In pursuit of the elusive ‘triple aim’, how are social determinants of health coming into play as payer and providers refocus their 2018 strategic and tactical goals. Triple Aim, a term coined by the Institute for Health Improvement and one of its founders Dr. Donald Berwick (former head of CMS), started out as “a framework for optimizing health system performance” with three components:
- Improve the experience of care
- Improve the health of populations
- Reduce the per capita costs of healthcare
Over the years, Berwick often speaks about social forces such as poverty, violence, trauma, racism, and inadequate education as determinants of healthcare outcomes…the circumstances that people are born into and live in that impact them as patients that go beyond clinical and medical delivery (according to one study these social and economic factors are responsible for as much as 40% of population health).
Here are two strategies for payers and providers as they recognize, leverage and deal with social determinants of health:
1. Know all of your customers. At the core of knowing your members or patients is the capacity to collect, organize, analyze and interpret customer data. Value is derived from turning data into insights, insights into intelligence, and intelligence into customer actions (e.g., communication, outreach, care management). The result is an ability to understand variations among every customer segment to develop a complete, personal snapshot or “single view” of your most valuable and most vulnerable Predictive consumer insights–core demographics, purchasing habits, lifestyle or lifestage attributes, and health attitudes and behaviors–create tighter, better managed engagement strategies. And, the more enriched intelligence you have about your customers – what’s important to them, where they go for information, how they shop, who they’re talking to…and what they’re saying – the more customers you will influence and keep.
Data only has value when you can do something useful with it. Across your organization, the goal is to unite fragmented systems and expedite how health information is accessed and shared. By translating real-time information into actionable approaches to the marketplace, payers and providers can create predictable, meaningful customer experiences. A purpose-driven approach to data personalization able to drill into micro-segments to inform execution has huge payoff. Integrating enterprise data enables cross-functional, coordinated approaches to achieve true 360°member or patient engagement.
2. Engage and inspire action. We live in a nation where 190 million people have at least one chronic condition…75 million have 2 or more. Treating chronically ill patients account for $3 out of every $4 spent on medical care. From obesity to opioid addiction to diabetes to heart disease, welcome to ‘Chronic America’. That said, most people believe they are significantly healthier than they are, impeding their motivation to change and stifling their interest in improving their health. It’s the ‘dilemma of health inertia’…getting people to face personal health challenges, adhere to a plan of action, and stay motivated to proactively deal with their health. Inspiring change when change is not perceived as necessary demands a shift away from traditional, brand-centric education-based information overload. Effective consumer change management requires motivational approaches that leverage emotions as drivers of action to create deeper and more lasting engagement with consumers.
Action is not about information. It’s about connecting across the customer lifecycle around personal, relevant motivations and deep, sometimes even unconscious desires, like freedom, happiness, or the ability to be a better parent or partner. Successfully using emotion to inspire action requires payers and providers to understand what’s important to people, what truly matters to them and why they do what they do…across all socio-econo-ethno demographic segments. Healthcare consumerism has your customers taking more financial and clinical responsibility in managing their health. Preferred payers and providers will be those that forge emotional relationships with consumers to motivate better health decisions. They understand that nothing is more personal than health.
With the ‘politics over policy’ bluster coming out of the DC healthcare scene these days, social determinants of health have never been more important. As public programs serving under-served populations such as CHIP and Medicaid are threatened, and social healthcare programs such as Meals on Wheels and women’s access to health care have become budget negotiation chits, payers and providers can not sit on the sidelines. Add to this mix of political chaos a reality that over half Americans cannot understand the healthcare information they receive. There’s an obligation among payers and providers in their pursuit of the 'triple aim' to help your community of customers stay connected and make smart, value-based choices to improve their quality of life and ultimately, life expectancy.