This document proposes and outlines a "Whole Health" plan that allows members to customize their health coverage to include both traditional and alternative practices. It discusses offering members "care baskets" focused on different health styles and situations that provide first dollar coverage for certain services. The plan would be piloted in a small area and offered through a high-deductible PPO. It describes a 3-phase rollout plan to first integrate existing WellPoint offerings, then create an expanded platform and extend the offerings to new groups and regions. The goal is to attract new members, capture more of their health spending, and provide personalized support through an online portal.
- Complementary and alternative medicine (CAM) is growing in popularity in the US, with 83 million Americans spending $33 billion annually on CAM. Chiropractic care is the 4th most commonly used CAM approach.
- Empowering Health Network was established to address growing demand for CAM in the US and abroad through various services including education, marketing, and a consumer-facing website called HelpWhatHurts.com.
- The company is seeking $1.25 million to expand offerings like HelpWhatHurts.com which will provide consumers information on musculoskeletal disorders and connect them with CAM practitioners.
The document proposes a business plan to capitalize on the disruption in the healthcare market caused by Obamacare. It aims to offer new preventative healthcare solutions focused on long term health and longevity. The plan is to consolidate the alternative health market, combine alternative and traditional medical approaches, and build a multi-billion dollar wellness organization worldwide. It currently offers training programs and products on holistic health principles but seeks funding to expand services, build corporate wellness programs, franchise centers, and scale operations globally to shift the paradigm to long term health.
William Shrank: Payment reform activities at CMSNuffield Trust
The document discusses activities at the CMS Innovation Center to test new payment and service delivery models. It outlines several initiatives to improve care coordination, such as ACO models and medical home programs. It also discusses initiatives to improve care quality like Partnership for Patients and reduce costs through bundled payments. Rapid-cycle evaluation is highlighted as important to provide feedback to support continuous quality improvement and identify successful models to scale nationally.
The document proposes three customer value propositions (CVPs) for a new digital health business. CVP1 focuses on integrated workplace wellness solutions. CVP2 targets wellness solutions for young communities. CVP3 proposes smart home solutions for remote patient monitoring. Each CVP outlines the target customers, their pain points, the proposed digital health solutions, required solution components, needed resources, strategic alignment, and go-to-market timeline. The CVPs aim to address issues like rising healthcare costs and the growing needs of chronic patients through personalized digital health and wellness programs.
Our product provides health data from diabetics to decrease business risks for insurance companies. We provide a home hub that collects data from partner devices and transmits it to help incentivize healthy behaviors and reduce long-term costs from diabetes complications. This benefits diabetics through improved health and lower insurance costs, while providing useful data to insurance companies and researchers.
The document provides an overview of the Affordable Care Act (ACA) and its implementation in California. It discusses how the ACA expands Medicaid (Medi-Cal) coverage and creates health insurance exchanges to cover the uninsured. It also addresses eligibility, enrollment, plan options, and the roles of social workers in outreach and advocacy.
The document discusses California's implementation of the Affordable Care Act. It aims to achieve universal coverage through Medicaid expansion and private health plans on the state's health insurance exchange. While coverage will increase, some groups like unauthorized immigrants will remain uninsured. The state is promoting enrollment through navigators and assisters. It is also working to protect consumers through insurance market reforms and establish essential health benefits. Accountable care organizations are being developed to coordinate care delivery and lower costs. Community health workers play an important role in care coordination and outreach.
White paper - Combating COVID19 - Payer in a Box BPaaS solutionsPaul Simon Arakkal
The U.S Healthcare Industry is going through an unprecedented 100 year phenomenon - COVID19. It has impacted clients, customers and their families. This White Paper points to Insurance in a Box BPaaS Solutions as a viable business option for Payers to combat COVID19 related healthcare and operational challenges.
- Complementary and alternative medicine (CAM) is growing in popularity in the US, with 83 million Americans spending $33 billion annually on CAM. Chiropractic care is the 4th most commonly used CAM approach.
- Empowering Health Network was established to address growing demand for CAM in the US and abroad through various services including education, marketing, and a consumer-facing website called HelpWhatHurts.com.
- The company is seeking $1.25 million to expand offerings like HelpWhatHurts.com which will provide consumers information on musculoskeletal disorders and connect them with CAM practitioners.
The document proposes a business plan to capitalize on the disruption in the healthcare market caused by Obamacare. It aims to offer new preventative healthcare solutions focused on long term health and longevity. The plan is to consolidate the alternative health market, combine alternative and traditional medical approaches, and build a multi-billion dollar wellness organization worldwide. It currently offers training programs and products on holistic health principles but seeks funding to expand services, build corporate wellness programs, franchise centers, and scale operations globally to shift the paradigm to long term health.
William Shrank: Payment reform activities at CMSNuffield Trust
The document discusses activities at the CMS Innovation Center to test new payment and service delivery models. It outlines several initiatives to improve care coordination, such as ACO models and medical home programs. It also discusses initiatives to improve care quality like Partnership for Patients and reduce costs through bundled payments. Rapid-cycle evaluation is highlighted as important to provide feedback to support continuous quality improvement and identify successful models to scale nationally.
The document proposes three customer value propositions (CVPs) for a new digital health business. CVP1 focuses on integrated workplace wellness solutions. CVP2 targets wellness solutions for young communities. CVP3 proposes smart home solutions for remote patient monitoring. Each CVP outlines the target customers, their pain points, the proposed digital health solutions, required solution components, needed resources, strategic alignment, and go-to-market timeline. The CVPs aim to address issues like rising healthcare costs and the growing needs of chronic patients through personalized digital health and wellness programs.
Our product provides health data from diabetics to decrease business risks for insurance companies. We provide a home hub that collects data from partner devices and transmits it to help incentivize healthy behaviors and reduce long-term costs from diabetes complications. This benefits diabetics through improved health and lower insurance costs, while providing useful data to insurance companies and researchers.
The document provides an overview of the Affordable Care Act (ACA) and its implementation in California. It discusses how the ACA expands Medicaid (Medi-Cal) coverage and creates health insurance exchanges to cover the uninsured. It also addresses eligibility, enrollment, plan options, and the roles of social workers in outreach and advocacy.
The document discusses California's implementation of the Affordable Care Act. It aims to achieve universal coverage through Medicaid expansion and private health plans on the state's health insurance exchange. While coverage will increase, some groups like unauthorized immigrants will remain uninsured. The state is promoting enrollment through navigators and assisters. It is also working to protect consumers through insurance market reforms and establish essential health benefits. Accountable care organizations are being developed to coordinate care delivery and lower costs. Community health workers play an important role in care coordination and outreach.
White paper - Combating COVID19 - Payer in a Box BPaaS solutionsPaul Simon Arakkal
The U.S Healthcare Industry is going through an unprecedented 100 year phenomenon - COVID19. It has impacted clients, customers and their families. This White Paper points to Insurance in a Box BPaaS Solutions as a viable business option for Payers to combat COVID19 related healthcare and operational challenges.
