Incentives and Patient Engagement

Health plans reasonably believe that they can be a primary source for aiding patients in managing their health and health care.  An article in Health Affairs describes UnitedHealth Group’s efforts towards this end.   (HA Article)   The company has identified several critical factors in engagement and offers them both to health plan members but also to the health plan used by its own employees.  Health plans have some advantages in encouraging patient engagement; they have large and near real-time sources of data, including claims data and they have a relationship with patients that crosses all providers of care.  Payers can use the data to help identify potential gaps in care and encourage both patients and their physicians to address those gaps.  UHG has focused on messaging that is most likely to reach patients–mail, email, text, etc; based on the patient’s own preferences.  The messaging can also be segmented by demographics or other characteristics.  A program using this messaging called HealtheNotes closed 64% more medical management gaps than usual methods.  The company has also developed programs to encouraged shared decision-making in nine preference sensitive conditions.  This program purportedly saves about $11,000 per treatment, apparently because patients tend to choose more conservative treatments when they are activated and involved.  For its own employees UHG uses a premium reduction incentive that scales depending on the level of engagement and results that an employee displays.  A large number of employees have participated and achieved rewards, with a savings to UHG of $107 million compared to industry average health care cost increases.  The UHG program appears to be successful but a more comprehensive research analysis that looks both at health outcomes and net savings would be useful.