Consumer Engagement Best Practices –A Profile of an Empowered PatientDavid Randall, Executive Director, CDHCiJohn Bull, Director CDH Product Strategy, FIS

Agenda

• David Randall, Executive Director, CDHCi– Consumer Directed Healthcare growth– Consumer engagement past and present– State of the market– Future trends and direction– Key metrics– Key metrics

• John Bull, Director CDH Product Strategy, FIS– FIS market perspective– Consumer needs/wants– The CDH lifecycle– A few real life examples– Solution imperatives

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Consumer Engagement Best Practices –A Profile of an Empowered Patient

Presented by:

David Randall, Ph.D. (A.B.D), Executive Director, David Randall, Ph.D. (A.B.D), Executive Director, CDHCi and The American Research and Policy Institute,

Washington, D.C.

What is Consumer Driven Healthcare?

• The application and use of tools, services and products that engage, inform and empower individual consumers of healthcare services to make healthcare choices in their own self economic and health interests.economic and health interests.

• CDHC removes the problem of Third Party Payment discussed by Tullock (1965, 1990), Friedman (1962,1975) and Herzlinger (2004).

• CDHC growth and adoption began after the passage of the Medicare Modernization Act of 2003 when Health Savings Accounts were created

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Enrollment Growth in HDHP

8

10

12

8

10.1

HDHP Growth

0

2

4

6

8

2008 2009 2010HCHP Growth 6.1 8 10.1

6.1

HCHP Growth

AHIP

HRA Account Growth and Balances

• More than 5 million accounts as of 2009• Average account balance of $1,419• Average roll over balance of $1,295• Projected growth by 2014 at more than 10

AHIP

• Projected growth by 2014 at more than 10 million HRA accounts

• Projected growth of all CDHC accounts to be more than 22 million by 2014

Economic Downturn Driving Consumer-driven Healthcare Adoption

DoubleDouble--digit digit healthcarehealthcarecost increasescost increasesaverage cost average cost perper--employee employee of health of health benefits $9,660benefits $9,660

Employers Employers more more aggressive in aggressive in managing their managing their health care health care costscosts

Currently only 17% Currently only 17% employers offer a employers offer a full replacement full replacement CDH program AND CDH program AND a MAJORITY of a MAJORITY of Fortune 500 offerFortune 500 offer

benefits $9,660benefits $9,660

Implementing a Consumer Driven Healthcare program is one of the leading healthcare strategies for employers

Employers looking for options to decrease the cost per employee of health benefits

Number of Consumer Driven Healthcare programs to increase in 2010

* Towers Watson, Aon

Consumer Engagement: Past and Present

• Past government efforts• State-of-the-market: From PHRs to mobile

payment platforms• Transaction metrics, spending trends from • Transaction metrics, spending trends from

CDHCi data

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Evolution and Devolution:

• Center for Medicare and Medicaid Services (CMS) posts prices, industry follows

• Aetna Price Transparency Project• Personal Health Record (PHRs)• Personal Health Record (PHRs)• Online tools − Google and Microsoft• Price disclosure in post-PPACA environment

State of the Market:

• State-based efforts to encourage or require providers to post prices

• The rise of retail-based healthcare• The rise of retail-based healthcare• CDHC growth trends and

impediments

Future Trends and Health Care Reform:

• Impact of Health Insurance Exchanges before and after 2014

• Watch the states − where all the action will be!will be!

• A generational shift away from third-party payers to CDHC products and services

• Mobile applications

Key Data Metrics:

• CDHCi market data advisory• Transaction trends• Mobile payments• Mobile payments• Retail model growth

Our Target Consumer:

• Healthcare consumer − Lori S., age 48, white female

• She is used to low co-pays and has never seen a price list!a price list!

• Question − How to engage her?• The retail model!• Keep it simple and make it easy!

New Healthcare Retail Model

• Retail 1.0

• Minute Clinic/CVS

• Retail 2.0-3.0

• Minute Clinic/CVS• Nurse Lines• Use of PHRs• Lower utilization,

convenience

• Consult A Doctor• Use of Web-based

technologies, 24-7 access• Higher ROI, reduced

utilization

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CDHCi Market Data

• Beginning in June, 2010 CDHCi launches a Quarterly Data Advisory Service that will track account-based plans across a range of metrics, including:

− Account balances, spending patterns and − Account balances, spending patterns and healthcare utilization trends, and projections for future growth.

− Data published quarterly that provides valuable insight for a range of marketing and account use purposes.

CDHCi Market Data AdvisoryKey Data Highlights

• CDH accounts (specifically HSAs) within existing programs, grew 6.46 percent in Q1.

• Account balances were $592 in individual HSAs, a decrease from average balances in Q4 ’09. While the average balance in family HSAs reached $1,408 in Q1 ’10.

• 56 percent of employees in family HSAs contributed to their • 56 percent of employees in family HSAs contributed to their accounts, while only 49 percent of employees in individual plans contributed to their accounts.

• On average, both reimbursements and check transactions exceeded debit card transactions nearly 2:1 both in individual and family account spending.

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What this all means

• Increasing Demand!

