WellNet Healthcare Lowers Your Company's and Employees' Health Care Costs

Claims data still a secret weapon in care, cost containment

2009-10-07T07:27:00.000-07:00

October 1, 2009 | Ken Krizner , Managed Healthcare Executive

The most potent weapon in the campaign to control costs—until EMRs reach critical mass—might be claims data. All the pertinent information is found there, including the provider, type of treatment or procedure, prescriptions, as well as the cost of service for the plan, sponsor and member.

While that information is useful, it only scratches the surface of what claims data can tell health plans and payers about their members. By accessing electronic claims data, health plans can mine, analyze and download information about members individually or collectively. This data can be used to determine which members are at risk for specific health issues and inform disease management program design to help them before the event occurs.

"So much of the information that would tell a plan what is driving the cost of healthcare is either unavailable or late," says Keith Lemer, president of WellNet Healthcare in Bethesda, Md. "What winds up happening is you don't get to the root cause of the problem—what is driving costs and what type of action can be implemented on the appropriate segment of the population to keep those costs down."

Click here to view the whole article

Mission Critical

2009-10-06T10:06:00.000-07:00

October 6, 2009 | Brett Chase , Portfolio.com

Fed up with rising health costs, CEO Lewis Dickey of radio-station owner Cumulus Media has used software from WellNet Healthcare to identify $4.1 million in potential savings.

Chief executive Lewis Dickey is taking an unusual step toward tackling health care costs: He's taking charge of the matter himself.

The head of Atlanta-based radio-station owner Cumulus Media Inc. scours data to learn what drives cost increases. Fed up with his human resources department's inability to halt runaway costs, he personally took over analyzing health care trends for his 3,500 employees.

Most CEOs delegate such tasks. But technology is allowing top managers such as Dickey to get more involved. He uses a software system from WellNet Healthcare in Bethesda, Maryland, that tracks pharmacy claims on a daily basis, helping him size up and manage health care costs. WellNet helped him identify $4.1 million in potential savings for Cumulus. One way to save: using nurses to counsel employees at high risk for health problems in the hopes of reducing hospital visits. WellNet also saved the company $400,000 by negotiating prescription-drug pricing and is identifying ways to save more money by switching employees from branded medicines to cheaper alternatives.

"The more time I spend with it, the amount of inefficiencies become very apparent," Dickey says. "Most of this does not make its way to the C-level. It's handled at human resources. I think that's a big mistake today."

Surging health insurance costs are a challenge for companies big and small. The average family premium for all employer-based health plans is $13,375, up 34 percent from five years ago and up 131 percent from 10 years earlier, according to Kaiser Family Foundation. Another group, Business Roundtable, predicts premiums will rise to almost $30,000 a year a decade from now unless health reform is passed.

As high as health care costs are today, they would be even steeper if companies weren't using data to help develop programs to combat costs, says one industry expert.

"It would be unimaginable to not have this analytic capability," says Helen Darling, president of the National Business Group on Health. "It would be a little like not having financial statements."

Despite the increasing frequency of upward premiums, there are companies that buck the trend. Some even hold their health insurance costs in check, says Michael Miele, president of the Princeton, New Jersey-based Healthcare Analytics division of insurance broker Arthur J. Gallagher & Co.

"Almost every one of them will tell you that they started with a deep base of analytics," Miele says.

Miele's group looks for clues to rising costs by studying hospital admissions, prescription patterns, and medical management cases. Miele tries to save companies money by challenging a company's health care vendors when a problem is detected.

Some companies are turning to vendors like WellNet, which creates programs aimed at simplifying information so even CEOs who can't maintain a full-time focus on the health care problem can quickly understand what's driving higher costs.

Michael McBride, CEO of nursing-home operator HMR Advantage Health Systems of Easley, South Carolina, says in years past he relied on data provided by insurance brokers that was cumbersome and not as easy to understand.

"They were just basically a messenger for the carriers with no efforts made toward claims management," McBride says. "I just knew we couldn't sustain 18 to 19 percent increases a year when the revenue stream was going up 3 percent a year."

Like Dickey, McBride turned to WellNet.

Using pharmacy-claim data, WellNet identified 379 of 1,900 HMR employees as high- or moderate-risk for health problems. A high number were identified as having high blood pressure and other health issues. With their permission, WellNet's nurses reached out to 132 of those employees and found some were not taking prescribed medicines or following up with doctors about medical issues.

WellNet lowered McBride's company health costs by $1.8 million from the year prior by changing employee health practices through counseling. The savings came from fewer visits to the hospital, especially the emergency room.

WellNet found a way to save money on employees' prescription-drug costs too. It studied HMR's drug spending and found the cholesterol drug Lipitor was costing the company on average $466 per employee each year. So WellNet suggested that HMR try switching employees over to an older, cheaper drug by offering to pay for that medication for three months. Twenty of the 48 Lipitor users ultimately converted to the cheaper medicine, which will save HMR around $5,000 a year. WellNet says there are at least 30 other drugs HMR employees are taking that can be replaced with cheaper or generic alternatives.

"We're self-funded. The only way you can control costs is through reduced claims or manage the claims you have," McBride says. "Our attempts are to drive people to more healthy lifestyle with some coaching and managing."

WellNet President Keith Lemer says top managers should get involved with health care oversight. Chief executives and chief financial officers understand the economics of ordering paper better than they understand major expenses like health care costs.

"If they want to control it, they have to take control," Lemer says.

Dickey concurs. "I could immerse myself in office supplies, and in 15 minutes I could have a knowledge about that," Dickey says. "It's a simple thing to jump into. But understanding health insurance is different."

WellNet Reports $350 Million in Customer Savings

2009-09-28T11:26:00.001-07:00

Amidst Rising Costs and Legislative Uncertainty, WellNet Customers Take Control of Healthcare Expenses Now

Bethesda, MD – September 29, 2009 — WellNet Healthcare, a healthcare technology company that enables companies to better manage their healthcare costs, today announced that it has helped client companies realize $350 million in healthcare expense savings.

Savings from more than 250 companies across the U.S. comprise the $350 million, which has been achieved through solutions within WellNet’s Point to Point Healthcare® (P2P) platform. P2P supports shared responsibility between plan sponsors, consultants, members and providers to manage healthcare and the risk mitigation of costs in a simplified collaborative environment. Leveraging Rx and medical data, P2P empowers businesses, for the first time, with real-time insight into their current health plans and provides accurate, actionable information to manage their healthcare expenses as they fiscally manage every other aspect of their business. Increased visibility and information validation helps not only improve outcomes but to lower medical benefit costs substantially every year.

According to the Kaiser Family Foundation’s “Employer Health Benefits 2009 Annual Survey: “40 percent of employers plan on increasing out-of pocket expenses for workers; about the same are raising annual deductibles and the prescription drug payments; 9 percent plan on tightening eligibility and 8 percent said they plan on dropping coverage completely.”

Bucking this trend, organizations such as Cumulus Media, Dewberry and Council Rock School District have all proactively saved $3 million or more partnering with WellNet.

Michael McBride, CEO of HMR Advantage Health Systems, shares similar success saving $1.8 million. "I told my VP of HR this past year that I wanted something that gave me control of my healthcare expenses, not the same 18 percent increase that then gets knocked down to 12 percent. WellNet has nailed it. I’ve never seen anything like P2P before."

