What Does Criticism of CVS Caremark’s New Healthcare Program Really Reveal?

CVS Caremark was in the news a couple weeks ago after they launched a new element to their health insurance program. As part of their standard coverage, all employees have been asked to take a health screening or face a $50 per month penalty through their premiums. As part of this screening, employees must disclose some sensitive information, such as weight or BMI, which would be collected and tracked by a third party.

This new policy created a firestorm.  The first objection was that it was mandatory, forcing employees to disclose information they may not be comfortable sharing.  On top of that, by including weight and BMI, some observers saw this as a first step towards a “fat tax”, where employers could raise premiums or deny coverage for poor health.

While I can't speak to how this info might be used in the future (although use of medical data by employers is illegal right now), I am bewildered by the criticism.  That criticism isn't difficult to respond to:

• Understanding your key health metrics is an important part of maintaining, and ultimately improving, your health.  Although there is little hard data around the quantified self movement, there is plenty of anecdotal evidence that having this data leads to better decisions
• Whether you interpret the $600 as a penalty or an incentive to do your health screening, employers should have some tool to encourage employees to collect this data.  Let’s be honest, most people will not do this on their own
• CVS Caremark isn't the only company doing this – according to the National Business Group on Health, 62% of large employers offered biometric screenings in 2011 and 52% of those had incentives to complete them.  And as one of the largest healthcare companies in the US, it’s important for CVS to be a leader and set the tone for other companies to follow

What I’m more fascinated by is the root causes of this fear.  Given the state of our healthcare system, you would think everyone would be open to new, innovative approaches to reducing costs.  Instead, this is a reflection of larger themes in our national dialogue:

• Backlash against any policy that is perceived to reduce individual choice, even when the decision is made with positive intent
• Mistrust of large corporations and government, with a believe they are nefarious and any data they collect will be used negatively
• A media that recognizes these fears and stirs up controversy by highlighting stories that play into them

As a country, are we so stubborn that we’re unwilling to try new approaches, even if it reduces some of our choice for our own benefit?  CVS Caremark is a Fortune 20 public company and I can guarantee if this program doesn't show results (monetarily or health-related), it will get shut down.  But that doesn’t mean we shouldn't try it, even for just one year.  I agree, there are some policies that may go too far (i.e., NYC’s soda ban – while I applaud the intent, it’s too capricious and difficult to enforce), but shutting down innovation under the pretense of individual choice sets a dangerous precedent.

On top of that, whether we want to acknowledge it or not, large corporations and government drive the economy and agenda of this nation, but also help us live better lives.  Without large business, we wouldn't have Walmart, Apple, or Google.  Without government, we wouldn't have roads, public education, or scientific advances.  And, for better or worse, in order for them to continue serving us and improving our collective lives, they need to be smart about their money, which often times means using data to make better decisions.

The controversy seems to have died down for now, but I believe this is only the start of a larger conversation about the employee-employer relationship around healthcare.

Should Healthcare Run More Like Airlines?

While most people dread flying during the holidays, it’s hard to ignore how efficiently the airlines are able to move millions of people across the country.  While we tend to dramatize issues with flying, today I want to appreciate the tremendous job the industry has done to create an effective (and dare I say friendly?) member experience that healthcare could learn from.

Flight Purchasing

How The Airlines Do It: How do you like to buy plane tickets?  Some people use a travel agent, some people call the airline, others buy online (either directly from the airline or from flight comparison websites).  Airlines give customers several channels to buy tickets by creating their own infrastructure, but also opening up their data for other companies to use.  Freeing up their data also creates price transparency, leading to greater competition and lower prices.  While everybody hates the new fees airlines tack on, decoupling extras (e.g., checked luggage) can also lower costs or keep them steady since only the people who use these services are paying for them.  Finally, customers can also get lower prices through group buying, using companies like Egencia that exchange volume for price.

