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Insurers offer expansions to consumer-driven health care

UnitedHealth Group's "all-in-one" magnetic stripe identification card allows real-time benefits checks and claims adjudication. Meanwhile, WellPoint expands its HSA initiative to all members.

By Jonathan G. Bethely — Posted Sept. 11, 2006

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UnitedHealth Group says it is making it easier for physicians to get paid more promptly by offering patients a new identification card.

Minneapolis-based United says the card will enable doctors to instantly verify patient eligibility, access online personal health records and debit financial accounts tied to consumer-driven health plans.

The magnetic stripe identification medical cards, which are scheduled to be available beginning next year to members in any of United's health plans, will provide confirmation of the patient's up-to-date benefits.

Also, through information tapped from United's banking service, Exante, the cards can be used to debit a patient's health savings or flexible spending account while the patient is still in the doctor's office, said Daryl Richard, a spokesman for Uniprise, United's consumer-driven care unit.

By the time the magnetic stripe identification cards are rolled out to consumers, the insurer also will have rolled out its real-time claims adjudication capability, Richard said.

Real-time claims adjudication, in which physicians can find out during the visit how much the insurer will cover, is being tested in Rhode Island. Humana introduced real-time claims adjudication earlier this year.

Some physicians say United's card is a step toward making it easier for payment to be collected at the point of service. But on the clinical side, physicians are skeptical about how United will protect patient privacy.

"We are supportive of it with some caution about protecting privacy and confidentiality," said Teresa Devine, director of health care finance for the Texas Medical Assn. "Anytime an insurer can make it easier for the patient to pay at the time of service, it's a good thing."

Richard said all health-related information attached to the card is available in a HIPAA-compliant format. Similar to other medical swipe card technology, no one would be able to access a patient's medical record without first entering the appropriate identification number.

"It isn't a stored value card," Richard said. "There's no fear that the card can be stolen and used to access the information."

Using the card, doctors will be able to access a patient's list of medications, diagnoses, test results and other services for which United has paid, Richard said. Patients also can augment their personal health records by adding details such as allergies, immunizations and family history.

United also says patients will be able to apply for a line of credit to cover costs when their health savings or flexible spending account doesn't have enough funds.

The line of credit is a loan, so patients will pay interest, Richard said, which he expects will be set at or slightly above the prime rate.

Meanwhile, WellPoint is expanding its consumer-directed health plans. Currently the Indianapolis-based insurer offers consumer-directed plans to employees of large national companies and individual plans geared toward the 20-something market. But starting on Jan. 1, 2007, WellPoint will make such plans -- which combine a high-deductible health plan with a tax-free health savings account -- available to any of its 34 million members.

Advocates of consumer-directed health plans say they hope WellPoint's move -- as well as United's -- will expand the popularity of those plans. Some surveys show around 3 million Americans enrolled in HSA-eligible high-deductible plans, with analysts expecting 10 million or so enrollees in the next five years. But that still is a small percentage of the overall insured. Also, those Americans don't necessarily have the health savings account component appended to their plan.

"There has been a lot of interest expressed, but the people haven't shown up," said Alwyn Cassil, spokeswoman for the Center for Studying Health System Change, a Washington, DC-based organization. "When employees are offered a choice of a consumer-directed health plan next to a traditional PPO, the take-up has not been that great."

About 700,000 of WellPoint's members are enrolled in consumer-directed health plans, up 30% since 2005.

While the AMA has come out in support of consumer-directed health care, the AMA House of Delegates also approved a report at its 2006 Annual Meeting directing the Association to closely monitor any pricing "transparency" initiatives by health plans to ensure that plans provide accurate information and to assess the impact of those initiatives on physicians.

WellPoint has not yet announced a major real-time claims adjudication initiative.

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