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Patient Engagement

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5 Trends for Health Plans to Watch

by Bailey Amber
written by Bailey Amber

Accelerated by the Covid-19 pandemic, healthcare innovation has skyrocketed over the last few years to meet the evolving demands of Americans who are eager for personalized, accessible, and quality healthcare. While this innovation brings a lot of benefits, including addressing consumer demand, it also exacerbated existing challenges, such as the continued rising costs of healthcare, and hastened the move toward value-based care models. While these changes can be difficult to keep up with, health plans must recognize them and adapt accordingly to improve outcomes for members and drive business growth.

Health plans are in a unique time of change and have the opportunity to be seen as partners for success with employers and providers. Here are a few key healthcare trends that health plans should watch in the coming months:

Embrace the power of personalization 

Consumers have become accustomed to convenient digital tools in all areas of life, including shopping, ordering food and groceries, and banking, among many others. With an abundance of curated social media content, playlists, shopping lists, and more at their fingertips, consumers expect this type of personalization in healthcare too.

Data shows that 88% of consumers prioritize personalization as much as or more than they did a few years ago, so it is imperative for health plans to offer their members personalized support that addresses their individual health risks, wellbeing priorities, and health goals. To successfully engage and activate these members, health plans can harness the power of data and predictive analytics to gain valuable insights into what offerings will resonate with certain populations and create personalized experiences that meet their unique needs – perhaps even before they know they’ll need it. Doing so will not only meet consumer expectations, but will drive better outcomes and create more brand stickiness.

Prepare for rising healthcare costs

The financial fallout of Covid-19 is leading health organizations to experience increased costs of resources, salaries, and supplies. On top of this, they also need to manage more costly patient care and a sicker overall population due to delayed screenings and diagnoses. To prevent revenue loss, excess costs, and falling quality performance, health plans need to build a strategy for how they will manage these costs in both the short- and long-term.

Technology is an effective way to support members’ health and wellbeing journeys. Digital platforms that deliver personalized, accessible, and timely health information can encourage members to get back on track with regular checkups and appointments and lead healthier lives. Plans can also maximize use of telehealth and other virtual and remote tools to shift care to a lower-cost setting.  Taking a proactive approach will help health plans get ahead of and manage high-cost events, as well as avoid expenses related to member attrition and acquisition.

Understand populations to drive health equity 

Health equity may be difficult to achieve, but it is an incredibly important movement for health plans to embrace. CMS recently announced its approach for advancing health equity along with a challenge to healthcare leaders to make similar commitments. To do this, health plan executives must fully understand their members and what they need to achieve their personal health and wellbeing goals.

Consumer and social determinants of health (SDOH) data should be analyzed and incorporated into any successful health equity strategy – a one-size-fits all approach will fall flat. SDOH data allows health plans to better understand their members and communities beyond surface-level insights, helping to establish solutions that help them overcome barriers to health. For example, some individuals may need transportation or scheduling support to get to medical appointments while others may need guidance around nutrition and exercise or prevention programs and screenings. Once these programs are established, health plans must also invest in strategies to educate members, and drive engagement and adoption.

Move beyond enrollment to activation and engagement 

Starting something new is hard, and health and wellbeing practices like better nutrition and exercise plans are no exception. Research shows that 80% of people will abandon a new habit in the first 30 days. Health plans need to be strategic about how they promote these initiatives. It is not enough to just offer a health and wellbeing program or service, health plans should go one step further to educate members and help them understand the next best action for achieving their goals, driving engagement.

This requires health plan leaders to adopt a data-and-science-based approach. Once they understand what resonates most with members through data analysis, they can make communication strategies personal and relevant, encouraging members to take the next best step, and connecting them with resources they both need and are likely to utilize. Understanding how to drive sustained engagement and what supports long-term behavior change is critical to achieving this success.

Consider the evolving definition of value

As the healthcare system evolves, so does the notion of value and what it means in terms of value-based contracts. From 2021 to 2025, value-based contracts are projected to grow to cover 22% of insured lives in the U.S. – nearly 65 million people.

Health plans can help providers deliver value to patients while also supporting the move to value-based care. This includes working with providers to support patients with telehealth and other digital health tools. It also involves meeting the unique needs of members to drive actions such as completing a missed cancer screening or attending a prenatal care appointment. To contribute to value-based care success, health plans can enable healthy actions and long-term behavior by simplifying how individuals navigate their benefits and interactions with the larger healthcare system. Better navigation leads to more engaged consumers who adhere to preventive care recommendations, adopt healthier habits, get control of their chronic conditions, and decrease overall risk.