What Healthcare Can Learn: Right now, you have very few choices about how you can pay for healthcare – given the high cost, insurance is the only route for most people, and that’s often tied to your employer.  This may change with the individual exchanges, as employers may drop coverage and folks will get to choose which plan is best.  As a result, insurance companies will need to create more customer-friendly plans and interfaces to help customers understand their choices in a much more competitive market. 

While healthcare is mostly fee-for-service (i.e., you’re only charged for what you use), there remains a lack of price transparency – do you know how much your x-ray costs?  While new startups have emerged to address this (e.g., Change Health, Healthcare BlueBook), we need to continue to create easier tools and better incentives for people make the right treatment decisions.  Finally, group buying has existed in groups such as Pharmacy Benefit Managers, but newer incentive-based models (e.g., ACOs) have the opportunity to be scaled up.

Pre-Flight Experience

How The Airlines Do It: Airlines have embraced technology to make the pre-flight experience better.  First, airlines use code sharing agreements to fill less crowded flights on other airlines or transfer frequent flyer points across multiple carriers, completely blind to the customer.  Second, airlines have embraced newer consumer technologies – for example, United and American are two of the first businesses to work closely with Apple to integrate their apps with their mobile payment service, Passbook.  Finally, security, one of the most important parts of the operation, is handled by a centralized agency, the Transportation Security Administration, meaning airlines can focus on what they’re good at rather than the complexities of security.

What Healthcare Can Learn: The code sharing agreements are akin to hospitals and doctors seamlessly transmitting patient information across systems.  While hospital systems do this today, it needs to be more portable and touch more patients, possibly through larger alliances that cover more health systems using the same technology.  I also like how airlines are working closely with mobile companies on cutting edge consumer technology – major health systems may benefit from tighter alliances with those major tech companies.  Finally, ceding certain activities to a single group takes healthcare companies out of what their bad at (e.g., data management).  EHRs may be a good example – does it make sense for the industry to name a single standard, and then allow health systems to outsource the work to dedicated vendors?

In-Flight Experience

How The Airlines Do It: Sure, the seats are cramped and the food is mediocre (when there’s food at all), but airlines have done some things right.  First, any in-flight purchases are cash-free, limiting the payment options, but simplifying the process to make things more efficient.  Next, airlines have created partnerships with movie and television studios to present current entertainment options or started handing out tablets to personalize the experience.  Finally, frequent flyers are often rewarded in-flight through a variety of special perks (e.g., free checked bags, automatic upgrades).

What Healthcare Can Learn: Efficiencies gained through limited payment systems would be a clear benefit to healthcare (i.e., eliminating the complexities of the fragmented insurance system means less admin headaches for providers).  The entertainment partnerships are vaguely similar to ACO’s, where there’s an incentive to produce and deliver high quality products – in this case, the airline benefits from having an engaged, happy flyers, and the studios have a captive audience to pitch their best shows.  Finally, I’ve written about “frequent flyer” healthcare programs in the past – integrating something like this into a hospital system could be an effective way to gain loyalty with select consumer segments.

These are certainly pipedreams with a multitude of complexities and challenges, but after flying this past week, I’ve come to appreciate what the airlines have done in the face of tremendous challenges and I’m hopeful healthcare can do the same.

“So, What Exactly Do You Do?”

I dread that question.  Insurance is unsexy, much less drug insurance which is obscure and sounds even more boring.  Then throw on top of that my actual role (product strategy and marketing), which is unique for our own company and tough to understand.  So even after I give the condensed version (“I help people get their drugs at the right place and at a low cost”), I still get quizzical looks before the conversation comes to a grinding halt.

Since the shortened version doesn't work, this week’s post is dedicated to the longer version, which also connects back to how the healthcare system needs to change and what small part my company is doing to help.