40.0

60.0

16.023.1 27.3

Mill

ions

of A

ccou

nts

CDH Accounts

Forrester views adoption Forrester views adoption of CDH as stronger than of CDH as stronger than predicted predicted –– calling out HSAs calling out HSAs as the growth engine.as the growth engine.

0.0

20.0

40.0

2007 2008 2009 2010 2011

16.5 17.3 16.8 16.3 15.5

3.7 7.0 10.9 12.9 12.33.99.3

16.023.1

Mill

ions

of A

ccou

nts

FSA Enrollees HRA Enrollees HSA EnrolleesSOURCE: BearingPoint

Thank You!

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Consumer Engagement Best PracticesJohn Bull, Director CDH Product Strategy, FIS

Consumer Engagement Best Practices

FIS Market Perspective − Consumer

Market Observations• CDH benefits can be complex, confusing and designed a la carte• Hands on information is a must• HSAs and HRAs will continue to grow in the future• Incentives are still drivers

Technology Needs• Online experience must be intuitive, fun and quick• Online banking is the barometer for success• Mobile is the future• Health Management and Integrated claims must be provided

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Before technology solves everything…

• We need to ask (and answer)…What does the consumer really want to know?– What plan should I enroll in?

– What’s the difference between an HSA and an HRA?

– Have my claims been paid?

– What’s my balance? – What’s my balance?

– What services does my account cover?

– What incentives do I have that I should be aware of?

– How can I save money on healthcare?

– How much is my healthcare going to cost me?

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So, how do we answer these questions…

• There are really just a few ways to answer the questions:1. Online2. Phone call to customer service3. IVR4. E-mail 5. Online chat5. Online chat6. Mobile7. Ask HR8. Finally, tell them before they think to ask

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Tell the before they ask….???

• How do we tell consumers what they want to know before they even ask?• The social media world of Facebook and Twitter make pro-active communication an

everyday and expected activity.• Messages are pushed based on your likes and who you follow. Advertising is

embedded into everything.• Can we do this for CDH? Absolutely!• Can we do this for CDH? Absolutely!

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Education

Driving information relies on understanding the CDH life cycle

Enrollment

Incentives

Wellness

Price & Quality

Claims

Payments

Year End Management

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Let’s take Jane…

• Jane’s 40 with two children• She has choices at enrollment − an HSA Plan with a deductible of $4,800 or a lower

deductible plan with a funding account.• How will she decide what to enroll in?

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Jane’s decision making process…

• Jane receives notice from HR as well as an e-mail about enrolling in an HSA• Jane goes online to learn more about HSAs and which plan is right for her• She views an interactive video on HSA for someone like her – Sarah who is married,

40 years old and has two children

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Jane’s decision making process…

• Jane likes what she hears, but she wants to forecast what plan is right for her so she uses the “Which plan is right for me?” planning tool.

1. She enters in her plan information

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Jane’s decision making process…

• Jane likes what she hears but, she wants to forecast what plan is right for her so she uses the “Which plan is right for me?” planning tool.

2. She enters in her medial expected services

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Jane’s decision making process…

• Jane likes what she hears but, she wants to forecast what plan is right for her so she uses the “Which plan is right for me?” planning tool.

3. She enters in her tax information and expected HSA Contributions

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Jane’s decision making process…

• Jane likes what she hears but, she wants to forecast what plan is right for her so she uses the “Which plan is right for me?” planning tool.

4. Based on her unique situation, the HSA looks right for Jane

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Jane’s ready to enroll, but she’s still not sure…

Jane reads through the FAQsNow, she’s ready to enroll…

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Now that Jane is enrolled, she can access her account online or on her mobile device

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Jane not only needs to manage her HSA, but she needs to manage her overall health

• Jane needs wellness tools, incentives and a personal health record − all in one place, through one, online experience

Mobile WellnessPHR

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Wellness tools and Health Risk Assessments

Now, it’s time to communicate!

E-mails and texts• Opt-in/out of

communications• Open enrollment• New claim received• Payment made

Online/mobile self-service capabilities• Claim submission• Enrollment• Bill payment for HSAs• Funding of HSAs

Online and mobile presentment requirements • My deductible status• My HRA rollover rules• My HSA contribution

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• Payment made• Debit card mailed• Deductible met• Incentive completed/

funding received• Time to refill• Preventive care notices• And more

• Funding of HSAs• Transfers out for HSA• Incentive-based

communications• Mobile balances• Upload of claims• Save receipts• Fun incentives• Health savings and

spend forecasting• Pricing analysis

• My HSA contribution status

• My claims status and payments

• Personal health records• Wellness information

and programs• Interactive education

To make the consumer engagement a reality, you need the strong technical and market-focused foundation

• First, you need technology that is real-time, dependable and integrated.

• Second, you need to respect the different communication channels demanded by consumers.

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demanded by consumers.• Third, you need to allow

users to manage their communication preferences

• Finally, you need an administrative and social media engine for driving the CDH messages.

Questions and AnswersQuestions and Answers

Thank You Thank You John Bull, Director CDH Product Strategy, FISjohn.bull@fisglobal.com

David Randall, Executive Director, CDHCidrandall@CDHCi.org