To successfully drive better health outcomes and business growth, health plans need to pay attention to trends within the industry and address them. Innovations in digital health are pushing the healthcare industry to evolve at a rapid pace. By embracing these advancements and adapting them to address and solve member needs, health plans can deliver personalized healthcare experiences that drive value and improve member satisfaction and health outcomes.

Photo: rudall30, Getty Images

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Self Care

Why TytoCare’s CEO Thinks Its New ROI-Focused Primary Care Offering Is Different Than the Competition

by Bailey Amber
written by Bailey Amber

Charity, care, cost, expense

Traditional telehealth delivered by the likes of Amwell, Teladoc and MDLive often leaves much to be desired, according to TytoCare CEO Dedi Gilad.

That’s why his company launched a new offering on Wednesday that promises to give providers and health plans the range of products and services needed to operate successful virtual primary care programs. In a recent interview, Gilad said the offering, named Home Smart Clinic, will be the first remote primary care offering that can address the ROI and care gaps that traditional telehealth offerings have.

“People can hardly see their own doctor in a virtual way, so they often have to rely on a doctor in the cloud. To some populations, this might be okay, but most consumers want continuity of care. Healthcare is not like Uber,” he said.

Home Smart Clinic delivers continuous care journeys to families in their home across care modalities, including acute, preventive and chronic. The offering includes TytoCare’s handheld remote examination and diagnosis kit, its AI-powered insights platform and its suite of user engagement services.

The program was built to be compatible with various provider models, such as family primary care physicians and cloud-based doctors. Home Smart Clinic can also be tailored to different patient populations, such as those covered by private or public health plans.

Some users of Home Smart Clinic include MemorialCare, Spectrum Health and Elevance Health, according to Gilad.

He said one of the main reasons that TytoCare rolled out this new offering is because healthcare organizations are not seeing enough value when they roll out virtual care programs.

“They’re not looking just for good technology or for innovation. They want to see real savings, and in our economy, they don’t have enough of a budget to play around with trials,” Gilad said. “They want to see something that is impactful to their bottom line. And I think this is what the industry is not talking enough about.”

TytoCare stands out because it is focused on user engagement and therefore has high utilization rates, Gilad claimed. He said utilization drives effectiveness.

He also said the company’s platform shows five to eight times higher utilization rates than other virtual care providers. The program’s average utilization in the U.S. is 45%, whereas the industry average is in the single digits, according to Gilad.

These high utilization rates drive value because they lead to emergency room avoidance, urgent care avoidance and lower volumes of prescription medicine, Gilad pointed out.

TytoCare is equipping the providers and health plans that adopt Home Smart Clinic with metrics to measure the program’s success. These “D.R.I.V.E.” metrics include measures for diagnostic capabilities, retention, inclusion, visits and engagement.

By having these metrics, providers and health plans will have an easier time seeing the ROI that they get from Home Smart Clinic, Gilad said.

Photo: eakrin rasadonyindee, Getty Images

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Self Care

How medtech can crack the patient engagement conundrum and transform the patient experience [Sponsored]

by Bailey Amber
written by Bailey Amber

virtual care technology

Note: This article is part of a series exploring how to unlock the value of remote patient monitoring. The next article in the series explores how medical device companies are using RWE as part of submissions to regulatory bodies. We’ll explore how medical device companies are navigating this segment of the regulatory landscape.

Patient engagement is a critical component of remote patient monitoring. Part of real world evidence (RWE) collection involves patient-reported data. But if medtech companies are to build a collaborative relationship with patients, building trust is critical to get opt-in to share their data. If patients understand why their data is needed and how it will be used, they will be more likely to view this request in a positive light. They’ll see this as a way to help them manage their condition and not as a cynical transactional relationship.

As well as ensuring that accurate, timely data is collected from devices, capturing patient reported outcomes (for example, chronic pain) is also important to build a fuller view of the patient. In a recent webinar on remote patient monitoring and RWE, sponsored by Huma, panelists discussed how they are using patient engagement to trigger earlier interventions, support patients through their care journey and de-escalate the stress and anxiety often associated with managing acute and chronic conditions.

