Patient Engagement: The core of effective population health management

The new patient-centric era of reform emphasizes taking into consideration an entire patient population, rather than simply tending to individual patients when they get sick, with the goal of minimizing costly interventions such as emergency department visits, hospitalizations, imaging tests and surgery.[i] This has sparked initiatives to more effectively reach high-risk plan members – those who generate the majority of health costs – and focus on prevention and the challenges of chronic illness.[ii] Engaging patients is not simply about providing them with basic health information, but going beyond this to provide information that is truly relevant and of use to them. For years, employers have taken a one-size-fits-all approach when communicating health information.[iii] The reality is that individuals have varying views and motivations when it comes to healthcare behavior. In a recent survey of healthcare stakeholders conducted by the Center for Advancing Health, six key themes emerged:[iv] Engagement needs to be active The healthcare system hampers engagement Everyone benefits from engagement Engagement is demanding, and many are unprepared Partnerships are required Some of the key barriers are time, access to health services, cost, conflict with lifestyle, and trust and confidence in the people/organizations providing programs.[v] In many cases, patients don’t understand what benefits are available or how to use them, including the wellness and disease management programs that rely so heavily on successful engagement. Others don’t know that they can take steps to improve their health, or know and don’t care. Ultimately, engagement programs must be designed to achieve positive changes in health behaviors, use of health benefits and interactions with providers.[vi] NEXT: Strategies that work Strategies That Work Employers are well positioned to reduce barriers and support engagement by providing access to information, tools, technologies and incentives. Experts agree that a higher touch approach that works directly with healthcare providers and builds on the patient/clinician relationship is necessary for improving engagement. Also, health coaching and disease management programs work well in terms of health outcomes and costs, especially when conducted in-person,.[vii] When employees make good behavioral decisions related to their health, both employees and employers benefit from better outcomes. But employers have to do more to engage their employees in their health and healthcare, especially by aligning incentives.[viii] Technology is now creating new opportunities for employers to do this. In fact, a growing number of employers are utilizing robust data to identify the risk profile of their employee population, and better engage employees by giving them access to: Accurate total and out-of-pocket costs for treatment Easy-to-understand provider quality of care and outcomes information Secure medical records Cost of medications Knowledge about treatment benefits and risks With access to price and quality information, patients can make informed decisions, and choose providers based on cost-effective, quality care measurements. This is significant given that 60 percent of all healthcare costs are influenced by the behavior and decisions of individual patients.[ix] NEXT: Tailoring healthcare Employers are also tailoring healthcare communication to be available across platforms – i.e. the web, smart phones, e-mail – when and where the employee is most likely to access it. These personalized, data-driven strategies target patients of every risk profile and for different populations, including factors such as ethnicity, education and income level.[x] Increased compliance helps employers save money. Therefore, an investment in reaching consumers in an effective, proactive way easily offsets costs by improving levels of engagement.[xi] Employers can also partner with a healthcare service company that offers engagement programs and access to high performance networks – exclusive groups of quality healthcare providers and health professional organizations recruited to serve a defined patient population. These networks are based upon sophisticated data analysis that identifies providers that deliver quality care while keeping costs low. By choosing the highest-quality providers, employers can better meet the healthcare needs of their employee population, improve individual outcomes and enhance personal satisfaction with healthcare coverage. There is also an opportunity to align interests and incentives with patients – rewarding them to focus on wellness/prevention and adherence – and lower provider utilization.[xii] When employers get involved in employee population health, they can make a significant difference, helping employees to develop the skills and confidence they need to become more accountable for their own health. Using data measurements, employers and providers alike can work together to tailor communications, support and education to each employee’s level of need. This in turn can lead to employees taking a more active role in their own health and disease management.[xiii] The combination of stakeholder partnerships and utilization of sophisticated data also makes it possible to identify employees who require the most attention – those who are at the highest risk but are also the least engaged – and who, for example, may require monitoring for blood pressure and blood sugar levels. While they may represent a large part of an employer’s health care spend, their early detection represents savings in contrast to identifying them later on. Joseph Berardo Jr. is CEO of MagnaCare, an administrator of self-insured health plans for employers in New York and New Jersey. [i] Hodach, Richard; Institute for Health Technology Transformation; Population Health Management; http://ihealthtran.com/pdf/PHMReport.pdf; accessed November 20, 2014. [ii] Hodach. [iii] Burns, Joseph; The Next Frontier: Patient Engagement; Managed Care; June 2010; http://www.managedcaremag.com/archives/1206/1206.engagement.html; accessed November 20, 2014. [iv] Center for Advancing Health; What Employers and Purchaser Representatives Told CFAH About Patient Engagement; August 2014; http://www.cfah.org/blog/2014/what-employers-and-purchaser-representatives-told-cfah-about-patient-engagement; accessed November 20, 2014. [v] Center for Advancing Health, 2014. [vi] Center for Advancing Health, 2014. [vii] Center for Advancing Health, 2014. [viii] Center for Advancing Health, 2014. [ix] Burns, 2010. [x] Burns, 2010. [xi] Burns, 2010. [xii] Goozner, Merrill; Building narrow networks that work; Modern Healthcare; 2013; http://www.modernhealthcare.com/article/20131221/MAGAZINE/312219986/building-narrow-networks-that-work&template=mobile; accessed September 9, 2014. [xiii] Burns, 2010.