Sam’s Club Offers The Prevention Plan

BRIAN KLEPPER

US Preventive Medicine (USPM), an investor-owned, market-savvy firm offering prevention and wellness services, scored a coup last week with its announcement that Sam’s Club would offer a $99 version of their Prevention Plan, a package that includes testing, tracking and guidance. I wasn’t able to grab the associated videos to show on C&C, but here’s a Fox Business Network interview with USPM CEO Christopher Fey, and here’s the Sam’s Club video promo.

The product is real, or appears to be. A study published recently in the journal Population Health Management, co-authored by the eminent team of Ron Loeppke, Dee Eddington and Sami Beg, found significant reductions in 10 of 15 health risks measured in employee populations. All three authors have had financial relationships with the USPM, but disclosed no financial conflicts in the article.

As an astute commenter pointed out in response to Matthew Holt’s post on this at the Health Care Blog, having a retail giant like Sam’s offer the Prevention Plan constitutes an extremely interesting real-world test. When the product is made available in the marketplace, what percentage of purchasers will choose it, and what are their demographic characteristics. Will the product have “stickiness,” and what will the numbers look like in Year 2? Will there be a way to determine whether the cohort of (self-selected) purchasers’ health improved in a way – such as reduced risk – that translates to actual value?

If ever there was a test of consumer-directed health care, this is it.

By way of full disclosure, I owned stock in Specialty Disease Management, a firm that was acquired by USPM, so now own stock in USPM.

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About Brian Klepper

Brian Klepper is a health care analyst, commentator and a Principal in Worksite Health Advisors.
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12 Responses to Sam’s Club Offers The Prevention Plan

  1. Doug Malie says:

    Seems to me tht all USPM did was by-pass the employer. This service offering is similar if not identical to employer sponsored wellness programs. Like employers have found it is difficult to evaluate the true return on investment of these programs and its difficult to incent people to not just participate but to continue to participate over time without having to continually give them financial incentives to do so. That is why companies like United Healthcare gives their employees as much as $350 a year if they participate and score well as measured by cholesterol, blood pressure, no tobacco use, etc. What is likely to happen is that this product will appeal to already healthy adults who haven’t been to the doctors in quite some time and want to validate their current health status. Again, like employers have found, the one who really need it are the ones who don’t want it…remember, ignorance is truly bliss because knowing means you might have to actually do something about it.

  2. I agree with Doug’s comments. Seems that the offering will be limited by affiliating with Sam’s Club. You need a membership to purchase at the “club”, so the demographics of those who might choose the product will be skewed to higher income folks. That’s not to say that middle to upper middle class individuals don’t need help with their health, but this product doesn’t combat some of the very serious and pervasive access issues and health disparities this country is struggling with. It strikes me as nothing more than an infomercial product.

  3. Bethany,

    Let me suggest that that assessment is a little harsh, on several levels. First, like many, many health care firms, USPM is a for-profit entity. They have a refined product that is available for purchase, and while they’re focused on delivering a good service and value, they’re also in it to make money. I’m sure that, by going through Sam’s Club, they were required to get very aggressive on pricing.

    I believe (but am not certain) that individuals interested in the program can purchase it directly, though it might be at a little higher rate than through Sam’s. I agree that the $99 may be out of range for many people, but it certainly compares very favorably with most weight-loss and fitness programs, and its undoubtedly a more evolved service.

  4. inchoate but earnest says:

    according to YouTube, the posted Fox Business Network videoclip has been “privatized”. Message is “This video is private. Sorry about that”.

    Sam’s Club may be on to something, but I agree with the skeptical commenters that Sam’s and/or USPM could have pushed for something a bit more ballsy by mining their customer data for people who they could have offered the program to as an included feature of their membership – with a ‘rebate’ for successful program participation (tell me their customer data bases don’t give them plenty of information to identify – by geography, purchasing patterns, age/gender demographics – an ‘at risk’ member pool).

