Healthcare Self-Management: An Economic Model

Friday, September 22nd, 2006
This post was written by Melanie Matthews

Our managing editor returned to the office this week after covering the Health Management Congress in Las Vegas last week. An overriding theme at the conference, she reported, was patient self-management. How do we put the responsibility for healthcare in the hands of the consumer?

In this week’s edition of our newsletter, The Healthcare Business Weekly Update , Dr. Richard Citrin, the former vice president of integrated care management at CorpHealth, discussed the ways that CorpHealth determines if a person is ready to make a healthcare behavior change.

He reported that people change when the benefits of changing a behavior exceed the resistance – it’s an economic model. His comments were excerpted from “Motivating Resistant Patients: Influencing Behaviors to Improve Outcomes.”

Accepting responsibility for one own’s healthcare and making the necessary behavior changes that can impact health are all part of this self-management.

Diabetics who measure their blood levels, asthmatics who use peak flow monitors, overweight individuals who begin exercise programs and choose healthy food options are just some of the ways that this self-management is occurring in the industry – with help from insurance companies and disease management companies that are incorporating this type of self-management into their program design.

Health coaches, web-based health information and interactive voice response systems are all emerging as new tools in this self-management arena.

Offering these options are truly a great way to get people more engaged in their health and accept responsibility for the management of their own care. But unless it’s done with an economic advantage, the required behavior changes just might not be made.

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One Response to “Healthcare Self-Management: An Economic Model”

  1. Health plans have not been able to get many of their members engaged with their own health and wellness. The research is pretty damning on consumer trust in plans, consumer adoption of health plan websites, and their assumptions about ‘secondary business agendas’ on the part of plans that put information up that’s intended to guide (or force) consumer behaviors.
    There is not much that I see that suggests this is going to be changing a lot. Carrots and sticks will be used, but I submit to you that the social contract between patient/consumers and their providers as proxies for health plans is so damaged that consumers are now primarily oriented to withholding information as a default position.
    This places health plans in an awkward position: they need to know who their ‘high ticket’ customers are and who they are going to be, and so health risk assessments, disease management programs, and ‘forced’ relationships with nurse case-managers, health coaches, and the like are common responses. But what passes for ‘engagement’ to a health plan is understood by consumers as ‘compliance’, and as health care becomes more ‘retailized’ it’s going to take more than incentives and disincentives to really get consumers to take their own health and wellness more seriously. And as I read the tea leaves, I don’t see the solution coming out of health plans.