3 ms·

I wonder if part of the B2C difficulty is that insurance pays for most healthcare but (with a few exceptions) not for the lifestyle choices that would reduce he

I wonder if part of the B2C difficulty is that insurance pays for most healthcare but (with a few exceptions) not for the lifestyle choices that would reduce healthcare costs. If there was more of an emphasis on preventative measures that insurance paid for, I wonder if it would be different.

tzier 11y ago
This is difficult due to ACA regulations. For example, Pact (formerly GymPact) was trying to give people discounts on Blue Shield of CA health insurance premiums for going to the gym. A provision/update in the ACA made this illegal about a year ago; not sure if it's changed since then. That said, it seems likely that insurance premiums will eventually be tied to real time health data, like Metromile is doing for car insurance.
ghaff 11y ago
What lifestyle changes would an insurer pay for--at least without very intrusive lifestyle monitoring? (Which will increasingly be possible to do whether it's done or not.) There are often discounts for gym memberships and the like. And annual physicals are typically paid for.
- wlesieutre 11y ago
  A friend of mine can log exercise and turn it into free money in his HSA. I don't know whether they validate it against an activity tracker or not, but this is already happening.
- msrpotus 11y ago
  I'm genuinely not sure. Paying for gym memberships, FitBits, and things to get people exercising could be one option. Or maybe insurers could use extra incentives to encourage people to get flu shots or regular checkups?
  - _delirium 11y ago
    One thing ACA did which at least is plausibly useful (though whether it'll move any statistics remains to be seen) is to include an annual physical plus all CDC-recommended vaccines with $0 billed-to-patient cost. So even if you otherwise have a high-deductible plan, you don't pay a copay or deductible for those services. This isn't quite an active incentive, but it's an attempt to remove the price disincentive, with the hope that'll result in higher vaccination rates (the flu vaccine is included).
brandonb 11y ago
One of the biggest barriers to preventative healthcare is that it doesn't pay -- at least not quickly enough to make business sense for an insurer. There's a famous paper that looked for cost-saving interventions in preventing heart attacks and strokes, and it concluded: "As they are currently delivered, almost all of the prevention activities are expensive. If applied fully, using current protocols and the reference assumptions about costs (Table 2), they would increase health care costs by $8.5 trillion over 30 years (Table 3), or $283 billion per year, or $1700 per person per year (data not shown). The only cost-saving activity is smoking cessation." You can read the full paper here. It's from 2008, so perhaps some entrepreneur will be able to find the breakthrough that finally bends the cost curve: http://circ.ahajournals.org/content/118/5/576.short http://circ.ahajournals.org/content/118/5/576.short
- webjprgm 11y ago
  The latest buzzword is precision medicine. Also if that's from 2008 then it is missing all the advancements in mobile (iPhone is 2007) and digital health monitoring like FitBit. So one of those three things could easily make an improvement over what that paper says. (Did not read the paper.)

tzier 11y ago

This is difficult due to ACA regulations. For example, Pact (formerly GymPact) was trying to give people discounts on Blue Shield of CA health insurance premiums for going to the gym. A provision/update in the ACA made this illegal about a year ago; not sure if it's changed since then. That said, it seems likely that insurance premiums will eventually be tied to real time health data, like Metromile is doing for car insurance.

ghaff 11y ago

What lifestyle changes would an insurer pay for--at least without very intrusive lifestyle monitoring? (Which will increasingly be possible to do whether it's done or not.) There are often discounts for gym memberships and the like. And annual physicals are typically paid for.

wlesieutre 11y ago
A friend of mine can log exercise and turn it into free money in his HSA. I don't know whether they validate it against an activity tracker or not, but this is already happening.
msrpotus 11y ago
I'm genuinely not sure. Paying for gym memberships, FitBits, and things to get people exercising could be one option. Or maybe insurers could use extra incentives to encourage people to get flu shots or regular checkups?
- _delirium 11y ago
  One thing ACA did which at least is plausibly useful (though whether it'll move any statistics remains to be seen) is to include an annual physical plus all CDC-recommended vaccines with $0 billed-to-patient cost. So even if you otherwise have a high-deductible plan, you don't pay a copay or deductible for those services. This isn't quite an active incentive, but it's an attempt to remove the price disincentive, with the hope that'll result in higher vaccination rates (the flu vaccine is included).

brandonb 11y ago

One of the biggest barriers to preventative healthcare is that it doesn't pay -- at least not quickly enough to make business sense for an insurer. There's a famous paper that looked for cost-saving interventions in preventing heart attacks and strokes, and it concluded: "As they are currently delivered, almost all of the prevention activities are expensive. If applied fully, using current protocols and the reference assumptions about costs (Table 2), they would increase health care costs by $8.5 trillion over 30 years (Table 3), or $283 billion per year, or $1700 per person per year (data not shown). The only cost-saving activity is smoking cessation." You can read the full paper here. It's from 2008, so perhaps some entrepreneur will be able to find the breakthrough that finally bends the cost curve: http://circ.ahajournals.org/content/118/5/576.short http://circ.ahajournals.org/content/118/5/576.short

webjprgm 11y ago
The latest buzzword is precision medicine. Also if that's from 2008 then it is missing all the advancements in mobile (iPhone is 2007) and digital health monitoring like FitBit. So one of those three things could easily make an improvement over what that paper says. (Did not read the paper.)