Paduda: What's Really Important in Health Plans

Tuesday, October 18, 2022 | 0

If your health plan could show:

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  Joe Paduda

  That it reduced the number of days kids stayed home from school due to illness.
• That it helped members with mental health conditions maintain a high level of functionality and engagement.
• That it reduced workdays lost due to illness.
• That it sped recovery from illness and injury.
• That it helped amateur athletes avoid injury and recover quickly.

Would that be important?

Heck yes.

So, why don’t health plans do that? It’s doable — if they stop focusing on and worrying so much about star ratings, patient experience and net promoter scores, which research shows consumers don’t really pay attention to or care about.

What if health plans focused on what consumers really care about: staying healthy and able to do the things we want to do? Such as:

• Play with our kids and grandkids.
• Do chores around the home.
• Do our sports.
• Shovel our walks, rake leaves, coach youth sports.
• Lift stuff and move it around.
• Get to the bathroom without help.
• Dress and undress without help.
• Go for a walk.
• Oh, and work.

What’s even more puzzling is why employers don’t demand that health plans compete on the basis of delivering fully functional, engaged workers.

What does this mean for you?

The most important component of any organization is its workers. No employers hold their health plans accountable for ensuring that those workers can actually, you know, work.

And that is why our health care system is so dysfunctional, ineffective and expensive.

Joseph Paduda is co-owner of CompPharma, a consulting firm focused on improving pharmacy programs in workers’ compensation. This column is republished with his permission from his Managed Care Matters blog.