Earlier interventions

One of the exciting opportunities in leveraging RWE and data insights for patients and clinicians is they can lead to earlier interventions for high risk patients. This patient population may include patients with multiple chronic conditions as well as patients recovering from surgery.

AliveCor uses biosensors to convert a smartphone into an EKG to track arrhythmias. This heart condition can be tough to spot in the relatively short window of a physician appointment because they are unpredictable. That spurs the need for data collection over a long period of time when arrhythmias can be detected. The goal of the company is not only to make it easy for patients to collect and share data to avoid a fragmented care experience, but to enable earlier interventions to avoid hospitalizations.

Dr. Archana Dubey, chief clinical officer with AliveCor, shared that by adding remote patient monitoring, the company reduced emergency room visits by 56%. It was also able to cut hospitalization for patients with arrhythmia by 68%.

“That is powerful. That is important … for a primary care physician to better manage and better understand the patients when they’re at home or in the workplace,” Dubey said. “It’s also important for payers because they care about total cost of care reduction.”

In order to provide effective early intervention for the portion of orthopedic surgery patients experiencing complications with recovery, it’s important for that insight to come within one week of surgery. Patient reported data is essential within the week following this surgery, according to Paul Trueman,  global VP for health economics and market access at Smith and Nephew. By receiving patient feedback on pain, mobility, and satisfaction through medical device RWE platforms, surgeons are better positioned to respond in a timely manner and, if possible, deliver better outcomes for the patient.

Trueman noted that the medical device industry’s ability to collect and build big data sets based on patient-reported outcomes as they recover from procedures is where the medtech industry can prove the value and effectiveness of their devices in the long term. 

“That’s where we start to get signals about overarching product performance, rare [adverse] events. We know that’s occurred in orthopedics in the past where we haven’t had that wholesale data collection – we either missed it as an industry or we found it too late. I think as we start to get more and more data or we recruit more patients …. we’ll start to get those signals a lot earlier and correct [problems] earlier as well.” 

As valuable as earlier interventions are, for clinicians to receive and act on data insights for high risk patients, alerts need to be managed in such a way that they don’t create alarm fatigue or otherwise add to the overworked physicians’ caseload.

Supporting patients

Patient engagement with their medical devices is also critical for more subjective measures, especially pain. Abbott’s Neuromodulation division developed the NeuroSphere platform to support virtual care and interactive data collection between patients who have received an implant as part of treatment for movement disorders such as Parkinson’s disease and/or chronic pain. 

What’s compelling about this platform from a medical device company is that physicians are able to adjust the patient’s implant settings remotely, based on patient-reported data. Abbott gets right to the sweet spot of the dynamics that can drive increased patient engagement and lead to better outcomes. If patients share data and express discomfort, that engagement will lead to a physician response, adjusting the settings of their implant, and help them feel and move better. This should empower patients and make them feel they can take an active role in managing their condition and potentially reduce their stress. So even patients in rural areas or where neurologists are in short supply can have the same level of access to physicians who receive their data and respond accordingly. 

Dr. Erika Ross, director of clinical and applied research of the Neuromodulation division at Abbott, noted that it’s incumbent upon the medical device manufacturer to balance the patient’s ownership of their own data with building interfaces so a clinician can use timely insights based on the patient’s data to make a decision in a short amount of time and communicate with patients as clearly as possible . 

“These small movements forward in truly understanding objectively what’s happening in a very subjective disorder, this is going to completely revolutionize an area like the chronic pain practice area,” said Dr. Erika Ross, director of clinical and applied research of the Neuromodulation division at Abbott.

The Covid-19 pandemic has played a role in making individuals more aware of their health and on the alert for symptoms related to the virus. That’s helped make people more engaged in their health generally. 

Alex Gilbert, who works in digital medicine at Huma, said Type 2 diabetes patients he’s working with are sharing data from their devices at a rate of 80%, which is an unusually high level of engagement for patients with this chronic condition. The implications are that when patients can see the benefits of sharing data to track and manage their condition they will be more likely to adopt medtech and companion digital health apps at a higher rate. That, in turn, will lead to more patients opting into sharing their information with both medical device manufacturers and hospitals. 

“It just pays to be very honest and clear about how data is being transferred and transmitted,” Gilbert shared. “We explain that to patients, we help them to understand the process that’s going on. We’ve actually spent a lot of time in terms of engaging them in the right way and getting them involved.”

