More on Patient Engagement

To engage patients, understand their needs and wants

There is often a disconnect between what health plans provide and what patients want, according to Keith Roberts of Change Healthcare.

Susan Morse, Managing Editor

When engaging patients, look for what works best for the individual.

Two organizations have turned their patient engagement strategies into more optimal care at a lower cost. Both work with the Medicare population.

CirrusMD's virtual care through a chat texting app is able to reach a growing population of baby boomers who are staying relatively healthy as they age.

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At least half of boomer-aged seniors text, and 60% of female boomers text, according to Dr. John Dutton, director at Sutter Roseville Medical Center and medical director at CirrusMD. Being able to offer virtual care is a big benefit for them.

"I think it's huge for seniors to contact their providers easily and get information quickly," Dutton said.

A 20-year-old with a cold is a different type of patient than a senior with a viral illness who is taking five medicines. For older adults, telehealth means getting questions answered without driving to the physician's office or urgent care center, and not having to wait for an appointment.

"Patients want to talk to a provider and they want to talk to them now," Dutton said. "Patients text us from work, home, from vacation."

Insurers are also looking for ways for patients to be treated in a lower cost setting.

The rules for Medicare are still being worked out, but patients will have a prospective minimal payment or no copay, Dutton said.

Several of the largest payer partners are expanding the CirrusMD app to more states and populations as claims-based data shows it saves time and money, Dutton said. 

"I think it really augments the patient experience," Dutton said.


Change Healthcare, in reaching out to Medicare patients who may also be eligible for Medicaid, found that to engage patients, it needed to offer these beneficiaries simplicity, control and personalization to develop the trust needed to sign up as dual eligibles.

There is often a disconnect between what health plans provide and what patients want, according to Keith Roberts, vice president of Engagement at Change Healthcare.

For instance, Change was mailing a 50-page enrollment packet that no one wanted to wade through. Because of regulations, they were only able to compress the document to so many pages. What they did was to mark a yellow stripe on the pages that needed a signature. The return rate increased by 7%.

Consumers also want control over how they receive information. Change was using a robo dialer under the misconception that the dually eligible population didn't use email, when in actuality, most preferred  email.

Change asks consumers about their preferred method of receiving support, by call advocate, in-person or online. The response used to be about 100%, for a call with an advocate. Now 67% prefer online outreach and 11 percent, in-person.

Digital outreach has an 87% rated impression as trustworthy and 100% of those reached in this way understand the call to action to schedule time with an advocate to enroll.

If health plans get all of this right, it's easier to develop trust of an industry of which close to half are skeptical. Forty-seven percent of consumers believe increases in premiums are not due to better care, but to insurance profit motives, Roberts said, citing a Gallup poll.

Health plans have a self-interest in signing up consumers who are eligible for both Medicare and Medicaid. Their reimbursement schedules are improved because they're not spending as much money for care. But neither are the beneficiaries. So conveying the information that becoming dually-eligible benefits both helps to foster trust.


Consumers only want relevant information, Roberts said.

To accomplish this, Change uses AI human-centered design to identify members. Before AI, people were being reached who were not eligible as dual eligibles, which wasted their time.

But AI must be humanized. At its core, design thinking is an empathy based understanding of a human being's needs.

"The healthcare encounter is highly personal," Roberts said.

The increasing trend towards telehealth and text communication must also keep the personal physician-patient encounter. Sometimes patients text because they have a simple question about a lab. But often what they're seeking is reassurance, Dutton said.


The Centers for Medicare and Medicaid Services last year gave Medicare Advantage plans the flexibility to offer virtual services from home, and in October, President Trump issued an executive order promising traditional Medicare beneficiaries the ability to better access innovative plan options, including telehealth.

There has been two views on telehealth. One, backed by Congressional Budget Office figures, is that telehealth saves no money as patients end up visiting a provider anyway. The other argument, which has become more of the trend for the industry, is that telehealth lowers utilization and cost.

Twitter: @SusanJMorse
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Focus on Patient Experience

This month, our coverage will continue a special focus on the patient experience. We'll talk to the thought leaders and first-movers reimagining the how and where of patient-friendly tech, and report on ways to activate, if not delight, the people they treat.