Archive for February, 2006

Few Healthcare Providers Paying Per Click

February 24th, 2006 by Melanie Matthews

Dr. Masoud Almasi, a pediatrician in Bridgewater, N.J., is slightly ahead of his peers in advertising his physician practice online.

I recently conducted a very unscientific poll of how healthcare provider organizations in New Jersey are using the Internet to market their services. It turns out, Dr. Almasi is way ahead of the curve.

On my Google search of pediatricians in Neptune, N.J., (my hometown),

Dr. Almasi's practice, Better Care Pediatrics, was the only pediatric practice placing Google adwords for the following keyword search conducted on Google: pediatricians, Neptune, N.J.

As I continued on my quest to find provider organizations advertising their services on the Internet, I found that cardiac rehab facilities, along with hospitals, nursing homes and hospice programs are also not taking advantage of the potential benefits of Google's pay per click advertising avenue, Google Adsense.

Two home care agencies, Expert Home Care and Care Plus Home Health, however, are advertising through Google Adsense.

I think there is an opportunity here. It might not be huge, but it's worth looking into. We've all seen the statistics on the number of people who use the Internet to search for healthcare information. It just might make sense to advertise where your potential patients might be searching.

Health Plan Challenge

February 22nd, 2006 by Melanie Matthews

So far this year I've seen web-based healthy lifestyle “Challenges” from magazines, newspapers, TV shows and my health club, but not my health plan.

Curious to the sophistication and real-life applicability of these challenges, I registered this past weekend for one that caught my eye. After a quick registration, I provided some healthy lifestyle indicators to the one I chose – my weight and height, along with my waist, hip and thigh circumference.

I can now track my workouts and my food journals on this site. I also had the option to receive some healthy reminders via email each week.

Not a whole lot to it, but to me, very engaging. And now this site has an indicator of potential health risks for me.

Why did I take this “Challenge” when I have not completed a health risk assessment from my own health plan? It's really just a matter of positioning. First of all, it was a “Challenge” that promises to deliver results. Secondly, there was a promise of prizes awarded throughout the length of the challenge.

Consumer engagement is one of the key elements in a successful health risk assessment (HRA), but an element that HRAs struggle to meet. Perhaps there are some lessons that healthcare organizations can take from the magazines, newspapers and TV shows on how to position the collection of this data.

I'll keep you up-to-date on how my challenge progresses, but in the meantime, I challenge health plans to maybe learn a lesson from these web-based initiatives to see how they might possibly integrate with a HRA to maximize the results of these efforts.

Quality in Healthcare: An Olympic Task

February 17th, 2006 by Melanie Matthews

As happens every four years, I'm hooked on this year's Winter Olympics. Last night while watching, I was once again amazed at the miniscule amounts of time that separate the gold medal winner in the men's downhill skiing competition from those who don't medal at all. I also watched a male figure skater placed out of medal contention because of one bad jump in an otherwise flawless performance.

The pressure on these athletes must be so incredibly intense when their life's work is judged by one performance. The men's downhill competition was just three minutes long; the men's figure skating program is not quite three minutes.

In the healthcare industry, there are, of course, many instances in where three minutes can make all the difference in someone's health, but for the most part we have significantly more than three minutes to make a difference.

But, I wonder if we can learn something from these Olympic athletes as they continually strive for performance improvement.

Performance improvement efforts are expanding in healthcare with pay for performance programs, hospital report cards and quality measurements.

Emulating the focus of these Olympic athletes, we can we tweak and test every element of our programs to make sure that we are getting the best results that we can? Take for instance, the snow-boarder who takes another “line” down the mountain, after seeing the results of someone else's performance; is the healthcare industry truly learning and emulating other organizations' best practices?

During our recent audio conference, CMS' New Voluntary Physician Pay-for-Performance Program: Identifying the Opportunities , Julie Baker, director of the healthcare advisory practice at PricewaterhouseCoopers, spoke of the December 2005 Institute of Medicine (IOM) report on improvement of performance measurements. In the report, the IOM recommended a nationally endorsed set of standards that are developed through consensus processes.

Baker said she strongly believes the industry is moving in the direction of national standards, part and parcel with the pay-for-performance programs that are being developed and expanded across the country.

Speaking with Baker was Robert Fortini, clinical operations manager, Community Care Physicians. Fortini walked through the QI initiatives at his 2,000-physician, multi-specialty practice in upstate New York. Community Care Physicians has seen remarkable results from its focus on QI and is striving with each initiative to improve its results even more – sort of like U.S. downhill skier Ted Ligety, who won a gold medal on Tuesday with an improved time in his second slalom run.