De-escalating patient concerns

As the case of Abbott demonstrates, medical device manufacturers are taking on a larger role in patient engagement. It’s part of a slow but widening trend. That interaction is not only illustrated by changing a patient’s device settings in response to them sharing data. It is also reflected by medtech companies using patient data and feedback to de-escalate patient concerns.

Patients using Smith and Nephew’s devices receive an explanation from the company when they’re concerned about the pace of their recovery from surgery or concerns over developments like swelling and stiffness and how long those symptoms will last and give them a sense of the parameters of their recovery. 

“We’re not directly intervening,” Trueman explained. “But where we have signs and symptoms of an escalation of an infection, for example, we’re trying to give the patient enough insight and knowledge and education to actually know when to pick up the phone to [call] their provider.” 

To optimize patient engagement, it’s crucial for there to be synchronicity between medical device companies, patients, clinicians and payers. When medical device companies build an interface for their devices that supports data sharing between patients and clinicians, this can make it easier for patients to share meaningful data with clinicians and, passively, medtech companies. It can also help patients better understand their condition and motivate them to be more candid about the data they share with their clinicians and even medtech companies. By sharing more personal information in a timely manner, it could improve communication between clinicians and patients and avoid needless trips to the emergency room and reduce complications that lead to hospitalization.

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Self Care

In developing at-home diagnostics, focus less on features more on user experience

by Bailey Amber
written by Bailey Amber

Fueled by the pandemic that boosted at-home consumer testing for Covid-19 as well as by increased investment over the last few years, the diagnostics industry is rapidly developing at-home testing capability.

However, it would be wise to focus less on features and more on the user experience.

“I have been in many different companies, financial services, healthcare gaming, et cetera, and people tend to focus on the product. How good is the product? Is it the most advanced? Does it have the most features? Does it have all of these kinds of things? I would rather have less features, 50% less features and a fantastic experience,” said Susan Moon, senior vice president, Customer & Digital Experience Team, Exact Sciences. [Exact Sciences makes and sells the at-home Cologuard colorectal-cancer screening tool. ] 

Moon was speaking Friday at the MedtechVision 2022, a hybrid conference organized by MedtechWomen. Her co-panelists were Archana Dubey chief clinical officer, AliveCor and Maital Rasmussen, chief commercial officer, Octave Bioscience and the panel was moderated by Lilly Li, principal, Northpond Ventures.

The focus on the consumer experience is especially key in the world of at-home diagnostics. First, because taking note of the consumer experience is part and parcel of developing a patient-centric healthcare world that everyone is striving for. And secondly, because, many consumers especially in the U.S. have a certain “opening the box” experience for tech devices driven by the likes of Apple.

“Think about when you open, uh, iPhone box or when you first got your Apple watch, right?” Moon prompted the audience. It’s like, pleasure.  You open it up. There are no instructions. It automatically starts. It’s very logical. That’s what has to happen to this space in, in care and in diagnostic tests and wearables, all of those kinds of things, because if they can’t figure it out, they’re not gonna do it or they’re gonna do it incorrectly. And that creates even more dissatisfaction.”

A good consumer/patient experience also helps to acquire an intangible commodity that has been sparse among certain sections of American society especially as it relates to Covid vaccines: trust.

“I think it’s applies to all of us who are working in MedTech — member experience is where you win trust,” said Dubey with AliveCor that has developed a mobile, personal EKG device that connects to a person’s smartphone to help monitor heart health. “So your EKG changes when you are running, when you are laying down, when you’re even in your sleep suits sometimes. And when the symptom happens, you have to make a doctor’s appointment. It’s two months away to get an EKG [appointment] …and  you will miss the diagnoses. So [our founder] took that big old [EKG] cart and put it in this credit card like device in the hands of people where they live, when, where heart disease or heart care is happening.”

Taking something that was only available in a clinical setting and democratizing that technology to be accessible in the home built trust between people who bought the device for use at home and AliveCor, Dubey said.

Another panelist implied that the focus on experience – be it the consumer/patient’s experience or the physician’s experience – needs to be in the DNA of the entire organization.

“It’s a whole company actually, it’s from the design of the product and it’s from the person who picks up the phone and it’s from the sales people. So you wanna create experiences, not only for the patients, but also for the physicians that actually supposed to, endorse it and bring it to the patient themselves,” said Maital Rasmussen, chief commercial officer, Octave Bioscience. “So it’s really — experiences is a currency right now.”

