July 30, 2019

The Future of Transparency: Can Data Fix Health Care? [Part 2]

Artemis Health recently hosted a discussion with industry experts at BenefitsPro. We’re recapping the live webcast, The Future of Transparency: Can Data Fix Health Care?” in a series of blog posts. Our featured panelists included Jim Blachek, co-founder and principal at the Benefits Group; Lester Morales, CEO of Next Impact; and David Contorno, founder and CEO of E Powered Benefits. Eric Silverman, founder of Voluntary Disruption, moderated. Slides and audio are available on-demand. 

Now let’s dive into the fascinating and controversial question of who owns healthcare data, who should access it, and how it should be used. 

Eric Silverman: I want to kick this one off with Jim. So Jim, who really owns a patient's healthcare data? Is there a danger in having too much accessibility to healthcare data? Why don't you weigh in on that for us?

Jim Blachek: Yeah, thanks Eric. Honestly, the patient in my determination should have access to their total data, as well as the plan sponsor. I've got an example of somebody I'm working with that's a fairly large employer, 175 lives, and their carrier isn't giving them data on a self-funded plan. It just blew my mind. The employer felt that they should have access to the data, but it's been like pulling teeth out of a chicken to get that data. And they've even gone to the extent of hiring a C-level employee at $90,000 a year to be able to manage that data. They couldn't get the data.

They spent money needlessly, and when they thought they could access the data and be able to make actionable items with that data. So the plan sponsor should have access to the data. No, there's never too much data, and access to the data in my opinion. And certainly the patient should have access to their data.

Eric Silverman: Thank you Jim. Lester, what do you think about this question? Who really owns patient's healthcare data and is there a danger in having too much data?

Lester Morales: I was actually Googling if chickens had teeth. I didn't know that. I never heard that expression before.

In my opinion, obviously the plan sponsor, which is the real word for payer. It drives me absolutely crazy when people use the word payer in a self-funded environment and say that the payer is anybody other than the actual employer who's funding most of it, and the employee. Between those two constituencies, those are absolutely the owners of the data.

There are obvious things that need to be protected with HIPAA, if we're going regulatory, but just the right things to do. You get yourselves into a whole bunch of discrimination concerns if data is getting too widely out there. We've all heard the experience of CEOs or CFOs knowing why people are out on leave, and that they're having healthcare issues and things of that nature. That stuff is inevitably going to happen.

As we start supplying more and more data to make more educated decisions, I would advise obviously the advisors on the phone to make sure that the type of data that's being provided to the employer to make the decisions that they are making and needing to make that it doesn't get them into any trouble. It can't be identifiable down to the minimum numbers in each group that they're identifying, and things of that nature. 100% the employer, and 100% the employee owns the data.

I agree with Jim that there's no such thing as too much data, I just think obviously everybody needs to be super smart on the way they display the data and who can see those.

Here's the last thing I'll leave everybody with. If you break the trust of the employee population, because they feel you had too much data, you have essentially sabotaged all of the good things that you could be able to do. Obviously participation, engagement, and overall success of the strategy that we all want to employ is contingent upon the employee population and the members covered under the plan supporting those things. Obviously, that can be done from a carrot or a stick standpoint, but you don't want to turn off the population by defying their trust.

Eric Silverman: Dave, what do you think about this question? Who really owns patient's healthcare data?

David Contorno: Well, I think Lester was in line with this. I might take a little bit more of a different approach, but I believe that it should be owned by two entities, two stakeholders. The payer, which is not only in a self-insured plan, but also a fully insured plan, the employer and the employee, and the patient. That's who the data should belong to. That's not the conventional wisdom. We're very transparent with our clients and we're transparent with their employees, and we talk about the fact that, especially if they're moving from a fully insured BUCA plan to an open network self-insured plan.

Some employees ask, "What access to data is my employer going to have?" Generally speaking, we say, "Any and all." And they say, "Well, I'm not really comfortable with that." And I said, "I totally get that and totally understand that and there's a real easy way for your employer to have zero data on your healthcare. Don't ask them to pay for any of it. But the second you ask them to pay for it, just like when they pay for your travel, just like when they pay for your software, and when they pay for your office supplies, they have a right to know. And a fiduciary responsibility under ERISA to protect not only you, but every single one of your co-workers, and prohibit you from advertently or inadvertently abusing the plan that negatively impacts every single one of your co-workers.

So they have a legal, moral, ethical and financial responsibility to have that data, and to be good stewards of that data. Not only in terms of protecting it from a HIPAA perspective, and the privacy of that data, but also from doing good within the health plan with it.

What do you think of the discussion? Do you agree that payers and patients should both have ownership of healthcare data? Do you think self-insured employers are using the data effectively to reduce costs and improve care? 

Stay tuned for Part 3 of this discussion, and if you’d like to learn more about how Artemis is using healthcare data, sign up for a personalized demo of our platform. 

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