A September 19, 2009 report by Business Roundtable, an association of chief executive officers of leading U.S. companies, finds that “annual per employee health care costs will triple to nearly $29,000 over the next decade without significant marketplace reforms that reduce costs, expand coverage and improve delivery.”

“The annual procurement process of shopping for healthcare and placing vendors on a spreadsheet is not working and proposed healthcare legislation will not take effect for years,” said Keith Lemer, president of WellNet Healthcare. “We are proud to be delivering new and innovative technology solutions right now to better manage health plans, drive down plan spending and more proactively involve plan sponsors as well as members.”

You Have No Idea What Health Costs; If You Did, You Might Just Want Real Reform

2009-09-21T09:03:00.000-07:00

September 20, 2009 | Ezra Klein , The Washington Post

Washington, D.C. -- The most important health-care document released this week was not Sen. Max Baucus's Healthy Future Act. It was the Kaiser Family Foundation's 2009 Employer Benefits Survey.

While the proposal by Baucus, chairman of the Senate Finance Committee, outlines a direction for policy, the survey, which polls employers about health benefits to assemble a detailed look at the actual cost of health care, fits it squarely in our pocketbooks.

The truth is we all pay, and much more than we recognize, for health care.

Click to view the full article

Keith Lemer: Health Care Needs Competition, Transparency

2009-09-11T12:41:00.000-07:00

September 10, 2009 | Keith Lemer , Business Week: In Your Face

BETHESDA, MD -- Reader Keith Lemer Writes: President Obama did an excellent job sharing his ideas and beliefs about the health care system and changes last night. Unmentioned details that are imperative to discuss, however, are transparency, employer and employee engagement, transportable medical records and increased competition. Wrapped around the removal of impediments to competition, all of the above will allow the private market to thrive. The call for increased accountability on the part of the nation's businesses requires more than a mandate to insure -- give cost-cutting technology to the entities paying the bills, as they have the greatest motive to find waste, overcharging, lower prices and alternative medical solutions. The end result of this is that the private market will force the insurers to be competitive. When transparency and alternatives are absent, consumers suffer from higher prices, fewer services and less choice - which is where we stand right now.

Mr. Lemer's comment was in response to the Obama: 'The Time for Bickering Is Over' article written by Catherine Arnst on September 9, 2009.

George Pantos: Charles Krauthammer's Article on The Great 'Prevention' Myth Does Not Tell the Whole Story

2009-09-02T07:15:00.000-07:00

August 16, 2009 | George Pantos, Esq., Former Washington General Counsel to Self-Insurance Institute of America (SIIA), MyHealthGuide Newsletter

BETHESDA, MD -- Charles Krauthammer wrote the article, The Great 'Prevention' Myth, that was published on August 14, 2009 in the Washington Post. The article states that "President Obama has lost the health-care debate... Accordingly, Democrats have trotted out various tax proposals to close the gap" such as prevention as saving heath care costs.

"This inconvenient truth comes, once again, from the CBO. In an Aug. 7 letter to Rep. Nathan Deal, CBO Director Doug Elmendorf writes: 'Researchers who have examined the effects of preventive care generally find that the added costs of widespread use of preventive services tend to exceed the savings from averted illness.'"

"The fallacy here is confusing the individual with society. For the individual, catching something early generally reduces later spending for t hat condition. But, explains Elmendorf, we don't know in advance which patients are going to develop costly illnesses. To avert one case, "it is usually necessary to provide preventive care to many patients, most of whom would not have suffered that illness anyway." And this costs society money that would not have been spent otherwise.

"...a rigorous study in the journal Circulation found that for cardiovascular diseases and diabetes, 'if all the recommended prevention activities were applied with 100% success,' the prevention would cost almost 10 times as much as the savings, increasing the country's total medical bill by 162%. That's because prevention applied to large populations is very expensive, as shown by another report Elmendorf cites, a definitive review in the New England Journal of Medicine of hundreds of studies that found that more than 80% of preventive measures added to medical costs.

"... prevention is not, as so widely advertised, healing on the cheap. It is not the magic bullet for health-care costs. You will hear some variation of that claim a hundred times in the coming health-care debate. Whenever you do, remember: It's nonsense -- empirically demonstrable and CBO-certified."

George Pantos Responds

Mr. Krauthammer's premise is that preventive health care increases medical cost. He concludes that the added costs of preventive services such as clinical screenings exceed the savings from averted illnesses. However, his analysis is incomplete because he fails to note that prevention also can occur thru inexpensive (often free) individual risk profiles such as Health Risk Assessments (HSAs) that can detect a propensity for future problems before illness occurs. Based on completion of simple yet in-depth questionnaires , such non-laboratory related screenings can serve as a harbinger of problems related to cost drivers such as obesity and smoking which add nearly 80 billion dollars in cost to the nation's health bill.

Employer sponsored wellness programs are successful market-based examples of prevention (intervention) that is working without adding to medical costs. Predictive modeling and data analytics also show early promise in preventing illness and reducing health costs--without the expenditure of a single dime in government spending. Predictive technology ( the ACG System) developed by Johns Hopkins University, one of the world's most respected academic and medical research institutions, permits early identification of health risk based on analysis of already available claims data.

While clinical screening is valuable in detecting disease and can be costly, prevention that detects disease before it occurs is a "priceless" way to avoid expensive treatment while lowering costs and improving individual health .A 2009 Report from the Health Research Center refers to a Miliken Institute Report noting that savings from modest improvements in risk factors such as unhealthy behaviors could bring about 40 million fewer cases of chronic disease and reduce economic costs by $1.1 trillion annually in treatment costs and productivity by 2023. So much for the "myth".

Cost Control Lost Amid Public Option Debate

2009-08-25T10:49:00.000-07:00

August 24, 2009 | Eliza Krigman , The National Journal

BETHESDA, MD Amid an August dominated by debate over the "public option," WellNet, a health technology company, maintains that the conversation is overlooking a critical variable: cost control.

The key to clamping down on health care costs will be increased transparency and information, said WellNet President Keith Lemer. Lemer's company creates software tools that help employers manage and understand their health care costs and advocates for two measures that would increase transparency and competition: leveling the playing field and unbundling benefits.

Leveling the playing field would mean eliminating "most favored nations" (MFN) clauses. Under MFNs, a health care provider cannot offer a lower rate than it does to the dominant insurer. To "unbundle benefits," employers would purchase medical and pharmaceutical coverage separately, resulting in greater clarity of the costs between the two. Presently, employers often purchase medical and pharmacy coverage together, hence the reason most people use the same insurance card at the doctor's office and at the pharmacy.

Before passing any major legislation, Lemer hopes lawmakers will take a step back to make sure they are addressing the root of problems with health care costs, not just expanding access.

WellNet Launches P2P Platform for Healthcare Consumers

2009-07-14T15:18:00.000-07:00

July 14, 2009 | Eric Wicklund, Managing Editor, Healthcare IT News

BETHESDA, MD – WellNet Healthcare is targeting the Web 2.0 movement with the release of Point to Point Healthcare, described as a “Facebook-like social networking platform” for healthcare consumers.

P2P, developed by the Bethesda, Md.-based company’s Healthcare Interactive subsidiary, creates a secure Web 2.0 platform from which consumers can manage their healthcare. It includes tools, a communication wall to allow the user to interact with healthcare providers, a pass-through version of the consumer’s electronic medical record (which can be posted on Microsoft’s HealthVault and Google Health, among others), and a view of prescription medications that includes potential substitutes and links to telemedicine, care management and wellness services.

