Apply consumer insights to drive high-value care

June 5, 2016

The hurdle for managed care organizations is not identifying individuals who may benefit from support, rather, it’s finding a way to tailor efforts to engage members in the solutions being offered.

Imagine being able to predict whether a consumer will visit the ER for a non-life-threatening condition. Take it a bit further and imagine pinpointing what condition the consumer will seek treatment for.

Now, imagine being able to prevent that ER visit from happening by providing hyper-personalized, targeted messaging to that consumer to point them to a less-expensive, and faster option near their house, complete with address and open hours.

This approach certainly beats mass mailings with generic literature on ER alternatives.  

Most organizations have predictive analytics engines. These software programs can identify those most likely to experience increased costs, or to follow a certain behavior pattern. This information can be coupled with a population health platform to identify cancer screening, disease management or behavioral health support opportunities.

The hurdle for organizations is not identifying individuals who may benefit from support, rather, it’s finding a way to tailor efforts to engage members in the solutions being offered.

At HealthPartners we don’t have to imagine solving the above problem. When our informatics team identified that every 1% shift in avoidable ER use equaled $1 million in cost savings, we acted.  

This informatics team is known for the National Quality Forum-endorsed Total Cost of Care measurement tool that continues to help our network providers identify and measure the impact of opportunities for affordability in their systems.

Recently, our informatics team added to our robust medical and claims data by including U.S. Census data and de-identified consumer financial data. This allows us to gain a better understanding of the attitudes and beliefs of consumers, and craft messages that will resonate most with our members.   

Using these consumer driven insights and a human-centered design approach, we created a relevant, relatable and responsive campaign to those most in need. Our messages spoke to a person’s consumer motivators and behavior. We saw an 18% reduction in ER use in the campaign’s first phase. Beyond the cost savings, we held true to our mission of providing consumers with affordable and trusted treatment alternatives.

It sounds simple. But having spent three years in a retail setting, I saw firsthand the challenges of creating and executing this approach. In retail, you’re influencing the purchase of a new toy or other commodity. In healthcare, you’re influencing a lifestyle change. Two inherently different things with one commonality: The need to have an understanding of what is important to an individual, and how to craft an experience that gets an individual to act.

Data helps us execute campaigns such as the ER campaign mentioned above, and a recent data analysis effort identified those who would benefit most from medication therapy management (MTM), a program with historically low participation.

The campaign used two messaging techniques tailored to a person’s behavior: social reciprocity, an obligation to take action as a result of receiving a favor from someone; and directed deference, taking action based on expert recommendation. We’ve seen a 44%engagement rate in this MTM campaign, and see an opportunity for $34 million in savings with the execution of a broader campaign.

It’s still early on and we’re learning more each day, but these results continue to validate the approach we’re taking. I can hardly wait to see the future impact we can make in the lives of our patients and members through use of consumer focused insights.

Kevin Ronneberg, MD, is vice president and associate medical director, Health Initiatives, at HealthPartners.