I know that one of my favorite bully pulpits is telemedicine, and I will try to keep those thoughts to a minimum. Today, however, I had lunch with a very longtime acquaintance who spent many years in a very senior advocacy position for a very large multinational communications company (have I hidden his identity enough?) before he moved on from communications to head up the United Healthcare (UHC) federal advocacy initiatives. As we sat down, I was grilling him on why he chose to make the move and what had driven his decision-making, given his senior position in a well-situated company. As he started unraveling his thought process of moving to an industry that had not necessarily been a monopoly but rather one that only had to do minimal outward facing to a limited number of “constituents” like HR directors, to having to really create a market and a brand for oneself in the health care industry with not only the national exchanges established by the ACA as a competitive market but certainly with the growing competitiveness of providers in the health care market, to his explanation of how the ACA moved everything from what had been a state-regulated model to now a federal overlay, given the requirements in the ACA to the new focus of the health care industry on technology, mobility and plan options, suddenly his move into a completely different field made sense to me. He was going to take the tools that he had gained living through the changes in telecom and apply them to health care and help his company stay ahead of the curve with this experience that he’s bringing to the table.
As we ate such a healthy lunch (I guess when you’re promoting wellness, it’s relatively bad form to eat a lot of “bad” foods), we talked a lot about the adoption of wellness programs across the country and what UHC is seeing. He drew on the tablecloth (paper) a bar graph, which showed that the lowest cost visits—with nurses and regular doctors—even with increased frequency can help keep the long-term costs lowered for participants. The best example he gave was a large corporation that had 20% of its operating budget—or $5 billion a year—going toward health care costs for employees, families and retirees. By using data and diagnostics, they were able to determine that 10% of their participants had diabetes or were predisposed to the disease. By getting their wellness Optimum nurses proactively working with these folks to actually manage their disease through exercise, diet and counseling, they were not only able to lower their health care costs by 10% (which is a lot of money at $5 billion or any total), but were also able to increase attendance at work and have fewer incidents of long-term complications, which were even more costly to the program. The analogy being that the best people to cover are those who pay their premiums and don’t get sick. Just like for car insurance, you want to have those customers who pay their premiums and never get in accidents. Wellness programs are the health insurance providers’ comparable seatbelt policies, teenage driver training programs and other efforts to lower the incident threshold.
Needless to say, it was impossible for me to go too long into the conversation without talking about ways we might find to work together on telemedicine initiatives in the future. There has to be a way to be proactive on the health care front and keep down future costs for participants and programs alike.