How Health Plans Can Accelerate Innovation

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Here are some of the elements we need:

Increasingly, health plans should look to become 'care system animators' and not merely risk aggregators and transactional processors. Using their population health data, their information on clinical performance, their technology platforms, and their ability to structure consumer and provider-facing incentives, health plans have enormous potential to help improve health and the quality, appropriateness and efficiency of care. At UnitedHealth Group, our new Diabetes Health Plan, new telemedicine program, new eSync technology, and work on new models of primary care are all examples of what this can mean in practice.

Health plans should act as change agents, partnering with others to bring good ideas to scale. A recent example: about a quarter of Americans are either diabetic or pre-diabetic, and some years ago government research funded by the National Institutes of Health and the Centers for Disease Control and Prevention (CDC) demonstrated, through the success of a pilot initiative to help people with pre-diabetes lose weight, that even a 5% reduction can reduce their chances of developing diabetes by almost 60%. If this intervention were a drug, it would have flown through the Food and Drug Administration and would now be in mainstream use. But instead, it was an organizational innovation, in which at-risk individuals were encouraged to complete an evidence-based program involving coaching, exercise, and lifestyle modification. So despite its potential, very little was done within the health-care system to scale the program and offer it more widely. That has now changed, thanks to a new partnership between the CDC, YMCA of the USA, UnitedHealth Group, and Walgreens, which has begun rolling the program out across the country.

Of course, unleashing the sort of transformation our health care system needs will take patience, persistence, and partnership. But done right, we have every reason to think we can indeed improve outcomes and access while also tackling costs. Forward-thinking and progressive health plans have an important responsibility and opportunity to help lead that effort.

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