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Self Care

Recenlt KLAS report reveals gaps between patient expectations and the reality of today’s digital healthcare interactions

by Bailey Amber
written by Bailey Amber

The recent data from KLAS, the highly regarded health IT research firm, reveals that capabilities which allow patients to digitally interact with healthcare organizations aren’t always available. More people are connecting with care providers via online and mobile channels than ever before, yet there is work to be done to meet patient expectations.

In the Patient Perspectives on Patient Engagement Technology 2022 report, surveyed patients identified in-demand digital tools and expressed their desire for more “actionable” capabilities. These include functions that add convenience—like appointment self-scheduling or requesting a referral—and provide easier access to manage healthcare services like prescription refills. Most respondents also stated that better, more frequent communication about healthcare visit preparation could enhance their experience.

Yet healthcare organizations don’t consistently have these types of features. For some, cost and infrastructure inhibit adoption. Others have attempted to add functionality via patient portals, but this technology offers limited real-time interaction and can be complicated for patients to navigate.

The KLAS report recommends exploring other solutions, including automated patient outreach or engagement, as one way to bridge this gap between patient needs and existing capabilities. Automated engagement involves sharing real-time messaging, links, education, and instructions via text or other methods that don’t require manual outreach. This simple communication option is preferred by many individuals.

Data highlights show what matters most to patients

Responses indicate that patients insist on online appointment scheduling abilities. Sixty-seven percent of respondents want the ability to schedule/reschedule an appointment, yet only 37% report the ability to do so.

Prescription refill services are also important. Half of these individuals indicated they want to be able to request prescription refills digitally, yet this is only available to 29% of those surveyed.

This desire for appointment management and prescription functions is aligned with general consumer demand for more digital interaction with the healthcare system. Another industry survey of millennial patients revealed that 92% want two-way communication with their healthcare providers, and 71% expect online scheduling abilities.

One area where digital tech has arguably met patient expectations is in the realm of virtual interaction. Now, this feedback is informing how healthcare organizations provide this popular delivery channel.

For example, KLAS found that pre-visit preparation and post-visit follow-up are of high importance to patients when it comes to virtual care. Respondents who felt neutral or some level of dissatisfaction with the quality of their telehealth experience stated that better preparation is needed.

This preparation could take a variety of forms. Nearly one-third of respondents said sending appointment links (32%) and receiving information about their condition and its appropriateness for a telehealth visit ahead of time (33%) would improve their experience.

Patient engagement technology also has the potential to drive improved outcomes following regular, in-person healthcare interactions. Studies show that nearly one in five people experience an adverse event within three weeks hospital discharge—but almost 75% of these could be prevented or corrected. Staying in contact with these individuals via digital channels can help care teams stay abreast of changes in status and offer patients an easy way to provide feedback or updates.

Giving patients control over their care improves experience, outcomes

All of these in-demand capabilities can impact the patient experience, close care gaps, and improve outcomes. As evidenced by the report, respondents most value technology capabilities that directly impact their ability to receive and control their care. The question is how to deliver these capabilities without overwhelming health system staff or patients with complex technologies.

Automation may be one answer, according to the report. It states automated tools can provide simple communication options and access to information. It also recommends that organizations evaluate new technology to enhance system capabilities and meet patient needs.

What does automation look like in the realm of patient engagement? In its early days, it began with basic reminders sent before a scheduled appointment. But today, it involves multichannel communication (including SMS text, interactive voice response or IVR, and email) to interact with individuals for all types of healthcare needs and services.

Some platforms offer interactive functions like two-way messaging. This means patients can respond to notifications just like they would during a one-on-one interaction. For example, patients can schedule or reschedule an appointment, or request support prompting pre-visit instructions, education, or clinical preparation in advance of a procedure. In this way, automated engagement can improve care gap closure.

This automated approach aligns with several specific recommendations outlined by KLAS. For one, multimodal outreach gives patients the option to participate in the way that is most comfortable for them. And enabling bidirectional communication means patients can stay involved in their care.

Given these benefits, why aren’t more health systems deploying automated engagement today? Some use technology to engage, as evidenced by the study. But they may not offer the right tool for the right job.

Patient portals are still widely used for engagement, but they have significant limitations. Portals are more complicated, less user-friendly interfaces, and require logins and passwords. In comparison, rescheduling an appointment over text happens via a device most people already use every day. Portal technology should be reserved for more complex tasks like reviewing test results or medical records. KLAS recommends that healthcare organizations supplement the portal with other technologies to engage patients in ways they find convenient and useful.

