The new healthcare consumer engagement landscape for whole-person health management

NOVEMBER 13, 2019 / BY MATT ADAMSON, VP Product Planning and Innovation, ZeOmega

As health plans and providers transform their operations to support value-based care, it’s important to keep in mind that successfully engaging consumers in their health is also critical to managing costs and outcomes. Inspiring patients to take action independently outside of care settings is notoriously difficult — typical communication tools like portals and behavioral techniques like incentivizing health goals have produced disappointing engagement results. (NEJM) What’s a healthcare organization to do when so much of their success is tied to consumer engagement?

Value-based care makes healthcare consumer engagement a necessity
The shift to quality and savings required for accountable care, Medicare Advantage, and commercial value-based models has fundamentally changed how health plans and providers work together to deliver and measure care. However, the patient’s role in their own health —and therefore quality and cost — cannot be overstated. Not only are they taking on an increasing share of the bill, but their engagement, or lack thereof, significantly influences outcomes.

More than 60 percent of American adults are living with at least one chronic disease (CDC), which cause seven in 10 deaths each year in the United States. (NCBI) As clinicians try to work more closely with healthcare consumers who are living with chronic illness, it’s easy to overlook that actual patient-provider time represents a very small percentage of the overall time spent managing conditions or treatments. Healthcare consumers and their personal care givers are largely responsible for adhering to care plans and making the necessary lifestyle changes to accommodate chronic conditions. Engaged patients educated about their conditions and involved in treatment will more likely succeed in keeping their chronic conditions in check than those who are not.

With better managed outcomes, of course, comes meaningful cost reduction. Patient engagement has proven essential to meeting the cost savings required of value-based models. A study for the National Health Service (NHS) found significant cost-of-care differences between those patients who were minimally activated (engaged) and those more highly activated. Patients with low engagement cost eight percent more in the first year and 21 percent more in the first half of the next year than more engaged patients. (Health Affairs)

Consumers expect more from their healthcare
Another factor amplifying the importance of healthcare consumer engagement is a shift in consumer expectations. As they take on a larger share of medical payments, consumers — especially millennials and Gen X consumers — are asserting more preference for convenience and a seamless patient experience. These groups show promise in wanting to be engaged about healthcare —the top five healthcare websites log more than 190 million unique visitors monthly (eBizMBA) — and will actively seek a provider with engagement methods tailored to their needs. (Salesforce) Without understanding patients’ engagement preferences up front, providers risk losing patients to practices more focused on the patient experience in and out of the office.

The roadblocks to effective engagement
Clearly, healthcare consumer engagement can have a huge impact on care costs and outcomes. While many healthcare stakeholders are creating and testing new solutions, the barriers to effective engagement remain pretty steep for providers, health plans, and patients.

For many providers and health plans, the struggle to engage patients results from:

  • A lack of meaningful, consolidated patient data. EMRs alone are not equipped to present whole-person health and often don’t include the full picture of services for a patient, the social determinants affecting their health, engagement tools like assessments, or analytics capabilities.
  • The primary care shortage across the U.S. means provider time is at a premium and time spent face-to-face is, understandably, prioritized over time spent on patient engagement activities. We’ll talk about how care coordinators are a key component in bridging this gap in the next blog.
  • Reimbursement that isn’t built for patient engagement. Not only is a provider’s time more valuable to the patient face to face, it’s more valuable to the provider, as few are reimbursed for patient engagement outside the exam room.

There are any number of reasons patients may not be engaged in their care, but here are a few we can tackle as an industry:

  • Lack of education and a clear action plan pertaining to wellness and managing chronic conditions.
  • Having the appropriate tools, triggers, and incentives in place. While incentive plans aren’t the be-all solution, they can be effective if paired with education and action
  • Missing the value in patient portals. Patients’ access to online records is a step in the right direction, but without personalization and educational content, most patients lose interest or never access them in the first place. (JMIR)
  • Communication, technology, and language barriers. Consumerization of healthcare means patients increasingly expect a retail experience — communicate with me how, when, and where I want. (Salesforce)

In our next two blogs (blog two and blog three) we’ll take a look at what tools haven’t been working for healthcare consumer engagement — at least not how they’re currently deployed — and how combining the personal touch of care coordination and the convenience of technology presents new engagement opportunities.

If your healthcare consumer engagement program could be more engaging, it may be time to chat. We hosted a webinar with our platform partner Comm100 discussing why and how healthcare organizations are embracing live chat and AI to take engagement to the next level.