Lingering in the shadows of the deadly coronavirus pandemic is another potentially devastating health crisis — or crises — which emerging evidence suggests could have far-reaching implications for an already-reeling healthcare system and economy. Population health management — a method of grouping patients based on the myriad factors that, together, make up a person’s overall health — should be considered as both a quality improvement and cost containment measure to mitigate the pandemic’s long-term health and economic impact.
Running in Parallel
At the onset of the pandemic, the National Comprehensive Cancer Network advised postponing cancer screenings — a recommendation that many institutions heeded. At the same time, many patients forewent preventive screenings themselves for fear of contracting the virus. A May 2020 Epic Health Research Network (EHRN) analysis showed a decline in preventive cancer screenings of more than 86%. Indeed, the number of newly identified cancer patients declined by 46% around this same period, according to a JAMA study. In an editorial published in the journal Science, Norman Sharpless, director of the National Cancer Institute, issued a grim warning: that deferred cancer screenings during the pandemic could cause nearly 10,000 excess deaths from breast and colorectal cancer over the next 10 years.
Delayed or foregone cancer screenings are not the only concerning public health trend to emerge from the pandemic; declining immunization rates, increases in opioid-related overdoses, mental health issues and racial/ethnic health disparities are just a few more among many. Meanwhile, chronic illnesses like diabetes and cardiovascular disease remain among the leading causes of death in the U.S. — a ranking COVID-19 has joined at number three — and will endure as such beyond the pandemic.
The current pandemic, along with its many derivative health and economic effects, highlights the need for innovative methods to improve health outcomes at population scale. In today’s virtual healthcare environment more than ever, this means meeting consumers where they are; proactively identifying those at risk of an adverse event or negative health outcome and engaging them in ways that are personal, actionable and relevant in the context of their daily lives.
COVID-19 provides a unique lens through which we can assess the effectiveness of population health management strategies in achieving the healthcare triple aim, which we can then apply to the broader spectrum of healthcare issues. For instance, a J.D. Power study of commercial health plans found that 60% of consumers had not been contacted by their health plan with information or guidance related to COVID-19. Though the timing of the study coincided with the pandemic, its findings point to broader and longer-standing insufficiencies in health plan consumer engagement — a metric found to correlate directly with consumer satisfaction.
Engage & Empower
Effective engagement empowers consumers, enables better outcomes, improves quality measures and lowers costs. Amid the ongoing pandemic and on the precipice of an extended period of challenge and uncertainty, keeping consumers informed and connected to healthcare is vital to sustaining the health of populations. Key areas of focus for healthcare organizations and government stakeholders include:
- Adopting sophisticated analytics tools. Proactively identify at-risk individuals and develop personalized outreach and care plans tailored to their comprehensive health needs.
- Leveraging multi-modal outreach. Understand consumer preferences across populations and institute a behavioral science-backed engagement strategy to meet them when and where it matters most.
- Educating consumers on accessing their full range of benefits. Research shows that, during the height of the pandemic in the U.S., 54% of members did not understand whether their benefits included telehealth services. Inform consumers of all their available benefits, including telehealth and behavioral health, and provide clear instructions on how to access these services.
- Urging preventive care. One-to-one engagement can promote the use of preventive care services, with HMS data showing a 45% improvement in preventive cancer screenings from such engagement and a 30% increase in immunization rates for a city-targeted vaccine outreach. Educate consumers on the importance of maintaining preventive screenings during and post-pandemic and make them aware of the measures in place to keep them safe.
- Removing barriers to engagement. Healthcare communications — particularly in a time of crisis — are unlike many other forms of consumer outreach. Extend rules and policies to overcome communication barriers during the COVID-19 emergency period, such as those eliminating Telephone Consumer Privacy Act restrictions, to ensure the delivery of critical healthcare information to consumers.
- Assessing and improving. We are dealing with an unprecedented public health crisis. Evaluating the effectiveness of COVID-19-specific adaptations and continuing to evolve plans and programs as necessary will help to pave the way toward a stronger healthcare system for the future.
COVID-19 Population Health Management
In addition to our COVID-19 health engagement solution (which has delivered, to date, more than 8 million COVID-19-specific communications to Medicaid and Medicare members), HMS is actively advocating for policies, legislation and programmatic actions that serve to control costs and improve health outcomes through the COVID-19 emergency period and beyond.
For more industry insights and perspectives, visit HMS Health Ideas.