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TPAs promote consumerism with products and services


The ability to incorporate consumerist elements into their products and services is a major priority for many third-party administrators operating in the health care benefits area.

Helping employers provide the tools their workers need to lead healthier lifestyles and become more informed consumers is paramount, said Elliot Cooperstone, chief executive officer of Prodigy Health Group Inc., the parent company of Meritain Health Inc., based in Westport, Conn. "Our belief is that consumerism is critical," he said.

The company's Healthy Merits wellness program provides a recommended template for healthy living, focusing on areas that people have the most control over and that can have the greatest impact on improving their health, such as physical fitness and nutrition, Mr. Cooperstone said.

The company also has transformed its standard explanation-of-benefits form into a member statement summary that not only lists the health care products and services that employees have received and health care account amounts, but also highlights how much they spend on prescription drugs, including the amount spent on brand-name drugs and how much they could save by choosing generics.

The expanded forms make employees better consumers, said Suzanne Parsons, director of human resources for the National DCP, a service and supply organization in Bellingham, Mass., owned collectively by Dunkin' Donuts franchises that launched a health insurance program last year with Meritain Health's help.

"I think they're keeping a better eye on the costs associated with visiting the doctor," Ms. Parsons said.

Technology is a key element in the ability to offer products and services that promote consumerism, TPAs say.

Minneapolis-based Fiserv Health Inc. acquired CareGain Inc. as part of Fiserv's efforts to help health plans and financial institutions manage consumer-driven health care plans and related health care spending accounts.

"Technology is really important," said Jay Anliker, division president of health plan services for Fiserv Health. "It's another way to help the consumers."