All posts in Healthcare

Treating Debt as a Chronic Disease

by Kael Kelly on September 28, 2011 in Healthcare, Kael Kelly, Varolii News with 2 Comments
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Lessons from the Healthcare Industry on Communicating with High-Risk Customers
Healthcare providers typically approach high-risk patients differently than other industries, such as financial services and its approach to high-risk borrowers. In healthcare, companies like Staywell, ActiveHealth and Alere contract with payers (health insurers) as well as employers to identify patients at-risk for chronic diseases like diabetes, hypertension, cardiac problems and so forth, and work to educate and inform them about behaviors and lifestyle changes that positively impact their health. The objectives are to stabilize their health issues or even move them out of the risk group altogether. The healthcare industry has clearly recognized that there is a huge opportunity to reduce healthcare costs, improve quality of life, and make happier, healthier more productive consumers by taking the time to educate and inform high-risk patients.

On the flip side, the financial services industry faces risk in the form of lending money – be it a secured loan like auto or home or unsecured credit card debt – to someone who ultimately may not or cannot pay the money back in the manner agreed upon in the lending arrangement. How does the financial services industry deal with this risk? They put the person into a general collections process and rely on various means to resolve overdue debt.

The collections process is an important and necessary part of business. The problem is that it's treating the symptom, not the cause.

The cause is that a consumer in collections has made a series of decisions that led them to a place where they are unable to meet their financial obligations. Sometimes unavoidable circumstances occur, like a workplace injury or unexpected health problem that derails an otherwise prudent borrower. Regardless of the reason, people sometimes overextend themselves based on things like false optimism about how much they'll be making, inability to plan, or simply not budgeting well. But what if the financial services industry took the same approach as healthcare, identifying financially at-risk consumers and embarking on a financial management education program, rather than punishing them with high interest rates and painful lending terms? Many banks and lending institutions are already doing this and can see positive results.

Imagine if we could re-wind the clock to 2005 and we had a robust financial management program in the U.S. targeting high financial risk consumers. A program whereby high-risk consumers were programmatically educated around financial risk and counseled periodically by financial management experts, much like a wellness plan engages at-risk members using an engagement specialist or skilled nurse? What if 20% of the people who ultimately have or will default on their mortgages instead decided that no, with a $14,000 annual salary, I can’t buy the $720,000 home (which really happened in central California)? What if there were 20% fewer defaults? Would the economy today be 20% "better?" We don't know. But to me it's an intriguing idea worth considering.

Care Continuum Alliance Forum Recap: The Need for Member Follow-through

by David McCann on September 23, 2011 in David McCann, Healthcare, Industry News with No comments

Dave McCannCCA Care Continuum Alliance Forum Recap: The Need for Member Follow throughEarlier this month, I had the opportunity to go to the annual Care Continuum Alliance Forum, a conference for dozens of disease management companies and health plans. It is a great opportunity to share the latest trends and perspectives on U.S. member/patient engagement. I had the chance to join several interesting conversations on the topic. Here are some thought-provoking factoids that came up during our dialogues:

  • Messaging to consumers in the U.S. is rising at a prolific rate – at least an 11% growth, if not more, when you look across email, texting, and voice.
  • Disease management companies are really wrestling with four problems:
    1. How to segment their member populations so that they can initiate the right engagement campaign to the right group. To get the segmentation right, they are looking at lots of analytics tools to "bucket" groups of patients into right-sized clusters, for whom they apply the right techniques.
    2. Once they get members segmented, they all admit they aren't getting the member engagement/adherence they want. So, they can segment, and get lots of information, but they can't accomplish compliance/adherence goals. This is obviously a big frustration.
    3. Phone access: most admitted they can't get members on the phone with nurses or call center staffs, at the right time or skill level they want. So they know they are trying to accomplish a Sysiphean task. ( remember, rock up the hill Greek guy ? )
    4. Most admitted they need to do more outbound, proactive interception of the patient/member.

In sampling about 40 people in one meeting, a high percentage admitted they hadn't yet achieved the right balance between personal dialogue with members and automated intervention. And economically, they all admitted that their budgets for staff are NOT going up at a prolific rate. Yet they are under pressure to do "better" next year. So there is a real squeeze going on. They have to do more, but with flat budgets at best.

It is clear that our healthcare economy spend can't go up. In one CCA executive meeting, CEOs and senior vice presidents of major health management companies, insurers and industry consultants acknowledged that cost has to come out of the service chain somewhere. At 16 percent of our U.S. GDP, we can't have costs continue to rise. There just isn't the money.

All companies are on the hunt for better efficiency. Efficiency came to the car industry. To the financial industry. Now efficiency is "in" at healthcare companies. And patient/member interaction is a huge potential cost zone. Talking to 100 million disease management members a year, just in the U.S., could cost up to $25 billion. Companies just can't absorb that cost. They need to put that money into their member communications infrastructure, considering the regulatory mandates they are all urgently striving toward.

So more, personalized, targeted, patient reminder technology has to happen. Our economy has digital consumers; who are now "digital" patients. For instance, a recent study out of the University Health Network in Toronto shows patients are far more likely to use their blood pressure monitors if they receive automatic phone calls or texts reminding them to perform the checks, or alerting them to negative trends in their results.

My Prediction: patient/member digital engagement will continue to rise, and accepted methods for reminding, informing and "nudging" patients into action, will only get more frequent, more accepted, and more sophisticated. What do you think?

Medical Therapy Should Include Treatment Adherence

by Mary Cook on July 19, 2011 in Healthcare, Mary Cook with 2 Comments

Being ill is hard. In order for a patient to feel better, he or she must follow the treatment suggested by his or her physician. This willingness to cooperate ensures that the patient is healthier, experiences a higher quality of life, has greater symptomatic relief, and requires less interventional care from unscheduled ER visits and nursing assistance.