At a very high level, my group does three core things:

1) Create Network Products: Employers and health plans (“clients” in our terms) come to us because they don’t want to manage drug spend for the people they employ or cover.  Our company provides this service by acting as a middleman between the clients, their members, pharmacies and pharmaceuticals.  We negotiate drug discounts with pharmacies and drug companies that are then passed back to the client and members through other discounts and lower copays. 

My group specifically analyzes and markets the best combination of pharmacies and discounts to save clients the most money, while still giving members access to get their drugs.  For example, a client can choose to let members fill prescriptions at more pharmacies, making it easy for their members to get their drugs.  However, the client saves money by cutting out duplicative pharmacies and only allow members to fill at selected retailers (i.e., clients can save more money by cutting out the CVS or Wagreens that are within 5 miles of one another).

2) Create Incentives: In addition to choosing what type of pharmacy network they want, clients also need to create incentives for their members to use these networks and continue taking their medication.  These incentives are usually either financial or hard stops.  For example, to encourage folks to use the smaller pharmacy network, we can increase the copay for their drugs by $10 if they fill at a non-preferred retailer – some people will pay that penalty, but many will switch over to our network.  If a client is really serious about saving money through these restrictions, they will put fill limits in place, which means a member’s prescription is not covered if they try to fill that Rx outside of their plan.

3) Encourage Usage: While the incentives are the dollars and cents, we also develop consumer marketing materials to take a softer approach.  These come in the form of letters or calls or emails that tell you how you can save money and the importance of staying on your medications.  They are also used in conjunction with the incentives to make sure we avoid as many rejects and unhappy members as possible.

These efforts result in saving the client and member money by passing along the discounts from these restrictions. At the same time, our company makes a very small profit by charging dispensing fees for each drug processed or a small spread between what the pharmacies pay and what the client pays.  Some argue that we’re increasing the cost of drugs, but without taking advantage of our size (we’re the second largest purchaser of generic drugs in the country), we couldn't get these discounts that far outweigh the fees.

So what does my group teach us about the healthcare system as a whole?  First, there’s real value in intelligently limiting healthcare choices.  By changing the pharmacies a person can fill at, we can recognize up to 10% savings across all drug spend – combine that with other programs (e.g., drug formularies, clinical programs) and we’re talking serious money.  On top of that, our customer satisfaction is at an all-time high, meaning people are not up in arms about having fewer choices.

Second, this is a delicate system that requires incredible coordination.  If any one of these systems breaks – fewer clients come to us for drug benefits, pharmacies start playing hardball, members stop taking their drugs – we will not be able to provide the same services and everyone will be worse off.  Prime examples of this are the spat between Walgreens / Express Scripts and the argument for the individual mandate (i.e., if everyone doesn't participate, then we can’t pay for the people who use the most care).

Finally, it’s going to take a lot of smart people to get out of this mess.  I work with some very intelligent people, yet we’re only impacting a very small part of the healthcare problem, and imperfectly at that.  If we’re going to keep our country healthy, we need a lot more brainpower and energy behind big ideas that are going to make real change.

Why Isn’t Everyone Talking To Their Doctors On The Phone?

Imagine being sprawled across your bed with a cold compress to relieve your throbbing headache.  You haven’t eaten for days and every muscle in your body feels like it’s been through a heavyweight bout.  You know you should see a doctor, but that requires energy that you can’t muster up.

This is the dream scenario for Ringadoc, a startup I recently ran across that lets you call a doctor to diagnose your issue for a flat fee.  Telemedicine has the potential to play a significant role healthcare delivery, filling a gap in primary care that may not be covered through general practitioners and retail clinics.  But despite the explosion of smartphones and tablets, why don’t I know anybody who has used or considered this type of service?  There are a few hurdles for the industry:

1) Accurate Diagnosis and Patient Trust: My wife recently had a skin issue and, because of her busy schedule, was only able to talk with several doctors over the phone.  They recommended some topical solutions and suggested she needed to reduce her stress.  After three weeks it was clear that wasn’t working, so we went to a retail clinic where she was diagnosed immediately, given antibiotics, and felt better in a few days.

