales, education, enrollment and servicing these new accounts. Here are some pointers:
Help the consumer, make it easy to understand, try to streamline the enrollment process for HDHPs and HSAs.
Offer solutions to engage the member as an active participant in making payments and understanding saving vs. spending decisions.
Consumers will expect a one-stop customer service solution for their health and savings-be prepared for the shift from a member to a consumer relationship.
Kathy McAleer, a veteran in the rapidly growing field of Consumer-Directed Healthcare, is vice president of operations for QCSI's MyHealthBank product line.