How Face to Face Encounters Influence Member Behavior & Improve Quality

April 14, 2016

In 2010, more than 140 million Americans were living with at least one chronic health condition. As health plans work to contain costs and improve care provisions, it is important to understand how to influence member behavior through face to face encounters as this is one powerful win-win scenario for both plans and patients.

While more than 16 million previously uninsured patients now have coverage, providers spend less and less time during each encounter. Much of this limited time is spent doing a quick recap of health history issues. Yet health care delivery continues to be experienced by patients as a scattershot effort that rarely adequately addresses the whole person. Patients rarely feel heard, and this pattern of too-fast visits with minimal big-picture treatment will only get worse as the newly insured require care for their acute and chronic conditions that may have never received adequate treatment.

Health plan professionals are realizing powerful benefits by incorporating an annual face-to-face health risk assessment for all members. This trend continues to gain strength in the industry and helps close the care gap and provide continuity of care. The health risk assessment in a member's home or local clinic is conducted by a physician who addresses all diagnoses and health concerns, and provides education for how to best deal with current health issues. Finally, results of the health risk assessment are forwarded to both the patient's plan and PCP.

Below are a few ways in-person health risk assessments and education influence member behavior to improve health, and reduce healthcare costs.

Member Satisfaction

People are desperate to be heard. They're used to providers who never have the time to discuss their whole health picture and provide constructive education on how to best manage chronic health concerns. By using an in-person encounter that addresses all health factors, members' satisfaction increases significantly.

Improve Member Health Outcomes

Rather than focusing on just one issue during a visit, the face to face health risk assessment is designed to address the whole person not just the clinical correlates. Members are able to see the big picture and receive a better understanding of lifestyle changes they may make that will positively impact their health. And by making the assessment available to the plan and provider, risk is reduced and coordinated care made more likely.  

Reduce Costs and Hospitalizations

By utilizing an in-person health risk assessment and education, it is less likely that chronic health conditions will go untreated. Risk assessment and early intervention are key to reducing costs. Providing education and resources to aid patients with positive lifestyle changes will directly reduce costs associated with crisis treatment and hospitalizations. Significantly, such positive lifestyle changes are made more likely by being addressed in person in the patient's home or local clinic, and follow-up care provided by the members' PCP is made simpler by having access to the data collected.

Improve Quality

The National Committee for Quality Assurance (NCQA) recently published The Essential Guide to Healthcare Quality, addressing the multiple issues affecting healthcare quality in the United States. Among many other issues addressed, this guide outlined how measurable quality improvements were being made in the areas of diabetes, high blood pressure, and high cholesterol. These are areas where face to face encounters that address lifestyle issues are making a big impact on overall health.

Increase Member Retention

Members who feel satisfied with the quality of care and education provided and who are participants in the plan to improve their health, are less likely to leave. Annual health risk assessments can also help predict which members are dissatisfied, allowing the plan to proactively address members' concerns.

With the focus on patient-centric quality care, evidence continues to accumulate showing the power of face to face encounters to influence healthy behavior. From diabetes to weight management, chronic pain to the issues facing the newly insured, in-person health risk assessments are providing tangible benefits for plans, patients, and providers.

As for getting members to agree to the face to face encounters? Be sure to check back for our upcoming blog post on “Improving Member Acceptance Rates for HRA’s.”

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