P2P is designed to complement WellNet’s Active Reporting System (ARS), an application for plan sponsors and employers. Launched late last year, ARS is designed to provide aggregated, unidentifiable employee healthcare data in a real-time, secure dashboard, giving employers a comprehensive view of the effectiveness of their health plan. The two applications round out WellNet’s Healthcare Performance Management (HPM) software suite.

“America’s current health system is mired by disjointed, untimely and hard-to-find information, hidden profit centers and monopolies in some markets. Those using and paying for healthcare, whether employers or consumers, are saddled with its inefficiencies and exorbitant costs,” said Keith Lemer, president of WellNet Healthcare, in a press release. “The revolution in healthcare won't be in electronic medical records, but in using technology like P2P and ARS to find out how to cut costs to make service more affordable. WellNet’s HPM solution increases the transparency and the flow of information to both the consumer and the health plan sponsor (employer) so as to increase health and drive down cost.”

Company officials say P2P has been beta tested with select customers for the past year. One of those customers is Cumulus Media.

"In the past, I wasn’t able to see more detail on where my company’s healthcare dollars were going,” said Martin Gausvik, CFO of Cumulus Media, a Blackstone Group portfolio company. “With ARS, I now understand where I am spending my money and how I can avoid future expenses while raising the level of employee engagement with P2P.”

WellNet Introduces Facebook-like Point to Point Healthcare®

2009-07-14T15:11:00.000-07:00

Technology Suite Provides Employees with Market Changing Engagement Tools; Ninety-two Percent of Employers Say the System is Crucial to Limiting Health Plan Costs

Bethesda, MD – July 14, 2009 — WellNet Healthcare, a healthcare technology company that enables companies to better manage their healthcare costs by analyzing their benefit programs to understand why costs are rising and implement actionable strategies to reduce expenses, today announced the formal launch of Point to Point Healthcare (P2P), developed by its healthcare technology subsidiary Healthcare Interactive.

P2P, which has been in beta testing with select customers over the last year, is a Facebook-like social networking platform that allows consumers to manage their healthcare from a single, secure Web 2.0 application. P2P’s all-inclusive platform helps close the gap between having a partially-informed and a fully-informed consumer, like its sister component, the Active Reporting System (ARS), does for plan sponsors (employers).

The introduction of the P2P component rounds out WellNet’s Healthcare Performance Management (HPM) software suite, and shakes up the healthcare industry via a solution that increases choice, competition and transparency and the ability to positively impact the delivery and cost of care in both the private and public sectors.

Sample P2P platform features include:

- A communication wall that allows consumers to request and receive help on a myriad of healthcare-related issues ranging from prescription medicine refills, to complex case management, to insurance claims.

- Tools with which consumers can manage their healthcare on an ongoing basis.

- A pass-through version of their electronic medical record hosted by industry leaders such as Microsoft’s HealthVault™ and Google Health.

- A view of consumers current prescription medications that includes potential substitutes and alternatives, access to telemedicine, care management and wellness services.

"In the past, I wasn’t able to see more detail on where my company’s healthcare dollars were going,” said Martin Gausvik, CFO of Cumulus Media, a Blackstone Group portfolio company. “With ARS, I now understand where I am spending my money and how I can avoid future expenses while raising the level of employee engagement with P2P.”

Regardless of the type of insurance or the particular health plan, P2P consolidates, in a single location, the information and resources necessary for consumers to make more informed decisions. P2P does not pretend to confer an MD on consumers, but it does give them the level of information buyers typically collect before purchasing an automobile, dishwasher or computer – options, pricing, availability, alternatives, pros and cons, etc.

“America’s current health system is mired by disjointed, untimely and hard-to-find information, hidden profit centers and monopolies in some markets. Those using and paying for healthcare, whether employers or consumers, are saddled with its inefficiencies and exorbitant costs,” said Keith Lemer, president of WellNet Healthcare. “The revolution in healthcare won't be in electronic medical records, but in using technology like P2P and ARS to find out how to cut costs to make service more affordable. WellNet’s HPM solution increases the transparency and the flow of information to both the consumer and the health plan sponsor (employer) so as to increase health and drive down cost.”

About WellNet
WellNet Healthcare enables companies and their executive management team to measure and manage their healthcare costs by finding and fixing problems using real-time healthcare information to make better business decisions that lower healthcare costs. WellNet’s technology subsidiary, Healthcare Interactive, provides a platform for employers and employees to view and manage healthcare costs in a dashboard format. Visit their Web site at www.wellnethealthcare.com.

About ARS
Like P2P, Active Reporting System (ARS), launched in 4Q08, removes the veil that blurs employers’ views of their second or third largest expense line item: their company’s healthcare expense. Providing aggregated, unidentifiable employee health data in a real-time, secure, easy-to-use dashboard, ARS enables company executives to understand where their health plan is working, whether the health coverage is meeting employees’ needs and if health plan members could benefit from additional health or wellness services. In a recent ARS features survey, 100% of executive management said that the system provided access to important heath plan data that they could not access before, while 92% said ARS was crucial to limiting health plan costs. Precision targeting of problem areas increases the efficiency of each dollar spent on healthcare and truly enables the C-suite and others involved in decision making to measure and manage their healthcare expenses as they would any other area within their business operations, all while actually improving the health of their employee population.

WellNet Healthcare Names Chris Kaiser and Jay Thompson Sales Executives

2009-06-29T08:37:00.000-07:00

Bethesda, MD (PRWEB) June 16, 2009 -- WellNet Healthcare, a healthcare technology company that enables companies to better manage their healthcare costs by analyzing their benefit programs to understand why costs are rising, today announced the appointment of Chris Kaiser as sales executive for the Mid-Atlantic territory and Jay Thompson as sales executive for the Northeast territory.

In this capacity, Kaiser and Thompson will be responsible for selling Healthcare Performance Management software to companies that provide and pay for employee health benefits.

"With the national focus on healthcare reform, we are at an exciting point in our company's growth. For years we have been helping our customers manage their benefits costs and programs like any other corporate expense by taking the mystery out of healthcare costs," said Keith Lemer, president of WellNet. "Chris and Jay's proven experience in sales and marketing will be an asset to the company at this critical time."

Prior to joining WellNet, Kaiser spent time in a territory sales role with Vocus Inc. Previously, he was with the Corporate Executive Board in Arlington, VA, with the specific responsibility of expanding the technology practice into the mid-market arena. Kaiser received his B.A. in economics, with honors, at Metropolitan State College of Denver.

Thompson, most recently, worked for the Corporate Executive Board as a research consultant. While at the Corporate Executive Board, he rotated through several parts of the company as part of a management development program and eventually found a home in the sales force. Prior to graduate school, Thompson worked in the public sector and for the CEO of a large insurance company as a cost management analyst. He holds bachelors degrees in finance and accounting from the University of Oklahoma and a Masters degree in International Relations from the University of Denver.

WellNet Introduces Healthcare Performance Management on Capitol Hill

2009-06-26T08:25:00.000-07:00

WellNet and Its Software Division, Healthcare Interactive, Discuss Progressive Approach
to Managing Escalating Costs as U.S. Healthcare Reform Debate Continues

Bethesda, MD – June 26, 2009 – WellNet Healthcare, a healthcare technology company servicing private sector Fortune 1000 businesses and other corporations for more than 10 years, and Healthcare Interactive (HCI), WellNet’s software division, introduced their Healthcare Performance Management (HPM) on Capitol Hill as a cost effective solution for addressing the countrys healthcare challenges. The HPM platform increases data transparency and provides organizations of all sizes tools they can use to immediately lower healthcare costs.

