NH Company Aims To Spread ‘Smart Shopping’ For Health Care

As you Christmas-shop, you’ll do price research online, drive a few extra miles, maybe even wait in line at 4 in the morning to save $100 on a big-screen TV, right?

So how about taking two minutes to go online or pick up the phone to save thousands of dollars on your health care?

That’s the question from Rob Graybill, CEO of a New Hampshire start-up whose eyes are now turning south to the Massachusetts health care market. The company, Compass HealthCare Advisers, launched in January and already has about 50,000 members in New Hampshire, including the city of Manchester.

How it works: Your employer signs up with Compass. When you need an MRI or a colonoscopy, a blood test or a knee “scope”, you go on-line to the Compass Website or call an 800 number. Compass’s algorithms and analytics sift through claims data, and turn you into a comparison shopper for health care, telling you which venues for the procedure you need would be cheaper. If you opt for a cheaper one, you qualify for a cash bonus of between $25 and $100. And you may save on any portion of the bill you pay yourself, too.

Compass is currently in talks with a couple of Massachusetts companies, Rob said, declining to specify beyond, “Some of them are insurers, some of them are employers.”

From a Compass press release:

“The exact same procedure performed by the exact same doctor can cost up to 250% more simply based on where it is performed,” adds Graybill. “Our clients are finding that each time a member picks up the phone or shops online, they save an average $450 off of a procedure without affecting quality. Our members rave about how easy the service is to use.”

A few questions for Rob:

Q: What’s the competition here? What about the state’s myhealthcareoptions site, which lets users compare quality and cost of various local providers?

A: “Compass believes tools such as this and sites such as nhhealthcost.org are helpful in letting members know there are cost differences. The trouble with such sites is that people just don’t seem to use them much. They have really, really low utilization and they are not as precise as they need to be. It would be like shopping at the store with approximate prices or price ranges. When it is your money, you want the amount to be as exact as possible.

So what we do is put together a complete engagement program to increase users, to help people understand how to shop, where to shop, what the information is that they’re looking at. We do all the hard work so that our members can get what they need with a 2-minute phone call or a few mouse clicks online. Because we make it so simple, our members utilize the service at higher levels.”

Q: But couldn’t an employer just do this itself? Couldn’t it just find ways to reward employees for patronizing facilities known to be lower-cost?

A: Its not that simple, Rob said. “To do this correctly, you need some significant analytic capability, and access to claims information.”

A couple of similar companies exist, according to company spokesman David Donohue: “Castlight Health out of San Francisco and New Choice Health out of Florida, although neither service is apples-to-apples and from what we can see are not as actively engaged with employers and employees.”

David noted in an email: “Hospitals do NOT like this service because it makes choice simple and shows the extreme cost disparities…often when it’s the same MRI truck and tech but at a different physical location.”

Here in Massachusetts, you tend to hear most about the high prices of Partners Healthcare or other Harvard-affiliated hospitals, but Rob said that New Hampshire sees similar gaps: “We have situations where the exact same procedure is 600% more depending on where it’s done.” Continue reading

EMC To Offer Employees Who Meet Health Goals A Break On Premiums

EMc headquarters in Hopkinton

WBUR’s Martha Bebinger reports:

EMC, the data storage company seen as a model for employers working to improve employees’ health, is taking the model to the next step.

EMC was among the first corporations nationwide to survey employees’ health and then connect them to nutrition or fitness counselors through Wellness programs. Next year, EMC will ask employees to choose a personal health improvement goal — to lose weight or lower their cholesterol, for example — and give those who meet the goals a substantial reward: a 12% break on insurance premiums.

Says Delia Vetter, the Senior Director of Benefits at EMC: “It’s smart on two fronts. One, it contains health care costs and two, it also increases productivity.”

Many employers have felt that discussing employees health is an invasion of privacy but Wellness programs are gaining interest as health care costs continue to rise.

State Regulators Huddle, Trying To Define ‘Wellness’

What is 'wellness' anyway?

Under a just-passed state law, small businesses can get a five percent discount on their health insurance premiums if they offer so-called “wellness” programs that effectively nudge employees to stop smoking, lose weight and in general adopt a healthier lifestyle.

The only problem is how to define “wellness.”

Today, members of the Connector Authority, the independent state agency and insurance exchange created under the 2006 health reform law, said they hope to define and design a straightforward, easily adoptable “wellness” program by July, The Boston Globe reports.

(In order to qualify for the premium discount, businesses must buy insurance through the Connector.)

Of course, “wellness” is a nebulous concept and “wellness” programs are all over the map — some exist in name only, while others actually manage to get people to change their behavior (usually when there are financial incentives involved).

For one approach, here’s a 2009 Wall Street Journal opinion piece by Safeway CEO Steven Burd on how he’s attempted to infuse a “culture of health” at the company. And Hannaford Supermarkets (with corporate offices in Maine but owned by a Belgian conglomerate) is also held up as a model for radically re-thinking “wellness” as a way to control costs.

(Both of these companies were highlighted by Bob Carey, Executive Director of the Employers Action Coalition on Healthcare, in an earlier post on CommonHealth).

‘Incestuous Relationships’ Hindering Health Care Cost Control?

Quite a lively spate of comments today in response to this Hubbub column about whether Paul Guzzi can combine his two leadership roles without running up against a conflict of interest.
Guzzi is both president of the Greater Boston Chamber of Commerce and board chairman at Blue Cross Blue Shield of Massachusetts, the state’s largest health insurer. Says one commenter:

Hospitals and health insurance companies are big employers in Massachusetts and it’s not a surprise that they are involved in the major business trade organizations in the state, nor that business leaders comprise a significant share of the board members of hospitals and health plans. But these incestuous relationships create some enormous conflicts of interest in the cost control arena. We need more public exploration and discussion about how all these overlaps limit the ability of Massachusetts employers to be a force to contain health care costs—in hospitals, health insurance companies, and on Beacon Hill.

That commenter also focuses on the leadership of the Massachusetts Taxpayers Foundation, and the foundation’s president, Michael J. Widmer, responds. Check out the full exchange here.

Daily Rounds: Genzyme Just Says No; Health Care Flat; Berwick Mum

Genzyme Rejects Sanofi-Aventis Offer – The Boston Globe (AP) “Biotechnology company Genzyme Corp. said Monday it rejected Sanofi-Aventis SA’s $18.5 billion buyout offer because it undervalues the company.” (Boston Globe)

Hiring slows in state’s stalwart health care industry – The Boston Globe “Over the past six months, according to state statistics, the health care sector has had no employment growth, a stunning development for an industry that has steadily added jobs through even the worst recessions.” (Boston Globe)

Medicare director won't ID donors to think tank – Washington Times “Dr. Berwick is declining to say exactly who provided funding to the Massachusetts-based Institute for Healthcare Improvement in response to Republicans who question whether the new Medicare chief could have a conflict of interest if medical-device companies or health plans helped make his generous compensation package possible in the first place.” (Washingtontimes.com)

Blue Cross Chairman Faces Questions About Conflicting Roles

Paul Guzzi

WBUR’s Martha Bebinger poses a great question in a post on Hubbub: Can Paul Guzzi, Chairman of the Board of Blue Cross Blue Shield Massachusetts effectively perform that role while he is also president and CEO of the Greater Boston Chamber of Commerce?

Or is representing both insurers and employers (hospitals) an inherent conflict of interest?

What do you think?