What Does Effective Adherence Management Involve?
Effective adherence management involves educating and engaging the patient. By making them an active participant in the therapy process, physicians can help their patients improve their health as well as clinical outcomes. Although this may appear to be an easy task, it is not due to the sheer number of patients requiring care.

Sadly, it is difficult for healthcare providers to administer effective adherence management because they are either:

a) forced to scale back to efficiently deal with current workloads

b) hire additional care support specialists to meet needs, or

c) find a more effective way to generate reports than surveys administered by care support specialists or sent through the mail.

How Does It Benefit Organizations?
Improved and demonstrable patient adherence ensures better care and lower medical cost. Unnecessary hospitalizations, ER visits, nursing home admissions, and excess consumption of interventional treatments become fewer and less expensive.  This is good news for both patient and physician.

Enrollment and Maintenance, an Effective Approach
Engaging plan participants involves three steps. This is an effective way to promote compliance. Here they are:

  1. Awareness of programs - Patients should know that wellness and disease management programs exist. Without this knowledge, they are not able to take part of treatments.
  2. Enrollment of patients and members - Patients or members can be enrolled quickly and without the hassle of long forms or impatient call center employees.  This opens up the arena for questioning. Patients are at ease and can obtain the information that they are looking for.
  3. Ongoing engagement - Once the patient or member is engaged and adherent, the physician will want to keep them this way. They will want to continue to take an interest in their health and the maintenance of it.

Why Patients Fail to Take Their Prescribed Medications
Although it can be a variety of factors, here are a few of the reasons why patients state they do not take their prescribed medications:

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  • Forgetfulness (30 percent)
  • Other priorities (16 percent)
  • Decision to omit doses (11 percent)
  • Lack of information (9 percent)
  • Emotional factors (7 percent)
  • No reason (27 percent)

Based on these answers, the four common areas to improve adherence include patient education, revised dosing schedules, increased hours when the clinic is open along with shorter waiting times, and improved communications between physicians and patients.

Three Secondary but Crucial Criteria
Three secondary but crucial criteria include:

  • Multi-lingual capabilities - Being able to effectively communication in a number of different languages is beneficial.
  • Multi-channel capabilities - Different channels such as cell phones, emails, and text messages improve communication because it appeals to other people.
  • Decisioning capabilities - Intervention strategy can be catered to the patient's needs as well as actual patient response data.

Treatment adherence results when patients and physicians feel comfortable in one another's presence. This allows them to forge a relationship that is built on trust. Once diagnosed with an illness, patients should be given the information that they need to maintain a healthier and happier lifestyle. Part of this education should include a lesson about how important treatments are and how adherence can improve the quality of their lives.

Varolii automates the patient outreach process, using any communication device, and personalizes messages that allow the patient to respond and take action. Our personalized messages to patients and members help efficiently monitor progress and manage care, effectively triage for intervention, and optimize care support resources. Keep in mind that the primary focus of all these efforts towards automating the engagement process are driving towards the goal of healthier patients, superior clinical outcomes, improved economic outcomes and better HEDIS scores. If you would like to learn more about of progressive engagement products, please visit our healthcare solutions.

You can also read the full whitepaper about Communications Therapy Improving Treatment Adherence.

Court Rules Consumer can Revoke Consent to be Autodialed

by Brian Moore on April 19, 2011 in Airlines, Banks/Finance, Brian Moore, Consumer Svcs, Healthcare, Industry News, Mobile/Telcom, Retail, Utilities with No comments
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The customer giveth...and the customer taketh away. Their consent that is.

The US District Court for the Southern District of California has ruled that a consumer can revoke their consent to be autodialed or receive recorded messages at their mobile number either orally or in writing.

The case is Gutierrez vs. Barclay's Bank. Gutierrez is suing the bank for violating the TCPA by continuing to call and text his and his wife's cell phone after he told them not to. Gutierrez gave both numbers to the bank on his credit card application, which by the FCC's declaratory ruling constitutes consent to be autodialed or messaged at those numbers. But after he went past due and started getting calls and texts, he orally withdrew his consent.

The court denied Barclay's motion for summary judgement (which would have ended the lawsuit) where they argued Gutierrez needed to "put it in writing". The court said there is nothing in the TCPA that requires either the provision or revocation of consent to be in writing.

While its never good to see a creditor in trouble for possibly violating the TCPA, there is a silver lining in this cloud.

Gutierrez did not argue against the FCC's ruling on Continue reading →

Strategic Defaulters and Cash Flow Managers

by Brian Moore on April 8, 2011 in Airlines, Banks/Finance, Brian Moore, Consumer Svcs, Healthcare, Mobile/Telcom, Retail, Utilities with No comments
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According to a study by Experian, the recession and housing market meltdown has spurred some borrowers to behave in unexpected ways - so different in fact they have come up with category names: Strategic Defaulters and Cash Flow Managers.

Strategic Defaulters are borrowers with prime or even super prime credit ratings that choose to default on their mortgage, not due to a loss of a job or some other catastrophe, but because they are under-water (house worth less than the mortgage) on their loan. These folks are treating the home loan like it was a bet on a Continue reading →

Welcome Calls are Effective Relationship Building Tool

by Brian Moore on March 15, 2011 in Airlines, Banks/Finance, Brian Moore, Call Centers, Consumer Svcs, Healthcare, Mobile/Telcom, Retail, Utilities with No comments

Welcome calls are a great way for a company to begin a relationship with a new customer. Beyond delivering a heartfelt "thank you" for their business, welcome calls effectively bridge the gap from the point of sale to the point of service. This is especially important when the relationship is established through an indirect channel such as Continue reading →

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