Harken Health – Betting on primary care

I just read about health insurance giant UnitedHealth’s bold but risky new insurance plan, Harken Health:

UnitedHealthcare is betting $65 million that it can profit by making primary care more attractive.

With little fanfare, the nation’s largest health insurer launched an independent subsidiary in January that offers unlimited free doctor visits and 24/7 access by phone. Every member gets a personal health coach to nudge them toward their goals, such as losing weight or exercising more. Mental health counseling is also provided, as are yoga, cooking and acupuncture classes.

At this time, Harken Health is only available in Chicago and Atlanta, to people buying health insurance on the health exchanges.

Health care analysts say Harken demonstrates the insurer’s search for a better way to provide affordable care and attract more customers. Its mission is to prove that convenient, no-cost primary care, delivered with top-notch customer service, can lower hospitalization rates and overall health costs.

“At the end of the day, United wants to know if this system can better control costs, as it’s a lot cheaper to prevent disease than treat one,” said Liz Frayer, an employee benefits consultant in Atlanta.

One of the biggest problems with typical Obamacare plans (other than really high premiums) are the high deductibles and co-pays that can make every doctor’s visit a financial strain. Rather than seeing a physician or other care provider on a regular basis, patients put off seeing a doctor until they are really sick and unhealthy.

Also, our fee-for-service health care model pays doctors to “do” something, not talk. So there is a financial incentive for them to order more tests and do more procedures, especially if their clinic owns its own lab, imaging equipment or surgery center. That’s expensive stuff that must be paid for!

Harken’s primary care physicians are on salary, which means they have no financial incentive to order unnecessary tests and gives the plan greater control over how they treat patients. Doctors work closely with teams of nurse practitioners, social workers and health coaches who follow treatment guidelines that Harken hopes will ensure more efficient care.

A huge percentage of today’s chronic health problems—diabetes, heart disease, obesity, depression, anxiety, dementia—have their roots in poor lifestyle choices.

But because the current physician practice model is to see as many patients as possible, every 5-10 minutes typically, there is very little time to discuss simple lifestyle changes, like nutrition and weight loss, stress reduction, and exercise programs that can make a big difference. This type of life coaching can’t be done in one visit, either.

Related post: The physician-patient dilemma

Another problem with Obamacare is that as plans use narrow networks to save money, and patients change plans every year to save money, the patient-doctor relationship is being undermined.

I’ve had three primary care doctors in the last five years because of changing plans and networks.

That contributes to poor continuity of care and causes patients to stop treatments or counseling, or forego screening tests and routine health visits.

Whether Harken succeeds depends on how doctors, coaches and customer service workers interact with patients, [Harken CEO Tom Vanderheyden] said.

“The secret sauce is not in rearranging the operational or financial components of health care models. It is about recreating the relationships that have been lost in the modern system, relationships that will lead to better health.

There are big parts of the health care system—Big Pharma, for one—that profit from keeping people sick (or at least thinking they are sick). The status quo won’t change without a fight.

So it’s a gamble, yes, but I hope it pays off over time and Harken Health or similar plans are established in other areas. I would love to have an insurance plan like this myself.


Frugal Nurse


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