Consumer participation is increasing and becoming part of our permanent health care landscape.
The result is an unprecedented array of options that give employers and their employees greater flexibility and choice. Along with options, however, comes the need for consumers to be more informed about the choices they make.
That’s where health insurers and employers assume an important role. By crafting care programs that inform and fortify consumers as they navigate an increasingly complex health care system, consumers will utilize services appropriately and efficiently, keeping costs down for everyone.
Demand management programs
To accomplish this, many companies turn to demand management programs, designed to boost health education among consumers. These provide critical health information to employees through tools such as brochures, audio health information and online resources, as well as one-on-one assistance from nurse lines. These tools enable employees to make better decisions about their health.
Without the guidance employees receive from these services, they’re often confused about when and where to seek proper medical attention. In fact, the American Medical Association estimates that problems stemming from a lack of health literacy result in $73 billion in annual health care costs.
In response, the AMA has launched an effort to educate physicians about the problem in order to improve health literacy. While literacy is a complicated issue and there isn’t a one-size-fits-all answer, there are steps employers can take to help employees become better health care consumers while containing costs.
One solution is the adoption of an integrated health care management program that combines disease management services — designed to improve the health of chronically ill employees and dependents — with demand management services.
Part of a holistic program
When integrated, these services can break down many of the barriers caused by limited literacy and expand the impact of health management programs. For example, a health information line nurse may identify a caller with symptoms indicative of a chronic disease and, if previously diagnosed, refer the employee to a disease management nurse for specialized support.
Demand management services such as a 24-hour health information line not only improve the health of employees but also reduce costs. A study of nearly 1 million eligible users shows when plan participants use a 24-hour health information line, health care costs are significantly lowered for seven out of 10 outpatient conditions.
Other studies suggest that talking with a nurse can raise a consumer’s retention level and understanding of health information to as high as 80 percent. When plan members call a 24-hour health information line, they receive information tailored to their specific request and can discuss the concern and ask questions.
Employers can be confident that as they empower employees to take charge of their health, demand management services will provide employees with information that, if followed, will lead to immediate cost savings and appropriate levels of care.
Over the long term, demand management services, integrated with programs for disease management, will produce quality of life improvements and enhance employee satisfaction through reduced lost time from work and greater employee retention. Jeanne McCarthy is president and general Manager of CIGNA HealthCare of Ohio.