Medical diagnosis is a very intimate process and often requires more than just descriptions or pictures to be accurate.  I think the public recognizes this, which is why many folks may feel uncomfortable with this process.  Until telemedicine provides and communicates accurate diagnoses on a regular basis, the public may be reluctant to give it a go.

2) Seamless Technology: To assist in these diagnoses, doctors may also require data such as blood pressure, glucose level, etc.  While the technology to do this over your smartphone exists, it would require a whole other set of devices for the patient to own, be accessible, and be able to use correctly.

On top of that, in order for telemedicine to provide significant value, there needs to be greater connectivity.  For example, if my wife had been accurately diagnosed over the phone, she still would have needed medication, requiring the doctor to send a prescription to the pharmacy.  I’m unclear on whether this connection or the ability to pass along data to specialists or a hosipital exists, but I suspect it’s several years out. 

3) Cost: Of course, looming above everything else is cost.  Telemedicine solutions can range anywhere from multimillion dollar, state-of-the-art labs (as I Simon Cowell plunked down for his tour bus) to Ringadoc’s $40 per call model.  However, until this is promoted or supported through insurance, likely reducing costs and giving the industry more credibility, I’m not sure we’ll see stronger adoption.

That’s not to say the industry isn’t looking at this.  Recently, my company has thought about virtual pharmacies, complete with live connections to pharmacists over video.  While this solution has been well-received, it will be years before we roll this out due to the scale and complexity.

Like the newer retail clinic model, I see a lot of potential for telemedicine to play a larger role in healthcare delivery.  However, there are still several fundamental patient issues to work out before it’s normal to talk with your doctor on your bed.

What Does An All-Inclusive Resort Teach Us About The Healthcare System?

Several weeks ago, I visited an all-inclusive resort In the Caribbean.  While I should have been relaxing and disconnecting from work, my mind kept drifting back to how this model reflected the challenges of our current healthcare system:

1) Overuse of benefits: Anyone who has been to an all-inclusive resort or cruise knows that there is an endless supply of food.  I found myself grazing on snacks throughout the day and having multiple meals even if I didn't need more food.  Although those meals provided no additional benefit (and probably hurt me – did I really need that last plate of nachos?), I ate and drank because it was there and it was free.  Similarly, people with more generous insurance benefits may use more than their fair share of services, which is costly to the system and does not always mean better outcomes for the patient.

2) Subsidizing high cost consumers: Given that a lot of people were eating a lot of food, how do these resorts stay in business?  Serving low cost products is one answer, but they also benefit from the people who don’t consume as much.  These guests are far less costly, but still pay a similar, flat price, helping to subsidize the other guests.  Insurance companies do the same thing, offsetting older, sicker, more expensive patients by balancing their risk pool with younger, healthier, and cheaper consumers.

3) Misaligned incentives for healthy behavior: The resort also offered excursions like scuba diving and zip lining that sounded like a lot of fun.  These trips could have been the best part of our trip, but we chose not to participate.  Why?  It took extra effort to book the trips (we wanted to make as few decisions as possible), they weren't pushed aggressively by the resort (they were provided by other companies), and they cost extra money. 

The public makes similar calculations when deciding between healthy or less healthy behavior.  For example, cooking healthy (or cooking at all vs. going out to eat) requires planning, time that many people may not have or want to invest.  Health foods are also marketed far less aggressively than fast food and processed meals (especially to kids), meaning consumer awareness of their options may be lower.  Finally, anything “healthy” has a stigma (whether true or not) of being more expensive, which dissuades people from making these better decisions even if it’s better for them in the long run.

Interestingly, all of these issues are addressed in the Affordable Care Act (i.e., eliminates Cadillac plans, requires individual mandate to pay for higher risk individuals, allows for free preventative services).  I’m not advocating for or against healthcare reform, but I do think addressing those problems moves our healthcare system away from being a hedonist escape for a select few towards a more balanced, sustainable model.

