A new United Hospital Fund report examines patient engagement in New York's commercial health insurance market, finding mixed evidence to date on the most effective ways to engage patients, but also a broad commitment to the effort, a byproduct of a growing consensus that “it's the right thing to do.”
The report, Meeting Consumers Where They Are: Patient Engagement in New York's Evolving Commercial Insurance Market, is organized around four forces shaping benefits and services available to commercially insured patients—New York's insurance regulatory framework, employers, health plans, and providers—and describes engagement activities (defined as the help provided to consumers to enable them to take an active role in improving or maintaining their health and effectively utilizing their health benefits) within these categories. In addition to providing a review of the current research on the effectiveness of various engagement activities, the report concludes with a discussion of options for purchasers and payers to improve patient engagement.
“Two themes emerged during our review,” said Peter Newell, director of the Fund's Health Insurance Project and a co-author of the report. “First, health plans are seeking to engage patients using traditional care management tools, but they are also delegating important functions to health care providers, some of them organized in models like patient-centered medical homes, a sign of the delivery system reform effort underway. Second, rapid enrollment growth in New York's individual market as a result of the Affordable Care Act represents a terrific opportunity for New York, and also a significant challenge. With hundreds of thousands of new enrollees joining the market, effective engagement strategies can help reduce the need for future premium increases.”
The report notes that the Affordable Care Act and New York State of Health have made a “night-and-day difference,” given that the affordability of coverage and the process of selecting a health plan are fundamental to patient engagement.
The report also includes an analysis of major insurers' quality improvement expenses for activities closely associated with patient engagement—an amount that reached nearly $157 million in 2013.*
Also examined are three important strategies employer groups use to better engage and motivate workers—High-Deductible Health Plans, Value-Based Insurance Design, and workplace wellness or health management programs.
Among the ideas presented for consideration to improve patient engagement in New York:
Get more feedback from consumers on their perceptions of value and quality, since their preferences may not necessarily align with efforts by payers and policymakers.
Increase coordination across the State initiatives currently underway, as well as between health plans and providers related to care management.
Revisit New York statutes and regulations related to patient engagement.
Determine how certain patient engagement-promoting elements of group plans could be translated to the individual market.
“Our health care system is rapidly evolving into one that focuses on improving quality, the health of populations, the patient experience with care, and controlling costs,” said Jim Tallon, president of the Fund. “Patient engagement is becoming increasingly important as a tool to contribute to all of these goals, which is what makes this new report so timely.”
Meeting Consumers Where They Are: Patient Engagement in New York's Evolving Commercial Insurance Market, written by Peter Newell and Nikhita Thaper, research assistant, is available on the Fund's website. The project was supported by the New York State Health Foundation.
About the United Hospital Fund: The United Hospital Fund is a health services research and philanthropic organization whose primary mission is to shape positive change in health care for the people of New York.
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* Note, added May 29, 2015: The final phrase from the original sentence has been deleted, following a correction made related to the understatement of a particular data point.