WellNet and its technology and government deployment partner, including Lockheed Martin, met with Representative Roy Blunt (R - MO) and members of his office, to position the HPM solution of providing a marketdriven, transparent and data-driven option for healthcare coverage in addition to suggesting open access for all companies to obtain Medicare pricing in order to create a level playing field. Congressman Blunt has gone on record to discuss the advantages of a different approach toward healthcare reform, including expanded access for Americans, the creation of a competitive landscape between private and public domains and greater empowerment for patients and their medical advisors.

“WellNet’s progressive platform leverages data and gives the American people additional access to information, enhances their quality of care and creates opportunities for greater transparency,” stated Henry Cha, president of HCI. “Our goal is to increase competition between insurers, physicians and hospitals without dismantling the insurance industry, and give tools to all parties involved to drive down costs.”

WellNet’s HPM solution, currently in Beta with its customers, enables company executives to have visibility into one of their business’ most expensive line items: the rising costs of covering healthcare premiums for employees. WellNet’s technology-enabled approach provides real-time data on the factors that drive-up costs. This unprecedented level of transparency provides companies with the data they need to maximize the value of the money they spend on healthcare, drive down overall costs, and utilize the savings to save American jobs.

“WellNet is in a unique position in this marketplace to deliver what the American people are looking for: complete transparency in managing their health plans,” stated Todd Thompson, CTO, director of engineering & technology - civil enterprise solutions at Lockheed Martin Corporation. “Until WellNet, I’ve not witnessed a technology to date that can provide this increased access, while adhering to privacy and HIPPA concerns that are critical to success.”

Healthcare Reform

2009-06-08T20:35:00.000-07:00

FROM TECHBISNOW - View the article here

As President Obama talks healthcare reform, earlier today we sat down with two tech minds who are already saving businesses oodles on costs: WellNet president Keith Lemer and Henry Cha, prez at Healthcare Interactive, a WellNet subsidiary.

Henry and Keith's Bethesda-based company created a web interface that lets execs manage healthcare spending and employees take a more active role in their coverage. "Healthcare is usually the second or third biggest expense a company will face, yet most businesses have no idea why costs keep going up," Henry says. Using different data streams (primarily pharmaceutical spending) and a simple interface, execs can see where dollars go and avoid cost increases before they hit.

If those are diplomas behind them, we'd hate to see the tuition bills. As for employees: To help engage workers, WellNet and Healthcare Interactive provides them with their own dashboard, along with incentives like gift cards and insurance cost reductions, to partake in particular programs. "The revolution in healthcare won't be in electronic medical records, but in using technology to find out how to cut costs to make service more affordable," Keith says.

A Message from WellNet's President

2009-04-27T07:25:00.000-07:00

Editor
Forbes Magazine
Attn: Letters to Editor

Mr. F. Mark Gumz correctly focuses on the CEO’s critical role in promoting employee wellness (CEO’s Rx: Improve Your Employees Health Now Apr. 18, see below for the piece). C-level management coping with health costs -- often one of the largest business expense line items -- increasingly recognizes the link between employee health, productivity and the bottom line. America’s corporate CEOs must become engaged in their health programs and lead the effort to improve the nation’s health. To reduce costs and reward outcomes, CEOs must adopt new corporate models that improve employee long-term health. This includes corporate wellness and disease management programs as well as technology-driven innovation that has always been at the core of successful U.S. companies. New business models now allow technology to be used by CEOs to make real-time strategic decisions about corporate health programs. Former Intel chairman Craig Barrett correctly noted the importance of CEO accountability for health by saying: “If you are a corporate CEO and you just send [this message] down your human resources chain of command for follow-up, you’ve missed the point.”

Keith Lemer
President
WellNet Healthcare
Bethesda, MD

///////

Leadership
One CEO's Rx: Improve Your Employees' Health Now
F. Mark Gumz 04.16.09, 2:40 PM ET

Providing your staff with quality health care options while managing bottom-line costs is harder than ever now. Chief executive officers have their hands full just addressing basic employee expenses like compensation. But we absolutely have to think creatively about improving the long-term health of our employees, and without spending too much.

Wise employee health care management saves money while bringing about long-term gains from increased overall employee wellness. Employees not performing at their full potential put their companies at risk just the way injured athletes put their teams at risk. That's why you need to find ways to enable your employees to make changes in their behavior that help themselves and help the company. It can have a turbocharged effect on your business.

All CEOs should know the top categories in their health care spending and address them head-on. The Centers for Disease Control informs us that more than 75% of the nation's health care costs can be attributed to patients with just five chronic conditions: congestive heart failure, asthma, diabetes, coronary artery disease and depression. The National Business Group on Health estimates that U.S. employers collectively spend $170 billion annually on smoking-related health expenses, lost productivity time and absenteeism. Know how such costs are affecting your company.

At Olympus Corporation of the Americas, the cost of insuring our 4,000 employees and their immediate families comes to more than $11,000 a year per family for the company-paid portion, which is at least 80% of the total cost per employee, so getting employees and their families to live a healthy life is very important for us. We have had great results with our overall employee wellness program by including benefits such as Weight Watchers programs, free flu shots, cancer screenings, and a personal wellness report that provides the findings from extensive blood tests and hypertension screening and offers confidential, customized suggestions to help employees identify and reduce their specific health risks, so they can lead healthier lives.

Why does the U.S. spend as vastly as it does on health care and still have so many challenges in health? Because people aren't as knowledgeable and active as they need to be about taking care of themselves. As consumers, employees increasingly seek out their own health care information. CEOs need to make sure to provide information that is thorough and correct, to help employees choose appropriate courses of treatment for themselves and their families. You can easily integrate online tools into your company's education program and offer information on new procedures and treatments. When educated employees change their behavior and that of their families, health care costs go down, sick days diminish and productivity rises.

It's also critical not only to offer health savings accounts but also to educate your employees in how to take advantage of them. HSAs not only help employees save money to pay medical bills; they also give them more control over how their health care dollars are spent.

Ultimately, every CEO has a responsibility to understand his or her line-item health care costs and know what he or she can do to produce a win-win scenario for the company: cutting bottom-line costs while improving employees' long-term health and thus productivity and morale. Employees appreciate an employer who cares about them and invests in them -- and that appreciation brings both immediate and long-term rewards to the company.

F. Mark Gumz is president and chief executive officer of Olympus Corporation of the Americas.

Keith Lemer Mentioned in Summit Series Recap

2009-04-09T08:30:00.000-07:00

Keith Lemer, President, WellNet Healthcare -- talk about a man on a mission! He’s articulate, sharp as a whip, bold, and determined -- thus destined -- to change the face of healthcare management. He’s staking a claim in a new territory self-described as Healthcare Performance Management (HPM) -- a way for CEOs to take control of their own healthcare programs. Watch out for him …

- Elizabeth Shea

Read the full blog

A Message from WellNet's President

2009-04-02T13:45:00.000-07:00

Outlined below in the New York Times is a concise value-statement of WellNet's Healthcare Performance Management (HPM) software featuring the Active Reporting System and Point to Point Healthcare.

The article below from the New York Times describes where the focus of healthcare reform is today using technology vs. what's actually necessary to lower and manage healthcare expenses, long-term, for all stakeholders. Clearly, what Mr. Lohr and the other experts mentioned in the article are defining is WellNet's HPM.

