Physician Endorsement Helps ‘Sell’ Medical Home Model to Patients

Tuesday, August 28th, 2012
This post was written by Patricia Donovan

medical home patient

Recorded Webinar: Patient Engagement in the Medical Home

Nothing will engage patients and health plan members in the medical home model more than a ringing testimonial from the individual’s own physician, advises Horizon Blue Cross Blue Shield of New Jersey. That’s one of the lessons the payor has learned as it shops its patient-centered medical home (PCMH) model around its member population.

“The endorsement of a physician is key in this model,” explains Jay Driggers, Horizon’s director of consumer experience and engagement. “An insurance company isn’t going be able to [engage members] all on its own. If a PCP says this is a good program, and I want you to be a part of it, then typically patients will agree, and will want to be a part of it as well.”

A danger of leaving providers out of this messaging is that patients may sense a downgrading in their level of care, Driggers warned during a recent webinar on Patient Engagement in the Medical Home: A Continuum Approach.

Other key words and phrases with which to pepper conversations about the medical home: “coordinated comprehensive care” and “increased access.” “These issues are really prominent in the patient’s mind, in the consumer’s mind. They love the idea of somebody helping them, not have to repeat themselves, or working with their specialists to obtain all of their health records.”

Horizon has invested a lot of time and resources to research and test consumers’ perceptions of the medical home. The verdict? Awareness and understanding of the model is low, but interest is strong.

To maximize the transformative effect of the medical home, accountable care organizations (ACO) and episodes of care (also known as bundled payments), Horizon created a wholly owned subsidiary called Horizon Healthcare Innovations (HHI). To achieve its mission of creating “an effective, efficient and affordable healthcare system,” HHI decided to take a closer look not only at physician behavior, but also at the behavior of patients and health plan members. The consumer engagement team is charged with identifying tools to engage patients and encourage behavior change.

HHI has crafted a broader view of engagement as a four-part continuum: awareness, understanding, action (behavior change) and outcome. Of its seven key consumer engagement objectives, HHI ranks “becoming knowledgeable on care models and benefits” at the top, and employs a variety of strategies, including behavioral economics and the Patient Activation Measure (PAM) model, to segment consumers by need and motivation.

Tempted to employ technologies like smartphone apps and telemonitoring to communicate with and engage the population? Don’t assume everyone’s ready and willing to use them, advises Driggers. “Mobile health is not yet a silver bullet,” he said. “If you’re a senior citizen who doesn’t even really use a cell phone, I shouldn’t expect that you’re going be able to manage your diabetes using a smartphone app.”

Among the five key components of Horizon’s medical home model are a population care coordinator to manage the care of high-risk patients and close care gaps, as well as a playbook and learning network of best practices.

HHI’s efforts have increased awareness, interest and overall engagement in the medical home, but Driggers said HHI is not stopping there. “A ‘one and done’ approach doesn’t work. It takes repetitive, constant work to raise awareness. And interest rises with frequent contact.”

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