consumer empowerment
For the longer term, consumer empowerment
approaches show promise for decreasing the rate of
health plan inflation. Consumer driven healthcare is
an effort to change long-term health care
purchasing behavior by giving consumers financial
incentives to intelligently access and use healthcare
services, and ultimately to make better choices
affecting their health status. Consumer empowerment
includes several key concepts. First, it means
incorporating economic consequences (skin in the game) for consumers.
Second, it attempts to empower consumers by providing
them with key data, including the cost and quality of
provider services, as well as important health
information for self-diagnosis and referral to
healthcare providers. Finally, it attempts to preserve
the best elements of earlier care models, including
significant direct clinical support to consumers who
suffer significant illnesses or injuries, use of
provider fee schedules to ensure reasonable pricing for
healthcare services, and best-in-class customer service
and claims adjudication.
Klais & Company,
Inc.
offers its clients a variety of Health and Wellness
Programs that attempt to identify consumers who
could benefit from long-term healthcare or lifestyle
changes and to provide those consumers with the
information and support they need to realize those
benefits such as:
Disease State Management programs
Health Risk Appraisals
Case Management
Employee Assistance Programs
Links to Health Information Websites
Tiered co-pays that reward consumers for
utilizing high-quality/low-cost providers
Tiered networks that attempt to identify
high-performing providers to consumers
Variable benefits that reward consumers for
taking health risk assessments, looking after their
own health, and complying with care management
instructions
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