Healthcare executives are part of the solution to better health and lowers costs, according to a new study.
According to a HealthMine Medicare Survey, 60% of Medicare Advantage beneficiaries with at least one chronic condition say that their plan does not offer any incentives to take actions, (e.g., annual doctor’s visit) in order to better manage or improve health. In addition, 75% of respondents say their plan does not provide personal health incentives and recommendations and simply provides similar recommendations to the entire population.
Most recommendations are for seasonal issues like flu shots (39%), and age or gender recommendations (33%). Only 15% of respondents noted that recommendations were about their chronic condition.
HealthMine queried 781 insured consumers age 65+ with a chronic condition who are enrolled in a Medicare Advantage plan. Survey Sampling International (SSI) in June/July 2018 fielded the survey. Data were collected via an opt-in panel.
“The study was conducted to highlight beneficiaries’ perceptions if their health plan provides incentives to manage health,” says Bryce Williams, president and CEO of HealthMine. “Because these respondents all have chronic conditions, the study indicates that some plans could improve in helping plan members better manage health outcomes and therefore cost.”
According to the National Council on Aging, approximately 80% of older adults have at least one chronic disease, and 77% have at least two. Four chronic diseases—heart disease, cancer, stroke, and diabetes—cause almost two-thirds of all deaths each year. Chronic diseases account for 75% of the money our nation spends on healthcare, yet only 1% of health dollars are spent on public efforts to improve overall health.
CMS has incented Medicare Advantage plans to improve health outcomes of beneficiaries while lowering healthcare costs. The focus is on improved clinical quality with the following:
- Improved STAR/HEDIS ratings
- Increased plan performance
- Improved member satisfaction
“The focus on Medicare Advantage plans is aimed at the chronically ill, who represent an outsize share of the healthcare costs in America,” says Williams.
“Health actions is what initiates proper care and disease management,” says Williams. “As beneficiaries are incentivized or reminded of health actions, we have a better chance at monitoring and managing chronic illness in the U.S.”
First and foremost, plans and providers must be able to know how to communicate with each beneficiary, according to Williams. “Generalizing, older Medicare Advantage beneficiaries may prefer phone communication, or email, while those between the ages of 65 to 70 years might gravitate more to texting and digital communications. But generalizations no longer count. The key to incentivizing people is personalized communication. Beneficiaries want to know their plans care about them and their health.”
The survey also found that 77% of respondents did not think that communication from their plan was highly personalized. In addition, according to the survey, Medicare respondents’ perceptions
on the personal or impersonal nature of their plan’s communications:
- Highly personalized for my health needs, 23%
- Only personal to my gender and demographics, 18%
- Impersonal/mass-oriented, 40%
- Only around my bills, 19% (77% not highly personalized)
According to Williams, here are the five ways to incentivize positive health actions among patients:
- Personalized SMS and email reminders for each member to complete appointments and screenings.
- Sweepstakes. Points earned for completing health actions, health coaching, reading articles, tracking health metrics. Users spend on chance to win gift cards.
- Direct rewards. 1:1 gift cards earned for completing health actions.
- Online health coaching for healthy behavior modification like smoking cessation, checking blood sugar for diabetics, eating a healthy diet for people with chronic heart disease.
- Exercise and fitness programs (e.g., Silver Sneakers).