America's Best Health Plans
Deciding on health coverage isn't getting easier-or cheaper
As useful as price and quality data may prove to be, health plans need to actively reach out to people about their specific health issues if they're going to dent spending, say experts. It's starting to happen. Humana has a telephone robot named Eliza that calls members to tell them about cheaper drug alternatives. In 18 months it has saved members $11 million, says Beth Bierbower, Humana's vice president of product innovation. In addition to periodic chats with a UnitedHealthcare nurse to discuss his diabetes, Al Meginniss now gets monthly statements that not only track which providers he sees but give him diabetic-specific reminders to get an annual eye exam, among other things.
"We need a healthcare Jiminy Cricket," says Arnold Milstein, chief physician at human resources consultant Mercer Health & Benefits and medical director of the Pacific Business Group on Health. Like the insect that whispered advice into Pinocchio's ear, says Milstein, "we need something that will tap you on your shoulder by phone or E-mail and say, 'Arnie, given your family history, age, and health background, you're a top candidate for developing a relationship with a cardiologist, and here are several doctors who are tops in quality, customer service, and resource use to choose from.'"
A worthy goal, but one we're at least a half-dozen years away from, says Milstein. "When you wish upon a star" may have worked for Jiminy Cricket. In the real world, workable healthcare solutions are harder to come by.
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