FINAL_Catholic_Health_Initiatives_Food_and_Nutrition_Commercialization_Recomm...Cheryl Lesh-Clark, MBA
This document evaluates a proposed standalone Food and Nutrition Support Services Program that Catholic Health Initiatives (CHI) aims to develop within its Supply Chain department and later market to other healthcare systems. The program seeks to commercialize CHI's food and nutrition operations and expertise to generate additional revenue. The document provides an overview of CHI and the changing healthcare landscape, a background of the proposed program, and recommendations to optimize operations, marketing, and finances for successful implementation and commercialization of the Food and Nutrition program.
Increasing Capacity for Health Outreach_Cassie Chandler_4.23.13CORE Group
This document summarizes a CORE Group Spring Meeting that discussed integrating health and financial services. It provides the following key points:
1) Access to health and financial services can help reduce poverty. Microfinance organizations and savings groups reach many poor clients and health problems are a common reason clients cannot save.
2) High impact health services can be added to microfinance institutions at low cost, with positive impacts for clients and potential to contribute to health goals. Health providers also gain new clients.
3) Freedom from Hunger's work in 10 countries shows over 2 million clients now receive health and financial services through various models. Analysis shows combinations can be low-cost or financially sustainable.
4) Integrating
Launching or expanding a telehealth & remote patient monitoring (RPM) program can be an intimidating task
*HRS health system, home health & hospice
*HRS’ Client Success, Implementation,Reimbursement & Clinical teams
WellPoint is committed to transforming health care by simplifying the system, making care more affordable and accessible, improving quality, and promoting better public health. In 2006, WellPoint made progress on these goals by:
1. Launching innovative consumer-driven health plans and programs like 360° Health across the country to empower consumers with choice, information and tools to better manage their health.
2. Developing programs to increase price and quality transparency, such as a tool allowing consumers to compare costs for procedures at local hospitals.
3. Continuing growth while reducing administrative costs and premium increases, and expanding individual and Medicaid coverage to more Americans.
Enabling Patient Centricity for Pfizer through AWS Cloud (LFS301-S-i) - AWS r...Amazon Web Services
Pfizer needed the ability to perform rapid analysis on its set of real-world evidence (RWE) data to improve patient outcomes, but its existing platform could not scale and meet its objectives. Pfizer collaborated with Deloitte to transform its real-world data and analytics capabilities that maximize insights and avoid duplicative investments by migrating their existing RWE data and analytics environment to the AWS Cloud. Learn how these strategies for planning, executing, and validating the success of these capabilities helped position Pfizer to use the AWS Cloud environment as the cornerstone of its patient-centric analytics to expand and incorporate new AI/ML capabilities, such as Amazon SageMaker. This session is brought to you by AWS partner, Deloitte Consulting LLP.
Overcoming Scalability Challenges in CHW Programs_ Cailey Gibson_10.14.11CORE Group
The document summarizes Living Goods' model of using community health promoters in Uganda to improve public health outcomes and achieve financial sustainability. Key elements include recruiting and training health entrepreneurs to provide health education and sell affordable health products door-to-door. Living Goods aims to reduce child mortality and morbidity while providing incomes for health promoters. It outlines the model's supply chain, product mix, mobile platform, and community impact.
Dr. Afshan Nuri Baig, Chief Medical Officer of Clinicas de Salud del Pueblo, presents “Affordable Care Act from the Clinical Perspective” at the AHF ACA Workshop.
About the Event:
To help those in Imperial County prepare for how the Affordable Care Act will impact work the community, Alliance Healthcare Foundation hosted a workshop on Sept. 11, 2013 at the San Diego Gas & Electric Renewable Energy Resource Center in Imperial County. In this workshop, we explored Covered California enrollment with an overview of multiple health plans and eligibility, discussed the community clinic perspective, and considered its potential impact on the underserved in Imperial County. This workshop was free and included a healthy lunch for all attendees.
Watch the complete event here: http://www.youtube.com/playlist?list=PL-CwI2rkvFSV1_XYs45kGqdJj_R-jfXHP
mHealth Israel_US Health Insurance Overview- An Insider's PerspectiveLevi Shapiro
Presentation about the US Health Insurance Sector by Lori Rund, VP, Product Management and Market Intelligence at Health Alliance Plan, a managed care organization owned by the Henry Ford Health System, with 650,000 lives. Lori is responsible for the identification, concept building, researching and business case developments for new products, services and markets. She develops and leads comprehensive market intelligence functions to help the organization better understand industry trends and identify business opportunities.
Prior to joining Health Alliance Plan, Lori was Director of Product Development and Market Intelligence at Health Alliance Medical Plans in Illinois and Director of Market Research and Strategy at Carle Clinic Association, also in Illinois.
Clinical Biometrics, Inc. Executive Overview
Description Clinical Biometrics is an organization dedicated to enabling predictive healthcare and disease prevention with the IoT. We are working on the IoT (Internet of Things) wireless, biomedical patient monitoring and vendor agnostic integration, pioneering programmable biosensors, integration products and services to monitor secure clinical data in real-time and over time, for inpatient and outpatient environments. Our model enables predictive and preventative healthcare delivery. We are developing vendor agnostic middleware that will allow the integration of the various vendor's sensors and protocols into a common platform with rich data analytics capabilities. This technology will impact our healthcare paradigms and usher us into the future of healthcare delivery including real-time predictive healthcare and disease prevention.
- Tim Crammer, CEO
This document provides an overview of key elements of the Affordable Care Act (ACA), including who is covered, what is covered, who pays for coverage, and how to get covered. It discusses the goals of universal coverage and affordable health plans. It also outlines provisions such as health insurance exchanges, Medicaid expansion, essential health benefits, accountable care organizations, and impacts on employers and individuals.
The document describes Jeevom, a platform that aims to simplify healthcare through user-centric innovations. It connects consumers, healthcare professionals, and businesses. The platform allows users to plan and track their health, connect to professionals, organize medical records, and achieve health goals. It also provides features for professionals and businesses to market themselves, manage schedules and customers, and optimize their operations.
PwC - Apps Formulary for Health Care OrganizationseHealthCareers
The document discusses different types of health apps that could be prescribed or recommended by healthcare providers, including apps to monitor chronic conditions, provide patient education, and support mental health issues like bipolar disorder. It proposes categorizing apps as being available over-the-counter without a prescription, prescribed by a provider, or for controlled substances. The goal is to develop an "apps formulary" process to evaluate and regulate health apps.
Population Health Management: Enabling Accountable Care in Collaborative Prov...Salus One Ed
This document provides the reader information about population health management (PMH), how it relates to incentive payments for healthcare providers and their health insurance partners (commercial and government). See details about required transformation of care delivery methods, typical accountable care payment models, how to achieve incentives, partnerships between state government (public health) and community shared services needs and necessary technology and data to achieve it.
