Cover: Power to the People

Power to the People

The Role of Consumer-Controlled Personal Health Management Systems in the Evolution of Employer-Based Health Care Benefits

Published Sep 13, 2011

by Spencer S. Jones, John P. Caloyeras, Soeren Mattke

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Research Questions

  1. What are promising employer-based approaches to reducing health care cost growth?
  2. What are the main barriers to implementing these approaches?
  3. What tools can aid implementation of new cost-reducing approaches as well as specific programs and plans?

The passage of the Patient Protection and Affordable Care Act has piqued employers' interest in new benefit designs because it includes numerous provisions that favor cost-reducing strategies, such as workplace wellness programs, value-based insurance design (VBID), and consumer-directed health plans (CDHPs). Consumer-controlled personal health management systems (HMSs) are a class of tools that provide encouragement, data, and decision support to individuals. Their functionalities fall into the following three categories: health information management, promotion of wellness and healthy lifestyles, and decision support. In this paper, we review the evidence for many of the possible components of an HMS, including personal health records, web-based health risk assessments, integrated remote monitoring data, personalized health education and messaging, nutrition solutions and physical activity monitoring, diabetes-management solutions, medication reminders, vaccination and preventive-care applications, integrated incentive programs, social-networking tools, comparative data on price and value of providers, telehealth consultations, virtual coaching, and an integrated nurse hotline. The value of the HMS will be borne out as employers begin to adopt and implement these emerging technologies, enabling further assessment as their benefits and costs become better understood.

Key Findings

Chronic disease, caused in part by lifestyle choices, increases health care costs

The current system pays for treatment and disincentivizes preventive care and healthy behavior, contributing to consumers' passivity in managing their own health.

Several obstacles impede the implementation of cost-saving approaches

Employers cite regulatory restrictions, inadequate tools, inability to measure implementation success, and payment delays as reasons for resistance to cost-saving designs. Health Management Systems (HMSs) are po

Health Management Systems (HMSs) are potentially useful in supporting individuals' management of their own health

HMSs give employees personalized health information, promote wellness and healthy lifestyles, and aid decision support, thus giving employees knowledge about their health and health care costs, and guidance.

The research described in this report was sponsored by The Dossia Consortium and was conducted in RAND Health, a division of the RAND Corporation.

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