Innovations in the privates sector are racing ahead. Taken together, they are adding up to a brand new business model for the delivery of health care in America.
Take HRAs, for example, not savings accounts, but Health Risk Assessments. This tool for keeping people healthy is becoming an increasingly powerful tool for keeping people out of expensive and dangerous hospitals.
At Serigraph, we make these annual mini-physicals virtually mandatory, and we are making these enhancements to the assessment process:
* The results from an employee’s HRA, including bio-metrics, are fed into his or her Employee Health Record (EHR). That report card serves as the basis for coaching sessions for health improvements.
* The EHR is being upgraded to an individual health plan. That plan includes goals for the next one to three years, such as reducing cholesterol or exercising more. The employee and on-site coach both sign the document.
* A questionnaire will be added to screen for depression, a pervasive chronic disease in the work force. On-site consultation for those with a problem should help to improve mental health and, as a byproduct, productivity.
* The coaches will be trained in the use of Advanced Directives (AD), which will be made available to every employee and spouse. We will offer incentives for those who execute an AD as part of the HRA process.
Some private sector entrepreneurs see the possibility of using HRAs, along with claims data, to do predictive modelling. These scientific and statistical methods will lead to the identification of high risk situations in the present and future.
Some employers are going even further. They install incentives for good health, as reported in the the HRA process. A “green” signal, all systems go, can bring low healthcare premiums if the individual agrees to, say, two face-to-face coaching sessions per year.
A red signal, meaning high risk, would require full premium payment and, say, four coaching sessions per year.
In our model, people dealing with diabetes or obesity are incentivised to check in with coaches every two weeks or monthly.
The use of HRAs as a monitoring and coaching tool is just one example of innovation in the emerging business model.
Don’t think that such measures don’t make a difference. Employers who are walking the talk on prevention and wellness are reporting dramatic reductions in hospital admissions.
Serigraph, for example, was at 71 admits per 1000 lives in 2007, about the U.S. average. Our two latest readings were 34/1000 in 2010 and 41/1000 in 2011. That trend is nothing’s short of astounding.