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August 10, 2003 at 08:00 PM
Two years ago, a pack of startup consumer-driven health plan (CDHP) companies were hoping to carve out a niche for themselves. Today, mega health insurers seem to be jumping into the market every week.
This is a sign that CDHPs are emerging from their infancy. The next step? Brokers need to educate customers about what these plans are and how they work.
CDHPs are health plans that, with the help of price and quality consumer information tools, give customers control over benefit decisions at enrollment and medical choices at point of care. Most combine high deductible health policies with a health care savings account (HSA) that the employee can draw from to pay non-insured medical costs.
In this market, to be a CDHP player, innovative product design is important. Robust technology tools are essential. Tightly integrated claims processing is vital. Customer-focused service is mandatory. And, like any viable insurance program, financial stability is imperative.
Still, the difference between winners and losers is coming down to customer education.
Employers and employees alike must understand–upfront–that they are taking on new responsibilities and new financial and clinical exposures. That means they need to learn the “rules of engagement,” or the basic CDHP tenets. Reliable customer education is therefore crucial. Here are a few education strategies that should help you bridge this education gap.
Employ change management. For instance, note that co-pays are out under these plans. The underlying goal of CDHPs is to change customer behavior by transforming the way consumers interact with their health care benefits and make their medical decisions. CDHPs introduce new cost-sharing mechanisms and have a benefit structure that uses intimidating tools to communicate volumes of information about price and quality of care. Providing an ID card to flash a $15 co-pay at the billing office will not cut it anymore.
Set appropriate expectations. From point of sale to point of care, setting realistic expectations about the consumer experience is crucial. Anticipate and address your customers questions: Is there a chance of balanced billing? Are there restrictions on HSA funds? Do I have to use the Internet to find a provider? Remember, this is a new product, with new features, new roles and new responsibilities. By addressing the expectations at the front end, you will help your clients avoid problems and disappointment with CDHPs at the back end.