How automation works in practice 

Automated patient engagement works best when integrated with the EHR, meaning it can tailor outreach based on information contained in this system. Such platforms interpret patient record data to identify care gaps, pending referrals, and other needs for care, in addition to honoring scheduling “rules” and communication or language preferences.

Then, as patients respond, their replies are captured and written back to the EHR. Health teams can then document care gap closure and even a lack of patient response (indicating a need for follow-up).

One example of this level of automation in action was demonstrated by a health system looking to reduce its bad prep rates for colonoscopies and canceled procedures. Two-way appointment SMS text and IVR reminders were sent so that patients could respond and confirm, cancel, or reschedule their appointment. Patients received additional reminders to pick up the required prep from the pharmacy, were sent educational information about the procedure, and received a final appointment reminder. After implementing the workflow, the health system saw a marked reduction in canceled procedures, and this approach involved no additional manual lift from staff members.

How health systems can address patient needs

As recommended by KLAS, healthcare organizations should consider new and different technology to enhance engagement. Here are three ways an automated engagement approach can improve experience scores, close care gaps, and meet patient technology needs:

Automation can power digital, self-service tools. The report states patients 18-34 years old are almost twice as likely to choose provider organizations that have digital access tools.

Automation can bolster virtual care. Pre-visit preparation can make or break care delivery. According to KLAS, health systems should share instructions, emails, texts, and educational materials to help individuals make the most of their healthcare visit.

Automation can allow for multi-modal communication. One recommendation from the report suggests providers include other solutions that can automate access to information and provide simple communication options.

Based on these findings, hospitals and health systems should consider implementing automated patient engagement technology that supports functions individuals value most—those that directly impact their ability to seek and receive healthcare. With benefits spanning patient experience improvement, a reduction in staff burden, and more easily delivered care that encourages higher visit volumes, this approach is poised to address today’s patients’ expectations.

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Report: 40% of chronically ill Americans delayed care during pandemic

by Bailey Amber
written by Bailey Amber

A major concern during the Covid-19 pandemic has been that Americans, especially those with underlying conditions, will delay necessary care. New survey results show this concern is not unfounded.

As of last September, about 40% of Americans with one or more chronic health conditions reported delaying or avoiding care, according to a new report from the Urban Institute and Robert Wood Johnson Foundation.

Report authors analyzed data from the second wave of the Urban Institute’s Coronavirus Tracking Survey, a nationally representative survey conducted Sept. 11-28, 2020. The survey polled 4,007 adults, ages 18 to 64 years.

About 36% of Americans said they delayed or did not receive healthcare due to a fear of exposure to the coronavirus or because a provider limited services during the pandemic, the report states. Black adults (39.7%) were more likely than white (34.3%) or Hispanic/Latinx (35.5%) adults to report delaying or forgoing care because of concerns about virus exposure.

About four in 10 adults with one or more chronic health conditions (40.7%) said they delayed or avoided care because of the pandemic, as compared with 26.4% of adults with no chronic conditions.

In addition, more than half of adults with both a physical and mental health condition (56.3%) reported delaying or avoiding healthcare due to the pandemic. About 43% of this group also reported delayed or forgoing multiple types of care.

The impacts of delaying or avoiding care were acutely felt by those with chronic conditions, the report shows. An estimated 23.2% of these adults reported that going without or delaying care worsened a health condition, 21% said it limited their ability to perform daily activities and 15.2% said it limited their ability to work.

Further, the report shows the kinds of care that Americans were avoiding. Dental care was the most common type of care adults delayed or did not receive because of the pandemic (25.3%), followed by seeing a general doctor or specialist (20.6%) and receiving preventive health screenings or medical tests (15.5%).

“Tackling unmet healthcare needs requires effectively assuaging fears about exposure to the coronavirus,” report authors concluded. Providers need to reassure patients that they are following public health guidelines and that these precautions can effectively prevent virus transmission.

“More data showing healthcare settings are not common sources of transmission and better communication with the public to promote the importance of seeking needed and routine care are also needed,” the authors wrote.

