Track D: Consumer Issues and Strategies in Disease Management

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Track D Consumer Issues and Strategies in
Disease Management
The Disease Management Colloquium May 11,
2006 Philadelphia
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• Has anyone met a consumer any consumer who
  has been involved in the design of Consumer
  Directed Healthcare?

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The Business of Health Care in 2006 Chronic
Health Conditions Underlie the Bulk of Health
Care Costs
1 of people
Diabetes Heart Failure Coronary Artery
Disease Depression Chronic Pain Cancer Asthma
and COPD Dementia Falls Obesity
100
80
38 total cost
60
40
?
Premium level
20
0 total cost
0
0
20
60
80
100
40
70 of people
20 of people
of People
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The Business of Health Care in 2006 Chronic
Health Conditions Underlie the Bulk of Health
Care Costs
What happens when we disrupt the revenue flow? To
demand? To discretionary services? To insurance?
100
?
80
60
40
?
?
Premium level
20
?
0
0
20
60
80
100
40
of People
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Value Model
Care
Affordability
Experience
Value
Clinical
Quality
Thanks to Matt Stiefel Jim Bellows PhD
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Care
Affordability
Experience
Purchaser Perspective
Value
Clinical
Quality
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How do we get the consumers attention?

• Rules of the Game model
• Managed Care
• Case management for high risk participants
• Skin in the game model
• Tiered co-pays
• Coinsurance
• High Deductible Health Plans
• Tiered networks hospitals, specialists, PCPs
• Consumer Directed Plans
• Do we need something in addition?

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Track D Consumer Issues and Strategies in
Disease Management

• Is Consumer Directed Healthcare the Magic
  Bullet?Paul Wallace, MD Medical Director for
  Health and Productivity Management Programs
  Kaiser Permanente
• Using Choice Incentives to Change Employee
  Behavior
• Michael Dermer President and Chief Executive
  Officer IncentOne
• So You Disclosed Disease Management Participation
  to the Patient's Secretary Now What?
• Rebekah N. Plowman, Esq.Partner, Epstein,
  Becker, and Green
• Personalizing Patient Messages to Induce
  Behavioral Change
• Earl P. Steinberg, MD, MPP CEO and President,
  Resolution Health, Inc.
• Using Financial Incentives to Change Employee
  Behavior
• Roger W. Reed, BSN, RN, FNP, PAChief Health
  Office Gordian Health Solutions, Inc.