Healthcare Performance Management software (HPM):

Minimizing or removing the annual healthcare procurement process altogether, HPM is a common technology platform that supports the shared responsibility between Plan Sponsors, Members and Providers to manage healthcare and the risk mitigation of costs in a simplified collaborative environment.

Similar to ERP (Enterprise Resource Planning) and CRM (Customer Relationship Management) software for traditional back-office operations, the HPM solution empowers corporations, for the first time, with innovative tools and methods to provide accurate, actionable information in real-time to measure and manage their healthcare expenses, as they fiscally manage every other aspect of their business.

Leveraging the prescription-drug portion of the medical-benefit plan, our technology and advisory services provide visibility and insight into our customers' plan risks, and combine patient-centric, Facebook-like social networking services to improve care, quality and efficiency, all operating within a fully-integrated, single-user interface that saves corporations
hundreds of thousands to millions of dollars annually.

Keith Lemer / President

Please click here to read the New York Times article.

WellNet in Washington Biz Journal

2009-03-01T17:27:00.000-08:00

Washington Business Journal
Friday, February 27, 2009
By Darlene Darcy
Staff Writer

Private industry trailing the government in innovation may seem surprising. But in the use of technology to deliver and manage health care more effectively, the government is taking the lead — at least for now.

Health-related agencies such as the Department of Veterans Affairs and components of the Defense Department have been plugged into electronic medical records and medical information exchanges for years.

But many private hospital groups and small physicians’ offices have not adopted big-ticket tech systems and software because of various hang-ups, including the cost of technology.

President Barack Obama’s technology agenda, not to mention his massive stimulus package, include plans and billions of dollars for a nationwide electronic health information system to house and exchange patient records, insurance information and other medical data.

He sees these information technology improvements as the foundation for future health care reforms.

Obama’s health care proposals would invest at least $10 billion annually for the next five years to accelerate technology adoption.

In addition, the new $787 billion stimulus legislation, the American Recovery and Reinvestment Act of 2009, includes $19 billion to boost the economy through implementation of electronic medical records.

Tech industry officials hope the cash infusion leads to a broader adoption of health care IT, which might benefit many Washington-area companies, including those building and supporting systems for electronic medical records, data exchanges and Web sites that enable doctors to interact with patients.

Here are several local companies involved in the effort to fix a costly and inefficient health care system.

Symptom: Inefficient operations

Treatment: Systems integrator CSC has developed a system for the government that would enable insurance companies, hospitals and doctors’ offices to exchange electronic records over a nationwide network.

The Falls Church company has installed electronic records systems for organizations that include the National Institutes of Health’s research hospital in Bethesda and New York’s Medicaid program. But without a way for electronic records to be shared, those systems can’t realize their full value.

Prognosis: “There hasn’t been a commitment at the federal level to do this,” said Dr. Robert Wah, chief medical officer of CSC’s North American public sector business.

CSC is connecting systems for the National Health Service in the United Kingdom, where a budget of more than $17 billion over 20 years was committed years ago, he said.

The U.S. is “going toward a national medical records system driven primarily through legislation and regulation ... [and] the pace is pretty clearly defined,” Wah said.

Electronic medical records for all patients by 2014 is “probably achievable,” but incentives for doctors to spend money today is critical for a nationwide system to emerge.

Symptom: The paper-to-digital divide

Treatment: Wisper Technologies LLC in Reston, a subsidiary of IMC Inc., is developing software that uses speech-recognition technology to capture and organize patient-doctor conversations for planning patient care and billing insurance companies. The resulting electronic records can be fed into digital health information systems.

Wisper Technologies launched the software on a trial basis in 2004 but has not yet found a commercial market for the product because it is too costly for doctors.

Prognosis: “Doctors don’t have the money to buy sophisticated technology,” said IMC’s chief executive officer, Sudakar Shenoy. “The only people who can help them do that is the federal government.”

Stimulus funds used to reimburse doctors for investments in medical records technology could help reduce the barriers to adoption of Wisper’s software. But at hundreds of thousands of dollars for a hospitalwide implementation, IMC’s software will remain costly until high volumes of sales bring the price down, Shenoy said.

Symptom: Patient data unleashed

Treatment: McLean-based Trust Digital Inc., which provides mobile security software, has created an application that secures patient data stored electronically on a care provider’s mobile device.

Early in January the company landed deals with three health care organizations to support as many as 15,000 doctors, nurses and other health professionals in a single implementation.

Care providers and administrators at hospitals, physician practices and insurance companies are increasingly sending information over mobile devices, and they need an inexpensive way to make those transmissions securely.

Prognosis: “Trust Digital is already doing a brisk business with health care providers who use our product to protect confidential patient and doctor information stored on employee smart phones,” said Chief Executive Officer Nick Magliato.

The loss of a doctor’s phone could have a huge impact on patient privacy if data is stored there, and “obviously the stakes go way up as hospitals and other health care institutions, spurred on by funding from the government, quickly move to electronic patient records,” he said.

Trust Digital is counting on the new federal funding to advance more efficient care delivery systems and create new customers for the company.

Symptom: Choking on costs

Treatment: Health care management company WellNet Inc. is testing software designed to help employers understand the medical risks driving up their cost of employee coverage.

The software, called Point to Point Healthcare, was developed by Glenwood, Md.-based Healthcare Interactive Inc. and uses The Johns Hopkins University’s predictive modeling and pharmaceutical claims data to create charts and reports for employers. The data reveals cost-saving options by simulating changes to the company’s benefits plan.

Point to Point, which complies with privacy provisions of the Health Insurance Portability and Accountability Act (HIPAA), keeps employees’ identities confidential but lets workers access social networking tools to manage their care.

Prognosis: WellNet already has 100 clients testing the software, which the Bethesda-based company and Healthcare Interactive plan commercialize this year.

Employee health care is one of the biggest expenses for companies, but employers don’t know what is driving up their costs and employees don’t have tools to take preventive health measures before those costs hit them, said WellNet CEO Keith Lemer. “We give that data back to the employer.”

Symptom: Good information can be hard to find

Treatment: Ozmosis Inc. provides a social networking Web site that doctors can use for collaboration, continuing education and sharing “best practices.”

Formed by Joel Selzer and Jason Bhan in 2008, Vienna-based Ozmosis has 1,000 active members and will grow by invitation-only so that doctors’ identities can be verified and the site remains a trusted environment for trading information. The service is free to member physicians, universities and hospitals.

Prince William Hospital in Manassas is using Ozmosis within its electronic health information system.

Although not a traditional ad-supported site, Ozmosis will get revenue from pages sponsored by medical device and drug companies. Physicians can opt into those pages for new product information.

Prognosis: Ozmosis hopes to “benefit from the tremendous momentum low-cost, social media solutions are gaining throughout the health care industry,” Selzer said.

“With 84 percent of physicians now searching online for health care product information, the pressure to shift physician marketing and product education online has never been greater.”

Ozmosis needs to capture those marketing dollars to make its site sustainable.

Selzer warns that “just giving economic incentives to doctors to buy [electronic medical record systems] and hospitals to deploy them doesn’t mean they’re going to use them effectively.” That requires education — a role Ozmosis can fill, he said.

How much and how long?

Despite the increased use of electronic technology in health care, the cost of implementing new systems remains a major roadblock to a nationwide network.

President Barack Obama’s health care agenda includes a $50 billion investment in information technology over five years, but critics say he should be thinking more like $100 billion over 10 years.

