June 2013

If Accenture's projections are accurate, one in four employees will purchase their health coverage from a private health exchange by 2018. The challenge is employees know squat about them.

That's a rough paraphrase of Accenture's Rich Birhanzel's quote from this press release. His explanation was more eloquent, perhaps, but the point's the same. Employees who are only now getting used to the world of consumer-directed health plans will soon be facing a whole new and more complex ball game.

Private health exchanges, particularly those with a defined contribution component, are being discussed as a positive for both employers and employees. Employers continue delivering highly valued health benefits, and do so while getting a firmer grip on their costs through the provision of a fixed subsidy to employees. Employees use this subsidy to defray the cost of individual or family coverage while constructing an individual plan from a wider array of options. Known costs for employers. Lots of choice for employees.

Whether this choice becomes a benefit or a burden remains to be seen. We can get some advance lessons from employees' handling of consumer-directed health plans, which also demand more from employees. A study published in the Health Affairs June issue suggests that things may not be all rosy. Employees enrolled in a high-deductible health plan had fewer doctor's appointments and filled fewer prescriptions, but visited the emergency room more frequently. In other words, they're not making the decisions that will serve them in the long run. They're focused on those that serve them today, or those that make sense based on their understanding or finances.

With high-deductible health plans, and now with private health exchanges, employers and those they contract with shoulder a tremendous and ongoing responsibility for simple, personalized communications and the necessary measurement to ensure their effectiveness over time.

Choice and control are advantages. The problem is, without the knowledge to wield them, you've got squat.

If you're interested in the topic, listen to this month's CoHealth Checkup, where my co-host Carol Harnett and I talk with WellPoint and Bloom Health about private health exchanges.


Other pieces worth your time:

Final Wellness Incentives Regulations (DOL)

Workplace Wellness Programs Study (RAND)

The $2.7 Trillion Medical Bill (The New York Times)

The Health Paradox (The Economist)

May's most-read post covers a study by the University of Michigan Health System and Stanford University that looks at the impact of outcomes-based incentive design. The study involved obese employees in the Healthy Blue Living program offered by the Blue Care Network. These employees had choices: enroll in a walking program or a weight management program, or pay nearly $2,000 more for their health care. Not surprisingly, many signed up for one of the programs. Read more...

Registration for the American Heart Association's pilot of Hotseat closed on May 31, and the numbers already tell a story. AHA doubled the participation of an earlier, different pilot, with more than 33% of eligible American Heart Association employees registering. Reflecting the value we put on playing with the social network we choose, these employees took advantage of the ability to include outside guests:

  • 45% invited one guest
  • 27% invited two guests
  • 20% invited three guests
  • Roughly 12% invited four or more (five maximum)

We'll share more from the pilot in July's newsletter and on June 27 at the 2013 Games for Health Conference in Boston.


Games for Health Conference
June 26-28, 2013
Boston, MA


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Review the full 2013 CoHealth calendar.

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