Author - consumermed

New survey confirms employees struggle to find quality behavioral health care for themselves and their loved ones

PEMBROKE, Mass. (October 10, 2017) – As part of its ongoing series of original, proprietary research, ConsumerMedical, a leading health care decision support and clinical advocacy company, has published results of another new survey of American workers employed at mid- and large-size companies that taps into those workers’ health care concerns and needs.

This research, the fifth in a series, was based on a survey of 1,000 employees at companies across the U.S. with 500 or more employees, and revealed employees struggle to find qualified behavioral health care providers for themselves and their loved ones. Among the findings:

  • Nearly half of all U.S. employees have dealt with a mental health issue for themselves or a family member in the past 12 months.
  • Employees had to wait, on average, three weeks to see a practitioner from the time they initially sought help.
  • One in five didn’t feel satisfied with the mental health practitioner that they chose.
  • Meanwhile, nearly half of employees surveyed said their search for a qualified mental health practitioner was a distraction for them while on the job.
  • Of those who consulted EAP, more than one in five did not find it useful.
  • Over 72 percent of employees dealing with a mental health concern said it was affecting their productivity on the job.

These findings, consistent with previous research, paint a stark picture of employees struggling to find good quality behavioral health care.

“Employees with behavioral health needs are really hurting,” explains David Hines, CEO of ConsumerMedical. “And employers are feeling the pain, too.  The reality is that health care costs, such as medical and pharmacy claims, are only the tip of the iceberg for employers; they are dwarfed by the productivity, absenteeism and health care expenses that result from employees with behavioral health concerns. “

In 2015, after looking at data for over 100 employers, Mercer concluded that the mental health and substance abuse cost trend was rising at 11 percent per-member-per-year (compared to 3.5 percent for other medical issues per-member-per-year).

“All of this points to the fact that employees are in deep need of additional support finding well-qualified behavioral health professionals,” explains Hines.

About ConsumerMedical – ConsumerMedical is a leading health care decision support and clinical advocacy company serving approximately 2 million individuals through some of the nation’s largest employers, health plans and private exchanges. The company has been serving patients and payers for over 20 years. As a Medical Ally, ConsumerMedical guides participants throughout their health care journey with compassionate, high-touch support and deep clinical expertise. ConsumerMedical offers a fully integrated suite of solutions including Medical Decision Support, Surgery Decision Support, Expert Medical Opinion, Claims Advocacy and more, helping individuals and families navigate the health care system while improving outcomes and reducing costs. ConsumerMedical’s results have been validated continuously by independent actuaries. More information is available at www.consumermedical.com.

In the News: IBM Watson has Long Way to Go on Cancer Care

Artificial intelligence solutions for cancer care are clearly in their infancy stage, according to a new STAT investigation. When fewer than 35% of physicians agree with the case recommendations, it’s a clear sign that the human intuition doctors provide, through which they are able to account for all factors, nuances and subtleties, has not been duplicated by AI just yet.  Farther down the road, once more actual patient experience and outcomes can be meaningfully integrated and considered, then perhaps AI’s potential to advance oncology medicine can begin to have beneficial impact.  Until then, patients are advised to do their homework and partner with their doctor. Read the full STAT report here.

New Research Finds Popular Online Doctor Review Sites Don’t Help Patients Find High-Quality Doctors

PEMBROKE, Mass. (June 7, 2017) – New research conducted by ConsumerMedical, a leading health care decision support and concierge company, has found that the vast majority of top-rated specialty physicians on YELP, Vitals and Healthgrades  aren’t the highest ranked physicians when it comes to examining actual performance data related to their medical specialty.

ConsumerMedical identified the top 10 ranked physicians across five common specialties in New York, Chicago, and Los Angeles on the three popular patient review websites. They then compared these lists to a list of the 10 physicians with the highest quality scores (by specialty) in these same cities. The second list was generated by ConsumerMedical using more than 5 billion data points at the procedure level that measure physician performance on variables such as: patient readmission rates; surgical infection rates; average length of stay; procedure volume; and patient outcomes. Only 2 percent of physicians who showed up as top 10 ranked on the popular websites also showed up as top performers when examining actual quality metrics.

“This research confirms what we have long suspected,” explains David Hines, CEO of ConsumerMedical. “Online patient reviews tend to reflect a patient’s care experiences, such as the physician’s bedside manner.  While these attributes are important, they are simply not the main indicators of a physician’s overall quality; sadly you can have a very kind orthopedic surgeon whose patients have hospital readmission rates that are through the roof.”

