The Metrics of Member Outcomes: A New Compensation Model

The Metrics of Member Outcomes: A New Compensation Model

As costs associated with health care continue to be a hot button issue for consumers, healthcare organizations and national politics, a recent decision by a large healthcare payer has sent repercussions throughout the industry regarding the best way to keep customers engaged in programs to keep them healthy.

Humana Decision

Humana, based in Louisville, Kentucky, recently announced a new compensation model for their executives, where 20 percent of their executive bonuses will be tied to consumer health metrics, including risk assessments, participating pharmacy use and even participation in a program that rewards members for engaging in healthy activities.

A Shift in Thinking

This change in compensation policies is a sign of change for healthcare organization leadership  to encourage more proactive thinking in how consumers interact with the company that is responsible for their healthcare, while encouraging both payers and providers, as stated by Humana spokesman Tom Noland, “to help focus on increasing the levels of participation by our members in various programs and services proven to improve health outcomes and lower the cost of care.”

Boosting Overall Health

For healthcare payers and consumers, the idea to work together to create an environment where healthcare payers have healthier members and consumers have more opportunity to stay healthy offers advantages for both sides. Healthcare organizations can work to create risk assessments for new patients to determine clinical program needs, develop additional programs to help patients manage chronic conditions and deploy the use of personalized member pharmacy mobile and secure portals to assist with following medication regimens.

Consumers will also have opportunities to be rewarded for behaviors that help improve their overall health. Following medication regimens, enrolling in and following healthy living support programs p and using company sponsored member portals could lead to reductions in overall medical care costs, and to improvements in the quality of life for many people.

Taking the Next Steps

A number of healthcare organizations will be watching this program to see the long term effects on the industry. As more pharmaceutical and medical device organizations look to offer something close to a “money-back guarantee” on their products, it will become increasingly important to confirm that consumers are either taking their medications or using the recommended medical devices on a consistent basis, thereby supporting the promise of better patient outcomes.

For these organizations, it is vitally important that they reach consumers with effective messaging, benefit information, prescription refill reminders, wellness program results, and support the consumer with personalized reporting that measures their progress. RxEOB’s member-focused software applications  are designed to offer continuity, engagement and reporting for both healthcare organizations and consumers to reduce healthcare costs and to increase care quality, which are the key metrics these new value-based payment models.

To learn more about the RxEOB business and how it can assist your healthcare organization, contact us at 888-648-0989 ext. 226 or email us at info@rxeob.com.