October 19, 2021

Volume XI, Number 292

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October 18, 2021

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Connection and Innovation Take Center Stage at the Patient ENGAGE Conference

MedCity News, a media property of Breaking Media hosted the third annual ENGAGE conference Nov. 6-7 in San Diego. The conference highlighted technology tools that increase patient engagement and strategies deployed by health plans and health systems to align patient incentives with promoting wellness and reducing healthcare delivery costs. There is increased interest from the healthcare industry, investment community and patient advocacy groups in fostering programs, technologies and services that focus on empowering patients to be a driving force in healthcare.  As many speakers reinforced at the conference, patient engagement has gone from an afterthought to a driving force in healthcare. The following are key themes:

The Power of Human Connection

Caremore, a division of Anthem, has created a position: Chief Togetherness Officer, whose role is to analyze and attempt to mitigate the impact of loneliness and social isolation, particularly among the elderly, on health outcomes. In a pilot program involving 1,100 participants with an average age of 74, Caremore representatives called the participants frequently, encouraged them to exercise, engage in social activities, and seek out more personal connections. The results yielded a 5% reduction in outpatient emergency room utilization, an 11% reduction in acute care costs, and a 22% reduction in depression.

Rise of the Chief Patient Officer

Speakers from Medtronic, Pfizer and Intermountain Healthcare discussed the increasingly prominent role of a “Chief Patient Officer.” The Chief Patient Officer of Medtronics Diabetes Group described the partnerships Medtronics pursues to advance patient engagement and assist individuals with diabetes make the best decisions in managing their care. Medtronics offers an app to monitor glycemic response and works with FitBit on wearable devices, it partners with the IBM Watson Health project in relation to decision algorithms, and it has a relationship with Nutrino, a provider of nutrition-related data services, analytics and technologies. Pfizer’s Global Patient Affairs Lead is a former intensivist/pulmonologist who now leads Pfizer’s efforts in patient-focused medicine development. Pfizer measures engagement by reviewing enrollment figures for clinical trials, calculating how many individuals remain in clinical trials, and assessing the extent of their adherence: metrics which assist Pfizer with its business objectives. The mission is to bring the patient’s voice into all aspects of healthcare that Pfizer touches, while avoiding conduct that may be viewed by regulators as veiled promotion. At Intermountain Healthcare, a provider and integrated delivery system, patient experience became a more important focus after HCAHPS scores included patient satisfaction. A new generation of patients demand information and control over their healthcare decisions: the “nothing about me without me” patient empowerment ethic is prevalent. While Amazon knows its customers’ preferences and can provide information based on past decisions, healthcare providers have a long way to go. The future of patient experience might be a net promoter score that patients give for each day of their hospital stay…

Social Determinants of Health

CMS announced in the Spring of 2018 that Medicare Advantage plans could, in 2019, expand the health-related benefits they offer, stating that it would “allow supplemental benefits if they compensate for physical impairments, diminish the impact of injuries or health conditions, and/or reduce avoidable emergency room utilization.” The trend towards recognizing that the social determinants of health have a critical impact is paving the way for innovation and alignment between the health insurance industry and the not-for-profit sector. BlueCross BlueShield of Kansas has 1 million members in Kansas and developed a cloud-based tool (“Healthify”) that allows users to search a database of 4,700 social services organizations throughout the state. The American Hospital Association is partnering with the RAND Corporation to analyze the role of hospitals and health systems in addressing social determinants of health such as food insecurity and lack of access to transportation. Vision y Compromiso works with “promotores” to address language and education barriers to populations adopting healthy habits and engaging in preventative care. Social determinants of health such as a community’s educational system, access to community banks, and the prevalence of violence and crime play a key role in health outcomes. LexisNexis Risk Solutions uses its vast database of publicly available information to make predictions that are used in developing population health strategies. The recent affirmative vote for Medicaid waivers in multiple states reflects an effort to combat health disparities and increase access to care.

Payor Initiatives to Foster Patient Engagement

Presenters addressed the need among commercial payors to increase patient engagement in order to manage healthcare costs and bolster member satisfaction. While the distrust of payors is pervasive among individuals and communities throughout the country, payors are striving to build trust by developing personal relationships with patients and increasing transparency of insurance coverages and costs.  Panelists presented exciting healthcare engagement solutions involving health plans and government programs. ConsejoSano’s Abner Mason discussed the company’s mission to reduce healthcare disparities by helping patients access in-network services, address questions and drive preventative care. Hope Kragh from Collective Health also discussed her organization’s role in bolstering patient engagement, which provides employees with useful digital tools for understanding and using their health benefits from employer-funded health plans, while also giving employers valuable analytic tools to maximize their return on investment for the health benefits that they provide their employees. The complex payment system for healthcare and lack of transparency of fees has served as a substantial barrier to patient engagement, but payors and innovative companies dedicated to bridging the informational gap between payors and patients have begun to improve patient engagement.

Copyright © 2021, Sheppard Mullin Richter & Hampton LLP.National Law Review, Volume VIII, Number 332
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About this Author

Elizabeth Balfour, health care attorney, litigation, Shepard Mullin Law FIrm, San DIego, California
Partner

Elizabeth S. Balfour is a litigator and healthcare attorney and works out of the firm's Del Mar Heights (Northern San Diego) office.

Ms. Balfour represents clients in investigations initiated by the Office of the Inspector General, the Office of Civil Rights of the Department of Health and Human Services, and other federal and state regulatory agencies.   Ms. Balfour advises hospitals and medical groups in relation to HIPAA, MACRA, and mandates arising out of the Affordable Care Act.  She advises management companies in relation to disputes involving the provision of property and...

858.720.8985
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