In the 2015 Health Research Institute’s annual report, PricewaterhouseCoopers examines 10 health care trends for employers to watch this year. Here are four notable mentions.
1. Do-it-yourself health care
Consumers (and employees) are looking to own more of their own health care experience. This can range from electronic devices that track their fitness regimen to seeking care in a way that fits their lifestyle.
In response to this trend of “health care independence,” Kaiser Permanente (formerly Group Health) has expanded its avenues of care beyond the traditional office or urgent care visit, allowing people to receive care at the time and by the method of their choosing.
Now members can access care via walk-in clinics (CareClinics) at select Bartell Drugs, get help by phone 24/7 via the Consulting Nurse Service, securely e-mail their doctors at Kaiser Permanente medical offices, receive diagnoses and even prescriptions via online visits, and more.
2. Cost-saving efforts for high-cost patients
PwC data points to the development of creative care delivery and management systems for, among others, aging baby boomers and patients with multiple conditions to manage.
There’s a sobering statistic from a Gallup-Healthways survey: About 80 percent of full-time workers are above normal weight or have at least one chronic condition, such as diabetes, obesity, or heart disease. To help employers and employees control costs associated with such conditions, Kaiser Permanente has developed two effective programs:
Nurses reach out to all members with diabetes, asthma, heart failure and other select chronic diseases and conditions, offering personalized education and advice to help patients make positive changes in their health.
Complex Case Management
This program focuses on network and group practice patients at greater risk, usually following hospitalization. They are typically less stable, often have multiple conditions and numerous providers, and may have difficulty managing their care. Without assistance, they are at greater risk of ER use or hospital readmission.
In our owned-and-operated care system, in conjunction with our primary care medical home model, our efforts have helped reduce emergency room visits by 29 percent, and have led to 11 percent fewer hospitalizations.1 Simple things like helping patients with chronic diseases stay on medication, be faithful to lab screenings, and make scheduled appointments can dramatically impact a person’s health. There’s no overemphasizing this point: The Rand Corporation reports that 87 percent of employers’ health care cost savings come from chronic disease management programs.
3. Positive emphasis on health outcomes
Whether it’s due to new products or high-priced specialty drugs, data suggests a demand from plan participants and sponsors to see evidence of positive health results.
Kaiser Permanente has long been a proponent of positive health results, both from the patient point of view as well as the employer’s. Our clinic doctors are salaried, not paid per service rendered. We stress value of care rather than volume, eliminating unnecessary or redundant tests or procedures.
We practice preventive medicine, figuring the best way to keep your employees healthy is to keep them from getting sick in the first place. When workers do need care, we practice evidence-based medicine, using proven pathways to expedite care. What’s more, we’ve entered into agreements with major contracted physician groups to reward better outcomes and lower costs. All to stress better health outcomes for our patients and lower costs for our plan participants.
4. Role of physician “extenders”
Providers such as nurses and nurse practitioners are becoming the first line of care for many plan participants.
As mentioned previously, Kaiser Permanente allows patients to access these “extenders” through the Consulting Nurse helpline. What’s more, our CareClinics are staffed by board-certified nurse practitioners or physician assistants. In so doing, we’re able to expand our points of care to more places in the community.
For the full list of Enterprise’s 10 trends, click here.