using a health savings account to pay for a yearly subscription to Akos MD to cover the whole family for minor health issues,” Anand says. Patients have unlimited virtual access to their doctor through Akos, Anand says. With telemedicine solutions like Akos, “chronic disease management for heart failure and diabetes not only help keep people healthy, but long-term (care) helps decrease cost of care as the patient’s need for high-cost care in hospitals decreases significantly,” Anand says. Maybe tradition isn’t so bad The private sector has been showing interest in “consumerism” type plans when it comes to engaging with traditional health insurance companies, says Mike Tilton, vice president of sales for Blue Cross Blue Shield of Arizona. Businesses are recognizing that healthcare costs are outpacing the consumer price index. With that in mind, employers are showing interest in higher deductible plans, Tilton explains. Some employers then place the money saved through higher-deductible plans into health savings accounts or health reimbursement accounts, he adds. Employees can then spend that money any way they want, or save it for a later date and even retirement. Another universal strategy to prevent unnecessary delays in healthcare caused by out-of-pocket costs is coupling coverage for preventive care with these higher-deductible plans, Tilton says. This way, “the employee or consumer wouldn’t experience any out-of-pocket costs for a routine annual examination, a wellwoman check or an annual physical,” Tilton says. Blue Cross Blue Shield of Arizona isn’t the only healthcare institution that wants to get people in front of a doctor as early as possible. Tilton says BCBSAZ has invested into the Patient-Centered Medical Home concept. The Patient-Centered Medical Home is a model of care that puts patients at the forefront of care. PCMHs build better relationships between people and their clinical care teams. Research shows that they improve quality, the patient experience and staff satisfaction, while reducing health care costs. Insurers and doctors don’t want to learn new things about a patient while they’re in a hospital, Tilton says, which is why it’s so important to get patients engaged with a primary care doctor right away. 26
AB | July - August 2017
Blue Cross also collects patient information through its online portal by having them take a health risk assessment. The assessment leads the patient down the pathway to the care they need before a condition worsens. Another tenant of consumerism is making sure consumers are making informed decisions when they pick their health plans, Tilton says. Blue Cross has invested a lot into consumerism and transparency methods, he says, so folks can make an informed decision based on what they know and the status of their health. This hasn’t always been the case. “As we expose customers to more costs, we want to make sure they know how to navigate more effectively, like the way they would purchase anything else,” Tilton says. “It shouldn’t be different, but it is. We’re working very hard to fix that.”
KEEPING DOCTORS INDEPENDENT As hospital systems buy up doctor’s practices, Blue Cross Blue Shield of Arizona has been working to keep these doctors independent. President of Sales Mike Tilton says BCBSAZ has been helping independent doctors integrate technology into their practices so they can provide a holistic care for patients. Tilton explains three other ways BCBSAZ has helped doctors stay independent: • Making changes to how doctors are compensated • Guidance to prescribe generic medications when appropriate • Ensuring someone with a chronic condition is treated before it gets worse “We’ve tried to give them the right incentives to stay independent, to stay in practice because we do know that the primary care doctor shortage is a very real issue right now,” Tilton says.
Published on Jul 19, 2017
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