The famous world traveler, Dr. Nick (he’s also CMIO for Nuance Healthcare), is attending #AMDIS15 and was kind enough to share out this awesome image:
This slide was shared by Coray Tate from KLAS and is a great message to consider.
I also don’t think we should come down too hard on Humana. As healthcare companies start to stretch the normal, stuff like this is going to happen. I think that’s a good thing. At least the diabetic now had a chocolate bar that they could share with someone like me. Then, they’d have a happy friend and making a friend happy is worth so much more than a chocolate bar.
Perhaps Humana has Joe Biden on their PR team.
So here’s my HMO Disease Management story.
I have two sons who when they were younger were diagnosed with asthma. After ten months of doctor visits, asthma meds and an ER visit for asthma, we get a letter that “We (the health plan) believe your child has asthma.” We get the same letter annually for four years. Then they say they are going to send us an asthma kit. The kit comes in a box in the mail and includes a good educational piece, a video tape and a hand puppet to go along with the character in the video tape. My wife a nurse proceeds to throw the hand puppet in the trash. I ask her why, she says our children are allergic to dust mites and I get rid of all the stuffed animals etc. The HMO sent us something that will trigger my sons asthma. (Unbelievable #1)
As the founder of a DM company doing asthma DM, I asked my wife to enroll my sons in the HMO’s asthma program so I can get some idea of what they do. It’s the typical quarterly phone call model. She does not tell them she is a nurse or that she also has HMO experience. During the first call she asks if one of our sons should get the pin prick allergy test or the blood one. The nurse on the phone responds ” I can’t discuss that; we can only talk about asthma, not allergies.” (Unbelievable #2)
On the next quarterly call the question from the nurse is “has your son been admitted or had an ER visit since we last spoke?” My wife asks her “Don’t you get the claims data?” Answer “No we can’t see that”
Then one year my elder son who is now about 12 years old gets a letter from the HMO addressed to him, it says “We believe your child has asthma.” (Unbelievable #4)
Little has changed…
Fred,
Thanks for sharing those stories. Pretty amazing stuff.
A bit disheartening for someone in the industry to see and part of the reason why DM, which actually does work when done right, went out of favor.