The Well-Being Journal

Attract Today’s Seniors and Impact Star Ratings

Jennifer Rudloff

Senior Couple on ScooterIn America, more and more people are living into their 80’s, 90’s and beyond. Each day over the next 18 years, 8,000 baby boomers join a population of seniors age 65+ that’s already larger than it’s ever been. And out of this growth, a new kind of senior is born. Gone are the images of rocking chairs and knitting needles. Today’s senior is tech savvy, uses a computer regularly, and seeks information from online sources. This shift in population demographics represents a huge opportunity for those serving this population.

With star ratings raising the profile of quality measure, Medicare Advantage plans can gain a competitive advantage with strategies that recognize the importance and value of proactive health support. Healthways can help. Our proven Senior Well-Being Improvement Solution takes a multifaceted approach to keeping the healthy healthy and managing chronic conditions. Designed to immediately impact star ratings, our senior solution includes the following:

  • Healthways CMS-approved Senior Well-Being Assessment (WBA) explores challenges specific to seniors, and delivers an insightful view of member health history, status, social and emotional health, and health related behaviors.
  • Personalized Well-Being Plans are generated using data from the Senior WBA; plans recommend behaviors for improvement and relevant action steps for individual health risks.
  • Guided online improvement is delivered via Well-Being Connect, an easy to use online tool designed to impact behaviors that directly influence star ratings like self-management, appointment adherence, healthy eating, and weight management.
  • Innergy™ and QuitNet® address obesity and tobacco use, two of the biggest risks for health care and costs, and provide targeted support to at-risk individuals as identified by the Senior WBA.
  • Senior focused telephonic health coaching provides support to drive risk reduction, behavior change, long-term health care savings, and star ratings gains for high-risk seniors.

And when it comes to engagement, we’ll do the legwork for you. Our solution includes built in engagement support from our award-winning marketing engagement team. Our fully developed, easily customized communications campaign drives initial and ongoing participation.

To learn more more about how we can help you drive star ratings and gain competitive advantage, visit our solutions page and choose Medicare/Senior Specific Support, or contact us today.

Topics: CMS Healthcare Seniors Star Ratings Prevention Healthways Medicare Advantage

Avoidable Cost Model Yields Big Savings

Jennifer Rudloff

When it comes to healthcare spending in the United States, there are some shocking facts:

  • By 2020 annual healthcare spending is estimated to reach $4.64 trillion dollars. (That’s a big chunk of change.)
  • In 2009, healthcare spending accounted for 17.6% of Gross Domestic Product (GDP). And by 2019, it’s projected to reach 19.3% of GDP.
  • America’s healthcare spending is projected to grow at an annual average rate of 5.8% from 2010 to 2020. (That’s a growth rate 1.1% faster than the expected growth in GDP.)

But it doesn’t have to be that way. With the help of timely interventions, a significant portion of this burden could be avoided. By taking a holistic approach to health and well-being, monitoring the entire population (both diseased and non-diseased members) we can deliver impactful, personalized interventions to members in the greatest need. That’s the philosophy behind Total Population Health, but it hasn’t always worked out that way in practice.

Historically, organizations have relied on risk assessments, age/sex demographics, and pharmacy based models designed and used in disease management to identify members in the greatest need of these programs. But these models are flawed – they often rely on cost triggers to target individuals who exceed a certain cost threshold. But we know that low cost doesn’t necessarily mean low risk – they may be a “ticking time bomb” as a result of not maintaining their health.

There had to be a better way. Our Healthways Center for Health Research went to work developing a predictive model that would bridge the gap between the conception of the total population health approach and reality.

The result? The Avoidable Cost Model. Designed to identify the high-risk segments of the population who are likely to have near term, costly (but avoidable) in patient events, the avoidable cost model allows for proactive care management tailor fit to meet the needs of your population using member claim data.

And unlike standard, disease-specific models that are frequently used to predict future health risks, our model allows for early interventions for members with whom there is the greatest opportunity to have an impact and helps to optimize the use of intervention resources. It also produces greater healthcare savings; in fact, when compared with a model developed to predict high-cost members in a diseased population, the avoidable cost model captured an additional $15 million dollars in total savings.

To find out more about our research on the avoidable cost model and see how it compares to other models in the market, check out the paper below.

Predictive Modeling: The Application of a Consumer-Specific Avoidable Cost Model in a Commercial Population

Topics: Healthcare Save on Health Business Performance Prevention

The single best thing you can do for your health in 2012

Jennifer Rudloff

For many of us, along with the new year comes resolutions aimed at creating happier and healthier lives. So now, how do you go about doing that? Well, we know that there are a number of factors that contribute to our health and well-being -- good diets, good friends, and healthy behaviors go a long way towards achieving health.

But there's one thing that trumps the rest - Exercise! Exercise is the single best thing you can do for your health. Among other things, just a little bit of movin' and shakin' each day has the ability improve our quality of life and reduce fatigue, anxiety, depression, pain, dementia.

Topics: Healthy Living Exercise Healthcare 23 & 1/2 hours Health Prevention Design Lab New Years Resolution Dr. Mike Evans Healthier You

Five Game Changing Trends in Healthcare

Jennifer Rudloff

While we can’t predict the future, we think that it’s always important to keep a watchful eye out for trends in our industry. The field of healthcare is one that constantly evolves, as new implications constantly arise for doctors, patients, and well-being support providers like us.

Below is a list of several major emerging trends in healthcare that we think could be truly ground breaking. In our opinion, these trends – for which we’ve begun to see the seedlings – could be total game-changers, for Healthways and for the industry at large.

Here are five patterns in the healthcare industry that we think have the potential to stick around, at least for the time being:

  1. Health plan preparation for state insurance exchange implementation, which is projected to cause significant disruption of individual and small group fully insured businesses;
  2. Change from a volume-based to a value-based payment system, a change which comes with the associated shift of financial responsibility (and thus, risk) for cost and quality from health plans to providers;
  3. Increasing payer requests for comprehensive, integrated solutions, as more insurance clients aim to address longitudinal health risks and care needs for total populations;
  4. Adoption of population health management on a global scale, by both foreign government and foreign private sector health organizations; and
  5. Recognition by large employers of the expanded value of improved well-being, to reduce medical cost and improve individual and company productivity and performance.

This is just the beginning of changes we expect to see in the industry; momentum has already begun to pick up, and we’re excited to see how the space evolves. Particularly due to the upcoming 2012 presidential elections, our healthcare industry may be in its most malleable state ever – and this may hold direct or indirect impact upon our well-being as a country.

So, what do you think? How have you witnessed these industry trends in your own healthcare experiences? What are some other major changes in healthcare that you see on the horizon? Let us know by leaving comments below or on our Facebook page!

Topics: Healthcare Health Healthways Trends in Healthcare Health Plan & Health System