Yesterday, I looked at consumer engagement from the provider organization perspective – the elements of consumer engagement and how to make it happen (see Is Consumer Engagement A Habit At Your Organization?). But engagement is a critical issue for payers as well. And, in The 2016 OPEN MINDS Strategy & Innovation Institute session, Engaging Consumers To Improve Outcomes: Bringing Patient Engagement To Population Health, Carol Taylor, RN, MSN, Chief Clinical Officer at Community Care Behavioral Health Organization described how their organization is increasing consumer connection with services.
Community Care is a non-profit managed behavioral health organization that is part of the UPMC Health System, operating in 39 of Pennsylvania’s 67 counties and responsible for more than 900,000 Medicaid covered lives. Ms. Taylor spoke about Community Care’s consumer engagement philosophy – which is focused on engaging consumers by improving the overall wellness of individual consumers and the community. Key to their engagement strategy is building a care coordination system that encourages peer and family involvement, focuses on integrating physical and mental health care, addresses social support needs, and works with consumers to develop a focused, individualized approach to managing care.
To illustrate, Ms. Taylor described three programs that Community Care has developed to engage consumers. The first is a high-risk intervention for consumers with serious mental illness (SMI). The second program utilizes integrated community teams; and the third uses a web-based technology to help consumers prepare for mental health visits and engage in their treatment planning.
The high-risk intervention program for consumers with serious mental illness (SMI) uses data and post-discharge interviews. The data, such as readmission within 30 days of an inpatient stay, is used to target consumers who are at high-risk of not meeting their recovery goals. Licensed care managers complete post-discharge face-to-face interviews with these consumers within 48 hours of discharge from an inpatient stay to review the social determinants that may lead to the readmission – issues like housing stability and food insecurity. The case managers and the consumer then develop and implement a plan that will help avoid future emergency department visits and inpatient stays. The plans have resulted in a 30-day readmission rate that is 37% lower than consumers in a comparison group.
The second program is an ongoing care coordination initiative using integrated community teams to provide intensive care management for high-needs, high-utilizing consumers. Care managers meet the consumers in their community and get to know them and their concerns. Ms. Taylor says it’s crucial to understand the issues that are important to the consumer and remember those issues. The goals of the program are to reduce thirty-day readmission rates, inpatient utilization rates, and total cost of care for members that have a history of utilization of inpatient services. The program has shown positive results – with a statistically significant decline in readmission rates and high rates of follow-up with primary care providers post-intervention.
The third program is a shared decision making program that utilizes a web-based technology to help consumers prepare for visits to clinical professionals and treatment planning in psychiatric medication clinics. Before a medication appointment, the consumer fills out an online questionnaire that is used to create their own treatment goals and identify their concerns with the treatment planning process. That consumer planning document is shared with the psychiatrist during the appointment. The focus of the program is to facilitate great consumer control over the treatment planning process. The specific consumer treatment planning technology used by Community Care for this function is CommonGround. The technology is made available to consumers through peer-run decision support centers (DSCs) in outpatient mental health centers (see Pennsylvania’s Community Care Behavioral Health Organization To Receive Gold Achievement Award From The American Psychiatric Association).
For more on hitching your consumer engagement strategies to whole person health, check out Consumer Engagement Is The Missing Piece In Population Health, Less Consumer Education Demands More Consumer Engagement, and Mental Health Consumer Engagement More Likely With Multiple Intervention Strategies. And be sure to join the OPEN MINDS team at The 2016 OPEN MINDS Technology & Informatics Institute on November 10 for the session, “Innovations In Consumer Technology: How To Use Tech To Increase Engagement & Improve Satisfaction.”