The images of the financial advisor lounging on the beach at your retirement home and attending your daughter’s college graduation will soon be joined by your health insurance agent taking high fat food off your kitchen table and imploring you to finish that 5K run with a sprint. That’s right, huge insurer WellPoint incentivized its employees to improve the health of the 34 million people it covers.
They picked 20 monitors and compiled them into a patient index. The various patient indexes are combined for an overall company score. If WellPoint meets its 2010 improvement goal then 42,000 employees will see the result in their bonus check.
The company’s chief medical officer said linking employee bonuses to care improvements will "get everyone energized about improving health care in our company.” Yes, but which way will this energy go? Corporate chiefs used 30% of their stock option energy to cheat by backdating. Some 700 Texas public schools had their No Child Left Behind bonuses held up due to suspicious test results.
Will the 42,000 work to rewrite their insurance products to cover the most effective treatment options? Will they simply choose not to write policies for even marginally unhealthy patients? A healthier patient to begin with brings “better outcomes”.
Will the 42,000 call you at breakfast to find what’s on the table? Will they meet you at the grocery store to monitor your food choices? Will they jog next to you at the gym making small talk like “how’s the weight?”
Or will 12,000 act like corporate big dogs by lying and cheating to meet their performance target?
Keep in mind other efforts to improve the quality of health care. One insurance company ranks and rates doctor performance in a manner similar to that called for by Medicare Super Chief Mike Leavitt. When one physician fell from the “best in class” status, he investigated why. The company cited his poor performance with diabetic patients. After a search of patient records, the doctor found 30% of his patients cited by the insurer didn’t even have the disease.
Who else will soon enter your living room based on inaccurate or erroneous information? Who is really looking to help you get healthier and who is looking to pad their personal compensation? This system (like all extrinsic motivation efforts) will be gamed. Watch as 2010 nears for the specific creative measures used by WellPoint employees as they spin the wheel faster to reach the cheese…