So many health and wellness-related programs today are pinpointing one area of disease, such as diabetes, and providing advice and support for just that one area without taking into effect a holistic picture of the person receiving support. Programs are not as effective this way, and often the members are just ‘checking the box’ in taking their health plan’s calls and texts in order to get the promised rewards.
I spoke to a friend yesterday who is a Type 1 diabetic. She is very frustrated, and remarked to me that she receives numerous ‘Type 1 diabetes support’ calls, texts, emails and mailers on a very regular basis from her large national health plan. But all of what she receives is advice fit for a Type 2 diabetic – and it is nothing that can help her meet her goals. She said it’s very frustrating that they are spending so much money to ‘support’ her needs, but don’t demonstrate that they have the fundamental knowledge that’s needed to support Type 1 diabetes rather than Type 2. She said what she really needs from them is to understand a more affordable option for getting her insulin pump and related supplies, not what they’re currently doing to ‘help’ her. But they are not able to answer her questions in that area – she said “they just keep reading from their scripts.”
I asked why she didn’t correct them, or share with them that their efforts are off base. She said she’d rather just take the incorrect information they are sharing so that she doesn’t risk losing the rewards she receives for participating in their diabetes program. She is concerned that they may not have an actual program for Type 1 diabetes, and then she’d be unable to earn the rewards.
How futile is this situation?
While this is what could be an unusual example, it’s not uncommon for members to be receiving disjointed and less than helpful information and outreach from their carrier. Some may not be receiving any outreach at all – though they would welcome some support.
What’s incredibly important in planning for the most impactful outreach possible is to consider the entire individual
What’s incredibly important in planning for the most impactful outreach possible is to consider the entire individual, and all that they’re facing health and wellness-wise, as well as other factors (such as Social Determinants of Health) that are potentially keeping them from taking the best healthcare actions to support improved health and lowered risk.
Look at this example of a longitudinal view of a member for instance – a 49 year old male with high blood pressure, Type 2 Diabetes, unusual pain script activity (6 prescribing providers, 3 pharmacies), Gaps in Care, High predicted risk score with a predicted risk for a hospital admission within the next 12 months and a predicted risk for Myocardial Infarction.
For this person, how far off base is his ‘wellness program with blinders on’ that’s just providing support and education for his high blood pressure or his Type 2 diabetes? VERY far off base.
This illustration is an example of our Poindexter analytics’ longitudinal member visibility that is powering very impactful outreach programs for our employer, broker, Provider, health plan and TPA clients.
Our clients are utilizing current state and predictive risk analytics to identify those who need support and education – then are taking those lists of identified cohorts and diving into individual-level details with each person they have identified as needing support. Being able to see the longitudinal view of each and every person is driving more powerful program outreach and quantifiable results (that are also measured within Poindexter).