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Consumer Engagement Best Practices

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FIS looks at the healthcare system from a consumer perspective. What do consumers need to better manage their healthcare and make informed decisions? What are the latest solutions and services that …

FIS looks at the healthcare system from a consumer perspective. What do consumers need to better manage their healthcare and make informed decisions? What are the latest solutions and services that are being introduced to empower consumers?

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  • Economy is more of a driver in managing health care costs than reformNeed adjust layout in order to see/read entire blue box on right -- Mike
  • In second bullet on right, lowercase A and Doctor; in third bullet on right, Change 24-7to 24/7/365
  • Transcript

    • 1. Consumer Engagement Best Practices – A Profile of an Empowered Patient
      David Randall, Executive Director, CDHCi
      John Bull, Director CDH Product Strategy, FIS
    • 2. Agenda
      David Randall, Executive Director, CDHCi
      Consumer Directed Healthcare growth
      Consumer engagement past and present
      State of the market
      Future trends and direction
      Key metrics
      John Bull, Director CDH Product Strategy, FIS
      FIS market perspective
      Consumer needs/wants
      The CDH lifecycle
      A few real life examples
      Solution imperatives
      2
    • 3. Consumer Engagement Best Practices – A Profile of an Empowered PatientPresented by:
      David Randall, Ph.D. (A.B.D), Executive Director, CDHCiand The American Research and Policy Institute, Washington, D.C.
    • 4. What is Consumer Driven Healthcare?
      The application and use of tools, services and products that engage, inform and empower individual consumers of healthcare services to make healthcare choices in their own self economic and health interests.
      CDHC removes the problem of Third Party Payment discussed by Tullock (1965, 1990), Friedman (1962,1975) and Herzlinger (2004).
      CDHC growth and adoption began after the passage of the Medicare Modernization Act of 2003 when Health Savings Accounts were created
      4
    • 5. Enrollment Growth in HDHP
      AHIP
    • 6. HRA Account Growth and Balances
      AHIP
      More than 5 million accounts as of 2009
      Average account balance of $1,419
      Average roll over balance of $1,295
      Projected growth by 2014 at more than 10 million HRA accounts
      Projected growth of all CDHC accounts to be more than 22 million by 2014
    • 7. Economic Downturn Driving Consumer-driven Healthcare Adoption
      Double-digit
      healthcare
      cost increases
      average cost per-employee
      of health benefits $9,660
      Employers more aggressive in managing their health care costs
      Currently only 17% employers offer a full replacement CDH program AND a MAJORITY of Fortune 500 offer
      Implementing a Consumer Driven Healthcare program is one of the leading healthcare strategies for employers
      Employers looking for options to decrease the cost per employee of health benefits
      Number of Consumer Driven Healthcare programs to increase in 2010
      * Towers Watson, Aon
    • 8. Consumer Engagement: Past and Present
      Past government efforts
      State-of-the-market: From PHRs to mobile payment platforms
      Transaction metrics, spending trends from CDHCidata
      8
    • 9. Evolution and Devolution:
      Center for Medicare and Medicaid Services (CMS) posts prices, industry follows
      Aetna Price Transparency Project
      Personal Health Record (PHRs)
      Online tools − Google and Microsoft
      Price disclosure in post-PPACA environment
    • 10. State of the Market:
      State-based efforts to encourage or require providers to post prices
      The rise of retail-based healthcare
      CDHC growth trends and impediments
    • 11. Future Trends and Health Care Reform:
      Impact of Health Insurance Exchanges before and after 2014
      Watch the states − where all the action will be!
      A generational shift away from third-party payers to CDHC products and services
      Mobile applications
    • 12. Key Data Metrics:
      CDHCimarket data advisory
      Transaction trends
      Mobile payments
      Retail model growth
    • 13. Our Target Consumer:
      Healthcare consumer − Lori S., age 48, white female
      She is used to low co-pays and has never seen a price list!
      Question − How to engage her?
      The retail model!
      Keep it simple and make it easy!
    • 14. New Healthcare Retail Model
      Retail 1.0
      Minute Clinic/CVS
      Nurse Lines
      Use of PHRs
      Lower utilization, convenience
      Retail 2.0-3.0
      Consult A Doctor
      Use of Web-based technologies, 24-7 access
      Higher ROI, reduced utilization
      14
    • 15. CDHCiMarket Data
      Beginning in June, 2010 CDHCilaunches a Quarterly Data Advisory Service that will track account-based plans across a range of metrics, including:
      − Account balances, spending patterns and healthcare utilization trends, and projections for future growth.
      − Data published quarterly that provides valuable insight for a range of marketing and account use purposes.
    • 16. CDHCiMarket Data AdvisoryKey Data Highlights
      CDH accounts (specifically HSAs) within existing programs, grew 6.46 percent in Q1.  
      Account balances were $592 in individual HSAs, a decrease from average balances in Q4 ’09. While the average balance in family HSAs reached $1,408 in Q1 ’10.
      56 percent of employees in family HSAs contributed to their accounts, while only 49 percent of employees in individual plans contributed to their accounts.
      On average, both reimbursements and check transactions exceeded debit card transactions nearly 2:1 both in individual and family account spending.
      16
