Health insurer Aetna Inc. announced its profit fell 57% in the fourth quarter as healthcare costs increased, and the company sustained large capital losses. Aetna earned $194.7 million, or 42 cents per share, down from $448.4 million, or 87 cents per share. The Hartford, CT-based company spent 81.8% of its premium revenue on medical care in the quarter, compared to 80.3% a year ago.
Queens, NY, residents rallied in the state's capital in an effort to save two ailing community hospitals that could close. The state has ordered the company that owns the hospitals to file closure plans following a recent bankruptcy filing. The hospitals have a combined 455 beds and serve about 200,000 patients each year. Some 2,500 people work at the hospitals.
To the government and fertility industry, large multiple births have begun to look like breakdowns in the system. The issue has taken on renewed scrutiny since a California woman, who already had six children conceived through in vitro procedures, gave birth to octuplets last month. Nearly a third of in vitro births involve twins or more. The government, along with professional associations, have been pushing fertility doctors to reduce that number, citing the disastrous health consequences that sometimes come with multiple births.
The public health clinic at the Nanjemoy Community Center, which serves many of Charles County, MD's most impoverished residents, will close within a few months unless the center can find sufficient funding. The executive director of Greater Baden Medical Services, which operates seven clinics in Maryland, said that its board of directors plans to close Nanjemoy Health Services, which operates out of a county-owned community center. The center is the only health clinic in the rural southwestern part of Charles County. For most residents, the next closest one is about 15 miles away.
Congressional leaders have agreed on the details of a nearly $790 billion stimulus package, an attempt by the federal government to jolt the economy, create millions of jobs and ease the financial woes facing individuals, businesses, and states. The bill is made up of four broad categories: tax breaks for individuals and businesses, investments in healthcare and alternative energy, funding for infrastructure projects, and aid to state and local governments that includes expanded benefits for individuals who are unemployed and lack health insurance.
The administration of Massachusetts Gov. Deval Patrick will provide $32.6 million in state grants and increased Medicaid payments to 69 hospitals and community health centers that are experiencing financial difficulties. Eighty-two medical centers applied for the funds. The state Executive Office of Health and Human Services awarded the grants based on the facilities' financial needs and their role in the state's system for delivering healthcare, according to a statement.
Consumer-directed healthcare (CDH) remains a potentially cost-saving, patient-empowering movement, but member buy-in is still not there yet—and the success or failure of these plans may decide whether private health insurers survive.
It's been six years since health insurers started offering health reimbursement arrangements, but the question remains: Are consumer-directed plans merely a way for employers and health plans to shift more costs onto members?
CDH advocates bristle at the question, but not everyone is convinced that CDH plans are the way to go—even those in health plans.
Consider these two facts:
More than 42% of those who took the health plan portion of the HealthLeaders Media Industry Survey 2009 said that CDH is the best hope for healthcare. That result easily outdistanced employer-sponsored healthcare, government-funded universal healthcare, and universal health insurance. However, when looking at that figure another way, more than 50% of health plan respondents in the survey do not believe CDH is the best hope for healthcare.
Those same health plan/managed care folks are not sure that CDH plans actually empower members either. Nearly half of health plan respondents in our survey do not think CDH plans empower consumers and almost 20% don't think they either save money or empower consumers.
One reason for the lingering question is that many see consumer-directed plans as a way to shift costs to members under the guise of patient empowerment.
That cost shift is evident in rising PPO deductibles. Mercer recently reported that the median PPO deductible in 2008 doubled to nearly $1,000. High-deductible PPOs, without consumer products like health savings accounts and patient education, are a cost shift—plain and simple.
High deductibles are the downside to greater consumerism, but there are also pluses to putting members in control of their healthcare. Take, for instance, CIGNA, which recently reported successes associated with its consumer-directed plan, called CIGNA Choice Fund. The consumer plan costs less than PPOs and HMOs, and members in the consumer plan use preventive care, comply with medication, and utilize the best medical practices at the same rate or better than traditional plan members, according to CIGNA.
Health plan members are not interested in consumer-directed plans because they are satisfied with their current health plans and/or fear change, and employers are offering traditional plans that are too similar to consumer-directed plans and/or not educating employees about consumerism. Employers have to offer real alternatives if they want change.
In its purest form, consumer-directed healthcare is about patient empowerment and providing credible health information that is easy to access and understandable. Health plans have started that process by offering cost and quality information for doctors and hospitals, but there is still a long way to go.
For their own survival, it is vital for insurers to improve consumerism. All you have to do is look at Washington. There is a new president who doesn't think much of health insurers and has already laid the groundwork for a public insurance option to compete against private insurers.
If healthcare consumerism fails, not only could it bankrupt health plans members but it may signal the demise of private insurers.
Les Masterson is senior editor of Health Plan Insider. He can be reached at lmasterson@healthleadersmedia.com.Note: You can sign up to receiveHealth Plan Insider, a free weekly e-newsletter designed to bring breaking news and analysis of important developments at health plans and other managed care organizations to your inbox.
I get a lot of e-mails from consultants suggesting various column topics about which they—coincidentally—happen to be experts. No problem. That's how they make a living. I appreciate the help. Keep those ideas coming.
The other day, however, one of my co-workers forwarded an e-mail that he'd received from a consultant offering strategies for retaining and motivating "Millennial" workers. The suggestions all make sense. Give these fresh-scrubbed young Millennials regular feedback. Give them "bragging rights" for a job well done. Make their workplace enjoyable. Give them a sense of ownership. Tap into their "unique talents." Who could argue with that? Recruiting and retaining workers are among the top priorities of hospital and physician leaders in rural and urban America, according to the just-released HealthLeaders Media Industry Survey 2009.
