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The Pursuit of Health Information – and Trust

Trusting a Partnership for Health InformationWhen making workplace health-plan decisions, what type of healthcare information is desired by Iowa employers? Do employers know about web-based resources on Iowa hospitals? Who do employers trust to be their primary source for health-related data?

We asked a series of important questions in our 2013 Study. And, you might be surprised by the results.

As you might imagine, the needs and desires can vary greatly based on employer size. Using a 6-point scale, with 6 being ‘most important,’ Iowa employers responded that ‘Cost’ information was most important to have (4.9 score), with the largest of employers (1000+ employees) scoring this a 5.7. ‘Comparing Physicians’ followed next with an overall score of 4.5, while ‘Health Status/Wellness’ and ‘Comparing Hospitals’ both scored 4.4. Healthcare ‘Use’ finished with an overall score of 4.3.

Importance of Health Information to Iowa Employers

As found in the chart below, Iowa employers are unfamiliar with existing web-based resources on Iowa hospitals. Larger employers appear to be more aware of these web resources, but only a very small number of employers reported being ‘Very Aware’ of this on-line information. In case you are curious, some of this information might be found on the Iowa Hospital Association and Iowa Healthcare Collaborative websites. As mentioned earlier, ‘cost’ information appears to be most desired, followed by comparing physicians and hospitals, presumably on quality-related metrics.

Knowledge of Web-based Data on Iowa Hospitals

When employers responded to how optimistic they are on the effectiveness of ‘Medical Homes’ and ‘Chronic Disease Management Programs,’ employers with over 1000 employees were at least twice as likely to be optimistic (43 percent) than smaller employers with under 250 employees. Overall, only 21 percent felt optimistic about these initiatives being effective to improve workforce health. Another 30 percent were not that optimistic and responded that such initiatives will make ‘No Difference.’ Half of all employers indicated that they would need to have more information on both programs before making judgments as to the effectiveness of health improvement.

Primary Care Initiatives in Iowa

So, if organizations desire critical information to make future decisions on workforce health, it begs the question who they desire to be the primary source of this information. This question elicits some very interesting results.

Overall, 27 percent of Iowa employers desire insurance companies to be the primary source of health information. Yet interestingly, the largest employers with 1000+ employees were less likely to desire insurance carriers to be the primary source – only 18 percent voiced their interest. Only three percent of organizations desired the government to be the primary source of health information, which speaks volumes about their lack of appetite for a single-payer system.

Primary Source of Health Data

The preponderance of organizations (two-thirds) voiced their desire for ‘Health Providers’ (hospitals and physicians) to be the primary source of health information to help manage their costs. More questions will need to be asked of organizations in the future as to ‘why’ they desire health providers to be the primary source, but my initial take is simply they appear to trust this source more than other sources.

The healthcare provider community may take some comfort in knowing that a majority of employers view them as a trusted resource. With this trust, however, comes the responsibility to validate and enhance it by providing a greater array of transparent information on costs and delivering higher-quality outcomes. From our 2014 Study, we know that employers expect to receive reasonable costs, consistent quality of care and safe care that is appropriately delivered to patients.

This type of feedback for insurance companies is most assuredly humbling. Yet, it should also re-awaken the pursuit of new initiatives to make inroads on gaining a trust-related partnership with their clients. The silver lining for both health providers and insurance companies reveals lots of room for improvement – and immense opportunities. But opportunities can only happen if relentlessly – and thoughtfully – pursued.

Trust is the currency of commerce. In our healthcare world, we can always use more of it.

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Employers and Health Data – Who is the Trusted Resource?

Health care data Resources in IowaLast week’s blog discussed a new module of questions we have included within our 2013 Iowa Employer Benefits Study©. Within this new module, employers are being asked to rate hospitals and physicians within their communities. Probing further, we included another battery of questions to gauge how employers feel about another health-related issue – identifying a reliable source to supply specific health care information to employers (and to their employees).

Frankly, these questions boil down to just one word – Trust.

Which resource does the Iowa employer trust when accessing and evaluating health care information for their employees? Would it be insurance companies? Maybe the medical provider community is most trusted, such as hospitals and/or physicians. The federal government is yet another possibility (I’m a bit suspicious, however). Perhaps, none of the above mentioned stakeholders, but instead, a trusted third party that has yet to emerge in this new evolving marketplace. Logic tells me that employers would like to use a combination of the above resources – not just one source. Much of this, I suspect, will also depend on the type of medical data that is desired by employers.

A large portion of the questions found in this particular module come from the Iowa Hospital Association (IHA). Transparency of health costs and effective health outcomes information is becoming a trendy discussion these days, with special thanks to the Affordable Care Act (ACA). The IHA has a great deal of interest in understanding how Iowa employers perceive these critical issues, and in learning more on how such information can be conveyed in a meaningful conduit of media (electronic format being the most likely culprit).

I applaud the IHA for their desire to find new ways to communicate and educate a major stakeholder (the employer) regarding local health care information. The healthcare snow globe in which we live continues to provide new opportunities for those willing to take the plunge to make our current health care ‘system’ a better place for all of us.

This particular survey module will provide us with additional insight on who should be providing this important information to Iowa employers, and what this critical information should convey.

The results of this survey will be published early this Fall by our new, sister organization, Heartland Health Research Institute.

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Seeking Truth in Health Care (Part I)

Iowa Employer Benefits StudyI recently had the privilege of presenting summary results of the 2012 Iowa Employer Benefits Study© to the Iowa Hospital Association (IHA) Board. This group consists of leaders from hospitals across the state who are confronted with many difficult and disruptive challenges that will forever change how health care will be delivered and paid. It is my view the paradigm shift occurring in the insurance industry, as great as it is, pales in comparison to what is happening in the health care provider world.

Health care is very a humbling subject – the deeper I dig to learn the truths about this vast topic, the less I actually know! What a great paradox – as the health care discussion is both exhilarating and frustrating at the same time.

My message to the IHA Board emanates from four observations about the employer community that come from previous consulting work, discussions with smart professionals, attending regional and national conferences, and from our annual studies. Such observations, in no particular order, are simply stating a few obvious facts:

  1. Health insurance premiums for Iowa employers have increased by 164 percent from 1999 to 2012. A great deal of uncertainty exists for employers about the future of health insurance.
  2. Momentum continues for employers to embrace wellness initiatives – as there is an increasing desire to have both a healthier and a more productive workforce.
  3. Lack of transparency in health care is a major concern and frustration to Iowa employers and their employees. Health insurance has become a huge distraction to employers.
  4. Health care reform is viewed with considerable skepticism by Iowa employers.

Again, I admit these observations are quite elementary, especially for those who follow health care issues and policies. However, it is the potential implications of these observations that will cause major disruption within the health care industry. In next week’s blog, I will address some of those implications and how health providers will most likely be impacted.

Vaclev Havel, a Czech playwright, essayist, poet, dissident and politician (President of the Czech Republic from 1993 – 2003) once said: “Keep the company of those who seek the truth. Run from those who have found it.”

I could not say it any better – especially in the ‘new world’ of health care.

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