Photo: YinYang, Getty Images

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Sharecare confirms plans to go public through SPAC merger

by Bailey Amber
written by Bailey Amber

Digital health startup Sharecare plans to go public through a merger with a special purpose acquisition company. Photo credit: Sharecare

Digital health startup Sharecare confirmed reports that it plans to go public through a merger with a blank-check company. The Atlanta-based startup plans to merge with a special-purpose acquisition company created by Alan Mnuchin, CEO of Falcon Capital and brother of former Treasury Secretary Steve Mnuchin.

The deal would value Sharecare at $3.9 billion and add $400 million to its balance sheet. It plans to use the funds to  grow its business, build out its salesforce, and help pay for its recent acquisition of healthcare artificial intelligence startup Doc.AI.

Sharecare was founded in 2012 WebMD creator Jeff Arnold and TV personality Dr. Mehmet Oz. Started as a health and wellness social media platform, the company later began working with heath plans with its acquisition of Healthways’ population health services business in 2016. It has raised $450 million in funding to date.

“We started Sharecare to leverage innovations in consumer technology – specifically the smartphone – to create a frictionless experience that engages people across the dynamic continuum of their healthcare needs,” Arnold said in a news release. “By integrating fragmented point solutions and bringing together stakeholders across the healthcare ecosystem into one connected virtual care platform, we believe that Sharecare is uniquely positioned to transform the way people access, providers deliver, and employers and health plans administer high quality, cost efficient healthcare.”

Blank-check company Falcon Capital Acquisition Corp. will bring $345 million of cash held in a trust to the deal. Private investors including Koch Strategic Platforms, Baron Capital Group, Eldridge, Woodline Partners LP and Digital Alpha will contribute $425 million in a private investment in public equity (PIPE).

Anthem will also make a direct investment into Sharecare for an undisclosed amount after its chief digital officer, Rajeev Ronanki, recently joined Sharecare’s board of directors. 

“Through this relationship, we will leverage human-centered design and digital technologies, including artificial intelligence, that increase consumer engagement, deliver more affordable healthcare, and achieve better health outcomes through services such as next generation personalized healthcare concierge and advocacy services,” Ronanki said in a news release.

After the acquisition closes, Falcon will own roughly 20% of the company. Mnuchin and Jeff Sagansky, an independent director of Falcon, will join Sharecare’s board.

Sharecare has a hodgepodge of features, from pharmacy discount cards to a smoking cessation app to a tool that’s supposed to detect a user’s stress levels from listening to their voice. So far, the lion’s share of the company’s business is  its work with health plans, which are expected to bring in more than half of its revenue for 2021, an estimated $227 million, according to the company’s investor presentation.

For example, Blue Cross and Blue Shield of Arizona began offering the app to its members last year, including rewarding them for tracking their steps. Users are also instructed to answer a lengthy survey for suggestions to improve their health. Some of Sharecare’s other customers include Anthem, Centene, Humana, Walmart and StateFarm.

Another portion of the Sharecare’s business is focused on offering solutions to payers and clinicians, which brought in roughly $80 million last year. For example, it acquired claims review company WhiteHatAI last year, and it also acquired medical records company BACTES, which it rebranded as Sharecare Health Data Services.

Sharecare also has an advertising business, which brought in roughly $56 million last year. Controversially, that included sponsored health advice in Q&As; the company offers condition-specific marketing to pharmaceutical companies and touts its “real-time health profiling engine” in investor slides. But it cannot target ads to users who access the app through their insurance, only those who download it for free, according to its privacy policy.

In the last three years, Sharecare’s revenue has declined slightly, from $347 million in 2017 to $340 million in 2019. Its expected revenue for 2020 is $330 million, with the company attributing the decrease to reduced physician visits and fewer visits at its in-person diabetes clinics, according to an investor presentation.

It reported a $40 million net loss in 2019, compared to a $55 million net loss in 2018.

Still, the company said it expects to bring in $512 million in revenue in 2022, and has “multiple paths” to more than $1 billion in medium-term revenue.

The deal is expected to close next quarter, with Sharecare trading on Nasdaq under the ticker “SHCR.”

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Managing medications during Covid-19: A team effort in transitional care

by Bailey Amber
written by Bailey Amber

Metoprolol (muh•tow•pruh•laal). Eszopiclone (es•zoe•pik•lone). Hydrochlorothiazide (hy•dro•klor•oh•thi•a•zide). Amitriptyline (a•muh•trip•tuh•leen). Canagliflozin (kan•a•gli•floe•zin).