What Can Employers Do To Encourage Healthy Behavior?

While traditional wellness programs are firmly embedded in corporate culture, a couple articles reminded me there are still a lot of innovative ideas for supercharging health in the workplace:

1) The Wall Street Journal spotlighted the gamefication of wellness program from companies such as UHG, Humana, and Aetna.  As I’ve discussed in the past, the ability to quantify and track progress to a goal, while wrapping in social communities, can make fitness fun. 

However, I’m still not convinced these are good investments.  First, as the article states, the research on these games is thin.  While anecdotes suggest they are successful, we can’t say with certainty if they drive better behavior, especially for people who need it most and may not be participating.

What I find more challenging is the incentive structure.  While a lot of people participate to improve their health, others are drawn in by the giveaways and prizes.  Arguably, the bigger the incentive, the more people who will participate, which is how employers will generate the most savings.  But a bigger prize also means more people may try to game the system (most of these programs are self-reported) or be less than honest about their progress.  The article mentions some programs require special equipment (e.g., a pedometer), but that may dissuade employees, especially those on the fringes, from participating. 

I’d be interested to see a business case comparing the value of the prize to the number of people participating and their average health improvements.  I would be curious to see if there is some prize level that encourages so many people to participate that their benefits, no matter how small, outweigh the costs of others trying to outwit the system.

2) Another article via PSFK highlighted a meeting table withbicycle pedals attached, allowing employees to exercise and generate electricity.  Similar to the hotel concept I previously discussed, I love this idea for a few reasons.

First, it brings fitness into the everyday work environment, but is less awkward than some solutions (e.g., standing treadmill desks), and offers the benefits to a wider range of employees.  Second, it brings a little green energy into the office and encourages environmental conservation.  Finally, from a more practical standpoint, it can cut down on meeting times, which has its own benefits for employees.  In fact, I’ve heard of one other company that has been successful by having only standing tables in meeting rooms. 

Sure, there are some practical concerns to implementing these bikes (e.g., price, worker buy-in, hygiene), but I could see employees of all shapes and sizes using this for the novelty and health benefits.

Can Technology Help Us Shop For Cheaper Healthcare?

Medical cost transparency is the holy grail for keeping our system in balance.  Any high school econ class will teach you that a market functions best with data, so it’s easy to understand why healthcare has continued to be inefficient – it keeps its customers in the dark about prices.  There are products today that force consumers to think more about costs and potentially shop around (i.e., individual health accounts like HRAs and FSAs), but without knowing how much they’re going to spend for treatments, people still can’t make the best decisions.

In light of this, I applaud the Castlight Health and their new app that gives consumers healthcare pricing and quality info on their phone.  By collecting claims data, negotiated rates, and quality metrics, the app and accompanying website show information about doctors in the area and expected costs for services.  The article highlights how the app is especially good for travelers, which help them make on-the-go decisions.

While I love the service, I struggle with the bigger question of how to change mindsets and encourage people to take price into consideration when working with a doctor.  This is especially challenging for patients who have seen the same physician for a long time.  Not only will they be reluctant to talk about prices, but they will also resist building a relationship with a new doctor who, at a lower cost, might be viewed as lower quality (even if data says different).

However, if we’re to rein in costs, patients shouldn’t blindly stick with one physician, or accept their prices, if there are others nearby that provide good quality at a lower cost.  Like any negotiation, the patient needs to be willing to walk away, but this can be a hard mindset to take when this is new territory for patients.

Maybe this will be solved as this generation, which is more comfortable with shopping around for price and understands the healthcare crisis, makes up the bulk of the patients.  I’d also be interested in seeing what Castlight is doing (e.g., member education and communications) to encourage customers to seek lower cost physicians.  Regardless, they have fired the first shot against healthcare price opacity, and I’m excited to see how this plays out.

