October 11 2016 | 0 Comments | 210 reads Average Rating: 3

Using Data Analytics to Know – and Engage – Consumers

by Rose Higgins in Population Health

You can lead a horse to water but you can’t make him drink. Or can you?

That’s the proverbial challenge facing healthcare organizations as they strive to engage consumers in various condition management and wellness programs. The good news: Analytics could be the key to not only identifying which patients to work with but also to figuring out how to get those patients to truly engage and comply with the interventions that will result in improved health.

To start, payer organizations can leverage data analytics to determine which members are at significant risk of seeking emergency department services or of potential hospitalization. And, they can use analytics to drill one step further down to actually determine which members are most “impactable” or most likely to achieve the best clinical outcomes.

The key to success, however, is engaging with these members to really make them drink. Here’s where analytics can once again come into play. Using consumer data -- such as the Zip+4 data or Metropolitan Statistical Area (MSA) data that is commonly deployed by retail companies -- can provide the insight into consumer behavior that healthcare organizations need. In fact, knowing more about consumer patterns and expected behaviors can help health plans design the condition management and wellness programs that ultimately lead to increased collaboration from consumers.

For example, a state Medicaid grant awardee recently took advantage of consumer segmentation and targeting data to implement a program aimed at encouraging individuals with diabetes to more proactively engage in their own care. The program awarded a specific number of points to those individuals every time they engaged in an intervention such as eye exams, lipid tests, Hba1C tests or microalbumin screenings. The participants could then use the points to receive a nominal yet (based on insight drawn from the data analysis) meaningful incentive. An individual’s level of participation in the program showed a direct correlation to compliance.

For example, compliance with Hba1C tests ranged from 23% for participants who did not take part in the program at all to 29% for participants who earned 200 points to 53% for those who earned 400 points to 80% for members with 600 points to 89% for participants with 800 Points (see chart). Costs for these participants also dropped from an average of $2,788 per hospital event for non-participants to $1,662 for those with 800 points and from an average $354 inpatient per member per month cost for non- participants to just $106 PMPM cost for those with 800 points.

This is just one example illustrating how health plans can use consumer data to improve engagement with members. Can you think of others?

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Rose Higgins
SVP & GM, Data and Analytics

With over 25 years in healthcare, Ms. Higgins brings considerable experience and expertise in working with both payers and providers in addressing the challenges of a changing healthcare landscape.

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