    This approach would have required them to do some advance communication with members, to let them know what they had in mind, to ‘win’ the acceptance of members before they ran their selection filters, etc. I believe where so many health-related filtering initiatives have failed in the past (think: CVS Rx mining debacle) is they did not properly introduce the ‘game’ to their clients well in advance of the exercise. People are more comfortable sharing their information with service providers they already trust (with their business) if they feel they have been included in the process, informed how it works, etc.

    But the potential value of the results would be considerably greater (particularly for Sam’s) than merely selling a few opportunistic discounted $99 USPM accounts.

  5. My father died at 29 of colon cancer ( I was 1 year, 3 days old)…my brother in law had a massive stroke at 39 years old…do you know of anyone who has had a catastrophic, preventable event? Join us in trying to make the world a healthier place…U.S. Preventive Medicine is not a government program…it is a clinically disciplined approach to using sophisticated web based applications + terrific nurse + health specialists to help you follow a personalized prevention plan.

    Sam’s Club has a visionary approach to improve the health and well being of its 47 million members’ health.

    I do not find anything but good in that.

    If you disagree call me on my cell at 214-288-7544 and I will tell you what it is like to grow up without a father.

    Christopher Fey
    Chairman & CEO
    U.S. Preventive Medicine
    ctfey@USPreventiveMedicine.com

  6. Stefan Wisbauer says:

    In what I say below, please take into account I run USPM’s UK arm.

    The programme is not dissimilar to employer wellness programs, but one does need to look under the bonnet a bit.

    1) It provides an in-depth risk assessment, actual screening, actual coaching, personal plan both for risks and preventive testing schedule, full personal health record, online interventions and more. 9 out of 10 employer programmes cover a fair share of that but are missing what I believe are ‘core components’ for it to work (e.g. do you want your fitness tracking separate from your health record, your coach uninformed about your screening test results, no ‘real measurement’, just self-submitted data etc.) – sounds basic but these things are often incomplete or split, even in employer programmes.

    2) Healthier people will always engage more easily but this seems to work quite well, we have published peer-reviewed outcomes (see Population Health Management, October 2010 issue) that actually track change over time, sure there are limitations to any research (see last section in article) but a lot peer-reviewed data just show that those who already lead healthier lives cost the system less (e.g. Discovery publishes this kind of result) but do not show any individuals actually improving their risk profiles. Check out the top 10 risk transitions, 30% of pre-diabetics were back to normal fasting glucose within a year. Imagine you could scale that to the US population, would save the system a fortune.

    3) Globally, we all have to figure out how to scale that kind of population impact and too few employers do their job on it (or have something that ticks a few boxes but doesn’t really achieve impact), so it’s great to open up an additional channel for those who don’t get it in their workplace or it’s too incomplete to really work. The absence of incentives does mean the average joiner is likely be more health conscious already, there’s no denying that.

  7. Being both a Sam’s Club member and a Costco member as well as an employee of U.S. Preventive Medicine, I can tell you that the members of Sam’s Club cross a very wide spectrum, in fact it appears to me that the Sam’s Club demographics may be of a lower average socioeconomic grouping than say Costco. But be that as it may…..

    We have a health care crisis in this country, with one of the main causes being an increase in the incidence of preventable chronic diseases. If one truly understands preventive medicine (primary, secondary and tertiary prevention) which is what The Prevention Plan is based upon, one would realize that as Dee Edington has stated in his book Zero Trends and in numerous presentations and I am paraphrasing:

    “yes we need to manage those with chronic diseases (tertiary prevention), but in order to bend health care cost trend we need to keep the healthy people healthy.”

    We have an Increasing Prevalence of preventable chronic diseases. There is nothing wrong with enrolling healthy people in a comprehensive prevention program as this is part of the key to bending trend. All of us accumulate health risks as we age, Dr. Edington calls this the Natural Flow and has documented this in studies using data from millions of employees over a long period of time. These health risks lead to health conditions which lead to heath care costs. By reducing risks, one can keep the condition and resulting costs from occurring. The CDC has stated that about 40% of cancers and about 70% of diabetes and heart disease are preventable.

