Something a professional can do is take note of the surrounding neighborhood to help fill out the social determinants of health (SDoH) picture. Members who live in “food deserts” will find it far more difficult to adhere to a healthier diet no matter how motivated they are. Understanding the inherent barriers to activation will help ensure plans of care are designed to overcome or avoid them.
To date, adoption has been slow due to costs in areas other than in Medicaid programs. But as healthcare in general recognizes the value of understanding the SDoH and other environmental factors that contribute to member health, the pervasiveness of face-to-face, in-home visits is expected to grow.
Once this non-clinical information has been gathered, health plans can work with members and their providers to help develop care pathways members will embrace rather than resist or avoid entirely. For example, the mother who has trouble walking but wants to dance at her daughter’s wedding can be shown how purposeful walking over a very short distance for a few days can lead to progressively longer walks, and ultimately lead to dance lessons or practice sessions at home.
Then, once the behavioral change has been implemented for that specific, member-driven goal, it will be far easier to carry forward as a matter of habit. This, in turn, can lead to slowing, stopping or even reversing disease progress, depending on the condition. When that happens, emergency department visits, inpatient stays, and unplanned readmissions are likely to be reduced, lowering the cost of caring for that member while improving member health and satisfaction overall.
Perhaps most important, the health plan will become an active partner in the member’s health instead of just a deduction on his/her paycheck or a place to send monthly checks. This relationship-based approach will help build member loyalty and gives health plans something to compete on other than price.
Analytics and population health management, by their nature, are about working with huge numbers. However, you can’t forget the human element behind those numbers.
As any successful professional coach can tell you, coaching people on an individual basis and determining what motivates them rather than using a single, cookie-cutter approach, isn’t easy. But it’s well worth the effort, because it enables you to make a real difference. It’s like women’s basketball legend Pat Summit has said, “Coaching is the great passion in my life, and the job to me has always been an opportunity to work with our student athletes and help them discover what they want.”
Approach your members in that way and the dividends will be enormous.
Marina Brown is vice president of clinical programs for eQHealth Solutions, a population health management and healthcare IT solutions company that touches millions of lives each year. The organization has more than 30 years of experience working with payers, providers and government entities on increasing quality outcomes and optimizing payer and provider networks. She can be reached at [email protected].