As Jerry Maguire famously said, help me, help you!
That sentiment has made its way in to our health care system. Accountable care organizations (ACOs) and Patient Centered Medical Homes (PCMHs) have begun to demonstrate early successes of tangible savings with an emphasis on care coordination and higher involvement of patients to improve outcomes. While there are several variables that contribute to ACO’s successes, the focus on more patient centered care is critical. To address the challenge of involving patients more effectively, whether within an ACO or not, there is an interesting concept of identifying and managing patient engagement. The thought being that the more engaged a patient is in their health decisions and their own behavior choices, the more effectively their health can be managed. This results in better patient outcomes and lower costs.
There have been a few studies recently that are beginning to show this trend.
Patient engagement can be defined using a general definition of the interventions designed to increase patient involvement, and the patient behavior that results from it. While there are multiple tools to evaluate and manage patient engagement, one particular tool known as patient activation measure is emerging as an up and coming tool to help to better understanding a person’s willingness and skills to engage in their care.
Patient activation is a term that describes the skills and confidence that patients possess to become actively engaged in their health care. The Patient Activation Measure (PAM) is an assessment consisting of thirteen items. The assessment produces a 0–100 score based on how patients answer questions about their beliefs, knowledge, and confidence in managing health-related tasks. The score can be used to assign people to one of four levels, ranging from least activated (level 1) to most activated (level 4).
A study at the University of Oregon, reported in the February issue of Health Affairs, highlights the role that patients play in determining health-related outcomes. For those patients who were more knowledgeable, skilled and confident about managing their day-to-day health and health care (also known as “patient activation,” measured by the Patient Activation Measure) had health care costs that were 8 percent lower in the base year and 21 percent lower in the next year compared to patients who lacked this type of confidence and skill. As noted below, the level 1 or lowest level of patient activation, had a predicted per capita cost of $966 while the highest level of patient activation, or level 4, had a predicted per capita cost of $766. It is noteworthy that the inpatient and RX costs were not included in the 2011 data due to system changes.
Below is an example of a PAM report for a member.
When combined with updated cost and utilization information, as well as the predictive capabilities within Milliman’s MedInsight decision warehouse, the addition of a patient engagement tool can be powerful. With this more comprehensive data set, it can help in effectively targeting outreach efforts as well as monitor the impact of patient engagement for improved patient outcomes and managing to lower costs.
Watch the blog for more details on how to approach these analytics.