"POOR RICHARD'S ALMANACK" ON CONSUMER-DIRECTED HEALTH CARE
by Ed Lanigan
Senior Strategist
Kicking off the discovery phase of a recent customer communications project, my team and I started exploring best practices in consumer-directed health care. We interviewed current clients, analyzed past projects, researched industry trends and reviewed journal articles.
After compiling a numbered list and organizing the points in a logical fashion, we made an accidental discovery. It seems that more than 200 years ago, founding father Benjamin Franklin had already published much the same aphorisms in his "Poor Richard’s Almanack."
So, with thanks (and apologies), here are a few of Poor Richard’s sayings (and our modern takes) as they apply to today’s consumer-directed health care challenges.
"An ounce of prevention is worth a pound of cure."
What would Poor Richard (or his alter ego, Franklin) make of our nation's current health care system? Contrary to these wise words, its focus is on disease rather than health, paying bills and shifting costs rather than preventing illness.
And what would he think of a system that deals with chronic medical conditions not by trying to avert them, but only after they afflict us? For example, insurers pay for pricey quadruple-bypass heart surgery. But in most cases, they do nothing to encourage the healthy behaviors that could prevent heart disease in the first place!
Our take: Reinforce wellness tips whenever possible.
Health plans should become wellness champions. After all, preventing illness is cheaper than treating it, so it's better for the would-be patient and the bottom line.
One tactic could be to provide systematic education and reminders about things each of us can do to maintain good health. Based on claims data, for example, insurers could publish wellness tips that let consumers know about screening tests they should consider.
"Honesty is the best policy."
Some complain that the health insurance industry purposely obscures its Explanations of Benefits (EOBs) by filling them with jargon, confusing math, complex footnotes and difficult-to-decipher remarks codes in order to avoid paying claims. But as Poor Richard said so long ago, honesty is the best policy.
Our take: Honesty is key, and clarity is key to honesty. Clear communication builds trust, reduces costly member service contacts and improves satisfaction.
Here are two ways in which greater clarity can be applied to alleviate confusion:
1. Use plain English.
Insurance jargon should be translated into straightforward language that the average person can easily understand. Show notes near the items discussed, not buried in tiny type at the end of the document. Define remarks codes in plain English, particularly when action is required. Consider using quotes from member contacts to help illustrate a point.
2. Use clear and simple math.
Be up front about charges and payments. Always show the total cost of each service or prescription, along with a breakdown of who paid, when payment was made, and any charges (such as copayments) to be paid by the member.
"An investment in knowledge always pays the best interest."
Poor Richard was on to something. In health care and wellness, as in all things, understanding beats ignorance. Put another way, an informed consumer is likely to be both happier and healthier.
Our take: Knowledge is power.
Here are two ways to share knowledge and empower health plan consumers.
1. Explain, explain, and explain some more.
How does your health plan work? Consumers want to understand, but most won't wade through jargon-filled coverage documents. Provide a simplified version that clearly explains what's covered, what's not, and how to take advantage of benefits. Consider using visual displays to explain key elements of the plan.
2. Empower members by explaining options, choices and alternatives.
"Consumer-directed health care" shouldn't be a euphemism for "the consumer pays more." Instead, it should be about helping consumers to understand options, make good choices and maximize benefits.
For instance, some health plans will reimburse the cost of gym membership. But members have to know about it (and find the right form) in order to take advantage. Likewise, generic drugs and mail order pharmacy benefits can save money, but only if members know this and make use of these options.
"Energy and persistence conquer all things."
As individuals, we know that today’s health care system is complicated and bureaucratic. If he were alive now, Poor Richard might need all the energy he could muster to fight for the best care.
More than ever, health care consumers need energy and persistence to become their own health care advocates. Only as advocates can consumers hope to influence the many powerful stakeholders (insurance firms, hospitals, doctors, pharmacies and other providers) and direct our own health care destinies.
Providers and payers (doctors, hospitals, pharmacies and pharmaceutical firms, and insurance firms) also need to maintain a clear consumer focus despite business pressures. That's where we come in. Addison's team of strategists, information designers and subject matter expert panelists have helped leading insurers to craft health care communications that empower consumers to participate and make informed decisions.