The administration believes the savings will be worth the investment. A “fully functional” nationwide system could reduce health care costs by $200 billion annually by decreasing human error and fraud, according to the Department of Health and Human Services.

In addition to the $50 billion investment in Obama’s health care agenda, $19 billion will be provided through the new stimulus legislation to offer financial incentives to hospitals and physicians’ offices that implement electronic health records systems. A minimum of $2 million would be awarded to each organization that can show meaningful use of those health IT systems by 2011.

“The challenge for hospitals that haven’t committed a budget to purchase electronic systems is that current economic conditions will make it difficult to find the extra money to deliver these systems,” said Deward Watts, president of CSC’s commercial health care sector.

An additional $87 billion of the stimulus money will be used to offset state contributions to Medicaid. It is unclear how states would be allowed to spend their savings and if any of that money would go toward health IT.

Whatever money is spent now could be viewed as a down payment on a bigger investment in health, Watts said. “We need to put in place some technical foundation to make sure that is done ... in the best way possible.”

All contents of this site © American City Business Journals Inc. All rights reserved.

Cronin Appointment in MyHealthGuide

2009-03-01T16:51:00.000-08:00

My HealthGuide Newsletter
Monday, February 23, 2009

WellNet Healthcare appointed Dan Cronin, a longtime sales and marketing executive and acclaimed author of technical books is the new senior vice president of sales for WellNet Healthcare and Healthcare Interactive (HCI), two companies that recently launched the game-changing software and technology platform, Point to Point Healthcare.

In joining Bethesda, Md.-based WellNet and Glenwood, Md.-based HCI, Dan Cronin will direct the team responsible for delivering Health-Care Performance Management software to large employer groups that provide and pay for employee health benefits.

Cronin’s more than 20 years of executive sales-management experience for industry-leading Fortune 500 companies such as EMC, Oracle and Sybase has resulted in major, multi-year contracts for enterprise products and services. In addition, he has written the best-selling technical books, “Mastering Oracle” and “Microcomputer Data Security.”

“Dan’s background and success make him the perfect fit as we roll out our Health-Care Performance Management software nationwide,” says Keith Lemer, WellNet’s president. “He will undoubtedly be a major force in driving our companies to the next level.”

A comprehensive and unique solution, the Active Reporting System (ARS) and Point to Point platform empowers employers for the first time, providing them with accurate, actionable, real-time information to measure and manage their health plans as they would any other aspect of their business. The technology provides visibility and insight into customers’ plan risks, combined with patient-centric services to improve outcomes and lower medical-benefit costs for both employers and their employees.

“ARS and Point to Point will revolutionize the health-care sector, and I’m enthusiastic about playing a key role in marketing this technology to the business community and saving employers hundreds of thousands to millions of dollars on their health-care costs while getting their workers healthier,” Cronin says.

WellNet Healthcare is the majority investor in HCI, which developed ARS and Point to Point. The two companies launched a beta version of their Health-Care Performance Management software last year, offering it to WellNet’s existing client base. ARS and Point to Point are now available to the entire business community.

WellNet in Washington Post

2009-03-01T16:50:00.000-08:00

Washington Post
Monday, February 16, 2009
By Anita Huslin
Staff Writer

The $19 billion prescribed in Congress's economic stimulus package to bring America's health-care records into the electronic age is a welcome opportunity for information technology firms seeking to build market share in a still-young industry.

Although the federal government set a goal five years ago of creating an electronic health record for every American by 2014, the effort has lagged for several reasons. Roadblocks include concerns over lack of universal protocols for collecting data as well as rules that establish how, with whom and under what circumstances the data can be shared. Many health-care providers -- physician practices, testing facilities, hospitals and clinics -- fear liability if private information gets into the wrong hands. Embedded in all these issues is the cost, an estimated $150 billion, which has proven to be a significant barrier to that 2014 target.

Few expect the new spending to change things immediately. "The incentives for doctors and hospitals to use these tools have months of regulatory processes to go through," said David Brailer, former head of the Office of the National Coordinator for Health Information Technology, created under the Bush administration to establish standards for the collection and use of electronic medical records. "I don't think doctors will go out tomorrow and buy electronic records because there is a little bit of money coming."

To computerize their medical records, physicians and their practices stand to get $44,000 to $64,000 in incentives, and hospitals up to $11 million. But there are also penalties. Providers who treat Medicare and Medicaid patients and have not gone to paperless systems within five years could lose funding. With the federal government spending more than $600 billion annually on 80 million Americans through Medicare, Medicaid and other programs, that could prove a powerful incentive for providers to get on board.

At least that's what businesses such as CNSI, a Rockville company that sells Medicaid reimbursement systems in four states and is pitching more than a dozen others, would like to see happen. Arvinder Singh, senior vice president of CNSI, said the company hopes the stimulus money will bring more customers and allow CNSI to expand pilot programs. "This will help create more of a market for analysts and support staff, and create jobs," he said.

Others, such as WellNet Healthcare of Bethesda, hope to take advantage of spending on a medical data infrastructure system linking doctors and hospitals to insurance companies. Such technology could provide a broader arena for sales of their systems, which help companies monitor and manage their employee health-care costs.

Brailer cautioned that spending will not really grow until standards are set for secure collection and handling of medical information. He said there was some progress, but funding limits mean there's still a way to go.

Many doctors' offices and smaller hospital systems have held back from adopting available systems, vendors said, because of the cost and because they don't know whether the one they choose ultimately would comply with federal standards.

"There are too many unknowns as to what might be required, standards-wise," said Kevin Hutchinson, president and chief executive of Prematics, a Vienna firm that is one of the largest sellers of electronic prescription systems. His prospective clients know "there's lots of money they could be in line for, but they've in the past got so frustrated with chasing new ways of reimbursement and then lo and behold it disappears."

The anticipated demand for workers with technology skills who can help install medical record systems and then train physicians and health-care workers to use them will require training programs. Getting such programs off the ground is "not an easy thing to do," said Ritu Agarwal, director of the Center for Health Information and Decision Systems at the University of Maryland's Robert H. Smith School of Business.

"Study after study show that physicians in their small and medium-sized practices are extremely challenged with incorporating technology into their current flow. They haven't been able to afford it," she said. "We would anticipate seeing significant spending on training dollars . . . and if government is going to help pay for that, through some pilots and demonstrations, that will help move things along."

WellNet, for example, last fall rolled out a preliminary version of a system that puts patients' health information online so they can schedule appointments. Information can then be aggregated into detailed reports -- with individual identities removed -- that employers can use to track cost and medical use trends.

WellNet gave the program free to companies that agreed to load their pharmaceutical benefits data into it. Company representatives say much of their client introduction to the technology includes ample reassurances about privacy.

If the new package helps more potential clients get accustomed to the idea that online medical records, like personal banking information, can be a tool and not a security risk, WellNet officials see that awareness opening the door to more business.

"Hopefully this will help the marketplace look outside large corporations with existing operating systems and focus more on entrepreneurial and transparent organizations," said Keith Lemer, president of WellNet health management company. "One of the messages we are getting loud and clear from the new administration is that we are looking for a change."

The Los Angeles Times picked up the Post article. Read here.

HCI Partnership in MyHealthGuide

2009-03-01T16:49:00.000-08:00

My HealthGuide Newsletter
Sunday, February 1, 2009

Point to Point Healthcare, a game-changing technology for the health-care sector that will save employers across the country hundreds of thousands to millions of dollars on their medical-benefit costs, is adding to its arsenal of innovative solutions.

