An iconic image from Matisse’s Jazz portfolio comes to my mind as I think about the chasm between social media and health on one side, and health plan data on the other. The image is shown on the left; I’m including him here to represent the health consumer engaged with social media, sharing opinions about his experience with health providers, payers, and other touchpoints in his health interactions.

A new survey published by the National Business Coalition on Health (NBCH) finds that only 31% of health plans collect and publish patient experience data. And, like the readers of the National Inquirer, health care consumers have inquiring minds that want to know. We also want to know about quality — and mortality and complication rates are provided by only 28% of plans.

Most plans have picked the low-hanging fruit of provider directories, with virtually all plans providing those. But frankly, that’s just Yellow Pages with physician listings. Over half of plans include information on office hours. Just under two-thirds furnish data from public sources on quality (e.g., HEDIS).

In Connecting the Dots in Health Care, released at the NBCH’s 12th annual conference, the eValue8 study also found that plans are sitting on mountains of valuable health data they aren’t leveraging to improve patient care.

For example, claims data easily identify enrollees who have received a mammograms; the plan could remind these women to schedule the test, and continue to alert her until she does.

Plans are on the ball when it comes to substituting generic drugs; “almost all health plans indicated they send notices to members about switching to lower cost generics as well as send notices to doctors.” Of course they do; moving patients to generics saves lots of money in medical trend in the plans’ current fiscal year.

Urging women to get mammograms does not. That’s a longer-term payback, which many plans don’t necessarily realize due to enrollee churn. But it’s sound public health policy for population health management, and the right thing to do.

Health Populi’s Hot Points: While health plans figure out how to mine and share the incredibly rich sources of data they generate, consumers will be reaching out to each other to share what they know. Sure, it’s anecdotal, unscientific, not always pretty. But patient-generated stories are empowering, available, and accessible. Social media are enabling a fast-growing cadre of consumers to share. Health plans, having sat on googolplex bytes of data for years, are now behind consumers in the sharing game.

Leave a Reply

Your email address will not be published. Required fields are marked