21-27 Feature 2

21 Arecent conference in Las Vegas, sponsored by the Emergent Group, focused on the newly emerging field of ConsumerDirected Health Care (CDHC). In many ways it was a flashback from the mid-to-late 1980s, when managed behavioral healthcare was just emerging as a field. Many of the same things are happening now in CDHC as they were then for managed care — the field is being invented as it grows, and there is a sense of a “movement” afoot. Many healthcare industry leaders are saying that we are at another key “inflection point” for healthcare services. Arnold Milstein, medical director of Mercer Human Resource Consulting and the Leapfrog Group, says the first key inflection point occurred with the advent of employer-sponsored healthcare post-World War II. The second was the advent of managed care in the ’80s. The insurance industry is already changing in response to the new products that have emerged with this third inflection point, and over the next decade we will likely find that all of our healthcare begins to incorporate many elements of consumer-directed care. CDHC refers to a number of changes in health plans that increase the role of consumers in purchasing healthcare services. These new health plans seek to increase the knowledge and choices that consumers have in purchasing services, including consumer decisions to purchase services from one of several types of spending accounts. The simple premise is that the involvement of third-party payers has artificially removed consumers from any sensitivity to the costs of their care. As Greg Scandlen of the Galen Institute states, “For too many years, Americans have been divorced from the consequences of By Richard H. Dougherty, Ph.D. Healthcare: Consumer-Directed