1. Track D: Consumer Issues and Strategies in Disease Management
The Disease Management Colloquium
May 11, 2006
Philadelphia

2. Has anyone met a consumer – any consumer – who has been involved in the design of “Consumer Directed Healthcare”?

3. The Business of Health Care in 2006… Chronic Health Conditions Underlie the Bulk of Health Care Costs
1% of people
100%
Diabetes
Heart Failure
Coronary Artery
Disease
Depression
Chronic Pain
Cancer
Asthma and COPD
Dementia
Falls
Obesity …
80%
38%
total
cost
60%
40% 
Premium level
20%
0% total cost 0% 0%
20%
40%
60%
80%
100%
20% of people
70% of people
% of People

4.     What happens when we disrupt the revenue flow?
The Business of Health Care in 2006… Chronic Health Conditions Underlie the Bulk of Health Care Costs
What happens when we disrupt the revenue flow?
To demand? To “discretionary” services? To insurance?
100% 
80%
60%
40%  
Premium level
20%  0% 0%
20%
40%
60%
80%
100%
% of People

5. Value Model Care Affordability Experience Value Clinical Quality
Thanks to:
Matt Stiefel
Jim Bellows PhD

6. Consumer Perspective Purchaser Perspective Clinician Perspective Care
Affordability
Experience
Purchaser
Perspective
Value
Clinical
Quality
Clinician
Perspective

7. How do we get the consumer’s attention?
“Rules of the Game” model
“Managed Care”
Case management for high risk participants
“Skin in the game” model
Tiered co-pays
Coinsurance
High Deductible Health Plans
Tiered networks: hospitals, specialists, PCPs
Consumer Directed Plans
Do we need something in addition?

9. Track D: Consumer Issues and Strategies in Disease Management
Is Consumer Directed Healthcare the Magic Bullet? Paul Wallace, MD; Medical Director for Health and Productivity Management Programs; Kaiser Permanente
Using Choice Incentives to Change Employee Behavior
Michael Dermer; President and Chief Executive Officer; IncentOne
So You Disclosed Disease Management Participation to the Patient's Secretary: Now What?
Rebekah N. Plowman, Esq. Partner, Epstein, Becker, and Green
Personalizing Patient Messages to Induce Behavioral Change
Earl P. Steinberg, MD, MPP; CEO and President, Resolution Health, Inc.
Using Financial Incentives to Change Employee Behavior
Roger W. Reed, BSN, RN, FNP, PA Chief Health Office Gordian Health Solutions, Inc.