Imagine a healthcare system where people live long, healthy lives, receiving quality, affordable care, with clinicians nationwide collaborating to improve outcomes. That's Accountable Care! Learn the benefits of becoming an ACO in this insightful eBook.
The document provides an integrated marketing communications proposal for the British Heart Foundation charity. It includes a context analysis, goal, objectives, strategy, positioning statement, and communications mix. The primary goal is to increase understanding of BHF's primary function as a research charity by 30%. Objectives include achieving app downloads, increasing social media engagement, and increasing website traffic. The strategy is primarily a profile strategy using above and below-the-line tactics to attract interest and provide information across platforms. Key elements of the communications mix include launching a "Track Your Pound" app, television advertising, in-store promotions, social media, and an updated website.
Five years in, and the Affordable Care Act continues to command conversation in the benefits landscape. Industry players are still scrambling to implement new provisions, keep healthcare costs down, create infrastructure to support new reporting requirements, and develop new payer, provider and care delivery models.
This has, in turn pushed the respective hands of health plans, who have had to change their strategies to fit both the consumerization of insurance and the standards set forth under the ACA.
With end-users in the forefront, health plans must take the strategy implemented 15 years ago with the rise of the internet, and push the marketing and communication initiatives into overdrive to gain and retain customers.
Health plans are shifting their mentality and communication, ant the best of the best are putting time, money, and energy into literacy and new business initiatives.
To simplify, a health plan needs to put the consumer at the center of every decision it makes.
However, in order to plan, communicate, and effectively market to consumers, your health plan must know the consumer, the technology, and the future.
If you’re looking to grow your health plan, we have just released a new guide to help your health plan leverage trends in the post-reform consumer marketplace.
In our latest whitepaper, we share the keys to success for health plans, including the following:
Consumer Trends: Top 5 Healthcare Executive Consumer Strategy Points, Today’s Healthcare Consumers: Six Types of Consumers You Need to Know, Millennial Consumers Special Report
Technology Trends: Big Data, Administration Technology, Payment Technology, mHealth and more.
Future Trends: Accountable Care Organizations, The Future of Telehealth, Continues Rise of Private Exchanges
All of this, and insights on how to make it work for your health plan.
Download this detailed guide, Health Plans: Your Guide to Leveraging Trends in the Post-Reform Consumer Marketplace, free from the Healthcare Trends Institute.
http://www.evolution1.com/health-plans-your-guide-to-leveraging-trends-in-the-post-reform-consumer-marketplace.html
Ahead of the marcus evans Healthcare Leaders Forum 2021, read here an interview with Nick Grant discussing how healthcare providers can benefit from providing patients different payment services
This document provides a summary of strategies for making health care more affordable for small businesses. It recaps health care reform changes through 2013 and changes coming in 2014 and beyond, including the individual and employer mandates. It then discusses the top 5 health care concerns for small businesses besides the Affordable Care Act, including rising costs. The document outlines strategies that work, including savvy plan design like partial self-funding, HRAs, and HDHP/HSAs. It also discusses wellness strategies that work through properly designed incentives and year-round communication. Finally, it discusses the importance of creating consumerism and proactive multi-year planning to control health care costs.
marketing Strategy on Android App-Health plusBiswajeet Sahu
Health Plus+ is a mobile app that aims to connect patients and healthcare organizations. It will allow patients to engage with their healthcare providers early and directly through the app, relieving physician responsibilities. The app will provide healthcare information and a question-and-answer forum. It will also offer youth consultancy services. The goal is to make healthcare more accessible, especially in rural areas of India. Key features will include an interactive directory of doctors and hospitals, appointment scheduling, and health tracking tools. The app will generate revenue through advertisements, in-app purchases, and premium subscriptions.
The Future of Personalizing Care Management & the Patient ExperienceRaphael Louis Vitón
Actionable segmentation model findings - by Raphael Louis Vitón & Dream team of industry experts, physicians and leaders from Blue Cross, GEHealthCare, RingLeaderVentures, Maddock Douglas, Dr.Daniel Friedland, etc working on improving health outcomes by Personalizing the Care Management business model for Better Outcomes & Better Economics (through patient empowerment)
D603-WhitePaper-The Consumerism Ultimatum 15th June 2015Manish Jain
The document discusses the shift in the health insurance marketplace from business-to-business to increasingly business-to-consumer as the Affordable Care Act has increased access to individual health plans. As employers embrace consumer-driven healthcare models, health plans will need to rethink how they serve and engage with individual consumers. The document outlines several areas health plans will need to address, including understanding evolving consumer behaviors and expectations, redesigning products, improving back-office efficiency, enhancing strategic customer engagement, and adopting new methods of care delivery.
FINAL_Catholic_Health_Initiatives_Food_and_Nutrition_Commercialization_Recomm...Cheryl Lesh-Clark, MBA
This document evaluates a proposed standalone Food and Nutrition Support Services Program that Catholic Health Initiatives (CHI) aims to develop within its Supply Chain department and later market to other healthcare systems. The program seeks to commercialize CHI's food and nutrition operations and expertise to generate additional revenue. The document provides an overview of CHI and the changing healthcare landscape, a background of the proposed program, and recommendations to optimize operations, marketing, and finances for successful implementation and commercialization of the Food and Nutrition program.
Increasing Capacity for Health Outreach_Cassie Chandler_4.23.13CORE Group
This document summarizes a CORE Group Spring Meeting that discussed integrating health and financial services. It provides the following key points:
1) Access to health and financial services can help reduce poverty. Microfinance organizations and savings groups reach many poor clients and health problems are a common reason clients cannot save.
2) High impact health services can be added to microfinance institutions at low cost, with positive impacts for clients and potential to contribute to health goals. Health providers also gain new clients.
3) Freedom from Hunger's work in 10 countries shows over 2 million clients now receive health and financial services through various models. Analysis shows combinations can be low-cost or financially sustainable.
4) Integrating
Launching or expanding a telehealth & remote patient monitoring (RPM) program can be an intimidating task
*HRS health system, home health & hospice
*HRS’ Client Success, Implementation,Reimbursement & Clinical teams
WellPoint is committed to transforming health care by simplifying the system, making care more affordable and accessible, improving quality, and promoting better public health. In 2006, WellPoint made progress on these goals by:
1. Launching innovative consumer-driven health plans and programs like 360° Health across the country to empower consumers with choice, information and tools to better manage their health.
2. Developing programs to increase price and quality transparency, such as a tool allowing consumers to compare costs for procedures at local hospitals.
3. Continuing growth while reducing administrative costs and premium increases, and expanding individual and Medicaid coverage to more Americans.