    Dr. Edington’s research has shown that each reduction in risks equates to about $215 in claims (this value is as I recall and I would have to look it up to get the actual figure but its close). And other studies have shown that the productivity costs to an employer are about $2 to $3 for every medical/pharmacy claims dollar. These productivity costs have also been shown to be reduced in association with a reduction in health risks.

    The study on The Prevention Plan I mentioned above as published in Population Health Management, showed that The Prevention Plan can assist individuals to reduce their specific health risks and move to a lower overall risk level, with a significant reduction in the populations overall risks. You can find a copy of this study at our website http://www.uspreventivemedicine.com.

    As to taking the program to those in need, first I would argue that given the trends in obesity, cardiac disease and diabetes all of which are affecting more and more Americans at younger and younger ages across all socioeconomic groups, we are all in need. But, in addition, we would love to take The Prevention Plan to disadvantaged groups or groups experiencing health disparities. We have been working in the Medicaid arena providing disease management (tertiary prevention) for almost a decade (even before The Prevention Plan was conceived) and currently serve Medicaid programs in North Dakota and Arkansas. We also have a contract with the State of Nebraska to provide lifestyle coaching and care coordination for the “Every Woman Matters” program which supplies cancer screenings and medical services to women without insurance.

    Additionally, I have personally testified before two State Health Care Committees and spoken with Governors, Medicaid Directors and Directors of State Departments of Health across the country with a message that if we truly want to bend Medicaid trends and help those in need, we need to provide comprehensive prevention services to them and not wait until they accumulate health risks and get sick thereby providing health care at a much higher cost. It is a very tough sell given the current condition of most State budgets, looking for a quick fix. But I will say that in the Health Reform bill there is $100 million in grants to States to provide incentives to Medicaid beneficiaries for doing preventive things such as smoking cessation etc. We will see what happens with it.

    In regards to the statement about employers already having programs like this. While many employers have some sort of wellness program, typically offered by their insurer, utilization rates nationally are very low. Why? Because people are afraid to share their data with their insurer. Furthermore programs of this type are typically not offered in the small group market. One State I know of that has an exchange where small businesses can purchase insurance from major insurers; has stated unequivocally that the insurers do not offer any wellness programs for the small group market, so they are looking to an outside vendor.

    Many of Sam’s Clubs members are small business owners who may wish to avail themselves and their employees of this service which is NCQA and URAC accredited, in use by large and small employers with employees in all 50 states, and one that also has a published study in a peer reviewed journal documenting results.

    Is the offering of The Prevention Plan today through Sam’s Club the total answer to our country’s health crisis? No, but its a unique effort to bring this type of service to hundreds of thousands of small businesses and millions of people who may not have access to services like it.

    Thanks,

    Fred Goldstein
    U.S. Preventive Medicine

  8. Cheryl Meyer says:

    I am a nurse for U.S. Preventive Medicine. When I “found” this job I couldn’t believe my good fortune. As a nurse, I prefer to focus on health and wellness rather than illness. Prevention makes sense to me. And when disease is already present it makes sense to live the healthiest life possible to avoid complications and progression. It is true that small changes a person chooses to make can make a big difference. And when a member chooses to make a change I love to be part of that. If I can share an idea, remind someone of something they know to be true or give some encouragement it is rewarding to me. All of the health coaches have stories of our member’s positive accomplishments. That’s the best part.

  9. Mark Marriott says:

    Surely the need to ascertain our current health, understand what our risks are and why and then receive the proactive help we need to control and reduce those risks, is relevant, fundamental and desirable for anyone on this planet. We only get 1 body! The means to do so has historically been expensive, poorly publicised, dull and 1 dimensional, focusing purely on assessment, but not the essential ‘what happens next?’ that really makes the difference. Making a product as well proven and charismatic as The Prevention Plan widely available and affordable, can only be a good thing. It will extend lives, save lives and add quality to those years for the individual, family and friends – How worthwhile and powerful is that?