Can Independent Health Advisors Help Consumers Make Better Decisions?

I attended a presentation this past week discussing health plan reactions to reform. One of my key takeaways was how new consumer attitudes and beliefs were driving change in the industry. A man-on-the-street video highlighted, among other topics, the diverse views around selecting health insurance and the trade-off between quality and price. While there was no consensus around what plans should specifically do, it was clear that consumers yearn for more empowerment as they make decisions about their health.

One of the new solutions described was deploying insurance-backed advisors to help patients choose the right coverage, especially in exchange markets. I think this is a good idea – having a representative walk consumers through the wide range of products can help match a person’s needs to the right product.

However, I’m not sure this model will work for all consumers, especially younger patients. The Internet has created savvy consumers, and any whiff of bias could turn these people off. I like the concept, but I think it could be taken a step further by creating health advisors independent of the industry.

I see this working like financial advisors today (or even rolled into existing financial services). These people would answer basic health questions and help improve health care literacy, whether it’s selecting the right insurance, settling a hospital bill, or understanding preventative medicine. While this could range in engagement (from an annual “checkup” to a 24/7 concierge service), the main focus would be to make healthcare understandable, especially the financial side that is rarely discussed.

The challenge is the business model. A fee-for-service model seems most logical, but could put this out of reach for many Americans. Any sort of rebates or kickback from insurers defeats the purpose and savings calculations, whether it’s vs. their previous plans or vs. expected medical costs, seem complex. Regardless of how this makes money, I think this hands-on service is the right way to customize healthcare to the individual and provide the empowerment consumers are looking for.

Should Patients Be Rewarded For Visiting A Hospital?

In my past life as a consultant, I was a slave to reward points. I would make every effort to fly a certain airline or stay at a particular hotel, even if it was completely illogical.

This is why my ears perked up when NPR highlighted efforts by hospitals to reward frequent customers. The article describes how these hospitals provide valued customers with perks ranging from free parking to gift shop discounts to exclusive classes on healthy living.

Their efforts seem well meaning. In an environment where hospitals are fighting to fill beds, it makes sense to build loyalty and relationships with people who they frequently see. The “rewards” themselves also sound worthwhile – educational programs and social events can be positive reinforcements for this at-risk population.

Despite these benefits, something doesn’t sit right with me. It is one thing to reward people for choosing to use a certain product or fly a particular airline, but it’s another to reward them for something they have limited control over. Patients want to avoid the hospital as much as possible, but these programs send mixed signals, i.e., we’ll teach you how to avoid hospitals, but when you need one, come to us (almost like the ‘Most Interesting Man in the World’ commercials – “I don’t drink beer, but when I do…”).

On top of that, I’m not sure how much choice a patient has in where they can be treated – the patient may be limited by either geography or insurance. Maybe this is a differentiator that can be applied to highly competitive geographies, but I see limited real-world application for this type of program.

Can Groupon Replace Health Insurance?

A recent article by BenefitsPro highlighted the growing trend of uninsured using daily deal sites for healthcare. You don’t need an article to know that this is on the rise – my inbox is regularly flooded with dental offers, skin care regiments, and other health services. In fact, the article says nearly 10% of daily deals last November were health or medical related.

There are certainly benefits to these deals. Consumers, especially those without insurance, have access to common healthcare procedures at a lower cost. As with any daily deal, businesses also benefit by using this as a platform to find and retain new customers.

Unfortunately, I see plenty of disadvantages that could hurt the customer in the long run. First, while customers clearly benefit from lower cost preventative services, many of the deals are for more expensive treatments or cosmetic procedures (e.g., laser eye surgery). These may require the customer to have screenings and a full understanding of the treatment. But with a ticking clock urging them to buy before the deal expires, some customers may make impulse decisions. Best case, they’re out several hundred dollars. Worst case, they put their health at serious risk.

