As insurers continue to grapple with rising healthcare costs, they're faced with an increasingly unhealthy member population. So payers have started taking matters into their own hands to engage members into becoming stewards of their own health and wellness--and reduce industry-wide risk and cut costs.
"To control healthcare costs on a sustainable basis, we have to make changes, and it starts with us," Natalie Bachman, director of benefits and compensation at Wellmark Blue Cross Blue Shield in Iowa, told FierceHealthPayer for the new eBook, Payer Strategies for Engaging Members.
So far, payers have found leveraging claims data one of the most effective methods to improve their wellness programs. "As we move toward a more consumer-centric health industry, data will help us better understand people's lifestyles and how they prefer to be engaged," said Daryl Wansink, director of research and evaluation at Blue Cross and Blue Shield of North Carolina (BCBSNC). The health insurer proactively uses statistical modeling to review its entire membership database, seeking members who would most benefit from its wellness programs. It then reaches out to those members with a wealth of claims data to help specifically improve their care.
Care coordination, including transitional coaching, patient navigating and health coaching, is another tactic insurers have deployed to help engage their members while also keeping them healthier. For example, Cigna's "gaps-in-care" program involves a care coordinator who identifies gaps in patient care to more effectively target services, says Robert McLaughlin, Cigna's senior medical director for Tennessee.
Insurers also are turning to mobile opportunities. Kaiser Permanente has been a leader in the mobile initiative, launching six apps since last July. "We believe that convenience, paired with a great user experience, will meet members' needs and will ultimately result in improved health and patient-physician relationships," said Christine Paige, senior vice president of marketing and Internet services for Kaiser Permanente.
Like mobile strategies, social gaming programs have become a new approach that payers use to engage members in their own healthcare. "Changing lifelong habits can be hard enough--slogging through dry, boring wellness programs shouldn't make it worse," said Bryce Williams, director of Wellvolution for Blue Shield of California. That's why the insurer leverages social media to help members improve their health and, perhaps more importantly, become fully engaged in that goal.
Even more methods, including six steps to building a successful wellness program, using data to trigger productive interventions, developing techniques that use externally-purchased consumer data, along with a list of successful strategies to increase members' wellness, can be found in the new eBook, Payer Strategies for Engaging Members. --Dina (@HealthPayer)