State of the Industry 2009: Trends

AMong The Top Issues in 2009 is increasing consumer engagement. Health plans have done a reasonably good job developing member portals and adopting technology that puts information and applications in the hands of the healthcare consumer to better manage their own care. The challenge going forward is to leverage technology to touch members even more.

"Some plans are very focused on how they leverage the Web as a way to reach and activate their members, but I think we still have a long way to go," says Kevin Noland, CEO and president of A.D.A.M., a consumer health information organization. "There needs to be a recognition that not everyone of us gets engaged at the same level. There are multiple touch points, and I think we have to recognize what those touch points are and how we best provide information, tools and support at all of those places."

Noland says that there are few standards for presenting cost information to consumers, for example, therefore rendering much of the information useless. Until standards are solidified and adopted across a broad use, it will be difficult for consumers to make heads or tails out of the information.

Roy Schoenberg, MD, CEO of American Well, an online healthcare marketplace, believes that the top three picks among survey respondents-which account for better than two-thirds of all responses-may indicate a transformation for the healthcare industry into a traditional service industry.

Consumers are effectively becoming buyers, according to Schoenberg, and are for the first time getting currency with which to buy. Industrywide standards for measurements will translate to better information detailing what they can purchase and how to make cost-effective choices.

"When you have a definition of a buyer, a definition of currency, and a definition of goods, you are well on the way to actually making a marketplace out of healthcare," he says.

PLAN DATA

David Knowlton, president and CEO of the New Jersey Health Care Quality Institute, and a director of the HealthWell Foundation, a non-profit organization that provides financial assistance to individuals, says MHE readers' top three choices spell great opportunities for health plans, but also great challenges.

"The way [health plans] would like this consumer engagement in care choices to take place is through the data that the health plan provides," says Knowlton. The problem, however, is that surveys indicate that consumers don't trust the data that health plans provide.

For example, Knowlton suggests that if a health plan rates hospitals and doctors objectively, and that objectivity is sustained by an independent group, the list might need to include doctors outside the health plan's network.

"If health plans really believe that this is the right way to go, and I think they do, they've got to [provide the data] through an independent, third-party group," says Knowlton.