Technologies, Games, Incentives: Patient Engagement and Cost Containment
September 21, 2012
Patient engagement has become a kind of rallying cry in health care circles. At times it is invoked in the form of an exhortation to patients: "You need to get involved in your own care! By becoming an engaged patient, you will be better equipped to make decisions about your treatment options and your health." It is also a mantra among many who believe that patients with more awareness, better knowledge, and more "skin in the game" in the form of greater cost-sharing have the potential to help tame rising costs.
It is hard to measure how many patients on their own seek to become better informed and to participate more actively in managing their health. Increasingly, though, they have help from others with a stake in keeping patients well informed and well behaved. Both health plans and employers benefit from a healthy, productive population that consumes fewer (and cheaper) health care services.
Motivation is key, since employees are not necessarily going to trust and fall in with a program urged on them by their employer or an insurance company. Aon Consulting found that 65 percent of employers surveyed on their plans for managing health benefits listed "motivating participants to promote behavior change" as among their top challenges.
Chilmark Research posted this observation, "Now it is well-known that payers have had a very mixed record in engaging their members," in part because of employee trust issues and in part because the companies did not themselves become fully engaged. But there is growing recognition that successful consumer engagement may be one of the few promising options for cutting costs. New technologies and techniques to support engagement are proliferating. Technologies range from the personal health record – not a success for Google but important for plans like Kaiser Permanente for purposes of quality, cost saving, and member satisfaction and retention – to a plethora of mobile apps, which may diagnose, remind, measure, monitor, and probably many other things.
Hot among techniques is the whole range of games designed to capture people’s attention, harness their competitive spirit, and (ultimately) change their behavior. Immediate goals may include such things as more physical activity during the day, better food choices, weight loss, or participation in team activities. Underlying goals are longer-term: reducing the incidence of disease, promoting health and energy, making people feel better about and more responsible for themselves.
This Forum session looked at how patient-engagement initiatives are structured, what really works to motivate behavior change, how to recognize and reward success, how employee preferences are factored in, and how today’s game may become tomorrow’s cost reduction.
David A. Asch, MD, MBA (bio)
Robert D. Eilers Professor
Leonard Davis Institute of Health Economics
University of Pennsylvania