Dan Prince

On the heels of the Super Bowl and both the good and bad ads that aired that night, do you ever wonder how well your organization’s ads would fare in the court of public opinion?

And wouldn’t it be great to know, in advance, before you commit all of your dollars to a campaign?

Campaign and concept testing used to be time consuming, very expensive, and not highly predictive.  Focus groups were the most frequent way we did this testing.

With new online approaches, much has changed.

Now you can ask your intended audience, preferably in the early stages of development, or right after launch, and get the guidance you need right away.

So much has shifted that we’ve just written a new eBook on how to use online methods for testing concepts and campaigns.  It clearly outlines the differences between the two types of online testing that we’ve used successfully: online surveys and online bulletin board focus groups.

Here is a quick summary of the contents:

• A Methodology Matchup weighing the pros and cons of the two approaches
• Case Studies for both approaches, including image examples
• An outline of estimated costs associated with both approaches

Click here to download

Dan Prince

In a recent nationwide survey of hospital executives that we did in conjunction with ReviveHealth, we learned that hospital leaders are extremely concerned about the rates they may be offered for patients who buy health insurance through the coming Health Insurance Exchanges.

First a quick primer on the exchange concept.  These are mandated under the Affordable Care Act.  A Nashville healthcare lawyer named Dick Cowart recently said that these health insurance exchanges can be viewed as a Travelocity for health insurance.  The idea is that consumers will visit a web portal to see, learn about, select, and enroll in a health plan.  In each state, the governor and insurance commissioner of that state will determine what benefits must be offered.  Various insurance companies have the option to create plans, and organize their networks around those benefits.  Then the insurance companies must play “let’s make a deal” with the local healthcare providers to agree on what rates will be paid for various services.  All of which will presumably be overseen by each state’s insurance commissioner to assure that the whole thing will work.*

Many hospital executives (over 60%) told us that they have started discussions with health insurance companies about participating in the networks and products that will be offered through the Health Insurance Exchanges.  But Providers want to start from the negotiating position of being paid rates comparable to those they receive for treating patients with commercial insurance.  Meanwhile, it seems that many insurance companies are starting the same discussions with Medicare rates in mind, hoping to get hospitals and physicians to ultimately accept much lower rates; those comparable to the rates paid by Medicaid!

If Medicaid rates, or something close to them prevail, over one-half (56%) said they would have to make substantial cuts to operating costs or do something drastic such as merge, cut service lines, or close entire units of their hospital.  Other hospitals said that they would refuse to participate under those circumstances.  Still others said they would wage a campaign with the public and with legislators to get better rates.  And some would try “all of the above!”

With more and more physician groups now owned by hospitals and health systems, the networks that emerge may be pretty “narrow” (i.e., limited in the number of participating providers).  And both insurers and providers will likely have a vested financial interest in stringent utilization controls, governing what services will be available where, for patients buying their insurance through an exchange. 

Do providers see any way to deliver high-value care in an environment where they may be receiving only Medicaid-level for that care?

More on that in my blog next week!

*States may opt out of setting up their own exchange, and then the federal government will run their exchange.

Dan Prince

Today’s the day for voting.  And hopefully by tomorrow, we’ll know who has won.

Meanwhile, a sampling of hospital executives across the country believe that the Health Insurance Exchanges will go forward, regardless of whether Mr. Obama or Mr. Romney ends up in the White House.

In conjunction with national health care PR firm ReviveHealth, we just completed a nationwide survey of hospital leaders.  Most respondents were the executives responsible for negotiating contracts with the major health insurance carriers – along with a smattering of CEOs, CFOs, and others.

From this online survey of 112 leaders across the country, we learned…

• Most (80%) hospital executives believe that the health insurance exchanges mandated by the Affordable Care Act (aka Obama Care) will most likely go forward, in some way, even if Mr. Romney is elected.

One third (34%) said the exchanges will continue, as is, regardless of who wins.  If Romney wins, 46% said the Exchanges will proceed, but only if administered by the states.  Only nine percent said a Romney victory means a halt to the Exchanges.  Another 10% offered their own opinions, including a one-year rollout delay or a rollout of private Exchanges with states contracting for certain target populations.

