I Use Zagats to Find Top Restaurants. What Do you Use to Find Top Hopsitals?

The two reasons why we've seen such an uptake in CDHP is two-fold: Technology and Transparency. Even just two years ago CDHP looked good in principle, empowering the masses to make informed health care decisions, but lacked the tools to do so. Now, tools abound.

I bought a home stereo receiver this month. Nothing fancy, but hopefully one that I'll keep for years to come. Did I stroll into Best Buy and plunk down $400 on the first one I saw? No way! I agonized over it. I price-compared, Internet Shopped, browsed A/V review magazines and visited no less than 4 consumer electronics stores PLUS Costco before pulling the trigger.

Not only did I find a great unit at a great price, but I feel great about my purchase. Even if I wind up hating it, it was my decision to make.

Why do so many Americans price and quality compare when shopping for groceries, restaurants, cars and vacations, but simply scroll to the first doc listed in their directory when it comes to their own health care? It makes no sense. Especially, when you do the math when it comes to personal finance. If we're spending even just a tenth of our income and a whopping 16% of the US GDP on health care, then why don't we shop around for it?

And I'm not talking about just price alone. I'm also talking about quality. Finding the hospitals with the highest surgical mortality rates, docs with the highest member satisfaction rates and outpatient surgicenters with the lowest rates of infection.

We wanted a good restaurant in our area the other night, only this time we were more concerned about quality than price. So we turned to our old friend Zagat (now online) to find a local eatery. We found a great spot near our place. Sure it was a little pricey for a weeknight dinner (we try to keep it manageable during weeknights ;) but the food was terrific.

Now these types of tools are slowly becoming available to the general public when it comes to health care- thanks to transparency and technology. We are on our way to resembling our coupon-cutting, circular-watching selves when we're in the grocery store, but only in the waiting room instead.

Potential Impact: The more these tools are available, the more data, analytics and patient reviews will spread. Could this create economies of scale en masse to impact health care prices?

I know I'm not going for a conlonoscopy from a guy who has a bedside manner rating of 1 out of 4 stars and quality and outcome indices that resemble those of a plumber. (Apologies to both the reader and plumbers for the harsh analogy).

Here are two examples of quality comparison tools:

The first is Cal Hopsital Compare.org. It enables you to compare local CA hospitals with layman's-terms output and easy to read comparison data. (Note: If you click on a hospital and save it as a pdf it will generate a full report for you.

The second is Castle Connolly Medical's Top Doc List. Top Doc is missing some data and only offers basic information for non-paying users, but it does provide a great place to start for someone looking for the best doc and facility for a known surgical procedure on the horizon.

-J|S

Make Health Insurance Like Real Insurance

Life Insurance: You smoke? Okay, your rates are higher b/c you have a lower mortality rate. You will live a longer period of time for us to collect premium from you. Auto: Have a safe driving record? Good for you. Your premium is lower b/c you pose less of a risk. Chances are less likely that we will have to pay a claim for you. Let the other drivers who have bad records subsidize your good rates.

Health Insurance should be no different. You have a chronic disease? That's okay, as long as you mange it proactively. You participate in the wellness program and it's resulting in higher health indices? Great, here's some money off your deductible.

Health Insurance should be no different. Until now, there was no vehicle to bring about this change. Not enough sophistication to provide the analytics to measure these complex things. Well that's all changed with the advent of Consumer Driven Health Care.

This article from Crains only scratches the surface, but it does provide some good insight.

-JS

This List Continues to Shrink. Will Someone Please Open a New Health Insurance Company?

Report: Employers Subsidize Public Health System by $88 Billion: Somebody's Got to Pay the Docs

My father is a podiatrist. Everyone always asks me why I never became a doctor. My reply is always the same: "Every night my father would come home and complain about how Medicare is literally squeezing him for every penny, and how insurance companies are bilking him out of house and home." So I decided to join the other side :)

Somebody has to pay the difference of the subsidy that providers receive from the gov't. This is the first study that quantifies how much that difference is.

Draw your own conclusions, but in order to fix a problem you first need all the facts. This is a step in the right direction. The article lives here.

-JS

Orgs Taking Closer Look @ Risk Management

Survey explicates how Risk Management is being scrutinized more heavily in the eyes of CFOs. This includes issues such as Reputational and Supply chain Risk. Not simply trad P/C exposures. Perhaps one day, RM will share equal importance with a company's balance sheet. The Article link is here.

2 Quick Thoughts: 1) All companies with revenue over $30m should have a full-time RM who deals with all aspects of the co's Risk and Insurance Plans. . .including health & welfare. This individual should interface regularly with the CFO and CHRO (Chief HR Officer). Each performs different functions.

Think the position of a CRO is superfluous in this economy? Insurance is the second largest expense behind payroll.

2) Health Insurance and EE Benefits should also fall within the purview of the CRO. The CFO and VP of HR have their own agendas to accomplish today. Analyzing their company's loss ratio isn't one of them.

-JS

More Calif. Employers Offering CDHPs

I sold one of the first CDHPs to a public employer in California about four years ago. Look how it's taken off since then and how its growing exponentially. 38% of employers in CA now offer high-deductible health plans to their employees, up from 18% in 2007. Read the short article here.

-JS

Maiden Lane III: Not a Home Furnishings Store

The Fed is beginning to dole out giant sums of money to banks and insurers without any safeguards or public transparency. "Maiden Lane III," is an LLC established by the Fed to serve as a clearinghouse for this money.

First reported as a breaking news story in National Underwriter Magazine on 3 December here.

There is a great BusinessWeek article here.

$20 billion was just deposited into MLIII (more than the auto bailout). This is the only public record of it. The numbers are staggering.

This is not meant as criticism, or commentary. Simply information.

- J|S