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Part 1 – Three Steps for Healthcare Payers to Save Money

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Healthcare payers have a challenging task when it comes to saving money. Whether it’s a government, a third party insurer, or a corporate employer, they control a mere fraction of what drives their spending. Only 10-15% of health and wellness can be attributed to formal health services. The rest depends mostly lifestyle and adherence.

If you lead a payer organization, you know the bulk of your spending is on chronic disease. Aging populations and rising rates of chronic illness will be your biggest challenges over the next decade. And you know lifestyle and medication adherence are essential for chronic disease prevention and management.

Trends in ‘consumer health’ and wearable technologies offer some hope. These devices and apps keep getting cooler, cheaper, and more popular than ever. But sometimes it seems like a lot of noise, with few strategies if any to ensure these technologies help payers to save money rather than spend more.

Meanwhile, you’ve probably been spending most of your health IT budget on clinician-focused tools. Maybe you’ve started to experiment with a patient portal, or even a personal health record. But now evidence is starting to indicate that these initiatives have limited impact on patient health and wellness.

What should you do next? You should empower your patients to achieve healthier lifestyles and better medication adherence. Patients will be healthier and you’ll save money. But simply paying for wearable health devices and stand-alone apps won’t get you there.

Here are three steps for healthcare payers to save money by empowering patients. Let’s call them, Education or “What did the doctor say?”, Collaboration or “What’s next?”, and Motivation or “Keep it up!”

Education or “What did the doctor say?”

Guess what, the healthcare professionals you pay are generally poor teachers. They know a ton about disease and diagnosis, but usually less about people and psychology. And they’re really busy, with little time to cater to each patient’s unique learning abilities.

Most patients aren’t great learners either. They are usually stressed at clinical visits. They don’t ask questions because they can tell their clinician is busy. And they forget most of what their clinician tells them anyway.

The Patient Visit Record is step one in empowering patients. Clinicians become great teachers by using preloaded and peer reviewed infographic content and recording the conversation. Patients become great learners by being able to replay the teaching session anytime, anywhere.

Collaboration or “What’s next?”

Individuals with chronic conditions have a lot to manage. Their care teams can include a broad spectrum of healthcare professionals as well as their family and friends. Getting all these people to work as an efficient team can be difficult under one roof, let alone across facilities.

To make matters worse, patients often get conflicting advice from different healthcare professionals.  One specialist’s advice can easily differ from another if they don’t have access to the same care plans. This can confuse patients at best, or threaten their safety at worst.

Patient-facing care plans are step two in empowering patients. They are a lay-language description of what’s being treated, what’s next in the treatment plan, and what to do in case of expected or adverse events. They ensure your patients entire care team is following the same roadmap.

Motivation or “Keep it up!”

Behavior change – eating better, exercising more, and taking prescribed meds – is a big part of managing chronic conditions. Behavior change is difficult for many of us, but it can also be the most important factor in your patients’ outcomes and how they use your health services.

Without regular monitoring and support, patients are less likely to adopt and sustain healthier behaviors necessary to achieve their best outcomes. You are less likely to achieve your results.

Personal health coaching is step three in empowering patients. Patients track their biometrics and daily behaviors such as exercise, food, and how they feel. Clinicians can easily monitor a patient population and easily see who needs support and securely message or send content or schedule a phone call.

What’s the value?

Empowering patients makes them healthier and healthcare payers will save money. Empowered patients who are actively working to achieve healthier lifestyles and better medication adherence cost less.  They use fewer health services. And when they do need help, they’ll access the right service at the right time.

If patients don’t learn well, they won’t do well. If clinicians don’t collaborate well, they’ll be inefficient. If patients aren’t motivated to achieve healthier lifestyles and better medication adherence, they won’t. And they’ll use more health services.

Without empowering patients, payers surrender their biggest cost drivers to chance.

Read more in our four part series on the value of empowering patients.