Patient Care Access News

Payer Patient Engagement Key for Chronic Disease Management

Half of patients report that their payers don't engage them enough in chronic disease management.

Source: Thinkstock

By Sara Heath

Despite the fact that one out of two Americans is managing a chronic disease, only half say they are getting enough support from their health payers to help them stay engaged in their health, according to a recent HealthMine survey.

HealthMine’s Health Plan Intelligence Survey, which includes responses from 750 patients, showed that payer support forchronic disease management is lacking, with 52 percent of patients saying they hear from their payers once per year or less.

Overall, 26 percent of patients hear from their health plans once per year, 21 percent never hear from payers, and 5 percent say their insurers don’t even know that they have a chronic illness. Thirty-five percent of patients said they hear from their payer between two and six times annually.

Seventy-five percent of chronically ill patients said they don’t receive reminders or recommendations regarding their specific disease throughout the year.

And when payers do interact with beneficiaries, they are not individualized to the patient’s needs.

Sixty-one percent of respondents said they believe their payer offers the same incentives to the entire beneficiary population, making some patient outreach efforts ineffective. Sixteen percent of respondents said their payers’ communication with them is targeted only to their gender demographics, and 22 percent said communications only centered on billing.

According to Brennan Collins, Vice President of Product at HealthMine, these findings are concerning, especially considering the large role patient engagement outside of the physician office plays in bolstering chronic disease management.

"People with chronic conditions spend 99 percent of their time outside of the doctor's office. What they do in that time determines the quality of their health—and the cost of their healthcare,” Collins said.

Part of a meaningful chronic disease management plan is offering preventive care and reducing the number of times the patient has to go into the clinic or hospital. Although clinicians and payers should ensure they have the resources to help a patient once she falls ill, they must also support the patient to prevent her from falling ill in the first place.

And according to Collins, the patient engagement aspect of chronic disease management should not fall solely on the clinician. Payers must also create strategies to support patients who are chronically ill.

"Plan sponsors must step up and play a bigger role here,” Collins asserted. “Members can be equipped with health intelligence and tools to help themselves. If plan sponsors communicate strategically, they can help teach members how to manage their own conditions. That will help them become better users of healthcare dollars, too."

Payers can better engage their chronically ill patients by using data analytics to determine the specific needs of different populations and creating targeted, personalized messages.

"Health plans have more data than ever about each member, thanks to the growing digitization of healthcare – but they're not deriving value from it,” Collins explained. “Health data creates value when plan sponsors combine and translate it into useful insights that improve health outcomes and lower costs for each member. That's health intelligence."

Ultimately, health intelligence helps individual patients create self-management plans that can contribute to their chronic disease management and overall wellness goals.

"Health intelligence provides personalized insight, personalized clinical guidance and personalized incentives to close gaps in care,” Collins concluded. “It adds up to improved population health, one member at a time."


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