Factor Returning Retired Workers Into Health Improvement Programs

February 8th, 2006 by Melanie Matthews

I've been reporting on the wealth of wellness initiatives health plans and employers are launching to identify health risks, suggest corrective regimens and reward wellness in their populations, all with an eye toward curtailing healthcare expenditures. More companies are rolling out online health improvement tools, rewarding the healthiest departments and promoting wellness on company time, all the while racking up some impressive ROI. Programs like Aetna's Simple Steps to a Healthier Life®, Blue Shield of California's Healthy Lifestyle Rewards Plan and A Call to Change from HealthPartners come to mind.

So far, the results are very positive. But in documenting these initiatives, I can't help but wonder whether another emerging trend will impact their efforts. In the United States and abroad, companies faced with a shrinking pool of young talent are (re-)turning to retired employees to round out the work force.

Whether for pleasure or paycheck, older workers are happy to oblige. According to the Bureau of Labor Statistics, the number of American workers ages 50 and over is projected to increase by 34 percent from 2003 to 2012, a net gain of 12.5 million workers. During the same time period, the number of workers aged 16 to 49 will increase by only 3 percent, a net increase of only 2.7 million workers. The American Association or Retired Persons (AARP) is on to this trend, having last year joined forces with a leading global online careers site to help connect mature job seekers with local jobs and provide tailored career resources.

Employers and health plans should consider this new demographic when crafting workplace wellness initiatives. These health promotion efforts should dovetail with a renewed look at workplace safety through the eyes of these aging employees. Companies would do well to take a page from Ford Europe's book, which has introduced health counseling and taken older employees' physical restrictions into account when modifying assembly line stations. Or from certain U.S. hospitals that have eased the physical strains of lifting patients by using hydraulic hospital beds or mobile “lift teams.” These and other nods to the aging workforce were chronicled in the
January 30, 2006 international edition of Newsweek.

These issues will be particularly important for French and German workers who until now have long enjoyed early and generously subsidized retirements. Feeling the financial pinch from their contributions, these governments are rethinking traditional retirement programs in ways that include keeping employees on the job longer. These countries were on hand at last month's World Economic Forum in Davos, Switzerland, where the aging workforce was high on the forum's agenda.

With a comprehensive safety and health promotion plan in place, all employees can stay on the job longer and enjoy safer conditions. Harder to measure will be the impact of the elder workers' presence on colleagues, workplace productivity and the corporate culture. Seventy percent of these returning retirees say they are working because they want to, not because they have to, so being happy at work just might be infectious. There's a pandemic we can live with.

HSAs Part of Bush’s Agenda for Healthcare

February 1st, 2006 by Melanie Matthews

Health savings accounts received a boost during President George Bush's State of the Union address last night.

Bush proposed giving individuals who purchase HSAs on their own to receive the same tax advantage as those with employer-sponsored insurance; and eliminating all taxes on out-of-pocket spending through the HSAs, not just their deductible as provided under current law.

Health savings accounts have really begun to emerge as one way to control healthcare spending by putting more onus on the consumer to be sensitive to healthcare costs. A Fidelity Investments
study found that almost half (45 percent) of large employers surveyed plan to offer a consumer-driven health plan (CDHP) this year.

This focus on HSAs and consumer-driven healthcare as a mechanism to control healthcare costs will truly only succeed if consumers are given the information they need to make informed healthcare decisions, including quality data and cost data; and we're just not there yet.

This week, I conducted an unscientific research project on the reporting of quality information by hospitals and health systems. While I didn't come close to visiting all 5,700 hospital web sites in the United States, I did visit a select few that are historically early adopters and are leading quality-based initiatives. Very few are actually reporting on their performance.

This month, HIN is conducting an online survey on hospital/health system performance report cards. There are challenges to reporting this type of information, ranging from data collection to knowing what kind of impact it can have on an organization. You can post your views on report cards at:
http://www.surveymonkey.com/s.asp?u=842921723240

Another challenge to address is educating consumers on using this data. Presbyterian Healthcare Services provides a description next to its quality indicators of the desired performance, comparing Presbyterian's performance with the National Top 10 percent and the National Average. Other hospitals compare only their previous year's performance.

The different reporting schemes make it difficult for a consumer to truly evaluate hospitals based on quality measures.

PricewaterhouseCoopers, in its Top 10 Issues for Healthcare 2006 predicted that health organizations will need to focus on developing proactive, coordinated reporting of their prices, error rates and safety standards this year. I think a coordinated approach is key to achieving the cost reductions that we're seeking HSAs to achieve.