As the number of employers offering health insurance continues to dwindle, plenty of politicians and insurance companies are betting that high- deductible health plans are the way to lure more businesses into offering coverage. The plans, because they require a patient to more actively direct his own medical care, require members to be armed with more medical information. Health insurance companies are taking a variety of routes, Blue Cross of California’s parent company WellPoint has launched a partnership with WebMD and Health Net is introducing more patients to its Decision Power Program, to ensuring that patients feel like they have enough information to make a high deductible plan work for them. Premiums for traditional HMO and PPO plans have been climbing higher every year, which is having a drastic effect on full-time workers. Only 66 percent of them have employer-sponsored health insurance, compared with 80 percent in 1989. High deductible plans offer coverage for significantly lower premiums, but they require members to meet a high spending limit, as much as $2,000 annually for families in some cases, before the insurer takes over the costs. The plans can be linked to tax free health care savings accounts, which are provided by independent banks, although some insurers are opening banks in order to manage the accounts that their members create. Woodland Hills-based Health Net is hoping that its Decision Power program will make its members feel more prepared to make choices when it comes to their medical care. “What we do is make our members more competent consumers, if we increase they’re confidence they being to approach situations very differently,” said Health Net’s chief medical director Dr. Gordon Yenokida. “In order to do that we have developed, with the Center for Share Decision Making (at Dartmouth-Hitchcock Medical Center in New Hampshire) a program where our members are assessed for risk of disease.” ‘Health coaches’ Members are contacted through mailings about certain conditions and can contact “health coaches” employed by the company to find out more about specific conditions. The health coaches are also available if members have questions about whether or not they should see a doctor, or questions about a specific procedure. A patient deciding whether or not to pay for an extensive test can request more information about the test and possible condition to review on his own. Throughout the process, a member will be assigned the same health coach. Yenokida said that although the company is not certain how many Decision Power users are in high-deductible plans, more than 80 percent of those who have used the program were happy with the process. “We’ve never had a negative encounter with a physician over the member taking advantage of the Decision Power,” said Yenokida. “We’ve sent endorsements and evidence of the program to physicians. We hope that medical groups will help expand the awareness of Decision Power among members,” he said. Joe Ruiz, vice president of sales development at Thousand Oaks-based Blue Cross of California said that sales of high-deductible plans have gone well in the last year. “In the small-group market we introduced HSA compatible plans in October of 2004, and in that time we’ve seen those sales ramp up. They comprise about 10 percent of our total sales,” said Ruiz. “We are seeing more people move to a lower cost product where employers are taking a plan that has higher deductibles of a higher co-payment structure.” Ruiz could not say how many employers electing to provide high deductible plans had offered no insurance in the past, but when the company launched a product called BeneFits earlier in 2004 aimed at small businesses, 80 percent of the plans members had never offered insurance at the group level. Online information Earlier this month, WellPoint announced that is providing more personalized health information through its partnership with WebMD. WellPoint members, which include Blue Cross of California, have access to a new health database, an online fitness management program, a portable health record and other options. The idea is that members will feel better about their decisions, have more information about the factors that contribute to deteriorating health and help slow the growing cost of health care. “Our members need useful, relevant information that is specific to their individual needs, as their health and life circumstances change so they can make informed decisions concerning their health and well being,” said Mark Boxer, president and CEO, Consumer-driven Health Plans, Enterprise Services and Medicare Government Business for WellPoint. Dr. Sam Nussbaum, executive vice president and chief medical officer for WellPoint, said that the online features will be useful for members looking for information about specific procedures or those managing chronic conditions. “By integrating these online health tools with our comprehensive medical management strategies, we are working collaboratively with our members and their physicians to improve both the quality and affordability of health care,” said Nussbaum in a statement.
