This week URAC released the third issue brief in a series

This week URAC released the third issue brief in a series tracking the progress and challenges facing consumers as they take on more responsibility to choose and pay for health care in an increasingly consumer-focused market.

URAC (www.urac.org), the independent, nonprofit leader in promoting health care quality through its accreditation and certification programs, is expanding its emphasis on ways to further protect and empower consumers in an increasingly more consumer-driven health care benefits and management environment. The three issue briefs tap into the expertise of nationally recognized thought leaders to examine the issues from the perspectives of purchasers, consumers and health plans.

Consumer protection and empowerment have become a leading focus of the accreditation agency. In June 2005, URAC released its Consumer Education and Support (CES) standards, the nationís first accreditation standards to address quality within health plan products with consumer-directed features. In 2006, URAC released its next generation of accreditation standards across 11 of its accreditation programs, including new requirements for Consumer Safety Quality Improvement Projects for medical management programs. Through its accreditation programs, URAC is promoting consumer empowerment by establishing benchmarks for appropriate practices in engaging consumers as they purchase and use health plans, whether traditional or consumer-directed plans.

The issue brief released today, entitled ìHealth Plans Partner with Purchasers in Consumerism Drive,î features observations and insights from Vicky Gregg, chief executive officer of BlueCross BlueShield of Tennessee, and John P. Weis, co-founder and chief executive officer of Quest Analytics, the software company that has linked with Health Grades, Inc. to provide a standardized method to measure and report quality outcome information on hospitals nationwide.

While consumerism is on the rise, consumer empowerment has not yet arrived. The market is still transitioning from one in which purchasers and health plans make most decisions on behalf of consumers. And the tools consumers need to make the best choices, based on both cost and quality, are still evolving.

ìIn the marketplace today, thereís receptivity on the part of employers that consumers should have more skin in the game,î Gregg said. ìHealth plans see increasing demand from purchasers for ways to move in this direction. Most large groups we work with view this period as a transition and are asking us, ëwhat are the steps that take us towards a more consumer-directed plan?í But one of the key challenges we still face is the receptivity of the actual consumer.î

The second issue brief, ìConsumerism Takes Center Stage As Newest Solution to Health Careís High Costsî takes the purchaserís perspective on the rapid rise of consumer-directed health care plans. The issue brief features the voices of Jerry Burgess, president and chief executive officer of the Knoxville, Tenn.-based HealthCare 21 Coalition, and Arnold Milstein, MD, MPH, medical director of the Pacific Business Group on Health and U.S. Thought Leader for Mercer Health and Benefits.

The third issue brief, ìTransforming Health Care: A Consumer-Centered Model Takes Hold in the Information Ageî is positioned from the consumer perspective. It features the voices of Grace-Marie Turner, founder and president of the Galen Institute, the Washington, D.C.-based public policy research organization, and Craig Froude, executive vice president and general manager of WebMD Health Services, a part of WebMD.

Consumer-directed health plans -- high-deductible plans combined with a health reimbursement arrangement (HRA) or health savings account (HSA)óare a small but rapidly-growing segment of the health care market. Between January 2005 to January 2006, the number of enrollees and dependents covered by these plans increased from about 3 million to between about 5 and 6 million, according to an April 2006 report from the Government Accountability Office . Traditional health plans are also taking steps to better educate and inform consumers in the new consumer-oriented environment.

ìConsumerism has experienced rapid growth, but overcoming some of these barriers will take ongoing innovation in the marketplace to ensure consumers get the information and tools they need to be comfortable as champions of their own health,î said Alan P. Spielman, URACís president and chief executive officer. ìURAC is uniquely positioned to provide leadership through education and accreditation to ensure quality initiatives enhance consumerism. We are already seeing leadership emerging from health plans that are transforming their practices in ways that are measurable through URACís Consumer Education and Support accreditation.î