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Learn how a personalized approach to population health can improve healthcare utilization, reduce costs, and enhance member satisfaction. Discover the benefits of high-touch, high-tech interventions for individuals like Betsy, who prefer contact via phone.
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Personalized Population Health A High-Touch High-Tech Approach Ivor Horn, MD, MPHAccolade Chief Medical OfficerOctober 15, 2018
Meet Betsy • PROFILE • 55 years old, low-engager, financial stress, low/med health score, diabetic • Unaware of the benefits provided by her employer • Prefers contact via phone
Influence Strategy Learned information is added to Betsy’s profile to influence smart decision-making Our team probe further and learn more about Betsy. A personalized experience begins to form and we can now influence smart decision-making. Betsy reached out with a question about whether a procedure is in-network.
Whole Person Life circumstance, behavior, and beliefs. 65% of members present contextual issues and barriers to care
Whole Population 1% catastrophic illness Nearly two-thirds of your high-cost population this year wasn’t categorized that way last year. • 4%5+ chronic conditions High-cost • 20%2-4 chronic conditions Rising-risk 25% 1 chronic condition At-risk people 15% at risk for developing a chronic condition At-risk people One-third of that number was classified as low-risk. 35% no ongoing physical health needs Healthy people Confidential
A B A B Health Assistants get a clear understanding of Betsy’s engagement and knows to give her preferred communication method. Event based alerts make it easy for the health assistant know which actions to be taken.
Personalized Experience Smart technology combined with human interaction for a personalized experience
Personalized Experience Smart technology combined with human interaction for a personalized experience “Don’t worry. I can help you with that.”
The single point of entry for personalized healthcare and benefits Reducing complexity and costs for employers and their employees Confidential
6 Early Identification and Engagement 5 RELAPSE. Returns to stage 3 4 IT IS POSSIBLE. Maintenance PERSONALIZEDAPPROACHES 3 OK. LET’S DO THIS. Action 2 SO, OK. WHAT DO I DO NOW? Preparation TRADITIONAL APPROACHES 1 WELL, MAYBE. Contemplation NO, NOT ME. Pre-contemplation • Adapted from Changing for Good, James Prochaska, John Norcross, Carlo DiClemente (2007)
The Accolade Platform Member Interactions Health Assistant Center Mobile and Web Member Apps UtilizationManagement Benefits Point Solutions Intelligent Platform Machine Learning AI Analytics Analytics Point Solutions Claims Biometrics Notifications PersonalizedHealth Profile
InView Member Relationship Manager Health Assistant Registered Nurse Claims Specialist Behavioral Health Clinician Confidential
High-Touch High-Tech Personalized Health Data Data Science/Intelligent Insights Medical Directors Price Transparency and Provider Search Nurses Health Plan TPA Telemedicine and 2nd Opinion “Health Optimizers” Provider Search Specialists ClaimsSpecialists Behavioral Health Clinicians Pharmacists
Better Decisions Better Health Better Business • 60% engaged prior to making a care decision • 98% Satisfaction • 73 NPS • Improved healthcare utilization • Increased Rx refills • Increased preventative care • 5-15% cost savings • <1% cost trend • 90% of total spend engaged • 100% of customers save in year 1 17% decrease in 30-day readmissions “ I was so lucky to have someone who understood both the medical issues and the insurance benefits. My Health Assistant helped me through every step of the process. ” 20% decrease in inpatient days 64% Maternity program1st trimester enrollment 90% High Cost Claimantbook-of-business engagement Accolade Member Confidential
Evaluating Your Population Health Strategy Are there resources available to my population outside the four walls of healthcare? How am I using technology to support my population? How am I maximizing our people and our technology? Am I engaging with my population before, during or after a critical healthcare decision? Is there opportunity for me to collaborate with other healthcare solutions to provide better care to my population? Questions to consider
Thank You Ivor.Horn@accolade.com