Enabling Patient Centricity for Pfizer through AWS Cloud (LFS301-S-i) - AWS r...Amazon Web Services
Pfizer needed the ability to perform rapid analysis on its set of real-world evidence (RWE) data to improve patient outcomes, but its existing platform could not scale and meet its objectives. Pfizer collaborated with Deloitte to transform its real-world data and analytics capabilities that maximize insights and avoid duplicative investments by migrating their existing RWE data and analytics environment to the AWS Cloud. Learn how these strategies for planning, executing, and validating the success of these capabilities helped position Pfizer to use the AWS Cloud environment as the cornerstone of its patient-centric analytics to expand and incorporate new AI/ML capabilities, such as Amazon SageMaker. This session is brought to you by AWS partner, Deloitte Consulting LLP.
Overcoming Scalability Challenges in CHW Programs_ Cailey Gibson_10.14.11CORE Group
The document summarizes Living Goods' model of using community health promoters in Uganda to improve public health outcomes and achieve financial sustainability. Key elements include recruiting and training health entrepreneurs to provide health education and sell affordable health products door-to-door. Living Goods aims to reduce child mortality and morbidity while providing incomes for health promoters. It outlines the model's supply chain, product mix, mobile platform, and community impact.
Dr. Afshan Nuri Baig, Chief Medical Officer of Clinicas de Salud del Pueblo, presents “Affordable Care Act from the Clinical Perspective” at the AHF ACA Workshop.
About the Event:
To help those in Imperial County prepare for how the Affordable Care Act will impact work the community, Alliance Healthcare Foundation hosted a workshop on Sept. 11, 2013 at the San Diego Gas & Electric Renewable Energy Resource Center in Imperial County. In this workshop, we explored Covered California enrollment with an overview of multiple health plans and eligibility, discussed the community clinic perspective, and considered its potential impact on the underserved in Imperial County. This workshop was free and included a healthy lunch for all attendees.
Watch the complete event here: http://www.youtube.com/playlist?list=PL-CwI2rkvFSV1_XYs45kGqdJj_R-jfXHP
mHealth Israel_US Health Insurance Overview- An Insider's PerspectiveLevi Shapiro
Presentation about the US Health Insurance Sector by Lori Rund, VP, Product Management and Market Intelligence at Health Alliance Plan, a managed care organization owned by the Henry Ford Health System, with 650,000 lives. Lori is responsible for the identification, concept building, researching and business case developments for new products, services and markets. She develops and leads comprehensive market intelligence functions to help the organization better understand industry trends and identify business opportunities.
Prior to joining Health Alliance Plan, Lori was Director of Product Development and Market Intelligence at Health Alliance Medical Plans in Illinois and Director of Market Research and Strategy at Carle Clinic Association, also in Illinois.
Clinical Biometrics, Inc. Executive Overview
Description Clinical Biometrics is an organization dedicated to enabling predictive healthcare and disease prevention with the IoT. We are working on the IoT (Internet of Things) wireless, biomedical patient monitoring and vendor agnostic integration, pioneering programmable biosensors, integration products and services to monitor secure clinical data in real-time and over time, for inpatient and outpatient environments. Our model enables predictive and preventative healthcare delivery. We are developing vendor agnostic middleware that will allow the integration of the various vendor's sensors and protocols into a common platform with rich data analytics capabilities. This technology will impact our healthcare paradigms and usher us into the future of healthcare delivery including real-time predictive healthcare and disease prevention.
- Tim Crammer, CEO
This document provides an overview of key elements of the Affordable Care Act (ACA), including who is covered, what is covered, who pays for coverage, and how to get covered. It discusses the goals of universal coverage and affordable health plans. It also outlines provisions such as health insurance exchanges, Medicaid expansion, essential health benefits, accountable care organizations, and impacts on employers and individuals.
The document describes Jeevom, a platform that aims to simplify healthcare through user-centric innovations. It connects consumers, healthcare professionals, and businesses. The platform allows users to plan and track their health, connect to professionals, organize medical records, and achieve health goals. It also provides features for professionals and businesses to market themselves, manage schedules and customers, and optimize their operations.
PwC - Apps Formulary for Health Care OrganizationseHealthCareers
The document discusses different types of health apps that could be prescribed or recommended by healthcare providers, including apps to monitor chronic conditions, provide patient education, and support mental health issues like bipolar disorder. It proposes categorizing apps as being available over-the-counter without a prescription, prescribed by a provider, or for controlled substances. The goal is to develop an "apps formulary" process to evaluate and regulate health apps.
Population Health Management: Enabling Accountable Care in Collaborative Prov...Salus One Ed
This document provides the reader information about population health management (PMH), how it relates to incentive payments for healthcare providers and their health insurance partners (commercial and government). See details about required transformation of care delivery methods, typical accountable care payment models, how to achieve incentives, partnerships between state government (public health) and community shared services needs and necessary technology and data to achieve it.
Imagine a healthcare system where people live long, healthy lives, receiving quality, affordable care, with clinicians nationwide collaborating to improve outcomes. That's Accountable Care! Learn the benefits of becoming an ACO in this insightful eBook.
The document provides an integrated marketing communications proposal for the British Heart Foundation charity. It includes a context analysis, goal, objectives, strategy, positioning statement, and communications mix. The primary goal is to increase understanding of BHF's primary function as a research charity by 30%. Objectives include achieving app downloads, increasing social media engagement, and increasing website traffic. The strategy is primarily a profile strategy using above and below-the-line tactics to attract interest and provide information across platforms. Key elements of the communications mix include launching a "Track Your Pound" app, television advertising, in-store promotions, social media, and an updated website.
Five years in, and the Affordable Care Act continues to command conversation in the benefits landscape. Industry players are still scrambling to implement new provisions, keep healthcare costs down, create infrastructure to support new reporting requirements, and develop new payer, provider and care delivery models.
This has, in turn pushed the respective hands of health plans, who have had to change their strategies to fit both the consumerization of insurance and the standards set forth under the ACA.
With end-users in the forefront, health plans must take the strategy implemented 15 years ago with the rise of the internet, and push the marketing and communication initiatives into overdrive to gain and retain customers.
Health plans are shifting their mentality and communication, ant the best of the best are putting time, money, and energy into literacy and new business initiatives.
To simplify, a health plan needs to put the consumer at the center of every decision it makes.
However, in order to plan, communicate, and effectively market to consumers, your health plan must know the consumer, the technology, and the future.
If you’re looking to grow your health plan, we have just released a new guide to help your health plan leverage trends in the post-reform consumer marketplace.
In our latest whitepaper, we share the keys to success for health plans, including the following:
Consumer Trends: Top 5 Healthcare Executive Consumer Strategy Points, Today’s Healthcare Consumers: Six Types of Consumers You Need to Know, Millennial Consumers Special Report
Technology Trends: Big Data, Administration Technology, Payment Technology, mHealth and more.