Here's the rub, though: Every suggestion for Millennials can be applied to every worker in your community hospital, physicians' office, restaurant, hardware store, fiberglass insulation manufacturing plant, or anywhere else—regardless of that worker's age, job description, level of education, or any other distinction you'd care to make. It all boils down to treating people like you'd want to be treated.
Sometimes these generational divisions we construct or adopt are nothing more than media-driven chatter and artificial distractions that really don't help. I've never heard my 40-something contemporaries carp, for example, that their working environment was too much fun, or that they were sick and tired of the CEO asking for their feedback, or that their sense of belonging and value at work made them ill, or that they were getting ready to go postal because of all the credit they get for a job well done. The only difference I can see between myself and my 20-something colleagues is that they're thinner, they're more computer savvy, and their music sucks.
By definition, Millennials are the latest demographic subset to enter the workforce. According to Wikipedia, they are born no earlier than 1976 or 1982, depending upon which Millennial is rewriting the definition this week. They are also known as Generation Y, Echo Boomers, the Net Generation, and the iGeneration. My personal favorite description is the marvelously snarky "Trophy Kids," because these youngsters apparently are taught that everybody wins, nobody loses, and everybody gets a trophy just for showing up.
Somehow, if you buy into the media sales pitch, Millennials are supposed to be completely different from the Greatest Generation, Baby Boomers, Generation Jones, Generation X, and any other generation that has gone on before or that you can market to. I've heard my fellow Boomers say—without a trace of irony—that Millennials are insufferably self-absorbed, overly opinionated, and have a strong sense of entitlement. To which I say: "Kettle, I'd like you to meet your new co-worker, Pot."
Ripping the new kids has been going on for as long as there have been older generations and short memories. Socrates railed against the youth of Classical Greece when he allegedly said: "The children now love luxury; they have bad manners, contempt for authority; they show disrespect for elders and love chatter in place of exercise. Children are now tyrants, not the servants of their households." In a history book I'm reading now about WWII and the Greatest Generation, an army general tells a reporter in 1942 "I'm afraid the Americans of this generation are not the same kind of Americans who fought the last war." As it turns out, those fears were unfounded.
It's true that generational differences exist. Of course there isn't a one-size-fits-all way to deal with employees, regardless of their age. A 55-year-old nurse with 30 years in the work force, two kids in college, and a mortgage is going to have some different ideas about how things are run than is a 25-year-old fresh out of med or nursing school, or some young hotshot with the ink still wet on his MHA degree.
But people who ought to know better are making way too big a deal out of small potatoes, nit picking the minutia of differences rather than recognizing our overwhelming commonality. Good managers know that and will treat all employees with respect, listen and act on their concerns, provide appropriate feedback in an appropriate setting, and will try to accommodate them in any way they can to make them comfortable and productive at their job. That formula for success crosses all generational divides.
John Commins is the human resources and community and rural hospitals editor withHealthLeaders Media. He can be reached atjcommins@healthleadersmedia.com.
Note: You can sign up to receive HealthLeaders Media Community and Rural Hospital Weekly, a free weekly e-newsletter that provides news and information tailored to the specific needs of community hospitals.
There are two sides to satisfaction: The first is the quality of the product or service being marketed, and the second is the level of quality the consumer expects. When the former exceeds the latter, marketers win a crucial battle.
Are you finding that your campaigns are flat-lining? A change of strategy could be just the thing you need to reconnect with your target audience. A campaign for St. Thomas Hospital in Nashville, TN, increased preference and awareness with a simple strategy and a few paper hearts. And the best part: St. Thomas didn't have to spend a lot to make it happen.
The goal of the campaign was to increase awareness and preference for St. Thomas's cardiac services and to position the hospital as the market leader. Of course, to obtain that goal St. Thomas needed a new strategy, a unique message, and it also needed to identify one point that really differentiated it and its cardiac services from the competition.
"We really like to plan our entire message around that one single point of interest," says Steve Castle, vice president of St. Thomas's agency, D S Tombras in Nashville. Through some market research the team found that St. Thomas was seeing the most heart patients out of any facility in the country. "People in the Nashville area have known I think that St. Thomas was the market leader, but I don't think they knew to what extent. This point really kind of hammered it home."
Using that strong differentiator to their advantage, the team decided to create a campaign that would focus on that message and that would deliver it in a unique and memorable way. "This market is very competitive," says Castle, "to the point where St. Thomas at the time was being out spent 2 to 1 by other hospitals in the market." The spot that was created didn't require a large investment but did manage to break through the clutter.
Featuring a downtown that the people of Nashville could relate to, the TV spot showed thousands of paper hearts raining down over the people of the city. In the background uplifting music plays while the campaign's message is delivered through a voiceover. The spot's tagline: "The hospital with heart," is shown before a shot of St. Thomas's logo and branding.
Creatively the spot is simple, yet the team found it to be remarkably effective. Though St. Thomas was being outspent 2–1, the team found that after the TV spot ran St. Thomas was preferred 2–1 over other hospitals in the region. "By using the strategy we did, we basically were able to flip the results," says Castle. Preference scores went from 50% to 56%. Overall, survey results showed that St. Thomas had a 230% increase in calls to its physician referral line and that top-of-mind awareness increased 64% over the previous year.
Kandace McLaughlin Doyle is an editor with HealthLeaders magazine. Send her Campaign Spotlight ideas at kdoyle@healthleadersmedia.com If you are a marketer submitting a campaign on behalf of your facility or client, please ensure you have permission before doing so.
