Copyright © 2006 Business Insurance

"Employers turning to e-health records - Aim to create informed consumers" April 24, 2006

by JOANNE WOJCIK

Employers that have been gathering and analyzing claims data from insurers and pharmacy benefit managers for years are beginning to turn the information over to their employees in the hope that this information will empower them to become more informed health care consumers.

While some employers are issuing individual statements that show how much was spent on each employee's health care during a given year, a few are going a step further and combining cost and clinical information to create comprehensive personal health records.

When Round Rock, Texas-based computer manufacturer Dell Inc. announced earlier this month that it was giving its employees the option of automatically importing their compete medical claims history into their electronic personal health records, it became one of the first and largest employers to do so. Hopkinton, Mass.-based EMC Corp., another high-tech company, has been doing it since 2004.

New York-based WebMD, which made the automatic import function available to its customers about 18 months ago, serves as the backbone to both of these employers' Internet health information portals where employees' personal health records are kept. The portals also include a health risk assessment that an employee can complete himself or herself but that changes automatically should the downloaded claims data contain any medical information that might affect the content of the health risk assessment. For example, with the automatic import function, if a blood test shows elevated cholesterol levels, the employee's previously self-reported cholesterol level will automatically be updated.

Dell and EMC are the first of the more than 250 employers that contract with WebMD for their health information portals that have elected to make the automatic claims import capability available to their employees, according to Craig Froude, executive vp of WebMD's health care services based in Portland, Ore.

Several insurers that contract with WebMD have also begun making this capability available to their plan members. But the only way an employer can provide this capability to all of its employees—and not just those enrolled in the health plans that provide the function—is to aggregate all of its claims information into a data warehouse and then link it to an engine such as WebMD, sources say.

"While it's helpful to have carriers moving in that direction, large employers have multiple health plans, so to try to solve the problem by going to the health plans is only going to take them so far," said Mindy Kairey, global health and welfare outsourcing leader at Hewitt Associates Inc. in Lincolnshire, Ill.

"We have a lot of employers on both the consulting and the outsourcing business side that are looking for solutions, and one of the sexy solutions they're exploring right now is the personal health record," she said. "But I would say that the vast majority are exploring it and are interested in it, and the minority of them have actually implemented something," the most popular solution being annual statements that generally provide a summary of how much was spent on each individual employee's health care in a given year. But, unlike personal health records, these statements generally do not include clinical information, she said.

"We have a growing number of employers and vendors offering e-health records, but this sounds more advanced than the others offered by employers that have been announced," agreed Helen Darling, president of the National Business Group on Health in Washington.

Early adopters

EMC was the first employer client to launch this approach with WebMD, according to Delia Vetter, senior director of benefits at EMC. She said EMC developed its Healthlinks portal for employees in 2003 with WebMD, and in 2004 integrated it with its data warehouse, which contains three years' of medical claims information from between 12 and 14 vendors, including a pharmacy benefit manager.

"The objective was to maximize data to drive employee behavior," Ms. Vetter said. "EMC believes that the key to containing health care costs in the long term is managing employee health. We also have taken information from the health risk assessments to do predictive modeling," she said, adding that 90% of EMC employees have completed health risk assessments. The data warehouse is also being used to develop onsite health management workshops.

When an employee signs onto EMC's Healthlinks portal to take the health risk assessment and view his or her personal health records, the individual is asked whether to have his or her claims information imported automatically from the data warehouse. Employees also have the capability of sharing their personal health records with their physicians via e-mails, printouts or by signing onto the portal via the Internet while in their physicians' offices. So far, about 90% of EMC's 18,000 U.S.-based employees who have completed health risk assessments have turned on the auto-import function.

Dell, which began collecting data in its warehouse more than two years ago, last week gave its employees the option of having their individual claims information automatically imported into their personal health records, according to Tre McCalister, senior benefits consultant and program manager for health improvement and disability.

"Dell believes that we need to encourage our partners and suppliers to adopt technology that improves processes and access to quality information, so, in (the request for proposal) process, we ask the vendors about the latest innovations," said Ms. McCalister. "When we learned about this technology in 2004, we included this additional feature as part of our contract with WebMD. We launched WebMD in 2004 with the manual input, knowing this would be Phase II."

Dell has also decided to make the personal health records portable, so that employees can take them with them when they leave the company by importing them into individual memberships on WebMD's public site.

"It's a great consumer tool. It puts information in the hands of the user and helps them to make wise health care decisions," Ms. McCalister said.

While EMC and Dell may be among the first employers that have chosen to share claims data with their employees via personal health records, they are at the forefront of a growing transparency trend that is part of the consumerism movement, industry experts say.

"There is growing employer interest and activity in this area," according to William P. Whitely, chief marketing officer of Eden Prairie, Minn.-based Ingenix, a subsidiary of UnitedHealth Group that consolidates claims information for about 100 employers. In the past, this information was used internally by employers, for such purposes as budgeting, trend analyses and comparing insurers with one another, but "now employers are asking if they should consolidate this data for use by employees."

"That's an awesome use of data," acknowledged Chris McSwain, manager of compensation and benefits at SCANA Inc. in Columbia, S.C., which recently contracted with Ingenix and the University of South Carolina to build a data warehouse of its employees' medical claims history for the same purpose.

"It's a little bit more personable, too," he said. "In concept, that is a wonderful way of weaving information together and helping people take more responsibility by pointing them gently into the right information stream to get more information about whatever is ailing them. It's really an awesome application of what a high-tech company should be able to do."

© Copyright Business Insurance 2006