Patient Engagement Strategies Are about to Become Even More Critical
Late last fall, Medicare announced that more than 2,600 hospitals were subject to hefty fines under the organization’s new Hospital Readmissions Reduction Program. Kaiser Health News reported that the price tag for those fines could reach $428 million this year.
While readmission rates actually improved from 2013 to 2014, only 128 of the hospitals that were fined in 2013 improved readmissions rates significantly enough to avoid the penalties in 2014. This could be attributed to the addition of two more patient categories to the scope of the program, but it’s clear that we need to refine our patient engagement strategies if we want to make a dent in readmission numbers.
Patient Engagement Positively Impacts Outcomes and Costs
Recently, researchers have found proof positive that successful patient activation is an effective tool for improving outcomes and reducing healthcare costs. The study, which was published by Health Affairs, analyzed activation among more than 32,000 adult patients at Fairview Health Services in Minnesota.
The research team, headed up by Jessica Greene, a professor in the George Washington University School of Nursing, conducted the study over two years, ranking patients on a scale of one to four based on their abilities to manage their own health and healthcare.
The study revealed that:
- High scoring patients fared better on 9 of 13 outcome measures.
- Low scoring patients showed reduced chances of positive outcomes on 7 of 13 measures than their more activated cohorts.
The study also brought to light significant cost advantages -- and disadvantages -- depending on a patient’s activation level.
- The most active patients enjoyed projected costs that were 31 percent lower than the least active patients.
- Costs increased as activation declined, rising 14 percent with a single level drop in the activation measure and rising 27 percent when activation dropped from level 4 or 3 to level 2 or 1.
Judith Hibbard, a senior researcher for the University of Oregon’s Health Policy Research Group and the creator of the Patient Activation Measure used by Greene’s team, told Fierce Healthcare, that the study suggests patient activation is a critical tool for care providers--and ACOs, in particular--that are looking to, simultaneously, reduce costs and improve health outcomes.
“The greater the activation level,” said Hibbard, “the greater the odds of better outcomes and lower costs.”
Important to keep in mind is that patients differ in their motivations and triggers for activation. How does a healthcare professional shift a patient from low to moderate to high levels of activation? A one-size-fits-all approach will not work, because patients do not all think and act alike, or share the same communication preferences.
Psychographics, or insights into patients’ attitudes, personalities and lifestyles, can help a healthcare provider appeal to patients’ motivations and trigger desired activation. Psychographic segmentation helps systematize these insights and make it practical to engage a patient population in practical outreach. For instance, patient engagement software like that offered by PatientBond can customize communications (message and vehicle) according to segment preferences to cost effectively address objectives such as reduction in 30 day hospital readmissions, medication adherence, and reduction in missed appointments through appointment reminders.
Hospital Budgets under More Pressure than Ever
Hospitals are still adopting new health IT at a rapid pace. According to a Health IT Analytics’ survey of 1,000 hospital executives, the top three technology investments on hospital leaders’ agendas are tools for:
- Managing the long-awaited transition to ICD-10.
- Addressing population health with better data management and clinical analytics.
- Driving patient engagement with patient portals.
Between these investments, financial penalties for failing to reduce readmissions and the pressure to transition to value-based reimbursement models, hospitals need to realize savings wherever possible. If the Health Affairs study is any indication, robust patient engagement strategies will be vital to effective budget management.
According to polls, “… more than 80 percent of Chief Medical Information Officers and 68 percent of Chief Information Officers leading the charge towards technologies that will drive participation in care coordination, chronic disease management, and patient-centered care in order to set up organizations for greater investment in risk-based accountable care arrangements.”
Technology, however, will only take hospitals so far.
After all, many hospitals have patient portals already, but are still failing to develop the desired levels of patient engagement, as evidenced by the 62 percent of hospital executives who indicated that they are abandoning current patient engagement vendors for new partners. Obviously, they are not realizing an acceptable Return on Engagement. The problem, however, may not lie in the technology, but rather in a lack of insight in how to make meaningful connections with patients.
Patient engagement strategies may actually fall short because they offer a one-size-fits-all approach, when psychographic segmentation points to distinct patient personalities that demand differing approaches to drive engagement. A patient portal, for example, may be an effective channel for a patient that belongs to the Self-Achiever segment but not to a patient who classifies as a Direction-Taker.