Health insurers, which have jacked up premiums a fat 13% this year, are facing growing pressure from corporate customers for price relief. For this, they must find ways to cut their own costs. WellPoint Health Networks (WLP), which has 13 million members, is looking for help from the Web.
In January, WellPoint will start rolling out a series of Web sites to help chronically ill patients manage their health. Executives at the nation's largest operator of Blue Cross plans won't say how much they're spending. But they estimate that for every dollar they invest in disease management, they'll save twice as much in medical costs. "Making patients just a little healthier results in fewer claims for us," says Dr. Peter Juhn, WellPoint's vice-president for health-improvement resources.
WellPoint is starting with heart disease. It figures that 3% of its members, or 390,000 people, suffer from coronary illness. WellPoint believes it can save $7,000 for each heart patient it keeps out of the emergency room. The plan is to focus first on the sickest among them, a group of 78,000. The company has started collecting data on diagnoses, hospital admissions, and prescriptions.
PRIVACY CONCERNS. The sickest patients will be eligible to receive WellPoint's "Love Your Heart" service. Here, users will have access to personal sites where they can track their weight, blood pressure, and other heart-attack triggers. They'll set goals, such as weight loss, and record their progress. A WellPoint nurse will be assigned to each patient, posting messages with health tips and answering questions over the phone.
Challenges? Plenty, starting with privacy. One federal regulation prevents insurers from marketing disease-specific information directly to patients who have those conditions. WellPoint is devising alternatives, such as vaguely worded letters inviting members to visit sites that can help them "improve their health."
Another concern is that many heart patients, who tend to be older, are not yet online. WellPoint will back up the Web service with a phone-based version. And it will be targeting younger audiences with its new asthma and diabetes Web services coming out later in the year. By Arlene Weintraub in Los Angeles