Online patient reviews typically focus on attributes like a physician’s bedside manner and availability, as well as other factors like the location of the office and punctuality in scheduling. Several studies show that most consumers aren’t fully aware that physician quality matters and varies significantly depending on specific skills, experience, and a variety of other factors.

“Getting care from a high-quality physician can literally be a matter of life and death,” says Hines. “This absence of consumer-friendly tools that help the public understand that quality matters, and that offer them meaningful quality information so they can choose a high-quality physician, is very problematic.”

A growing number of Americans are using online patient review sites to find a physician. For example, a recent survey suggested that 62 percent of patients use online reviews as the first step to find a new doctor, while 19 percent use online reviews to validate their choice before making a first appointment.

“All of this reinforces what we keep saying: health care consumers need more support to help them navigate the system and get the best care,” says Hines.

 

About ConsumerMedical – ConsumerMedical is a leading health care decision support and concierge company serving approximately 2 million individuals through some of the nation’s largest employers, health plans and private exchanges. The company has been serving patients and payers for over 20 years. As a Medical Ally, ConsumerMedical guides participants throughout their health care journey with compassionate, high-touch support and deep clinical expertise. ConsumerMedical offers a fully integrated suite of solutions including Medical Decision Support, Surgery Decision Support, Expert Medical Opinion, Claims Advocacy and more, helping individuals and families navigate the health care system while improving outcomes and reducing costs. ConsumerMedical’s results have been validated continuously by independent actuaries. More information is available at www.consumermedical.com.

ConsumerMedical Appoints Health Care Expert James K. Foreman to its Board of Directors

PEMBROKE, Mass. (May 23, 2017) – ConsumerMedical, a leading health care decision support and concierge company, has announced the appointment of James K. Foreman to its Board of Directors.

“We are so pleased to have Jim join our team. He has tremendous experience in our industry and a great strategic mind. He will be of significant help to us as we prepare for accelerated growth,” says David Hines, CEO and founder of ConsumerMedical.

“Having spent my career focusing on figuring out ways to make the healthcare system easier to navigate I am thrilled to join the Board of ConsumerMedical,” says Foreman. “Consumer Medical has a track record of working to ensure the ultimate consumer of healthcare—the patient—has access to all of the information and support necessary for making medical decisions that are right for them. I am looking forward to working with the management team and the other board members to ensure success for all constituents of ConsumerMedical.”

Foreman is currently a Senior Advisor at Lightyear Capital and Century Equity Partners. He spent three decades as a consultant, starting at Towers Perrin, which became Towers Watson, now Willis Towers Watson. In his most recent role there, he led their exchange solutions segment, which included the acquisition of Extend and Liaison. When the organization was still Towers Perrin, Foreman was Managing Director for Global Health and Welfare.

Foreman was also Executive Vice President of National Accounts, Global Benefits, Group Insurance and Government, Labor and Medicaid for Aetna, where he managed a $13.1 billion P&L with 11,000 associates.

He began his early career as a Senior Employee Benefits Representative for the company when it was still Aetna Life and Causality.

Foreman has a B.A. from UCLA in Business and Economics and a degree from the University of Melbourne in International Business. Married with three children, he has served on numerous boards, including for the Joffrey Ballet and the Employee Benefits Research Institute.

About ConsumerMedical – ConsumerMedical is a leading health care decision support and concierge company serving approximately 2 million individuals through some of the nation’s largest employers, health plans and private exchanges. The company has been serving patients and payers for over 20 years. As a Medical Ally, ConsumerMedical guides participants throughout their health care journey with compassionate, high-touch support and deep clinical expertise. ConsumerMedical offers a fully integrated suite of solutions including Medical Decision Support, Surgery Decision Support, Expert Medical Opinion, Claims Advocacy and more, helping individuals and families navigate the health care system while improving outcomes and reducing costs. ConsumerMedical’s results have been validated continuously by independent actuaries. More information is available at www.consumermedical.com.

ConsumerMedical Enters into Agreement with CoreTrust for Medical Decision Support Services

PEMBROKE, MA (March 14, 2017) – ConsumerMedical, a health care decision support and concierge company, announced that it has signed an agreement with CoreTrust, a group purchasing organization for large corporations and private equity firms, to support the employee health care needs of CoreTrust’s member companies.

