Earlier this month, my colleague Athena Mandros discussed the relationship between education level and the management of chronic conditions – and the importance of consumer engagement to improving health outcomes (see Less Consumer Education Demands More Consumer Engagement). As we move into a more value-based market, there is an increased focus on consumer engagement – studies show that consumers who are engaged or “activated” in their care have lower health care costs and better outcomes. Health Affairs reports that consumers who are the least engaged have health costs averaging between eight percent and 21% higher than consumers who are highly engaged in their care (see Health Policy Briefs: Patient Engagement). And countless other studies have demonstrated that consumer engagement strategies can result in better medication adherence (see Nurse’s Notes: Patient engagement reduces harm related to medications and Medication Adherence Up 12% For Medicaid Beneficiaries Using Text Messaging For Patient Engagement); reduced utilization of the emergency department (see A New Twist on Emergency Department Utilization – An Innovative ED Outreach Program Using C&BI to Improve Population Health); and lower readmission rates (see Four Ways Hospitals Can Reduce Patient Readmissions).
Value-based care demands that payers and provider organizations think more holistically about care delivery – and a big part of that equation is consumer engagement. To discuss this idea in more detail, I spoke with OPEN MINDS senior associate Sharon Hicks. She noted that the transition to a new model of financing and service delivery means that provider organizations need to consider a new way of thinking about consumer relationships as our system evolves:
When it comes to value-based contracting, the biggest cultural change for provider organizations is taking a step back and thinking about care delivery on a holistic scale. We are used to earning revenue by providing a direct service to an individual consumer, so we think about our role in terms of individual transactions. Value-based payments make us take a step back and think about the health of our population as a whole. Under a value-based arrangement, it may be better for a provider organization’s bottom line to keep people out of the office. Initiatives like text message check-ins, email reminders, and telephone support are designed to help people to function in their real life – rather than only thinking about their care when they’re in the provider organization office. It’s about transitioning from being reactive to consumer needs, to being proactive. That’s a huge psychological change for provider organizations. At the heart of it, there is a goal of moving both the person receiving care and the person providing care into this idea of a holistic and wellness-focused approach to care.
We used to think about patient engagement in terms of how often a person shows up for service, but if we’re not in a transaction-based economy, then patient engagement is something much broader and bigger. It means engaging a consumer to be active in their own care and their own health and well being. Without that engagement, you still have the risk of someone being disconnected from the care environment. And being disconnected results in things like a consumer going to an ER when they don’t feel well because they have no relationship with their primary care doctor, and they don’t know who to call, or how to get a hold of someone to help after hours. The engagement component is really what the entire holistic model is dependent on. If a consumer is engaged as part of a care team, then they are thinking about their role and responsibilities as part of that team when they have a need – as opposed to thinking about themselves as a lone entity who is getting services from all these disconnected care providers.
We have to find a way to get people engaged. That engagement has to transcend just a call introduction from a care coordinator. That’s not engagement and that’s not population focused. Patient engagement in a holistic, population-focused model is about understanding the consumer and their issues and being able to anticipate their needs based on the data and knowledge that you have gathered from across the system.
What does this type of consumer engagement look like? Patient education, shared decisionmaking, more time with health care providers in office to answer questions, remote monitoring technologies, increased tech-enabled communication, consumer wellness incentives – these are all tactics that provider organizations are working with at the consumer level. And at the structural level, patient-centered medical homes, health homes, accountable care organizations (ACOs), and other care coordination models that focus on a holistic, population-focused approach to care are incentivizing increased engagement through value-based contracting.
To see these consumer engagement strategies in action, be sure to join Sharon in New Orleans at The 2016 OPEN MINDS Strategy & Innovation Institute on June 9 for her session, “Engaging Consumers To Improve Outcomes: Bringing Patient Engagement To Population Health.” The session will feature Carole Taylor, RN, MSN, Chief Clinical Officer, Community Care; Nancy Ruddy, Ph.D., Vice President, Patient Engagement, McCann Health, & Principal, Nancy Ruddy, Ph.D., LLC; Nicole Schechter, Psy.D., Rehabilitation Psychologist, Division of Rehabilitation Psychology and Neuropsychology, Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine.
And for more on patient engagement, you can sign up for a free web briefing, “Patient Engagement In Mental Health: Strategies To Improve Care,” hosted by PsychU – featuring Rebecca Roma, M.D., MBA, Medical Director of Community Treatment Teams at Mercy Behavioral Health and Heather Fair, RN, Registered Nurse at Mercy Behavioral Health Organization.