Medical Bankruptcies

I will give credit to the Health Care Reform Now blog for leading me to this article in The Indianapolis Star, but I think it is a sad reality.
“More and more of the middle class is finding out that even if they have jobs and insurance, they can be wiped out by medical events that [...]

Why Can’t I Go To Any Physician?

In pharmacy, there is a rarely used benefit structure called Therapeutic MAC (Maximum Allowable Cost).  What this does is say that in any class of drugs (e.g., cholesterol lowering drugs) there is a maximum amount of money that will be paid by the plan.  But the individual can get any drug.
That can be controversial since [...]

Diabetes or Depression: Which Comes First

Since many of us understand the risk of co-morbidities (i.e., two diseases that commonly exist together), I think it makes a lot of sense to ask this question.  Dr. Gupta from CNN had an article earlier this week on his blog about a study that was recently out on the relationship between diabetes and depression.

Those [...]

Why People Choose Mail Order Pharmacy?

I was looking for something else in the Express Scripts Drug Trend Report 2005 when I came across this study referenced on page 209. I should have remembered since I wrote this section (yes I was a contributor see page 332). This is a Morgan Stanley study which talks about why people choose [...]

Sell Your Captive PBM - Why?

I was a little surprised by the quote from Lisa Gill from JPMorgan Chase about why health plans should sell their in-house PBMs (Pharmacy Benefit Management):
“I think it makes a lot of sense for PBMs [pharmacy benefit managers] to be sold or spun off as a stand-alone business. The only time it will make sense [...]

More On Silverlink’s Think Different Event

I am now up in Minneapolis at our 4th Think Different event on how to engage the healthcare consumer.  I talked about the first few speakers the other day, and I finally had a chance to hear the other speakers present.  This week, I had the chance to listen to  James Taylor (of Smart (enough) [...]

Wisdom Of The Crowd – Socializing Wellness

You probably caught the articles last year about how obesity seemed to spread throughout social networks. Now, in an article in the Washington Post (5/27/08), they talk about another example of research showing that smoking is similarly affected by social networks. Theoretically, this research could have significant implications for using social media (i.e., [...]

When Would I Pay More – Z-Lists and Green

The other day, someone was talking to me about the Z-List at Harvard. Basically, Harvard will allow a certain number of students to come in if their parents give $1M. Makes sense, and it allow them to provide lots of other students with aid.
At the grocery store, we pay a premium for organic [...]

Our First Think Different Event

Today was our first Think Different event in Boston. This is a road show we are doing around our new positioning and how health care companies need to get outside the box to improve the effectiveness of their communications. It has four external speakers plus our CEO.
[Spoiler Alert: If you are attending an [...]

Groups And Microsegments

When I was listening to Kinney Zalesne (Microtrends author) present this morning at our Think Different event, there were several things that crossed my mind:

Which micro-trends am I part of?

How much micro-targeting is too much?

Will consumers self-identify into groups?

Without going back to the whole book, I can think of several micro-trends with which I associate:

Marathoning
Stay-at-home [...]

Missing The First Step

When I saw Forrester’s data around Personal Health Records (PHRs), it reminded me of one of the facts we struggled with around increasing mail order utilization…most people didn’t know what it was or whether they had it as a benefit.  (From their Q2 - 2007 Social Technographics Online Healthcare Survey)

So, given all the buzz about [...]

Are You Going To AHIP Institute 2008?

Are you going to the AHIP (America’s Health Insurance Plans) Institute 2008 event in San Francisco in June?  I will be there and would love to connect.  Just let me know.

Book Review: Health Care Reform Now!

Health Care Reform Now! A Prescription For Change is the latest book by George Halvorson (CEO of Kaiser Permanente). I have been talking about it and using quotes from it for a few months. I finished the book a few weeks ago and figured that I better carve out the time to capture [...]

Incentives and Communications

Everybody looking at the healthcare system understands that incentives and alignment of goals is a critical component for successful change.

Providers need to be motivated to focus on wellness and prevention.
Individuals need to be motivated to care about the cost of care and to act in a healthy manner.
Pharmacists need to be motivated to take the [...]

Poor Health Plan Satisfaction Due To Poor Communications

JD Power just finished their second annual National Health Insurance Plan Study which looks at member satisfaction.
“The study finds that the majority of health plan members rate their insurer lowest for the communications and information that are provided to help them understand their plan. Only 45 percent of members reported they fully understand how to [...]

