By Julie Appleby
USA TODAY
When Denise Micale was diagnosed with a rare form of cancer, she began a frustrating
search for information: Was it treatable? Where could she find doctors familiar
with the condition?
Even
though she's a nurse who helps patients in similar situations, Micale was stumped.
A search of the Internet wasn't helpful.
"Basically, the information said, 'You’re going to die in a year
and a half,'" Micale recalls. "My husband panicked."
She turned to an unlikely source: her husband's employer, Honeywell. The company
offers a new kind of benefit for employees or dependants diagnosed with serious
health concerns.
With a telephone call, Micale was linked to researchers and doctors, who asked
about her diagnosis, then sent her stacks of the latest medical research on
the condition.
Micale, 46, learned her cancer of the abdominal lining wasn't necessarily fatal
-- and was able to find five places in the USA where doctors are treating the
condition.
As employers begin to offer insurance coverage that requires workers to take
on more financial responsibility for their health care choices, a few are also
trying to provide information to help them make those decisions.
A handful of start-up firms are rushing to fill the information void, offering
medical literature searches, data on the quality of local hospitals and information
about treatment options. Even though such services cost more at a time when
health care spending is already rising in the double digits, employers say the
services will improve medical care, cut expenses and boost worker productivity.
"It's been very successful," says Brian Marcotte, vice president,
benefits and compensation programs, at Honeywell. "People are very interested
in finding out what's the best treatment, the side effects, what to ask physicians."
Consumer groups are greeting the new services cautiously. Much depends, they
say, on the accuracy of the information and how it is used.
But, overall, "More information for consumers tends to be a good thing,"
says Gail Shearer of Consumers Union, publisher of Consumer Reports magazine.
"Too often in the past, treatment alternatives have been treated like secrets
to be kept from patients."
In the two years since Honeywell signed on with Consumer's Medical Resource,
the program has been extended to 80,000 employees. CMR charges Honeywell $1.35
per employee per month -- and provides those diagnosed with any of more than
40 conditions with tailored medical information. It does not make recommendations,
nor do its doctors examine patients.
"This is not a second-opinion service," says David Hines, founder
of CMR. "This is an informed-decision-making service, to help you know
everything about a disease, its prognosis, treatment options and the questions
you should be asking. We don't tell people what to do."
Hines says CMR saves Honeywell more than $2 for every $1 it spends, even though
only a small percentage of employees will ever need to use it: "We're probably
addressing 3% of the population, who drive 35% to 45% of the cost of health
care."
Now that Honeywell has rolled out the information service, it plans to introduce
new types of health insurance options next year. Dubbed "consumer-driven
health care," such policies are increasingly being offered by insurers.
Many employers are eyeing them as a way to help save costs by getting patients
to act more like consumers, directly spending some of their own money on health
care.
The CMR service will help patients decide which types of treatments to pursue.
"Consumer-driven health care will be the future," Hines predicts,
"but the way you do it is to support employees with the proper information
before you run off and start giving them spending accounts. Otherwise, it will
fail."
Hines says his service saves money in a variety of ways. Sometimes, the information
leads patients to choose more conservative treatment: medication rather than
surgery. Some are able to reduce the medication they take. In a few cases, patients
have learned they were misdiagnosed.
At iHealer, President Hollis Leech says her firm uses data developed by the
think tank Rand to help patients decide on treatment options. According to the
data, some surgeries are unnecessary or inappropriate, putting patients at risk
and raising health care costs by billions each year.
Leech says that if more women, for example, found out about alternatives to
hysterectomy, the USA might save up to $2 billion a year in unnecessary surgical
costs.
Marcotte said one Honeywell employee was told he had Parkinson's disease and
began taking an expensive medication. The man sold his home, moved closer to
his children and built wheelchair ramps, in anticipation of declining health.
Then the employee called CMR for more information and was asked if he'd ever
had a specific diagnostic test for the condition. He had not. Turned out, he
didn't have Parkinson's.
Another employee had a child for whom heart transplant surgery was recommended.
Through research provided by CMR, the child's parents learned of an alternative
that did not require the risky procedure. The child is now doing fine, Marcotte
says.
Micale says the service helped her avoid a second surgery for her condition,
although it did also result in some medical expenses. Armed with the data from
CMR, she persuaded her HMO to send her to see an expert at the M.D. Anderson
Cancer Center in Houston, although the HMO had initially turned down her request.
"My original oncologist said, 'We'll just have to open you up again if
you continue to have a problem,'" says Micale. "I was getting to the
point where I might have gone through another surgery."
After consulting the expert in Houston, Micale switched medications and will undergo a specialized X-ray scan every four months to track the cancer -- and she's feeling better: "This made me feel that I have some hope."
