Eight ways managed care should be using mHealth

March 14, 2016
Robert Oscar
Robert Oscar

Robert S. Oscar, R.Ph. CEO/president of RxEOB, has more than 25 years of experience in healthcare, having developed and implemented successful programs to effectively manage pharmacy benefit risk, including pioneering work in the Medicare HMO market. In 2

Learning to use mobile health or mhealth is a critical advantage to providing the highest return on investment for plans and providers.

 

 

U.S. healthcare is the most expensive in the world, according to The Commonwealth Fund. Despite the high cost of healthcare, American doctors and patients rate the U.S. healthcare system lower than its cohorts on most performance dimensions, from patient outcomes to access, efficiency, and equity.

One proven method of improving those performance dimensions is mobile health, or mhealth. It offers new strategies for meeting healthcare needs. These strategies are more efficient and convenient for the patient, and they streamline the management of chronic diseases and pharmacy utilization.

Mobile Health also helps improve flagging performance dimensions while decreasing costs through time savings, fewer hospital readmissions (up to 44% in one case), and better patient outcomes, especially with traditionally hard-to-reach populations like the homebound or patients in rural areas.

By focusing on certain trigger points in the patient’s health cycle, like appointment reminders, medication reminders and even educational opportunities through mobile devices, patients receive the information and guidance they need to become active participants in their healthcare.

Similar to the strategy used successfully by marketers to convert customers and increase sales, mHealth prompts plan members to act as consumers of their own health and wellness.

Since more than 50% of payers intend to invest in some type of trigger-based communication, according to a study from IDC Health Insights, learning to use the medium is a critical advantage to providing the highest return on investment. Here are eight ways to maximize mHealth.

 

 

 

Mobile apps

According to industry experts, 500 million mobile users worldwide are now using a healthcare app. Patients aren’t the only users, they also include professionals and caregivers. Apps can be developed for pharmacy benefits, provider networks, preventative care or general managed care. They can range from texted appointment reminders (for more, see the next slide); to on-demand, paid video appointments with doctors; to apps that take an accurate cardiogram and send the results directly to a physician. In 2013, FDA issued its protocol for overseeing mobile medical applications. They must approve any apps that would put patients at risk if they don’t work as intended, and any apps with technology that can impact the functionality or performance of traditional medical devices.

 

 

Text messaging

Using healthcare messaging allows providers to take advantage of texting and push notification technology. This can reduce costs by decreasing the traditional, more costly contact methods like phone calls and mailers. It also lets consumers receive the info in the method they prefer. One survey found that 68% of patients feel comfortable when their doctor uses digital technology to automate administrative functions. In addition to appointment reminders, messaging can also include reminders, wellness and medication adherence.

 

 

Wellness reminders

Due to increased copays and higher deductibles, the consumer’s cost-share of healthcare is growing. One way to help patients improve their health, which also cuts costs and improves patient outcomes, is to send wellness reminders. Studies show that text messaging helps patients with smoking cessation and diabetes management. Wellness reminders also improve treatment compliance, such as medication adherence and doctors’ appointment attendance.

 

 

Medication adherence

Only 50% of American consumers take their medications properly and even fewer get their prescriptions refilled. This poses a pricey issue for managed care as the cost for medication-related hospital visits totals approximately $100 billion a year, according to one study. Mobile health solutions can help lower this expense by targeting consumers with reminders to fill, take and refill their prescriptions. Because most patients find technology inviting rather than intimidating when it comes to helping them manage their health, using mHealth to push for better medication adherence can also improve consumer satisfaction.

 

 

Big data

More healthcare data is being captured than ever before. Smartphone apps are just the beginning, as data will also be collected from wearables like Fitbit and Jawbone, as well as the data from doctors, managed care companies, pharmacies and more. This information will be rolled up with the data from millions of other patients and used for predictive modeling, early diagnosis and treatment of illnesses.

 

 

 

Remote monitoring

mHealth can be used to obtain information such as blood pressure, weight, blood sugar and even cardiac function. This real-time data can be used to more effectively manage chronic illnesses and predict when an intervention is necessary. Apple and Cleveland Clinic are already moving into the remote monitoring marketplace. Remote monitoring is especially useful for homebound patients or patients in rural areas, where doctors anywhere in the world can continuously track both healthy and at-risk patients. Catching and correcting conditions early should reduce costs and improve outcomes. The main issue with remote monitoring, in addition to pulling data from multiple platforms, is getting doctors paid equitably for the new service.

 

 

 

 

Patient education

Patient education, particularly pre-surgery education, has proven to increase patient satisfaction, reduce post-surgery problems and improve patients’ quality of life. Technology applications include chronic disease management, surgery prep and wellness. Potential outcomes include reduced hospitalizations and costs, plus increased customer satisfaction.

 

 

 

Reporting

Whether it’s drug utilization, prior authorization or formulary management, reporting is a critical aspect of managed care. Noncompliance issues are costly in regards to lost time and labor, and they can be detrimental to a healthcare organization’s overall standing. Taking advantage of mHealth solutions that allow reporting to be handled in real-time on any mobile device can streamline administrative tasks that many managed care companies have to deal with on an ongoing basis.

Robert S. Oscar, R.Ph. CEO/president of RxEOB, has more than 25 years of experience in healthcare, having developed and implemented successful programs to effectively manage pharmacy benefit risk, including pioneering work in the Medicare HMO market. In 2000, he founded RxEOB, a provider of software and mHealth solutions for PBMs and health plan providers.