As Poor Richard may never have said, how can we help you?
Senior Strategist
Kicking off the discovery phase of a recent customer communications project, my team and I started exploring best practices in consumer-directed health care. We interviewed current clients, analyzed past projects, researched industry trends and reviewed journal articles.
After compiling a numbered list and organizing the points in a logical fashion, we made an accidental discovery. It seems that more than 200 years ago, founding father Benjamin Franklin had already published much the same aphorisms in his "Poor Richard’s Almanack."
So, with thanks (and apologies), here are a few of Poor Richard’s sayings (and our modern takes) as they apply to today’s consumer-directed health care challenges.
"An ounce of prevention is worth a pound of cure."
What would Poor Richard (or his alter ego, Franklin) make of our nation's current health care system? Contrary to these wise words, its focus is on disease rather than health, paying bills and shifting costs rather than preventing illness.
And what would he think of a system that deals with chronic medical conditions not by trying to avert them, but only after they afflict us? For example, insurers pay for pricey quadruple-bypass heart surgery. But in most cases, they do nothing to encourage the healthy behaviors that could prevent heart disease in the first place!
Our take: Reinforce wellness tips whenever possible.
Health plans should become wellness champions. After all, preventing illness is cheaper than treating it, so it's better for the would-be patient and the bottom line.
One tactic could be to provide systematic education and reminders about things each of us can do to maintain good health. Based on claims data, for example, insurers could publish wellness tips that let consumers know about screening tests they should consider.
"Honesty is the best policy."
Some complain that the health insurance industry purposely obscures its Explanations of Benefits (EOBs) by filling them with jargon, confusing math, complex footnotes and difficult-to-decipher remarks codes in order to avoid paying claims. But as Poor Richard said so long ago, honesty is the best policy.
Our take: Honesty is key, and clarity is key to honesty. Clear communication builds trust, reduces costly member service contacts and improves satisfaction.
Here are two ways in which greater clarity can be applied to alleviate confusion:
1. Use plain English.
Insurance jargon should be translated into straightforward language that the average person can easily understand. Show notes near the items discussed, not buried in tiny type at the end of the document. Define remarks codes in plain English, particularly when action is required. Consider using quotes from member contacts to help illustrate a point.
2. Use clear and simple math.
Be up front about charges and payments. Always show the total cost of each service or prescription, along with a breakdown of who paid, when payment was made, and any charges (such as copayments) to be paid by the member.
"An investment in knowledge always pays the best interest."
Poor Richard was on to something. In health care and wellness, as in all things, understanding beats ignorance. Put another way, an informed consumer is likely to be both happier and healthier.
Our take: Knowledge is power.
Here are two ways to share knowledge and empower health plan consumers.
1. Explain, explain, and explain some more.
How does your health plan work? Consumers want to understand, but most won't wade through jargon-filled coverage documents. Provide a simplified version that clearly explains what's covered, what's not, and how to take advantage of benefits. Consider using visual displays to explain key elements of the plan.
2. Empower members by explaining options, choices and alternatives.
"Consumer-directed health care" shouldn't be a euphemism for "the consumer pays more." Instead, it should be about helping consumers to understand options, make good choices and maximize benefits.
For instance, some health plans will reimburse the cost of gym membership. But members have to know about it (and find the right form) in order to take advantage. Likewise, generic drugs and mail order pharmacy benefits can save money, but only if members know this and make use of these options.
"Energy and persistence conquer all things."
As individuals, we know that today’s health care system is complicated and bureaucratic. If he were alive now, Poor Richard might need all the energy he could muster to fight for the best care.
More than ever, health care consumers need energy and persistence to become their own health care advocates. Only as advocates can consumers hope to influence the many powerful stakeholders (insurance firms, hospitals, doctors, pharmacies and other providers) and direct our own health care destinies.
Providers and payers (doctors, hospitals, pharmacies and pharmaceutical firms, and insurance firms) also need to maintain a clear consumer focus despite business pressures. That's where we come in. Addison's team of strategists, information designers and subject matter expert panelists have helped leading insurers to craft health care communications that empower consumers to participate and make informed decisions.
As Poor Richard may never have said, how can we help you?
