Craig Froude Executive Vice President and General Manager

Looking Ahead:
Wellness Trends to Watch in 2010

By Craig Froude, executive vice president and general manager, WebMD Health Services

All of us operate in a dynamic industry that is influenced both by developments outside of healthcare and innovation within it. As we look ahead to 2010, we see important trends emerging in six key areas that will affect WebMD and our client organizations. We’ll touch on those trends here, and tell you how WebMD is responding to help you manage the health of your population and your organizational healthcare costs.

1. Access to care

The American Academy of Family Physicians (AAFP) is predicting a shortage of 40,000 family physicians in 2020; approximately the same time demand is expected to spike with a rapidly growing senior population. This shortage of healthcare professionals will drive changes in how we access care.

We expect to see increased use of alternative providers such as nurse practitioners to complement relationships with primary care physicians. Care givers will likely rely more heavily on technology such as web diagnostics, e-mail patient communication, e-prescribing, remote monitoring of conditions, and other “medical home” technologies to provide services to more patients.

WebMD’s online resources continue to support cost-effective access to care. The WebMD Health Record^SM, our enhanced personal health record (PHR), provides connectivity to providers’ electronic medical records, including secure messaging between doctor and patient and remote monitoring from home medical devices. Consumers, who have widely adopted mobile technologies, will soon be able to access their complete, lifelong health record at any time, anywhere in the world. This increased access supports cost-effective, appropriate care with fewer redundancies or medical errors.

2. Cost of care

We continue to see unsustainable increases in healthcare costs that are as much as five times the pace of inflation. The cost of care is being driven by an aging population combined with more sophisticated medical treatments.

WebMD is working to help individuals:

• Prevent chronic illnesses that drive costs. Through targeted awareness and behavior modification programs, we’re helping organizations place new emphasis on keeping healthy people healthy, helping those at risk of chronic conditions step down the risk continuum, and helping those with chronic conditions better manage their health.
• Select the most cost-effective treatment options. Consumers need easy access to objective quality and cost information, as well as decision-support applications that help them compare alternative treatments and discuss them with their care providers.
• Improve productivity and reduce absenteeism. According to a recent study, the financial impact of productivity loss due to the presence of health risks and conditions is even greater than the impact of medical claims.¹ Behavior modification programs can help keep people healthier and more productive. Even for those with chronic conditions, care options such as remote monitoring and e-mailing doctors for routine follow-up are more efficient, so people can be more productive.

3. Healthcare consumerism

Healthcare consumerism is a market response to converging factors such as cost, quality, and access. It has become a significant trend in industries such as banking, shopping, and now, healthcare. As part of this trend towards consumerism, we’re seeing cost-shifting to individuals through higher co-insurance and premiums. This is stimulating consumers who already think they should have the ability to choose a provider and a convenient care delivery setting to also better manage their healthcare finances.

WebMD is helping employers and health plans make the connection between individuals’ health status and their benefit structure. We provide access to complete, personalized information so people understand their health status and corresponding risks, can project their healthcare utilization, can compare options and make the best plan choices, and can budget appropriately based upon their projected healthcare utilization. As the most trusted brand of health information, we help consumers understand how they share the financial responsibility for health outcomes and give them the information they need to make better healthcare decisions. The result will be better healthcare choices that benefit both the individual and sponsoring organizations.

4. Prevention and wellness

Prevention is tied to the overall cost of care. Individual behavior drives as much as 88% of all healthcare costs.² WebMD helps organizations identify the overall risk factors of their population so they can offer specific behavior modification programs to address the most costly conditions.

Through the technologies in our health portal, we develop a personal health profile for each individual. With that, organizations can target individuals based on a wide range of factors, including risk and readiness-to-change, and then offer appropriate, timely programs such as coaching and behavior modification programs that match individuals’ needs.

We’re also driving the trend towards a more integrated, value-based approach to population health management. Historically, organizations rewarded specific activities such as completing a health risk assessment (HRA) or enrolling in a behavior modification program. Now, we support pre-population of the HRA from professional sources as well as on-site biometric screenings. Our customized programs help individuals track and monitor their progress. As a result, organizations can reward on compliance to a wellness program that is based on individuals’ profiles and success. And these rewards can be tied directly to costs through insurance premium discounts.

5. Quality of care

Today, consumers pay the same for all procedures regardless of quality or outcomes. The industry is shifting towards pay-for-performance, which will apply appropriate competitive pressures to improve outcomes and control costs.

WebMD is in the vanguard of efforts to measure care quality from the consumer’s perspective and display the results for better decision-making. With this information, individuals can choose doctors and hospitals based on the criteria that are most important to them, such as procedure volume, mortality rates, complications, and length of stay. Consumers also have access to cost information, which they can weigh against quality data.

Consistently, studies that explore the relationship between spending and the quality and outcomes of care are finding that higher spending does not result in better quality of care. This is true for the quality and reliability of hospital or ambulatory care and survival following such serious conditions as a heart attack or hip fracture. Higher spending also did not result in improved patient perceptions of the accessibility or quality of medical care and patients’ experiences in the hospital. ³

6. Government activities

Government legislation is driving U.S. healthcare reform. Spurred by federal and state legislation, efforts to reform healthcare are focusing on re-engineering the delivery system to improve quality, access, and coverage. At the same time, government stimulus funding is driving health IT investment. Significant initial technology investment has launched pilot projects to promote provider adoption, systemic efficiency, and consumer access.

The American Recovery and Rehabilitation Act (ARRA) specifies several initiatives that may encourage improvements in PHR accessibility and interoperability, and an increase in use. While health information exchange (HIE) efforts and even many electronic health record (EHR) efforts have not prioritized connectivity of the patient, there are several efforts converging to support broader connectivity between them and independent PHRs such as the WebMD Health Record. These include recent legislation that requires access for consumers to their electronic health records, and the requirements for use of specific data exchange standards.

HIEs, EHRs, and the Nationwide Health Information Network (NHIN) promise to make data more available to care providers over the next 10 years. Within these efforts, connectivity and access to information are key. The WebMD Health Record keeps the focus of care and information on the consumer, while ensuring interoperability with provider and other professional systems.

WebMD moving forward

As we head into 2010, WebMD will continue its focus on integrating health, wellness, and benefits programs that specifically target the individual. WebMD continues to lead in several principal areas:

• We are defining the standards of health information, and are involved in key organizations that are charting the future of healthcare.
• We are at the forefront of new technologies and solutions that inform, educate, and engage your employees and health plan members.
• We are constantly working to help you deliver on the promise of consumer-directed healthcare.

1. The Association of Health Risks With On-the-Job Productivity, Burton, Chen, Conti, Schultz, Pransky, Edington. JOEM. 47(8):769-777. 2005.
2. University-Purdue University, Fort Wayne (IPFW) Study, 2006.
3. The Dartmouth Institute for Health Policy and Clinical Practice. “Healthcare Spending, Quality, and Outcomes. More Isn’t Always Better.” February 2009. http://www.dartmouthatlas.org/atlases/Spending_Brief_022709.pdf.