The way the founders of MedEncentive figure it, the health care system is a failure because someone always feels like they're losing, whether it's the patient, the physician or the payers.
To fix it, the company created a program that provides financial rewards to physicians and patients based on their level of participation. The process is based on evidence-based medicine and pay-for-performance. MedEncentive believes it has created a "win-win-win" for all parties that can be "bolted on" existing plans.
"We want to create financial and non-financial incentives that are interactive between doctors and patients that cause a performance standard to be accomplished," says Jeff Greene, CEO of the Oklahoma City-based company. "We hope to triangulate the interests of patients, the purchaser/payer and physicians. Everything revolves around these three key stakeholders."
A doctor will answer MedEncentives questions via email such as, "How do you rate this patient's compliance to recommended care for this diagnosis?" Doctor responses affect an automatic increase in reimbursement and send an information therapy prescription to the patient.
Patients are asked to read evidence-based content and answer a series of questions, testing their understanding and adherence. They score points toward a reward or rebate of their out-of-pocket medical expenses. The patient's score is forwarded to their health plan. Their responses are forwarded to their doctor to support subsequent care.
One of the principal features of the system, Greene says, is its ability to treat medical illiteracy. "We've become students of the fact that patients don't want their doctor to think they're medically illiterate and not compliant," he says. "The basis of our intervention is to treat illiteracy."
Thus far six employers offer MedEncentive's program to their workers, including the Wichita Clinic and Dollar Thrifty Automotive Group. The latter started the program at the turn of the year and is testing it through approximately 1,000 employees at its headquarters in Tulsa, Okla.
"Our long-term strategy is on patient education, wellness and providing tools to our employees to help them stay healthy," remarks Angel Stacy, senior director of employee benefits and payroll at Dollar Thrifty.
Patients often don't have access to enough preventive care information to manage their health, and physicians are often too busy to establish strong relationships with all of their patients, Stacy says. "MedEncentive creates a platform for physicians and patients to come together and discuss the evidence-based medicine for their illnesses or for preventive care issues."
Dollar Thrifty usually requires a $20 copay from employees for medical services. Workers who follow MedEncentive's therapy instructions will receive $10 back, Stacy says. The program is available to everyone and workers will be encouraged to participate through a communications campaign that will include "town-hall" meetings, information kits and brown-bag lunches.
The program will be operated on a pilot basis for most of 2008. Towards the end of the year, Dollar Thrifty will assess results and consider offering it to the rest of its employee population, which includes about 8,500 workers nationwide.
"We've been in [business] now for over three years, and we've seen small rebates and large rebates. It works in a kind of stair-step approach. Year one, an employer can do a certain amount, and year two they can ratchet that up and maybe even make it targeted to a medical condition," Greene says.
The Wichita Clinic started its MedEncentive program June 1, 2007 after hearing about it through a consultant.
"We feel it's a nice add-on benefit to our current structure," says Robert Kenagy, chief medical officer for the Wichita Clinic, which manages health benefits for 1,200 employees and dependants. "The employees think it's a very good concept, and the primary care physicians find it easy to use and applicable to what they're doing."
Being a registered M.D., Kenagy has an employer's and a physician's perspective on the MedEncentive program.
"As a physician, I'm enamored with it because it enhances the communication between doctor and patient ... and for understanding the best practice for treating [conditions]," he says. "From an administrator's standpoint, I like all those things as well, but a different perspective is that we're looking out for our organization's health care costs ... and we're looking for ways to provide a very good benefit while controlling costs."
The program has been most effective in providing evidenced-based information for both physicians and patients on chronic diseases like asthma, diabetes and hypertension.