Your neighborhood bank could become a powerful ally in today’s drive to improve population health.
How? Let’s start with something that is already in the dual domain of medical banking – Health Savings Accounts (HSAs). Many experts have compared consumer acceptance and growth of HSAs with that experienced in the past by 401(k) accounts.
According to Restoring Quality Health Care by Scott Atlas of the Hoover Institute, “HSAs have grown rapidly over the past decade, with a one-year jump of 29 percent as of the end of 2014, reaching a record high of 14.5 million as of mid-2015. Nearly one-third of all employers (31%) now offer some type of HSA, up from just 4 percent since 2005. HSA account holders deposited $21 billion in 2014, and investment assets increased by 40 percent since the previous year to an estimated $3.2 billion by year-end. By the end of 2017, the HSA market will surpass $46 billion in assets held in almost 25 million accounts.”
HSAs are growing despite ACA-derived regulatory pressure, and they represent an opportunity to improve health value for Americans. For example, per the Hoover report, “health spending reductions averaged 15 percent annually, and the savings increased with the level of the (insurance plan) deductible and when paired with health savings accounts.”
If HSAs continue to grow, we need to wrestle with ideas of how to speed adoption to optimize health value for more Americans. One idea being advanced by neurosurgeon and presidential candidate Ben Carson, MD, is a “lifetime HSA.” He advocates for an individual to receive an HSA at birth coupled with a personal health record and Social Security Number (SSN).
In health IT circles, we’ve tried to go down this rocky road of using SSNs for linking data to create a longitudinal record, and it’s rife with issues, so perhaps a unique digital identity can be added to it so that the combined identifier could be used throughout one’s life. With this type of approach, keeping this identity information secure and protected would be crucial, and the nation could lean heavily on the approaches and technology widely used in the financial sector.
You wouldn’t put money into a bank if it allowed other people to access your account; in fact, you expect the bank to know, without a shadow of doubt, that you are you – especially when it comes to accessing your money. To ensure this level of identity protection, banks have spent many millions in current and ongoing investment to prevent unauthorized access. Their consumer identity and integrity solutions are likely more advanced than any industry segment, and certainly more than the healthcare sector. Why reinvent the wheel? We need this capability, and perhaps even more so, when accessing health information.
So how do medical banking and HSAs intersect? Well, banking’s investment in marketing, technology, payments, portals and mobile delivery could be aggregated to provide at least three tools for consumers—a lifetime HSA, mobile PHR and secure digital identity—within a “health-wealth” portal, which could be accessed through online banking to take advantage of a bank’s authentication regime.
For most of my professional life, I’ve advocated for tighter linkage between banking and health IT systems to improve administrative efficiency and health value. Specialized treasury programs automate the processing of payments and remittance data, and point of service transaction systems integrate checking for insurance eligibility with processing of payments. Leveraging bank infrastructure and extending HSA programs to integrate health information makes all the sense in the world.
Healthcare would gain decades-long bank expertise and investment to market health programs, overcoming linguistic and diverse technology adoption barriers across consumer segments, moving the masses from offline to online to mobile banking. We could give life to “lifetime HSAs” plus much more, like dispersing, at large population scale, e-tools to optimize health in a safe digital home. Online banking is already used by more than 70 million households in America, and that number is growing.
There are many ways to evolve this idea. A contextualized, highly personalized experience that is accessible online or mobile—with highly secure access to a PHR, sound lifestyle information, management of employer/health plan incentives, health expense tools and more—is compelling, especially when a healthcare consumer can use the information and make payment and money management decisions on the same platform.
We have a long way to go to move the American health experience onto a digital platform that is consumer-friendly. Moving health online, as banks have done with finance, would have to match where and when the consumer wants to engage health-related information. It would require a multi-pronged approach harnessing many assets—public relations and marketing, multi-lingual resources, multiple IT platforms from laptops to tablets to mobile phones that span generational preference in technology usage, and community presence to drive the change.
Online banking didn’t happen overnight. Someone has to pay to drive that. You can build health IT infrastructure, as many hospitals and doctors are doing using Meaningful Use guidance today, but to get consumers to come is a different story. It’s a paradigm shift.
A key enabler is persistent IT investment, but that’s only part of the need. Banks have shrewd discipline in consumer engagement and proven ability to build global solutions like ATM networks that work 24x7 across multiple geo-policy settings, enabling consumers to access money and financial information anywhere, anytime. Why not harness this well-financed engine to drive healthier lifestyles and health-derived savings and investment?
John Casillas is CEO of BoardTrust LLC, an advisory and advocacy firm to advance medical banking to create sustainable healthcare systems and improve global health.
Register or login for access to this item and much more
All Health Data Management content is archived after seven days.
Community members receive:
- All recent and archived articles
- Conference offers and updates
- A full menu of enewsletter options
- Web seminars, white papers, ebooks
Already have an account? Log In
Don't have an account? Register for Free Unlimited Access