Future Trends: Accountable Care Organizations, The Future of Telehealth, Continues Rise of Private Exchanges
All of this, and insights on how to make it work for your health plan.
Download this detailed guide, Health Plans: Your Guide to Leveraging Trends in the Post-Reform Consumer Marketplace, free from the Healthcare Trends Institute.
http://www.evolution1.com/health-plans-your-guide-to-leveraging-trends-in-the-post-reform-consumer-marketplace.html
Ahead of the marcus evans Healthcare Leaders Forum 2021, read here an interview with Nick Grant discussing how healthcare providers can benefit from providing patients different payment services
This document provides a summary of strategies for making health care more affordable for small businesses. It recaps health care reform changes through 2013 and changes coming in 2014 and beyond, including the individual and employer mandates. It then discusses the top 5 health care concerns for small businesses besides the Affordable Care Act, including rising costs. The document outlines strategies that work, including savvy plan design like partial self-funding, HRAs, and HDHP/HSAs. It also discusses wellness strategies that work through properly designed incentives and year-round communication. Finally, it discusses the importance of creating consumerism and proactive multi-year planning to control health care costs.
marketing Strategy on Android App-Health plusBiswajeet Sahu
Health Plus+ is a mobile app that aims to connect patients and healthcare organizations. It will allow patients to engage with their healthcare providers early and directly through the app, relieving physician responsibilities. The app will provide healthcare information and a question-and-answer forum. It will also offer youth consultancy services. The goal is to make healthcare more accessible, especially in rural areas of India. Key features will include an interactive directory of doctors and hospitals, appointment scheduling, and health tracking tools. The app will generate revenue through advertisements, in-app purchases, and premium subscriptions.
The Future of Personalizing Care Management & the Patient ExperienceRaphael Louis Vitón
Actionable segmentation model findings - by Raphael Louis Vitón & Dream team of industry experts, physicians and leaders from Blue Cross, GEHealthCare, RingLeaderVentures, Maddock Douglas, Dr.Daniel Friedland, etc working on improving health outcomes by Personalizing the Care Management business model for Better Outcomes & Better Economics (through patient empowerment)
D603-WhitePaper-The Consumerism Ultimatum 15th June 2015Manish Jain
The document discusses the shift in the health insurance marketplace from business-to-business to increasingly business-to-consumer as the Affordable Care Act has increased access to individual health plans. As employers embrace consumer-driven healthcare models, health plans will need to rethink how they serve and engage with individual consumers. The document outlines several areas health plans will need to address, including understanding evolving consumer behaviors and expectations, redesigning products, improving back-office efficiency, enhancing strategic customer engagement, and adopting new methods of care delivery.
The document discusses different approaches to financing healthcare:
1. Fee for service rewards volume over quality and does not incentivize care coordination.
2. Capitation rewards cost reduction but not outcomes and limits patient choice.
3. Diagnosis related groups does not cover all services or incentivize innovation.
4. Bundled payments incentivize integrated care across settings but specialist coordination can be difficult.
5. Payment when healthy incentivizes preventative care but is not discussed in detail.
All approaches face challenges in properly balancing cost, quality, and access. Bundled payments and payment for health show most promise by linking reimbursement to outcomes and prevention.
Disruption Set in Motion by Healthcare Consumerism.pdfMindfire LLC
Healthcare consumerism is the health industry’s shift towards a more value based care; it is a movement for a more cost effective and efficient delivery of healthcare services. It connotes the patient taking control of their health and wellness by managing all aspects of one’s healthcare landscape – including health benefits, medical insurance and retail health. In short, the goal of healthcare consumerism is to enable patients to become wholly involved in their healthcare decisions.
Health innovation think tank key takeawaysGary Grimes
The document provides key takeaways and best practices for value-based care, connected health, and virtual care from a health innovation think tank. It discusses transitioning to value-based models, using data to address chronic conditions, connecting patients to community resources, and taking on appropriate levels of risk. It also emphasizes integrating connected health strategies and designing virtual care as part of the overall care model. The document outlines future goals of improving communication across organizations, enhancing patient engagement through technology, and reimbursing telehealth services.
2016 04 29 MedSpan Research - POPs White Paper finalMedSpanResearch
This document provides an overview of provider-owned health plans (POPs). It discusses the history of POPs, including their brief popularity in the 1990s but failure then. Today, POPs are growing in popularity again as providers address earlier challenges. The document examines the current POP market profile, why providers develop POPs, case studies of successful and challenging POPs, and the future outlook for POPs, which remains uncertain despite interest from providers.
The document discusses a quality premium program that rewards clinical commissioning groups for improvements in quality and outcomes. It explains that the premium is based on performance on 4 national measures and 3 local measures selected by each CCG. The national measures relate to reducing mortality, emergency admissions, patient experience, and infections. For a sample CCG, emergency admissions are a major issue, with over 56,000 total admissions last year. Selecting local measures that help achieve the national measures, like reducing emergency admissions, could maximize the CCG's quality premium payment.
OptumHealth ran an awareness campaign targeting C-level executives and benefit administrators to position itself as an expert in complementary financial and health benefit products. The campaign included print ads, online media, and events where executives could feel "big by association." OptumHealth also ran targeted messaging campaigns to increase usage and deposits in health savings accounts, segmenting account holders and tailoring messages based on their healthcare needs and financial planning horizons. Finally, Baxter repositioned its home dialysis brand to reignite adoption rates by overcoming barriers providers face through an integrated marketing strategy appealing to both personal and patient benefits.
Big Bang Health is a total population health management solution for self-funded employers that addresses problems with ineffective health management, cost management, and customer service in current plans. It offers a fully integrated solution including claims administration, stop loss insurance, pricing transparency, and reference based pricing, supported by data analytics. This solution aims to improve care coordination and advocacy for high-risk populations that drive up costs through multiple chronic conditions.
This document summarizes key differences between third party administrators (TPAs) and administrative services only (ASO) divisions for self-funded health plans. TPAs offer more customized plan options and flexibility compared to ASOs, which are limited to parent company plan designs and provider networks. TPAs also have more innovative reimbursement structures and capture more detailed plan and member data than ASOs. While ASOs aim to meet parent company objectives, TPAs take a more personalized approach focused on client service and plan performance. Overall, TPAs provide employers with more options to design plans tailored to their specific needs and interests.
Keynote "Health IT Through your Customers’ Eyes: What Meaningful Use and The HIT Strategic Plan Say About The Changing Health Care Market"
Since 2009 the federal EHR incentive program has challenged providers to adopt, use, and interoperate with new information technologies. The criteria for incentive payments sometimes seem burdensome or irrelevant to providers. Most recently, a federal HIT strategic plan has outlined the likely federal programs and requirements over the next six years. This session will dissect the competing interests shaping these programs, and what large public and private health care purchasers - including CMS and large employers - are expecting from IT investments over the next decade.