• Opinion was evenly split on who they think will win the Presidency.

Given three possible answers, 43% said the race is too close to call; 29% picked Romney; and 28% picked Obama.  In other words, mirroring national sentiment, executives are not sure who will emerge as the next president of the country.

• Whatever happens, hospital executives are very concerned about what rates will be offered to them to care for people who end up buying health insurance through an exchange.

More on this in a subsequent blog – stay tuned!

Dan Prince

Why are EOBs (explanation of benefits statements) and provider bills so hard to understand?

Sometimes it seems that you need a PhD to read an EOB!  If you follow a simple doctor visit with a visit to a specialist or two, and they order various tests, it can get pretty complex, pretty fast.  Sometimes you don’t even recognize the name of the provider that shows up on the EOB, compounding the problem of figuring out how much you will end up paying, to whom, for what.

Weeks, or sometimes months later, various medical bills trickle in from the individual doctors, hospitals, and labs.  You then put on your accountant’s hat and try to reconcile all of them against what the EOBs hinted is your share.  Ahhh – frustration!

To their credit, my health insurance provider, BlueCross BlueShield, has attempted to put a lot of this information online, keeping it current and clickable behind a secure log-in.  However, I still get confused.  For example, are the amounts listed under “Deductible Amount” the costs that will end up being billed to me by the medical provider?  On the EOBs themselves, there’s no explanation of what the various headings really mean.  Then there are the quirks that detract from the online experience.  For example, in clicking on the tab labeled “Printable EOBs,” there is no place on the page that is a “print” button.  And when I do print, it only prints one page, not all of the pages in this year’s EOB listing.  And there is a section for HRAs and FSAs, but not for HSAs, which is what I have, making it extremely difficult to reconcile what I’ve been billed, by everybody, with what I’ve actually paid out this year.

I did come across a company called Simplee that is trying to help consumers make sense of their healthcare expenses.  Their mission is to empower consumers to take control of healthcare expenses by helping us understand and manage them.  Simplee is a free website that centralizes all your health care information in a HIPAA-safe environment and displays it in a dashboard style to make it intuitive and easy to understand.  As an added bonus, the company has ways to detect billing errors, which most consumers would never catch.  Once you create your account, Simplee will guide you through getting all of your health care accounts online.  Linking your accounts to Simplee will alllow them to access your healthcare plan information and display it all for you in a way that makes sense.  Key idea: in a way that make sense!

In the absence of simplified billing (which may arrive with the move to bundled payments), we have to work our way through the maze.  So I applaud Simplee in their effort to empower healthcare consumers to deal with the frustrating world of EOBs and medical bills.

Dan Prince

We’ve all done it – we pick up our prescription medicine and wonder if the price was that high somewhere else.  My first question to the pharmacy person is always, “Did you run that through insurance?” because this drug can’t possibly cost that much!  But it does, at least at that pharmacy.

What other service do we purchase where we go into the transaction blindly, not knowing the total cost?  We can compare pricing on cars, hotels, TVs, and coffee makers.  Why can’t we get the information we need to achieve the most value for our healthcare dollars?

A company named GoodRx is trying to bridge the gap when it comes to prescription drug costs. The company has created an innovative prescription drug price comparison technology that provides consumers with accurate drug prices from virtually every pharmacy.  It’s done through a website and a free iPhone app that not only compares medications in a certain zip code, but it also shows available discounts, coupons, and savings tips.

Whether you are a senior citizen covered by Medicare stuck in the “donut hole”, one of the 48 million uninsured Americans, or an insured person with a high deductible plan, comparison shopping for prescription drugs is a worthwhile investment in time.

According to Dr. Sharon Orrange, Associate Professor of Medicine at the University of Southern California and author of GoodRx’s blog, “one of the best ways patients can use GoodRx is at their doctor’s office when they receive a prescription.  Too often prescriptions go unfilled because patients cannot afford them.”  With more people carrying and using mobile devices, this comparison shopping is now possible.

I applaud this initiative to empower consumers with real-time, relevant information.  It’s one way to start bending the cost curve in healthcare, don’t you agree?