ConsumerMedical serves as a Medical Ally to member organizations, helping their employees make better-informed medical decisions and find quality health care, including physicians and hospitals. The company uses its Five Drivers of Quality™ model to help patients make informed decisions and receive evidence-based care and longitudinal support for their entire health care journey.

“We’re happy to bring our clinical expertise to this collective of organizations in order to help employees of CoreTrust and HealthTrust member companies make informed decisions and receive quality health care,” says Kevin Kickhaefer, Chief Revenue Officer for ConsumerMedical.

By helping employees make better-informed decisions and receive their care from quality providers, ConsumerMedical helps companies manage their spend on health care services. In addition, employees may enjoy better health outcomes and feel more confident in their health care decisions.

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About ConsumerMedical – ConsumerMedical is a leading health care decision support and concierge company serving approximately 2 million individuals through some of the nation’s largest employers, health plans and private exchanges. As a Medical Ally, ConsumerMedical guides participants throughout their health care journey with compassionate, high-touch support and deep clinical expertise. ConsumerMedical offers a fully integrated suite of solutions including Medical Decision Support, Expert Medical Opinions, Claims Advocacy and more, helping individuals and families navigate the health care system while reducing unnecessary elective surgeries and driving patients to the highest quality providers. More information is available at www.consumermedical.com.

About CoreTrust – CoreTrust (www.coretrustpg.com) serves an exclusive membership of select private equity firms and Fortune 1000 companies. A division of HealthTrust—the healthcare industry’s leading group purchasing organization—CoreTrust leverages its purchasing volume along with that of HealthTrust members to achieve market-leading pricing for a portfolio of contracts in more than 100 indirect spend categories including human resources employee benefits. This unique and highly compliant business model affords most members double-digit savings across all categories.

ConsumerMedical Announces Partnership with MD Insider to Enhance Identification of Top Physicians

PEMBROKE, MA (January 10, 2017) — ConsumerMedical, a leading health care decision support and concierge company, announced today a strategic partnership with MD Insider, a leading health care data and technology company, that will enhance their ability to recommend the highest quality physicians in the country to individuals.

ConsumerMedical serves as a trusted Medical Ally to employees and health plan members, helping them make better-informed medical decisions and finding the best care, including physicians and hospitals. A key feature is the company’s longstanding ability to identify and match the highest quality providers to individuals, using a combination of data and real-time, personalized research based on the patient’s needs and preferences. With MD Insider’s ability to analyze over 4 billion clinical data records, ConsumerMedical will be able to further identify and recommend the very best physicians in the country from among a pool of 850,000 practicing doctors and 6,000 hospitals. Moreover, using MD Insider data, ConsumerMedical will be able to assess physician quality not just at the specialty level but at the procedure level—the most cutting edge quality assessment currently available. The partnership will also enhance ConsumerMedical’s ability to recommend physicians to patients based on features like availability, location, hospital affiliation, and insurance.

“This is a very exciting partnership,” says Sue Lewis, Chief Product and Strategy Officer for ConsumerMedical. “It is the powerful blend of sophisticated data and analytics, and technology with personalized, high-touch support and coaching. When the member calls in, our support specialist can serve as a trusted guide, while matching the participant’s needs using the most current, data-driven review of physicians’ performance in the country.“

MD Insider’s proprietary algorithm looks at data points such as procedure volume, readmission rates, and complication rates to develop a total picture of physician quality. If the employer or health plan uses a Centers of Excellence or High Performance Network strategy, ConsumerMedical can also recommend physicians practicing within those quality strategies.

“We’re excited our data and algorithms will be able to help ConsumerMedical’s 2 million members get better care,” says David Norris, CEO of MD Insider.

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About ConsumerMedical ConsumerMedical is a leading health care decision support and concierge company serving approximately 2 million individuals through some of the nation’s largest employers, health plans and private exchanges. As a Medical Ally, ConsumerMedical guides participants throughout their health care journey with compassionate, high-touch support and deep clinical expertise. ConsumerMedical offers a fully integrated suite of solutions including Medical Decision Support, Expert Medical Opinions, Claims Advocacy and more, helping individuals and families navigate the health care system while reducing unnecessary elective surgeries and driving patients to the highest quality providers.

About MDInsider MD Insider is an innovative healthcare technology company that uses big data to provide a Physician Performance Transparency solution, which is fully integrated into a consumer-friendly physician search, match, and scheduling solution that better matches patients with the right doctors.