Learning Objectives:
Gain understanding of the evolving drivers of meaningful use criteria since 2009
Gain understanding of the current debate about the federal HIT strategic plan
Gain understanding of what large health care purchasers are expecting providers to achieve with HIT adoption
David Lansky, PhD
Chief Executive Officer
Pacific Business Group on Health
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2. Whole Health PPO – concept description
Whole Health PPO is plan
that allows members to tailor
their health coverage to their
personal health style or
situation, combining
coverage for traditional and
alternative health practices.
A high deductible plan
combined with a free health
style basket provides first
dollar benefit for consumers.
The concept was intended to
be tested in a small
geographical area, where the
network could be quickly
assembled and managed, and
utilization measured.
2
3. Overall concept – core intentions
One health style basket is included in the basic plan, with the cost covered
through an increased deductible. Additional baskets can be added for $30 per
month.
+
The premium covers:
High-deductible PPO + 1 health basket
+
Additional baskets can
be added at $30 PMPM
The plan’s intention is that the higher deductible for the PPO plan will cover
the cost of the one “free” basket. The basket price was intentionally set at
~$30, a figure the focus groups found attractive and “worth it.”
3
4. Care baskets – core intentions
The core of the Whole Health offer are four baskets tailored to health styles
and situations. Over time, more baskets will be developed.
The baskets were conceived with a compelling core benefit that was ‘free.’
This benefit was surrounded with thematically similar services provided as a
covered benefit or as a discount. The mix of these services were intended to
help utilization.
4
5. My Health portal – core intentions
The My Health portal is a personalized
website with personal coverage and
health information. It links to memberselected Whole Health wellness programs
and to an on-line health store, where
members can purchase prescriptions,
supplements, vitamins and herbs.
The core intention behind the portal is to
allow members to manage and interact
with their coverage (to stay actively
engaged in their health) and to frequent
the online store where they can purchase
prescriptions, herbs, vitamins, etc.
The original idea was for the site to be
the portal for all BCC members, not just
for Whole Health, leveraging the
development investment.
5
7. Plan details
The concept was meant to target consumers with a high level of engagement with
their own health. The “menu” items (or care baskets) were tested with consumers
and subsequently refined.
The concept can be a model for many BCC offerings, and the original idea
centered on the Power HealthFund as a good candidate for piloting the concept. In
later stages, replicating the architecture and leveraging resources to ISG and
possibly beyond was the goal.
The plan had four levels of coverage, with simple and logical differences in
deductible, copay, co-insurance, out-of-pocket maximum and pharmacy benefit.
The intention was for straightforward communication and easy-to-understand
benefits.
The people who were the target for this plan were already involved in the
activities covered by the plan, and would likely “do the math” in order to justify
the plan. Therefore, clear and tangible benefits were important. Discounts were
not seen in testing as a sufficient benefit on their own.
Initial pricing for the pilot was meant to be competitive with other high deductible
plans. The medical and utilization experience data would help adjust baskets and
pricing for the actual launch.
7
8. Basket details
The baskets were conceived to have a clear and compelling core benefit
completely covered, surrounded by related services provided with limits
or at a discount. The additional services raise the perceived value of the
basket, while avoiding adverse selection. As people are already spending
money on many of these activities (one estimate showed this spending to
be ~$34 Billion), the increased baskets would enhance WP revenues.
The core benefits of each basket are currently popular health-related
activities. The additional basket elements are to complement the core,
making the overall appeal of the basket stronger.
New baskets will be developed as new activities become popular, and as
experience data became available.
The baskets or bundling of benefits are key to managing the risk of the
plan. However, the value of the experience data will be beneficial to all
WP plans, and might allow for lower margins on some benefits.
8
9. My Health portal – intentions of basic portal functions
My Health
Records
Coverage,
health history,
reminders for
appointments
and contacts
Simplifies the
ongoing
management
of healthcare
activities,
offloading calls
to BCC.
1
2
3
4
My Expenses
Tracking of expenses, payments and deductibles make ongoing
account management simpler, offloading calls to BCC.
Health Store
On-line source
for health and
wellness
products. This
helps drive
traffic to the
site, while
helping to
increase
utilization of
PrecisionRx.
News
Personalized
medical news
scours the web
for relevant
stories, and help
bring members
back to the
website.
9
10. My Health portal – details
There is a high correlation between the target market for Whole
Health and online research regarding health issues. For this reason,
the website – if it contains rich and useful information – will be one
of the key channels through which members interact with BCC and
their health information. The key information for the site was found
to be plan management (timely enrollment, provider listings, claims
tracking, levels of deductible, FSA status, health history and
resume), tailored health news and information (as news to healthy
individuals, and as disease management information to members
with chronic or acute conditions).
With a “critical mass” of content, the retail part of the site can
capitalize through convenient one-click ordering of prescriptions,
vitamins, herbs and other health-related products and services etc.
10
12. Phase 1 Goal
To enhance existing offerings with insights from the
consumer experience project, while gaining insights on
consumer ‘appetite’ for the broader health related
concept. The ambition at this stage is to design
expanded and improved coverage offerings while
leveraging existing resources.
By selecting existing offerings (e.g.Power Health Fund, Precision
Rx), we can achieve quick wins and grow the concept quickly.
12
13. Phase 1: integrate existing pieces
WellPoint Benefits
My Health
Experience Portal
• Offer tailorable,
personalized interactions
• Shift and channel
spending to Precision Rx
• Capture a portion of CAM
spend
• Facilitate avoidance of
hazardous drug
interactions
Whole Health PPO
Wellness Promotion Programs
• Attract new members
• Integrate existing services
• Capture a portion of out of
pocket health expenditures
• Build extended network
(ASHN+)
• Augment and accelerate
appeal of existing products
(Power HealthFund)
13
14. Phase 1: integrate existing pieces
Member Benefits
My Health
Experience Portal
Whole Health PPO
• Personalized and simplified • Reduce out of pocket
expenses for non-traditional
interactions
• Reliable information on
health related activities
health concerns and
coverage
• Convenience of shopping
through one channel for
drugs and CAM
• Guidance on herbs and
supplement choices
• Drug interaction notification
14
15. Phase 2 Goal
To gain regulatory approval and extend the concept to
other groups within BCC while augmenting the
consumer offer through increasing coverage and
available services. The ambition at this stage is to gain
significantly greater share of member’s health spending.
