News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel

News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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Kaiser Permanente has taken the radical step of introducing a new suite of consumer-driven products called Custom Care. This is the first time, since its founding more than 60 years ago, that Kaiser Permenante is offering a health insurance plan that is not based on its staff-model HMO. For lab directors and pathologists, this is an important sign of the steadily-increasing importance of consumer-directed health plans (CDHPs) in the American healthcare marketplace.

Kaiser Permanente first launched the Custom Care products in its California region in May 2006. According to the press release from Kaiser, “This new suite of Consumer Directed Health Care products offers a range of benefit design and financial accounts options, along with online health information, decision support tools, incentive and discount programs, and access to Kaiser Permanente’s integrated delivery system. Kaiser Permanente Custom Care provides customers with additional options to actively manage their health care expenses and provides consumers with the tools to become more active participants in managing their health care services and costs.”

Based on response to the response of its test marketing of Custom Care insurance products, an emboldened Kaiser upped their stake in CDHPs by launching Custom Care HealthInvestor HSA. These plans became effective on January 1, 2007. HealthInvestor combines a Wells-Fargo-administered health savings account with a high-deductible health plan in which members pay a larger share of bills in exchange for lower premiums. Kaiser does not expect people to flock to this new plan model, but says that it is laying the ground work for the future of health care. “It’s a new business strategy for us, “said Kaiser spokeswoman Beverly Hayon in the August 14, 2006 issue of Modern Healthcare, “to be much more responsive to the marketplace in terms of what our employers need and what individual consumers are looking for.”

Laboratories should take note that, when an organization the size of Kaiser Permanente feels obligated to offer consumer-driven health care options after 60 years of offering only HMO products, other large insurers cannot be far behind. Consumers enrolled in consumer-driven healthcare plans are more likely to be highly involved in their health care and to only want the bare minimum of health care services. They are also likely to shop around to find a fair and reasonable price for such services.

Laboratories and pathology groups need to track the progress of the CDHP trend. Consumers covered under high-deductible policies and HSA plans are being educated to shop carefully for healthcare providers and to use both price and quality to guide their decisions. To be competitive and to serve the changing expectations of patients, laboratories and pathology groups will need to create services that are patient-friendly and deliver this care in a cost-effective fashion.

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