Consumer Engagement Tools

This next session is with James (Jim) Roosevelt (President and CEO of Tufts Health Plan) and Phyllis Anderson (VP of Marketing from Humana). It should include real-life discussions on what works.

Interestingly, Jim is making a point that he made earlier which is about how to differentiate when all the providers are in each plan. I talk about this a lot. My opinion based on what JD Power showed in their study is that communications is the differentiator. How? What? When? Personalization? Rules? Preference based? Integrated?

Jim said that 3-years ago they were in touch with 1.5% of their members on a regular basis…that number is now 22%. I am not sure there is a benchmark to know if that’s too much or too little…but it seems good. Some of the words he uses which I think are important are – cost management, quality improvement, evidence-based, self-care, comprehensive and integrated, effective, and positive ROI.

He laid out a good continuum of programs moving from low cost, healthy programs (wellness) to more expensive programs for at-risk people (disease mgmt) to high cost programs for the chronic patients. Tufts is moving to a consumer empowerment plan called My Wellness Plan which will focus on engaging 100% of their members and still get an ROI of greater than or equal to 1.5:1. He showed a chart that 50% of health costs are driven by health behaviors (good news in that it is an addressable challenge).

He talked about an example around bariatric surgery which I thought was a good case study. Rather than simply not covering it, they cover it after certain steps including a six-month lifestyle modification program. The key point he made is that surgery without behavior modification is dangerous.

They have 3 categories for engaging members:

  1. Lead a Healthly Lifestyle
  2. Manage Care and Treatment
  3. Effectively Navigate Health Care System

He made the point that it could be copied, but the question is do you act first. I think the question really is how well do you implement the vision. It’s easy to envision and know what to do. It’s very difficult to execute it well and make a difference.

Phyllis started with some patient messages which were interesting.

  • Take a deep breath. We dare you.
  • The food groups are your friends.
  • Make you next smoke break a clean break from smoking.
  • Where do you see yourself in 5 pounds?
  • Lower back under attack?

“Healthiness is a nuance.”

As the quote indicates, health information and engagement varies dramatically, and it will take a while and some trial and error.

“Incremental change will ulimately result in significant impact.”

She talked about a pilot they did and what they learned:

  1. Create real-life goals (relevant to where they are and where they live)
    • Want to fit a dress by reunion versus lose 100 pounds in the next 6 months
  2. Community is key
    • Coach
    • Peers (the participants blogged and got feedback via the blog)
  3. Rewards and incentives are necessary
    • Personalized to individual
    • Not just monetary
    • Include recognition

“It costs less to support well people.”  Phyllis went on to make the point that it’s worth spending the money now rather than waiting until people get sick.

There was a good question from the audience on whether ROI mattered.  Apparently, some of the employers here at the conference had said that they were willing to invest in programs that promoted health without any ROI.  I think the key is that there are limited resources…I would spend money first where I got a return.  I am willing to bet that I don’t have much money (or time) to address the other programs.

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