15
16. Phase 2: create platform
WellPoint Benefits
My Health
Experience Portal
• Increase interactions with
members
• Proactively push
information to members
• Reduce call center loads
• Expand CAM and DME
offerings
• Collection of herb and
supplement data
Whole Health PPO
• Implement new care baskets
to attract additional potential
members
• Extend network
• Capture actuarial data on nontraditional health activities
• Extend product to ISG
16
17. Phase 2: create platform
Member Benefits
My Health
Experience Portal
• Reliable breaking news
and information pertinent
to individual health
concerns and interests
• Link to FSA/HRA
accounts (ISG) and FSA
tracker and alerts
• Expanded information on
PPO providers (through
HealthScope)
Whole Health PPO
• Expanded non-traditional
coverage and discounts with
new and refined care
baskets
• Benefits enjoyed by ISG as
well as Large Group
members
17
18. Phase 3 Goal
To open the platform to other groups and regions, while
continuing to extend the consumer offer and make the
provider offer compelling. The ambition at this stage is
to leverage the platform and architecture throughout
WellPoint to achieve improved margins and enhanced
member satisfaction.
18
19. Phase 3: extend platform
WellPoint Benefits
My Health
Experience Portal
• Extend website across
WP, other regions and
products
• Support and foster
WellPoint’s relationship
with providers
• Expedited transactions
with My Health
debit/credit and stored
value cards
Whole Health PPO
• Potentially lowering medical
expenses
• Utilize actuarial data to refine
care basket proposition and
offer new ones
• Potential licensing or network
renting opportunity
19
20. Phase 3: extend platform
Member Benefits
My Health
Experience Portal
• Seamless integration of
health information and
health spending
Whole Health PPO
• Additional baskets provide a
broader array of choices for
coverage of non-traditional
health activities
20
23. Phase 2 research
Goal:
To gather insured (individual & group), uninsured customers’ and breast cancer
survivors’ reactions to the Whole Health product concept (n=20).
Objectives:
• Assess consumers’ reactions to the basic concept. Questions explored how
consumers’ attitudes and behaviors influence their interest in the concept;
• Determine how compelling the Balanced Meal concept, web portal, and breast
cancer components are terms of value to consumers versus their current healthcare
coverage;
• Explore consumers’ receptivity to each of the four traditional healthcare coverage
options and six care basket choices;
• Explore consumer price sensitivity as well as uncover potential ways to make the
concept more financially attractive;
• Gather information on consumers’ perceptions of their overall health, associated
health goals, and interest in and use of complementary and alternative healthcare
options.
23
24. Phase 2 research screening
This behavioral health style model was used to screen participants for Phase 2 concept
testing. It was intended as a starting point to map people’s approaches to dealing with
their health in maintain and monitor modes.
Multi-focus
Challenged
maintainer
Active
maintainer
Generally feels
healthy and works
to maintain this
state
Primarily internal
motivators
Striver
Goal oriented – e.g.
wants to lose
weight, or run a
marathon
Has a difficult time
keeping health
indicators like
weight, cholesterol
or blood pressure at
acceptable levels
Primarily external
motivators
Water-treader
Experiences
chronic health
conditions such as
asthma, or IBS
Single focus
24
25. Phase 2 research screening, continued
All participants:
• Had at least minimal interest in Complementary/Alternative medicine
• Where medium to high health information seekers
• Were comfortable being interview in English
25
26. Research methods: Phase 2
In-depth interviews
Goal: To understand consumer reactionsto the base components of the Whole Health
concept.
Gender
Insured (12)
Actual 12
Age
Income
Race
WP
coverage
Geo
Male (6)
25-36 (4) 4
Mixed
Yes (8) 8
So. Cal (6) 6
Female (6)
37-49 (4) 4
35K-55K (4)
4
Caucasian 9
No (4) 4
No. Cal (6) 6
NA
So. Cal (2) 2
50-60 (4) 4
Uninsured (4) Male (2) 2
Actual 4 Female(2) 2
56K-75K (4)
4
Other 3
76K+ (4) 4
Mixed
25-36 (3)
37-49 (1)
Mixed
35K-55K (1)
2
No. Cal (2) 2
Caucasian 3
Other 1
56K-75 (2) 1
76K+ (1) 1
Breast cancer
survivors (4)
Actual 4
NA
25-36 (1) 3
35K-55K (1) 3
Cauc. (2) 2
Yes (2) 2
So. Cal (2) 2
37-49 (2) 1
56K-75 (2) 1
Other (2) 2
No (2) 2
No. Cal (2) 2
50-60 (1) 0
76K+ (1) 0
26
27. Research methods: Phase 2
In-depth interviews
Goal: To understand insured consumer reactions, by behavior categories, to the base
components of the Whole Health concept
Age
Income
25-36 (1) 0
35K-55K (1) 0
37-49 (1) 2
56K-75K (1) 2
50-60 (1) 1
76K+ (1) 1
M (1) 2
25-36 (1) 2
35K-55K (2) 1
F (2) 1
37-49 (1) 0
56K-75K (1) 1
50-60 (1) 1
76K+ (1) 0
M (1) 2
25-36 (1) 0
35K-55K (1) 0
Cauc. (2) 3
F (2) 1
37-49 (2) 2
56K-75K (1) 1
Other (1) 0
50-60 (1) 1
76K+ (1) 2
M (1) 2
25-36 (1) 2
35K-55K (1) 1
Cauc. (2) 1
F (2) 1
37-49 (1) 1
56K-75K (1) 1
Other (1) 2
50-60 (1) 0
76K+ (1) 1
Gender
Male (1) 0
Active
Maintainer (3) Female (2) 3
Actual 3
Challenged
Maintainer (3) 3
Striver (3) 3
Water
Treader (3) 3
Race
WP
coverage
Cauc. (2) 2 Yes:(1)grp1
Other (1) 1 (1) ind. 1
No (1) 1
Cauc. (2) 3 Yes: (1)grp 1
Other (1) 0 (1) ind. 1
No (1) 1
Geo
So. Cal (1) 1
No. Cal (2) 2
So. Cal (2) 2
No. Cal (1) 1
Yes: (1)grp 2 So. Cal (2) 2
(1) ind. 0 No. Cal (1) 1
No (1) 1
Yes: (1)grp 0 So. Cal (1) 1
(1) ind. 2
No. Cal (2) 2
No (1) 1
27
28. Phase 2
Research findings: medical coverage options
Preferred coverage option
across all participants
(including uninsured):
Preferred coverage option by
type of current coverage:
Premium:
Preferred:
Standard:
Basic:
Those with Group coverage:
Premium:
100%
Preferred:
0%
Standard:
0%
Basic:
0%
85%
10%
0%
5%
Preferred coverage option
across participants with
health insurance only:
Premium:
Preferred:
Standard:
Basic:
76%
12%
0%
5%
Those with Individual coverage:
Premium:
66%
Preferred:
22%
Standard:
0%
Basic:
11%
28
29. Phase 2
Research findings: medical coverage by behavioral category
Premium
Active Maintainers: 100%
Challenged Maintainers:
Water Treaders:
Strivers:
Uninsured
Breast Cancer Survivors
Other
Preferred
Active Maintainers: 0%
Challenged Maintainers:
Water Treaders:
Strivers:
Uninsured
Breast Cancer Survivors
Other
33%
66%
100%
100%
100%
100%
Standard
Active Maintainers: 0%
Challenged Maintainers:
Water Treaders:
Strivers:
Uninsured
Breast Cancer Survivors
Other
0%
0%
0%
0%
0%
0%
33%
33%
0%
0%
0%
0%
Basic
Active Maintainers: 0%
Challenged Maintainers:
Water Treaders:
Strivers:
Uninsured
Breast Cancer Survivors
Other
33%
0%
0%
0%
0%
0%
29
30. Phase 2
Research findings: care basket preferences
Most to least liked (by rank)
1. Rejuvenation
2. Alternative (therapy)
3. Enhanced health
4. Integrative care
5. Elder caregiver support
6. Family support
30
31. Phase 2
Research findings: web portal components
Participant ranking of web portal components they would use most
regularly**:
1. Automated Reminders (especially if they could be uploaded to a PDA)
2. Provider Ratings
3. Health Resume (doctor forms)
4. Automated Health History
5. Health Expense Tracking (for both pre and post-tax health expenses)
Overall, the web portal received 108 points out of a possible 140 total.