Healthcare Interactive, the Glenwood, MD-based developer of Point to Point, today announces that it has licensed an online tool for use in Point to Point that allows employers and their employees to access vital prescription-drug information.

WellNet Healthcare, with nine U.S. offices, is the majority investor in Healthcare Interactive, which is licensing the technology, called DestinationRx Drug Compare, from Los Angeles-based DestinationRx, a leader in consumer drug-comparison and purchasing technology.

DestinationRx Drug Compare allows self-funded employers, plan sponsors and consumers to reduce their prescription-drug spending by up to 20% by comparing their current therapeutics with lower-cost alternatives.

The DestinationRx technology enables consumers to find direct comparisons on prescription-drug prices as well as therapeutic safety and effectiveness, helping to improve medication compliance.

“One of the biggest flaws with the U.S. health-care sector is that employers and their employees don’t have the necessary information to make wise decisions about their prescription-drug spending,” says Henry Cha, Healthcare Interactive’s president.

“DestinationRx Drug Compare provides an accurate and convenient way for people to find less-expensive prescription drugs,” Cha says, adding that this tool is yet another important feature of Point to Point Healthcare, which he expects will revolutionize the health-care sector.

“Comparing and shopping for prescription drugs is one of the easiest and most effective actions consumers can take to save on their health-care costs,” says Toby Rogers, executive vice president of DestinationRx. “We are excited to be part of this innovative platform to help patients manage their entire health-care experience.”

Point to Point is a Web-based storage system for employers to analyze and interpret critical pharmacy and medical data combined with an online health-care social network that allows employees to connect with all their providers in a secure environment.

Healthcare Interactive and WellNet Healthcare, a data-analysis and health-management company, launched a beta version of Point to Point last August, offering it to WellNet’s more than 200 existing clients. Healthcare Interactive and WellNet will make Point to Point available to the entire business community in the first quarter of 2009.

This technology and administrative platform seamlessly links employees to, among other things, their pharmacy and medical data, care providers, scheduling, chats, gaps in care, drug-utilization alerts, predictive modeling and health-management programs.

About Healthcare Interactive
Healthcare Interactive, founded in 2007, is a privately held software company commercializing innovative technologies for health-care administration and insurance. Based in Glenwood, Md., Healthcare Interactive has developed an information portal and intelligence technologies to enhance existing health- are products that focus on predictive modeling, information sharing and Web services. The company’s signature product is Point to Point Healthcare. Visit www.hciactive.com.

WellNet in Washington Biz Journal

2009-03-01T16:47:00.000-08:00

Washington Business Journal
Tuesday, January 27, 2009
By Darlene Darcy
Staff Writer

WellNet Healthcare's' Healthcare Interactive has licensed a technology from DestinationRX in Los Angeles to help reduce medical costs for its customers.

Bethesda-based WellNet will use the technology, called DestinationRX Drug Compare, for comparing pharmaceuticals and identifying less expensive drug alternatives to enhance software that it developed with Glenwood-based Healthcare Interactive.

WellNet, which manages health care benefits for commercial customers, is the majority stake holder in Healthcare Interactive, which launched in 2007.

“One of the biggest flaws with the U.S. health care sector is that employers and their employees don’t have the necessary information to make wise decisions about their prescription-drug spending,” said Healthcare Interactive President Henry Cha. “DestinationRx Drug Compare provides an accurate and convenient way for people to find less-expensive prescription drugs.”

WellNet, led by Keith Lemer, and Healthcare Interactive will integrate the drug comparison tool with the Web-based software that the two companies launched in August 2008.

The software, which is compliant with the Health Insurance Portability and Accountability Act (HIPAA), allows employers to manage their employee health care plan by providing timely pharmacy and medical data translated into comprehensive and actionable charts and reports. HIPAA regulations ensure health care coverage and establish privacy standards for electronic communication about patients’ medical information.

The software also helps employers better manage their plans through predictive medical modeling and by linking employers and employees with care providers through social networking tools such as chats, alerts and scheduling.

A test version of the software is being used by 200 of WellNet’s existing health care management clients and is expected to be available commercially in the first quarter of 2009.

With 40 percent growth in 2008, WellNet’s annual revenue is about $100 million, Lemer said. The 50-person health care management company has a small internal sales team that Lemer expects to grow modestly. Lemer said he expects adoption of his software to increase through word of mouth as customers recognize savings.

All contents of this site © American City Business Journals Inc. All rights reserved.

WellNet in Thompson Publishing Guide

2009-03-01T16:45:00.000-08:00

Thompson Publishing Group
February 2009
By Todd Leeuwenburgh
Editor

Everyone’s heard that old saw: "20% of the population drives 80% of plan costs". If plan sponsors only knew exactly which plan participants are in that 20%, they could head off future acute conditions by managing high-risk conditions early on. But how should one identify those high-risk members?

It seems obvious: Ask plan participants, and analyze what prescription drugs they are taking, vendors and other experts tell the Employer’s Guide to Self-insuring Health Benefits ("Guide").

Bethesda, Md.-based WellNet Healthcare says prescription drug utilization data can identify those high-risk plan members. This will allow plans to understand their treatment needs, budget for those needs down the road, and adopt management strategies to change member behavior.

Predictive modeling software marketed by WellNet enables self-funded plans to use pharmacy benefit data to manage the plan as a whole. Based on the insights, plans may adopt strategies — such as chronic care management and wellness programs — to improve member health and manage utilization.

Many businesses use predictive modeling to build a picture of health risks, but only with medical data after the fact, company executives said. Claims processors and third-party administrators deliver data quarterly, but that’s often too late for the employer to take preventive action. Drug data enable the plan to micromanage care based on daily information.

Using Rx as the Leading Predictive Indicator
The advantage is that Rx data enables self-funded plans to manage benefits before expensive charges hit the system. And since drug claims come in faster than medical claims, companies can act more proactively. “It’s a window into the future,” WellNet Healthcare President Keith Lemer tells the Guide. The data analysis can also help the employer create personalized treatment plans and wellness initiatives.

WellNet executives say that drug data is 95% accurate at forecasting future risk. Analyzing drug utilization helps planning for the next three to five years, the company says. “Learning what’s driving costs in your health plan is not the same as shopping for vendors,” Lemer says.

Today’s Rx Data Reveals Tomorrow’s Risk
In a demonstration for the Guide, WellNet executives showed how the software sifts though a hypothetical 1,460-member self-funded plan to find the people who are most at risk. Without betraying patient privacy, the software found:
-Thirty-two employees who were at high risk of incurring major medical expenses soon. Those employees had an average of nine conditions.

-Two hundred and sixty-three employees were at medium risk. Those members had an average of five conditions each.

-That the total anticipated cost of high- plus medium-risk patients was $4.3 million to the plan, but it could go as high as $20 million.

The program revealed conditions that are most prevalent, and in this case they were: allergy/immunology, cardiovascular conditions, infections, and skin and respiratory problems. The software broke down these broad categories to more specific clinical conditions. For example, under cardiovascular, the software identified patients at high risk for high blood pressure, lipids, vascular disorders and congestive heart failure.

Software Lets You Tinker With the Plan
After the initial analysis, the software enables plan managers to plug in limited plan design changes and estimate outcomes. The design changes are mostly drug benefit tweaks like generic conversions, switches to OTC medications and mail order.