    • 17. What this all means
      Increasing Demand!
      Forrester views adoption of CDH as stronger than predicted – calling out HSAs as the growth engine.
      SOURCE: BearingPoint
    • 18. Thank You!
      18
    • 19. John Bull, Director CDH Product Strategy, FIS
      Consumer Engagement Best Practices
    • 20. FIS Market Perspective − Consumer
      Market Observations
      CDH benefits can be complex, confusing and designed a la carte
      Hands on information is a must
      HSAs and HRAs will continue to grow in the future
      Incentives are still drivers
      Technology Needs
      Online experience must be intuitive, fun and quick
      Online banking is the barometer for success
      Mobile is the future
      Health Management and Integrated claims must be provided
      20
    • 21. Before technology solves everything…
      We need to ask (and answer)…What does the consumer really want to know?
      What plan should I enroll in?
      What’s the difference between an HSA and an HRA?
      Have my claims been paid?
      What’s my balance?
      What services does my account cover?
      What incentives do I have that I should be aware of?
      How can I save money on healthcare?
      How much is my healthcare going to cost me?
      21
    • 22. So, how do we answer these questions…
      There are really just a few ways to answer the questions:
      Online
      Phone call to customer service
      IVR
      E-mail
      Online chat
      Mobile
      Ask HR
      Finally, tell them before they think to ask
      22
    • 23. Tell the before they ask….???
      How do we tell consumers what they want to know before they even ask?
      The social media world of Facebook and Twitter make pro-active communication an everyday and expected activity.
      Messages are pushed based on your likes and who you follow. Advertising is embedded into everything.
      Can we do this for CDH? Absolutely!
      23
    • 24. Driving information relies on understanding the CDH life cycle
      24
    • 25. Let’s take Jane…
      Jane’s 40 with two children
      She has choices at enrollment − an HSA Plan with a deductible of $4,800 or a lower deductible plan with a funding account.
      How will she decide what to enroll in?
      25
      HDHP
      PPO
      IRS Limits
      Deductibles
      HSA
      HRA
    • 26. Jane’s decision making process…
      Jane receives notice from HR as well as an e-mail about enrolling in an HSA
      Jane goes online to learn more about HSAs and which plan is right for her
      She views an interactive video on HSA for someone like her – Sarah who is married, 40 years old and has two children
      26
    • 27. Jane’s decision making process…
      Jane likes what she hears, but she wants to forecast what plan is right for her so she uses the “Which plan is right for me?” planning tool.
      27
      1. She enters in her plan information
    • 28. Jane’s decision making process…
      Jane likes what she hears but, she wants to forecast what plan is right for her so she uses the “Which plan is right for me?” planning tool.
      28
      2. She enters in her medial expected services
    • 29. Jane’s decision making process…
      Jane likes what she hears but, she wants to forecast what plan is right for her so she uses the “Which plan is right for me?” planning tool.
      29
      3. She enters in her tax information and expected HSA Contributions
    • 30. Jane’s decision making process…
      Jane likes what she hears but, she wants to forecast what plan is right for her so she uses the “Which plan is right for me?” planning tool.
      30
      4. Based on her unique situation, the HSA looks right for Jane
    • 31. Jane’s ready to enroll, but she’s still not sure…
      31
      Jane reads through the FAQs
      Now, she’s ready to enroll…
    • 32. Now that Jane is enrolled, she can access her account online or on her mobile device
      32
    • 33. Jane not only needs to manage her HSA, but she needs to manage her overall health
      Jane needs wellness tools, incentives and a personal health record − all in one place, through one, online experience
      33
      PHR
      Mobile Wellness
      Wellness tools and Health Risk Assessments
    • 34. Now, it’s time to communicate!
      34
      E-mails and texts
      Opt-in/out of communications
      Open enrollment
      New claim received
      Payment made
      Debit card mailed
      Deductible met
      Incentive completed/ funding received
      Time to refill
      Preventive care notices
      And more
      Online/mobile self-service capabilities
      Claim submission
      Enrollment
      Bill payment for HSAs
      Funding of HSAs
      Transfers out for HSA
      Incentive-based communications
      Mobile balances
      Upload of claims
      Save receipts
      Fun incentives
      Health savings and spend forecasting
      Pricing analysis
      Online and mobile presentment requirements
      • My deductiblestatus
      • 35. My HRA rollover rules
      • 36. My HSA contribution status
      • 37. My claims status and payments
      • 38. Personal health records
      • 39. Wellness information and programs
      • 40. Interactive education
    • To make the consumer engagement a reality, you need the strong technical and market-focused foundation
      35
      First, you need technology that is real-time, dependable and integrated.
      Second, you need to respect the different communication channels demanded by consumers.
      Third, you need to allow users to manage their communication preferences
      Finally, you need an administrative and social media engine for driving the CDH messages.
    • 41. Questions and Answers
    • 42. Thank You
      John Bull, Director CDH Product Strategy, FIS
      john.bull@fisglobal.com
      David Randall, Executive Director, CDHCi
      drandall@CDHCi.org

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