** Regularly was self-defined by each participant.
31
32. Phase 2
Research findings: breast cancer support
Breast cancer research participants:
• Liked the overall concept as it demonstrated an intuitive understanding of what
breast cancer patients endure.
• Found the five steps and sub-points accurately captured the issues and questions
that they had as breast cancer patients.
• Stated it is an informational resource they would have used, if it had been
available at the time of their diagnosis.
• Suggested that the language be as positive and empowering as possible
(e.g., change “coping with the bad news” to “coping with the news.”).
• Suggested that a sub-point be added to Step 2 called “Understanding your
treatment plan, or something that reflects planning one’s course of treatment with
the doctor.
• Stated the need to have this resources available via telephone as well as on-line.
32
34. Preliminary financial analysis
•
•
•
•
•
•
•
•
Key assumptions:
Income tax = 40%
Premium increase = 5% per year
Broker commission = 5.60% (based on total BCC)
Discount rate = 12.50%
One time costs:
– Development costs = estimated at $4M (rounded up from the first year of
PHF at $3.9M)
– Launch and marketing costs = estimated at $2M
– Infrastructure costs = estimated at $1.5M
Investment income = average 3% (from PHF)
Premiums = average of $250 PMPM (average of LG rates supplied)
Underwriting margin = average 12% (from PHF)
Using these assumptions, the concept would
need 16,667 members to break-even
34
35. Preliminary financial analysis
Members
Growth rate
Member months
(assumes 1/1 enrollment)
Base revenue PMPM
Premium Increase
MCR
Premium Revenue
Claims Expense
U/W Margin
Broker commissions
U/W Margin after
Broker
One time costs
Development
Launch
Total
Infrastructure costs
Total costs
Pretax Income
Income tax
Net Income
NPV
Year 1
----
Year 2
2,000
-24,000
Year 3
4,000
100%
48,000
Year 4
7,000
75%
84,000
$250
-88%
------
$4,000,000
$2,000,000
$6,000,000
$1,500,000
$7,500,000
($7,500,000)
($3,000,000)
($4,500,000)
$54,477
Year 5
10,500
50%
126,000
Year 6
13,125
25%
157,500
$250
-88%
$6,000,000
$5,280,000
$720,000
$336,000
$384,000
$262.50
5%
88%
$12,600,000
$11,088,000
$1,512,000
$705,600
$806,400
$275.63
5%
88%
$23,152,500
$20,374,200
$2,778,300
$1,296,540
$1,481,760
$289.41
5%
88%
$36,465,188
$32,089,365
$4,375,823
$2,042,051
$2,333,772
$303.88
5%
88%
$47,860,559
$42,117,292
$5,743,267
$2,680,191
$3,063,076
-----$564,000
$225,600
$338,400
-----$1,184,400
$473,760
$710,640
-----$2,176,335
$870,534
$1,305,801
-----$3,427,728
$1,371,091
$2,056,637
-----$4,498,893
$1,799,557
$2,699,336
35
37. Traditional coverage levels
Small group
$5000 deductible
30% co-insurance up to out of pocket maximums of
$7500 per person
4 provider visits per year for a $40 copay
Full hospital coverage
MyHealth™ web portal
$500 deductible
40% co-insurance up to out of pocket maximums of
$7500 per person
4 provider visits per year for a $40 copay
Full hospital coverage
MyHealth™ web portal
$2500 deductible
30% co-insurance up to out of pocket maximums of
$6000 per person
12 provider visits per year for a $30 copay
Pharmacy coverage (after a $250 deductible)
Full hospital coverage
MyHealth™ web portal
$500 deductible
30% co-insurance up to out of pocket maximums of
$6000 per person
12 provider visits per year for a $30 copay
Pharmacy coverage (after a $250 deductible)
Full hospital coverage
MyHealth™ web portal
$1500 deductible
30% co-insurance up to out of pocket maximums of
$5000 per person
Provider visits at $25/visit
Full pharmacy coverage
Full hospital coverage
MyHealth™ web portal
Basic
Individual
$250 deductible
20% co-insurance up to out of pocket maximums of
$5000 per person Provider visits at $20/visit
Full pharmacy coverage
Full hospital coverage
MyHealth™ web portal
$500 deductible
30% co-insurance up to out of pocket maximums of
$4000 per person
Provider visits at $10/visit
Full pharmacy coverage
Full hospital coverage
MyHealth™ web portal
$250 deductible
10% co-insurance up to out of pocket maximums of
$4000 per person
Provider visits at $10/visit
Full pharmacy coverage
Full hospital coverage
MyHealth™ web portal
Standard
Preferred
Premium
37
38. Potential pricing of Whole Health PPO for Individual
Number of baskets selected
1
3
4
basic
Traditional
medical
coverage
2
$115
$145
$175
$205
standard
$150
$180
$210
$240
preferred
$205
$235
$265
$295
premium
$290
$320
$350
$380
38
39. Potential pricing of Whole Health PPO for Small Group
Number of baskets selected
1
3
4
basic
Traditional
medical
coverage
2
$205
$235
$265
$295
standard
$245
$275
$305
$335
preferred
$285
$315
$345
$375
premium
$330
$360
$390
$420
39
40. Potential pricing of Whole Health PPO for Large Group
Southern CA: LA
Northern CA: SF
Ranges from:
Ranges from:
$268.14 - $238.77
$344.21 - $306.15
Includes one basket
Includes one basket
40
41. Thank you!
Access the Doblin client website at:
http://clientweb.doblin.com
username: WellPoint
password: innovate
Doblin Inc.
One IBM Plaza
330 North Wabash Avenue
Suite 1300
Chicago IL 60611
312 443 0800 phone
312 443 0567 fax
www.doblin.com
41
Editor's Notes
<number>
The Blue denotes those variables where there’s difference between the planned and the actual counts