"Health FICO Score"
Dr. Scott Shreeve applies his skills to work on the convergence of medicine, business and technology---which could "... enhance patient safety, increase clinical efficiency, and improve overall quality of care..."
A recent post... brought about by the fact the he fundamentally believes that the medical community has a lot to learn from the finance industry, focuses on one of the tenets of personal borrowing. Scott proposes the creation of a health FICO score. Similar in concept to your FICO score the bank utilizes to determine your credit risk or worthiness, your health FICO score would allow you to cater you insurance plan according to where you fall on the curve of H-FICO scores.
Think about how much better it would be if there was a HealthCare FICO Scoring system in place and a health plan that actually rewarded and incented me to take care of myself. In this scenario, I would be seeking a long relationship with my health plan, independent of my employer, because I might be switching jobs over time, moving, or a host of other things that disrupt that relationship and my insurance. Because of the longer time horizon, my health plan would really invest in getting to know me because our relationship would actually matter. I would take a health risk assessment, a basic laboratory panel, perhaps some physical fitness test, and in the future apply genetic forecasting as well. I would also have a health counselor work with me to determine my real age, which would include reducing my life stressors, improving my health, and applying all the best-practice, evidence-based, preventive medicine practices we currently know. In fact, there might an entire secondary industry built up around "repairing" your HealthCare FICO Score through a boot camp approach to improving your health. My Health Plan would be my advocate and I would pay them money to keep my HealthCare FICO score as high as it can be.
While the concept makes sense and could potentially stimulate many of us to get off the couch, exercise, raise our VO2 max and drop the tire from around our abdomen---as put forth this will be a tool the insurance companies (as they exist today) will use to cherry pick the healthiest of us and deny coverage to the old, infirmed or chronically ill. Perhaps as part of a tiered system where the majority could be covered by a H-FICO concept ---the under 500 club could be further supported by a safety net program so those that fall 2 standard deviations off the curve are not bankrupted by their premiums. A lot of thought and a lot of work needs to go into making a concept like this a reality (In some ways I'm sure the payors are working on this themselves)---but it is an interesting concept.
Howard J Luks, MD
2 Comments
Reader Comments (2)
H-FICO - an interesting concept, indeed. A FICO score can make or break a good rate one is pulling for on that first house. Or devastate someone's chances to get a good rate on a home loan, but would not prevent them from providing for their family. Someone filing chapter 11, 12 or even 7 in bankruptcy court can still buy a car, get a house or have credit cards.
The line an H-FICO would have to tread is a dangerous one in that it could it become the case of life or death. A father with a poor H-FICO who cannot afford the forced out of pocket expense of his cancer treatment and chooses to forgo treatment when faced with tapping into his children's college funds.
Or a young adult riddled with orthopedic injuries is given a poor H-FICO, and can't afford the causal affect from the heightened price of his/her insurance. Whose fault is the orthopedic injuries? The active, “healthy” adult whose injury now has an adverse affect on his/her entire “health future?”
I'd like to think I'd get a good “grade” because I take an active role in my health, but at some point my orthopedic history would win out and I'd probably have the same H-FICO as a life long crack addict.
Great blog - great food for thought...but the reality of this possibility is hard to imagine..
-LD
There is only one important catch when it comes to implementing such an organized and professional insurance program: it costs money and a lot of them the only persons that could benefit from such a program would still be the rich persons that can afford to keep up the pace with the insurance rates.