  10. Msworthy says:

    I am also a nurse for USPM but on a more personal note: I come from a family background that honestly did not take “health” seriously but rather ignore it by thinking “It won’t happen to me”. While ignoring our widespread family history of Diabetes and Hypertension, we maintain our culture of good ole’ southern eating. I have watched my grandfather and all of his siblings suffer and die as a result of these Preventible conditions. Now my mother and her siblings are inflicted with these conditions as well and have not taken accountabilty for their health but rely on health care as a presumed easy fix. Being diagnosed with hypertension at 21 was a wake up call. I could have simply taken the medication and said “Oh well, it runs in the family”, but I decided to become more involved in prevention as opposed to intervention by taking the steps needed to lower my risks. I refuse to be the next generation that looks for an easy out by way of medication and costly visits to the Dr, but take accountability daily for my own health. I know my risks, but a product like this helps put my risks in perspective, and also help ME to execute a plan for a healthier lifestyle for myself, my family, and our next generation. To Know more means to Do more.

  11. Rosanne Cain says:

    I joined U.S. Preventive Medicine after thoroughly investigating the company’s mission. Being a licensed health care risk manager with 14 years of medical-legal investigation experience, I tend to look at healthcare practices through a magnifying glass, by nature. When I listened to Chris Fey’s message on the company’s website, I also came to know I would be joining a team with some similar sentiments on a more personal level:
    …my mother died of melanoma at age 39 (a life-long sunburned out-door sports fanatic)
    …my father died of congestive heart failure when he was 57— (hypertension, sedentary lifestyle)
    …my brother died of Hodgkin’s lymphoma at age 39 (thought to be caused by exposure to “atomic cocktail” radiation treatments of his mother)
    …I survived thyroid cancer since age 37 (also thought to be caused by exposure to the experimental radioactive mixtures taken by my mother when I was between 3 and 5 years old)
    All of the illnesses my family had were related to lack of preventive measures we now know of and can share with the world.
    I want to be a part of the crowd changing our culture to one of prevention by spreading the word about all the things we have learned–a brighter, longer future to anyone who wants to listen. This is not some outrageous snake-oil scam…..U.S. Preventive Medicine promotes the truth based on facts in evidence. Check them out.

  12. Wesley Ward says:

    USPM’s wellness program evolves the realm of healthcare. Primarily, its criterion is centered on an educationally based discipline. It provides the individual with the resources to target and monitor potential risk factors, under the direction of certified health professionals in accordance with HIPAA and in accreditation in wellness and health promotion by NCQA and disease management by URAC. The Prevention Plan agenda is effective, primarily, because it addresses the two major needs of its members. USPM understands that healthcare costs (especially corporate employee benefit rates all over the country) are spiking and individuals require an accountable, yet affordable means of centering their specific and general health concerns.
    People, now more than ever, want more for their buck. With a $99.00 membership fee, which includes; an extensive blood examination, evaluation sessions with a personal health coach, and 24-7 online accessibility to your personalized account with the most up-to-date information and associated links about your specific health issues, I argue that The Prevention Plan is a great value and pays dividends to its members through providing healthier, more enjoyable good years! I am an employee of USPM, I am a member of The Prevention Plan and I am a believer in the wellness movement.
    Quite simply, people want to expand the value of their money and they want themselves and their family members to be healthy. This program, reaches out a hand and a means for individuals who have a desire to be proactive and engage life as they want it to be! Being healthy and sustaining a healthy way of life, is an ongoing process. We have harnessed the tool… it is up to the individual to use it.
    In response to the critics and associates of other preventive/wellness firms…perhaps it may be better to build your product up, rather than tear ours down. Thanks for your time and consideration… Wes W.

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