The latest goal for managed-care plans anxious to inspire enrollee loyalty is to top the customer-satisfaction charts by providing loads of health and wellness information.
The target is a new breed of consumer-dubbed "information seekers"-who pursue information they can use in healthcare decisionmaking. And they go wherever they can to find the data, from newspapers and magazines to cyberspace. They also expect their health plans and healthcare providers to deliver more information.
These consumers "are more demanding and have higher expectations" than past generations, says Bob Mayo, a senior vice president at the Sachs Group, an Evanston, Ill.-based healthcare information company that tracks consumer attitudes about managed-care plans.
A competitive edge. Because of the consumer pressure for more and better information, health plans "have to do more than they've done in the past," Mayo says.
Sachs officials say that delivering the information will be a central strategy to attract and retain consumers. It also will be a key way for health plans to differentiate themselves in highly competitive markets.
This year's Sachs survey, the fourth-annual attempt to tackle consumer satisfaction with managed-care plans, focused on links between loyalty to plans and health/wellness information. The findings are based on responses from 34 markets (See chart). The survey tracked more than 140 health plans and studied responses from about 100,000 consumers who were enrollees in health plans.
Consumers filled out questionnaires rating health plans in their local markets. Responses were made on a 1-to-5 scale, with 1 representing "poor" and 5 "excellent." Sachs has used the same methodology since the survey's inception in 1995.
Health plans that ranked highest in their local markets in both loyalty and wellness education were named to Sachs' 1999 HMO honor roll; those that excelled in one of the two categories were awarded a seal of excellence (See charts, this page and p. 58).
Nearly half, or 47%, of the consumers surveyed for this year's survey were classified as information seekers, who are more likely than other enrollees to search actively for information about health plans, doctors and hospitals.
"What's glaringly clear is that the consumer is playing a bigger role in the healthcare arena," Mayo says. Because more patients are better informed, they are taking a more proactive role in decisions about their care, he says.
For health plans that adjust to the needs of this brave new information-age segment, "there's an opportunity to engage enrollees to a significant degree," Mayo says.
Among the most productive ways to reach these consumers is providing the information via direct mail and the Internet, according to Sachs.
But less-adaptive health plans risk losing enrollees to savvier competitors. Depending on the market, attracting an enrollee can cost $700 to $1,300, so high attrition is costly to health plans.
Hard to please. Adding urgency to the challenge, Sachs notes that information-seeking consumers also are less likely than other enrollees to be loyal to a particular health plan. And since many of the financial benefits of health education and wellness programs are long- term, a health plan stands to make big gains if it can foster loyalty and thus reduce the rate of disenrollment.
According to this year's survey, HMO enrollees are more satisfied with the wellness information they receive from their health plans than are people covered by PPOs or point-of-service and fee-for-service coverage.
But overall, consumers are considerably less satisfied with the health and wellness information than with other aspects of health plan service, including customer service, overall value, physician office experiences, access to care and information about benefits.
Those findings give health plans an incentive to reach out to the information seekers, Mayo says. But it also suggests trouble ahead for managed-care organizations that fail to do so.
"What you need to do to keep the consumer loyal is changing," Mayo adds.
The good news, Sachs officials say, is that providing health and wellness information can reduce the demand for healthcare services-and consequently boost the bottom lines of health plans and the employers that pay many of the bills.
Sachs cites an Oct. 8, 1998, study in the New England Journal of Medicine that compared three ways of treating patients with chronic back pain: physical therapy, chiropractic manipulation and an educational booklet provided to patients.
Over two years, the study discovered that patients who received physical therapy or chiropractic treatment had outcomes that were only "marginally better" than did the patients who received the booklet. And the mean cost of care for the group receiving the booklet was less than half that of the other treatments.
The study suggests that informed consumers are more likely to use health services wisely, which benefits the individual, the health plan and the patient's employer.
In the long run, health-conscious employees cost less to insure and are more productive in the workplace, a double bonus for employers, Sachs researchers say.
Informed consumers also are more likely to have health-promoting habits, according to the Sachs study, including:
* Exercising frequently.
* Seeing a primary-care physician or obstetrician regularly.
* Going to a specialist when necessary.
* Getting routine exams, Pap smears, mammograms, cholesterol tests and other screening procedures.
Health plans also benefit because health and wellness education programs that focus on prevention and early diagnosis are needed to comply with next year's Health Plan Employer Data and Information Set (HEDIS 2000) quality guidelines.
All the data from this year's study haven't been analyzed yet, so Sachs is still developing a detailed profile of these "information seekers" and the differences between them and other enrollees. But their numbers are significant, so meeting their needs is critical, Mayo says. Health plans that don't respond to consumers' demand for more information and their desire for greater participation in healthcare decisionmaking are likely to pay a high price, he warns.