Regence is trying to invoke a vision of health care as everyone’s community asset: the consumer has to recognize that it’s his money and his future. Although there’s plenty of blame to go around in the health care industry, rather than trying to find someone to blame, Nair says, insurers have to change, and change quickly, altering their centers of gravity to the consumer and helping the consumer make better decisions, balancing medical management with consumer engagement. Of Regence BC/BS’s 3 million members, 30% are already actively engaged in online communities.
Over the past two years, CIgna’s 8.5 million domestic” lives” have already seen a transformation from their old school insurance company to a customer-centric universe Focused on what people actually want from this system, Cigna participates in Facebook, Twitter, Second Life, Eliza, and Intuit (Quicken Health). Cigna patients can download all their claims information in Quicken Health and see what’s been paid, what hasn’t been paid, and what their responsibility is. The application both tells people how much is actually being covered by their insurance, and explains why things are not covered — in plain English. Cigna patients have seen their information made transparent and delivered to them through many interactive channels. However, merely making information available does not necessarily encourage people to change their behavior. You need to have a motivated patient that’s willing to act on the information.
But at least the new system invites the patient in, which the current health system does not do.
Nathan Moracco, St of Mn Management and Budget supports the employer group for the state of Minnesota, and has devised for the state a tiered product with care systems ranked on a cost and quality basis, layered on top of incentives for members to seek the right care at the right time. The state is doing quality management around diabetes and depression care right now, because everyone knows that 5 chronic diseases account for 70% of the health care spend.