Second, a doctor or center that agrees to discount services may not have a high degree of quality or experience. Clearly customers need to have the right expectations for what they’re getting, but there’s also a moral question of whether deal sites have the responsibility ensure their products meet certain standards.

Third, one benefit of insurance is that the provider can use data from doctors to track a patient’s health and proactively screen for any issues. When a consumer relies on Groupon, they are bypassing this system by running from doctor to doctor. Obviously this is tricky as is with the uninsured, but could be more so with these price sensitive customers.

That said, I think the daily deal model could work under the right circumstances. I could see something like this being valuable for the individual exchanges that will be created through the Affordable Care Act. Customers going through these exchanges will already be cost conscious, and, if the individual mandate stands, they will be forced to purchase insurance. A provider could partner with a daily deal site and promote offers targeted to its members that go above and beyond their coverage, providing more value to the customer. This type of arrangement could provide the oversight and quality assurance missing from daily deals today while not eliminating any of the benefits.

Can the Healthcare Industry Improve New Year’s Resolutions?

The New Year brings an opportunity to reflect on the past 12 months and set goals for self-improvement. Most of us will dust off old resolutions given that most end in failure (almost 90% according to one study). Considering half of people will make a health resolution this year, there is a huge opportunity for healthcare companies to engage an unusually captive audience to keep them on the right path. I believe they can get involved in three ways:

1) Goal Setting: Using industry research or proprietary data, healthcare companies may be able to identify improvement areas, provide specific guidelines to set realistic targets, and clearly illustrate how achieving the goal will improve the consumer's life. For example, a health insurance company may use data to identify specific risk factors and potential behavior changes for a member (e.g., Patient X needs to lose weight based on BMI). Based on their research and Patient X’s profile, they can calculate the optimal amount of weight Patient X should lose over a year. Finally, by demonstrating the insurance premium savings and added life expectancy, Patient X may feel motivated to set these goals

2) Program Development: Users need to develop a realistic action plan and healthcare companies can help users create a timeline and provide advice. For example, after Patient X decides to lose weight, milestones can be set throughout the year (e.g., how much weight should be lost each month) and the company can provide advice on steps to take each month. While Patient X’s insurance company may not provide the services it recommends (e.g., gym memberships, health food providers), the company could partner and offer discounts with other suppliers

3) Program Tracking: Users also need an easy, unobtrusive way to track their progress. This tracking could be through a smart phone app or website, but would ideally be linked to the custom timeline and provide reminders / motivation to the user

The challenge with these solutions is that they require significant infrastructure and data, and ROI could be difficult to calculate. If this is appealing, however, a company could start with program tracking – there are some apps and websites dedicated to monitoring progress (e.g., Big Change). By partnering with one of these developers, a company could start helping customers achieve their existing goals and gradually roll out other features over time.

Should Healthcare Companies Target Pet Owners?

This week, I'm house sitting an adorable hound. I never had a four-legged pet growing up and this is the first time I've had a dog for a longer period of time. Even though I'm several decades behind most people, this first experience is living up to expectations - it can be a pain altering my schedule to feed and walk Lily, but the affection and energy she has more than makes up for it.

The health benefits of owning a pet are pretty clear. Physically, having to take her out every four hours, especially up and down my three-story walk up, keeps me moving. Emotionally, the companionship is a great outlet and can melt away stress in an instant.

I'm surprised that health insurance companies haven't taken more advantage of these relationships. There are easy ways to incorporate this information (e.g., pet ownership as a factor in setting premiums), but there could be other opportunities:

- Partnerships: Could health insurance companies partner with pet retail stores or other animal groups to promote their services within the pet community?

- Pet Insurance: The market for pet insurance is growing - I'm surprised this hasn't been pursued more aggressively especially given 1) a similar, somewhat overlapping business model and 2) these members would likely be more healthy and profitable

- Targeted Messaging: If companies were to collect information about pet ownership, there's an opportunity to create a new segment to target messaging and opportunities