Skip to main content

A Value-Based Insurance Model From SeeChange Health

From Health Plan Week (via AIS's Health Business Daily) comes word of a "startup health insurer aiming to incentivize behavior change for both healthy and chronically ill members (beginning to market) its products to small employers in Fresno, CA this fall."

One observer calls SeeChange's model "...the next logical iteration in plan design."

Several interesting things:
  • Small employers (fewer than 50 employees) are the target market here, a segment more used to being over-looked, over-charged and under-served by larger insurers.
  • Behavior change is incentivized. Members receive richer benefits if they're screened for - and actively managing - a chronic condition.
  • Not only does the plan accept the chronically ill and those at risk for developing a chronic condition, but it appears to embrace the possibilities of a new model based on prevention, active management and customer engagement through PHRs (offered through Health Insight), delivered through a narrow, focused provider network.
Venture capital firm Psilos Group provided $40 million in startup funding.

Comments

Popular posts from this blog

Michael Porter On Health Care Reform

Michael Porter, writing in the New England Journal of Medicine, proposes "A Strategy For Health Care Reform - Toward A Value-Based System." His proposals are fundamental, lucid and right-on, meaning they're sure to be opposed by some parties to the debate, the so-called "Yes, but..." crowd. Most important, in my opinion, is this: "... electronic medical records will enable value improvement, but only if they support integrated care and outcome measurement. Simply automating current delivery practices will be a hugely expensive exercise in futility. Among our highest near-term priorities is to finalize and then continuously update health information technology (HIT) standards that include precise data definitions (for diagnoses and treatments, for example), an architecture for aggregating data for each patient over time and across providers, and protocols for seamless communication among systems. "Finally, consumers must become much mor...

gapingvoid cartoon #378

Buy your own, here.

"An Affordable Fix For Modernizing Medical Records"

...from the Veterans Health Administration and Midland (TX) Memorial Hospital. I know enough about my own strengths and weaknesses to know that I'm no IT expert. But I am acutely interested in examples of people and teams thinking differently to solve long-standing, intractable problems and, for better or worse, there are lots of those to be found in the IT realm. Yesterday, it was a story about a team adding iPhone portability to MEDITECH functionality, delivering to harried physicians better access to clinical data and more productive hours in every work day. (Wow. Apple in the boardroom AND the physician lounge. Has to be an IT traditionalist's worst nightmare. But I digress...) Today, the Wall Street Journal features a story about Midland (TX) Memorial Hospital finding an affordable, open-source alternative to proprietary EMR systems : "In the push to digitize America's hospitals, Midland Memorial faced an all-too-common dilemma: a crying need for information ...