WellNet’s Plan Simulator gives plan sponsors a look at the impact of changes in drug plan design. It will predict savings from switching to generics and/or mail order.

Plan sponsors can also apply case management and other means to encourage treatment compliance, but the software will not predict impact in advance for these measures.

After 120 days with the design variation, the software measures results over time. It estimates what medical claims volume would have been without the intervention to claims volume since analysis and management strategies were applied.

The software highlights new prescriptions; those indicate a new diagnosis, and signal that it is the right time to reach out to the patient and maybe renew care management efforts on that person for the new diagnosis.

The approach builds on the self-funding plan’s access to data that insured plans don’t have. Insurers and PBMs do not share raw utilization data, because if inner workings remain secret, employers cannot question double digit cost increases, Lemer tells the Guide. WellNet’s program promises to fill in that transparency gap, he says.

Networking Software and Managing Health
Networking software takes the transparency further. “Point to Point Healthcare” offers online tools that connect employees to their utilization data, keeps track of health appointments, allows instant messaging with providers, and helps the employee create a network of providers he or she usually confers with.

Point to Point requires participation by the patient’s caregivers, by no means a given. Right now caregivers are invited to participate, but participation is voluntary.

Download Full Report in PDF Format

Texas Office in Philadelphia Biz Journal

2009-03-01T16:43:00.000-08:00

Philadelphia Business Journal
Friday, January 2, 2009
By John George
Staff Writer

Southampton, Pa.-based WellNet Healthcare is expanding out West by opening an office in San Antonio. Led by Texas native Dr. Dan Van Ackeren, the new office will provide services to businesses in Texas, Arkansas, Colorado, Louisiana and New Mexico. WellNet, founded in 1994, designs, implements and administers employer-sponsored health benefits including prescription drug coverage … Pottstown Memorial Medical Center opened a wound healing center. Drs. Benjamin Eskra and Dennis Montiero, plastic surgeons on staff at Pottstown Memorial, are serving as co-medical directors of the center … Lourdes Medical Center of Burlington County in Willingboro invested $35,000 in an OB simulator, the Noelle S575 made by Gaumard Scientific, to better prepare and educate physicians, nurses and other staff members on how to manage rare but life-threatening labor and delivery scenarios. The simulator is comprised of a mannequin of a pregnant woman and a newborn connected to a motorized system that can create standardized and unique delivery-related scenarios. Lourdes Health System plans to expand the use of the simulator to Our Lady of Lourdes Medical Center in Camden early this year.

WellNet Appoints Dan Cronin Senior VP of Sales

2009-03-01T16:13:00.001-08:00

February 17, 2009 - A longtime sales and marketing executive and acclaimed author of technical books is the new senior vice president of sales for WellNet Healthcare and Healthcare Interactive (HCI), two companies that recently launched the game-changing software and technology platform, Point to Point Healthcare.

In joining WellNet Healthcare, which has nine U.S. offices, and Glenwood, Md.-based HCI, Dan Cronin will direct the team responsible for delivering Health-Care Performance Management software to large employer groups that provide and pay for employee health benefits.

Cronin’s more than 20 years of executive sales-management experience for industry-leading Fortune 500 companies such as EMC, Oracle and Sybase has resulted in major, multi-year contracts for enterprise products and services. In addition, he has written the best-selling technical books, “Mastering Oracle” and “Microcomputer
Data Security.”

“Dan’s background and success make him the perfect fit as we roll out our Health-Care Performance Management software nationwide,” says Keith Lemer, WellNet’s president. “He will undoubtedly be a major force in driving our companies to the
next level.”

A comprehensive and unique solution, the Active Reporting System (ARS) and Point to Point platform empowers employers for the first time, providing them with accurate, actionable, real-time information to measure and manage their health plans as they would any other aspect of their business. The technology provides visibility and insight into customers’ plan risks, combined with patient-centric services to improve outcomes and lower medical-benefit costs for both employers and their employees.

“ARS and Point to Point will revolutionize the health-care sector, and I’m enthusiastic about playing a key role in marketing this technology to the business community and saving employers hundreds of thousands to millions of dollars on their health-care costs while getting their workers healthier,” Cronin says.

WellNet Healthcare is the majority investor in HCI, which developed ARS and Point to Point Healthcare. The two companies launched a beta version of their Health-Care Performance Management software last year, offering it to WellNet’s existing client base. ARS and Point to Point Healthcare are now available to the entire business community.

HCI Partners with DestinationRx

2009-03-01T16:12:00.002-08:00

January 28, 2009 - Point to Point Healthcare, a game-changing technology for the health-care sector that will save employers across the country hundreds of thousands to millions of dollars on their medical-benefit costs, is adding to its arsenal of innovative solutions.

Healthcare Interactive, the Glenwood, Md.-based developer of Point to Point, today announces that it has licensed an online tool for use in Point to Point that allows employers and their employees to access vital prescription-drug information.

WellNet Healthcare, with nine U.S. offices, is the majority investor in Healthcare Interactive, which is licensing the technology, called DestinationRx Drug Compare, from Los Angeles-based DestinationRx, a leader in consumer drug-comparison and purchasing technology.

DestinationRx Drug Compare allows self-funded employers, plan sponsors and consumers to reduce their prescription-drug spending by up to 20 percent by comparing their current therapeutics with lower-cost alternatives.

The DestinationRx technology enables consumers to find direct comparisons on prescription-drug prices as well as therapeutic safety and effectiveness, helping to improve medication compliance.

“One of the biggest flaws with the U.S. health-care sector is that employers and their employees don’t have the necessary information to make wise decisions about their prescription-drug spending,” says Henry Cha, Healthcare Interactive’s president.

“DestinationRx Drug Compare provides an accurate and convenient way for people to find less-expensive prescription drugs,” Cha says, adding that this tool is yet another important feature of Point to Point Healthcare, which he expects will revolutionize the health-care sector.

“Comparing and shopping for prescription drugs is one of the easiest and most effective actions consumers can take to save on their health-care costs,” says Toby Rogers, executive vice president of DestinationRx. “We are excited to be part of this innovative platform to help patients manage their entire health-care experience.”

Point to Point is a Web-based storage system for employers to analyze and interpret critical pharmacy and medical data combined with an online health-care social network that allows employees to connect with all their providers in a secure environment.

Healthcare Interactive and WellNet Healthcare, a data-analysis and health-management company, launched a beta version of Point to Point last August, offering it to WellNet’s more than 200 existing clients. Healthcare Interactive and WellNet will make Point to Point available to the entire business community in the first quarter of 2009.

This technology and administrative platform seamlessly links employees to, among other things, their pharmacy and medical data, care providers, scheduling, chats, gaps in care, drug-utilization alerts, predictive modeling and health-management programs.

About Healthcare Interactive:
Healthcare Interactive, founded in 2007, is a privately held software company commercializing innovative technologies for health-care administration and insurance.
Based in Glenwood, Md., Healthcare Interactive has developed an information portal and intelligence technologies to enhance existing health-care products that focus on predictive modeling, information sharing and Web services. The company’s signature product is Point to Point Healthcare.

To learn more about Healthcare Interactive, please visit www.hciactive.com.

About DestinationRx:
Founded in 1999 and based in Los Angeles, DestinationRx is a leader in consumer drug-comparison and purchasing technology. The company provides government and commercial plan providers with the resources to create fully integrated and comprehensive decision-support capabilities for their members.

To learn more about DestinationRx, please visit www.destinationrxinc.com.