Reminder: It’s Time For Your Patient To Come In For A Visit

Aetna announced that it is launching electronic alerts to 320,000 physicians. They will be called Care Considerations.
My understanding is that they will use the ActiveHealth engine to compare claims data to treatment guidelines to identify gaps in care. They will then send the physician a message through the NaviMedix platform and through fax, [...]

Kaiser Kid Advertisement

I am sure it is out there somewhere, but I found this on the EverythingHealth Blog and thought it was a cute video capturing the Kaiser advertisement along with an Ellen interview of the child “star”.

Deloitte On Healthcare Consumers

Deloitte recently published their results from a survey of more than 3,000 Americans on healthcare.  Here were some of their high level findings:

93 percent of consumers say they’re not adequately prepared for future health care costs
79 percent say candidates’ positions on health care are likely to influence their presidential vote
46 percent place health care among [...]

Facts About The Uninsured

The Robert Woods Johnson Foundation has a project called Cover The Uninsured.  As we all know, this is a major issue which is only getting more pressing with the economy the way it is today.  With food going up and gas going up, it is putting more and more economic pressure on people.
Granted…not all the [...]

Defensive Medicine

On April 23rd, USA Today had an article on Defensive Medicine by Kevin Pho (a PCP who blogs at KevinMD).
It was a well written piece with a few facts that I thought I would capture here:

$2.2T are wasted in our healthcare system (per PWC) due to medical errors, inefficient use of technology, and poorly managed [...]

Healthcare Retention

Retention in healthcare has become an emerging focus.  With the initial land grab for Medicare lives over, it is more and more important to retain them.  Focusing on new lives is becoming harder.  And, with one of the few green fields out there being individual lives, retention will continue to be a business driver for [...]

Doctors Won’t Trust PHRs

One step forward and two steps backwards is my reaction to this comment…if it’s true.
Steve Leiber — who runs Healthcare Information and Management Systems Society, the trade group for health IT — told the WSJ Health Blog that physicians won’t trust PHRs.  As John Sharp mentions on the eHealth Blog, this points to the need [...]

What A Difference A Few Years Makes

Before a whole week passes, I need to capture my interview with Gene Drabinski from Trizetto. Gene is the President of Cost and Quality of Care. This was a fun interview where we just kicked back at the end of day two at the World Healthcare Congress and talked.
I haven’t spent much time [...]

Silverlink Coming To A City Near You

I am really excited about a new initiative at work.  We have pulled together a great set of speakers and are doing a road show around the country.
The speakers include:

E. Kinney Zalesne, co-author of Microtrends
Liz Boehm, Principal Analyst, Forrester Research
James Taylor, Author on Enterprise Decision Management
Fred Jubitz, Former VP of Consumer Cards at American Express
Stan [...]

WHCC 2008 Potpourri

I am flying home and trying to catch up on all my notes so that I can get back to work. It has been a good 2.5 days, and I got some business done, learned several things, and met a bunch of interesting people. Not bad. I have a few more interviews [...]

Hidden Gem at WHCC 2008

For those of you missing the World Health Care Congress 2008 in DC, you are missing a good meeting.  It has lots of networking opportunities, good speakers, lots of company booths, and good content.  I have been here and trying to run between presentations, meetings, and interviews.
I went to a presentation yesterday on PHRs (personal [...]

Data + Rules + Transportable = ActiveHealth PHR

I had the chance yesterday to sit down with Nita Stella (SVP of Product Management at ActiveHealth) and talk about their PHR.  It was a helpful meeting given that I spent much of today in PHR discussions.  Some of my takeaways were:

You have to have a PHR which pulls in your claims data.
You need to [...]

Consumer Engagement Tools

This next session is with James (Jim) Roosevelt (President and CEO of Tufts Health Plan) and Phyllis Anderson (VP of Marketing from Humana). It should include real-life discussions on what works.
Interestingly, Jim is making a point that he made earlier which is about how to differentiate when all the providers are in each plan. [...]

Upcoming Webinars

If you missed it last week, I am giving a repeat performance of my webinar on retention.  I am going to talk about driving customer satisfaction and building loyalty to improve retention which is and should be a hot topic for everyone in healthcare. (Sign up here for the 23rd at 1:00 EDT)
Additionally, my peers [...]

Wrong Question: What Does The Consumer Want?

After hearing Grant Harrison (VP, Integrated Consumer Experience) speak a few times on stage yesterday about his role at Humana, I was glad that I had time booked with him to learn more about what he does. I found it to be a very interesting discussion. Grant works in the Innovation group at [...]