How does a TV on-air news talent wind up as a president in Ohio’s largest health insurance company?

For Erin Hoeflinger, who took over as president and general manager for Anthem Blue Cross and Blue Shield of Ohio last February, the portal was information technology. She knew within a year of starting her broadcasting career that she wanted to do something else.

“Information technology has always been a love of mine,” she explains. “I love to pull things apart to better understand them.” This interest ultimately led her to a position as an IT analyst with Anthem’s prescription management division.

Personal interests also drove her move into health care. When her mother developed serious medical problems, Hoeflinger saw how access to complete and accurate information was critical. She came to understand that information and technology were keys for quality care.

Hoeflinger moved into management at Anthem, working her way up through customer relations. She transferred to Maine and went into sales. In 1995, she was named president of Anthem of Maine. Now back in her home state, she’s ready to push forward with new products that build upon the concept that first brought her to the health benefits industry: using technology to get the right information into the hands of both consumers and providers to secure the best health care possible.

Some of this information comes in the form of what Hoeflinger calls “transparency initiatives” such as Anthem Care Comparison, ePrescribe and the Zagat Health Survey. All three products are online tools. Care Comparison helps members access the costs associated with all aspects of specific medical procedures, comparing fees of local area hospitals. ePrescribe is a program being piloted in the Dayton and Youngstown regions to help physicians manage patients’ prescriptions. Zagat is a site where consumers can post their experiences with physicians.


Informing Consumers
The purpose of these and similar products is to create more informed consumers, Hoeflinger says. Coupled with online wellness programs, such approaches are changing the face of the industry. That’s why she’s precise in talking about Anthem as a “health benefits company,” not a health insurance corporation, because the days of simply collecting premiums and paying claims are over. She sees her mission as helping ensure that Anthem members — 3.3 million in Ohio and 35 million nationally — better understand what it takes to lead healthier lives.

“People with the right information and tools are making better decisions,” she explains.

As an example, Hoeflinger cites personal health savings accounts, where health care dollars can accumulate for medical expenses at a later date. Initially, some in the industry worried that HSAs would discourage people from seeking medical care. But statistics show that people with HSAs are more likely to see a doctor for preventative services and more likely to follow the treatment regimen — practices that ultimately can help hold rising healthcare costs down.

What about the healthcare cost crisis? Hoeflinger points to overuse or misuse of medical services as one part of the problem. But the core culprits, she adds, are the cost of new technology, the consequences of an aging population, and the impact of poor health habits. Only about 3 percent of the U.S. population, she notes, adheres to the four key health behaviors: not smoking, maintaining a healthy weight, eating right and exercising regularly.

“Personal responsibility and behavior account for 50 percent of healthcare costs. That’s why we use incentives in our programs to help our members get healthy,” Hoeflinger remarks. For example, Anthem will deposit up to $100 in members’ HSAs if they complete an online health risk assessment or finish a smoking cessation program.

“We use the carrot approach to health care and changing behavior,” she adds. “People are beginning to understand what it takes to be healthy and are recognizing what it costs when they’re not.”

That leads her back to information as key to bringing spiraling costs under control.

“We spend twice as much per capita on health care than any other country, but we know some statistics say we’re not receiving the right care at the right time,” Hoeflinger observes. “Our goal is to give our members and physicians and hospitals tools to improve that.”

Would universal health care be a step in the right or wrong direction? Before replying, Hoeflinger first makes a clarification.

“I think people get confused between universal care and single payer,” she explains. “Universal care is about everybody being covered. Single payer is government-run health care.” Universal coverage without a single-payer system would be “a bit like Medicaid for everybody,” she adds.

“(At Anthem), we believe getting all the children covered is critical. We also believe in choice in the system. That’s what makes it better, and that’s what people want.”



ANSWERING THE CRITICS

For those who cast health insurers as villains, Hoeflinger points to the efforts that say otherwise. Last year, Anthem’s parent company, WellPoint Inc., announced a three-year, $30 million commitment in grants to support community and state-based initiatives designed to help expand access to care. This included a $2.5 million grant to the CoverMe Foundation to identify and assist uninsured population to secure healthcare coverage in the 14 states where WellPoint has affiliated health plans, including Ohio.

This year in Ohio, the Anthem Blue Cross and Blue Shield Foundation has awarded approximately $340,000 to organizations supporting initiatives such as improving healthy habits for children and identifying disparities in chronic disease treatment. In addition, Anthem has contributed more than $450,000 to local organizations including the March of Dimes, American Heart Association and Red Cross.

This community focus mirrors Hoeflinger’s own leadership style.

“I believe being a business leader also means you have to be a community leader, and that responsibility is so important to me,” she says.

While in Maine, she served on various boards, including organizations with health-related missions. She has yet to join any in Ohio, but is looking at what the needs are and where she may best contribute.

No matter where she commits her service, Hoeflinger stands firm on this ideal: People need to be empowered to take care of themselves. “I think that’s critical, and I think that’s where we come in.”