Are you able to recognize or pronounce any of these commonly prescribed medications? If so, you might be a pharmacist, or at least have experience providing patient care. It’s fair to say that most people find it challenging to pronounce drug names, and it may be even more challenging for the elderly.

It’s not uncommon for elderly patients to be prescribed multiple medications to treat multiple chronic conditions, and sometimes these medications come from multiple providers. In my experience, I have seen many patients fail to understand what, why and how to take their prescriptions. Some have the help of family or caregivers while others may not, which makes it even more challenging to manage. Many factors can contribute to these challenges including vision problems, memory loss, swallowing problems and or hearing loss. Medications can be extremely helpful in treating and preventing disease, or they can cause a major health setback if not taken appropriately.

As a pharmacist by training, or “pharmist” as my Grandpa likes to call me, I spend my time reviewing his medications when I’m in town to visit. He loves to sit down with me and tell me all about the medications he’s taking and what he takes them for.  At 87 years old, he’s impressively taking only three (3) medications. Up until last year, he was taking only taking one (1). He’s incredibly sharp and has never needed any extra assistance. My Grandpa is the perfect patient. He’s highly adherent and takes his medications every day, at the same time, right before his morning coffee. I understand the importance of adherence and adherence to the right medications, but I have never personally experienced or witnessed the challenges that come with adherence following discharge from a hospital stay, until now.

Covid-19 hit close to home and affected both of my grandparents this past Thanksgiving. After a few days, it was apparent they were unable to weather this virus alone. It severely affected their cognitive status and caused weakness so severe they were unable to stand or walk on their own. While staying with them during this time, a decision was made to take my Grandpa to the E.R., which led to a six-day hospital stay. Because I know he visits multiple providers and pharmacies, I knew the hospital wouldn’t have a complete record of all the medications he takes….and I was right.  I made sure he went with an updated med-list so that the doctors could give him his regular medications while in the hospital.  I knew this med-list would likely change following his discharge.

Upon discharge, I was provided with a long list of instructions from multiple people on the care team that was difficult to follow along even for me. First came a call from the nurse,  then a call from the provider, then a call from the pharmacist, and lastly a call from the company who would be dropping off his home oxygen. The pharmacist’s call was helpful, but not appropriately timed — I had no discharge papers to reference.  The provider called again, to go over the medications with us. The review was fast. Medications were discontinued. Medications were added. Some medications were named in their brand name while others were listed generically.

Who could possibly follow along? No one expressed to us the duration of these medications. When could they be stopped? Will they ever be stopped? Were refills needed, what doctor would continue to prescribe them? What if I had not been around to help?

Following my Grandpa’s return, I immediately sat down to review and organize all of his medications, new and old. One medication was discontinued, while 4 were added. My Grandpa went from taking 3 medications to 7 overnight, and each medication came with its own set of directions:

  1. Take this tablet with food.
  2. Take this tablet on an empty stomach.
  3. Take this tablet every day and skip on Saturdays.
  4. Take this tablet on Monday, Wednesday, and Friday.
  5. Skip this tablet for two days. Restart on Sunday.
    1. 2 days later* “Actually, take this medication every other day starting Tuesday.”
  6. Take this tablet every day.
  7. Take this tablet three times a day and make sure not to eat too much sugar or salt with this med.

With all of this information, I created a “Fridge Report” for when I’m not around. A Fridge Report is a simple and easy to read medication list. It displays all medications a patient is taking and how to take them in a nice visual display that is easy to follow. I also called and spoke with his primary care provider (PCP) and cardiologist to confirm his active medications and to notify them of the newly added and discontinued medications. I can’t imagine my grandparents, or anyone else’s grandparents, managing this without the help of a pharmacist. The Fridge Report was highly appreciated by my family.

“We need that (Fridge Report). It’s very detailed. No mixing up or second-guessing of medications. Now I know what to give and when to give it.” – Lorraine Armenta, My Aunt

According to the World Health Organization (WHO), care transitions threaten patient safety as they can increase the possibility of losing critical clinical information and require an increased degree of coordination. I believe a multifaceted approach is needed to improve care transitions and is especially needed for vulnerable and high-risk individuals. The transition between inpatient and community settings, in particular, is prone to medication errors related to a lack of communication between health care providers, missed patient follow-up, inadequate patient education, incomplete medication reconciliation, and the absence of patient involvement in medication management. Pharmacists can and should take a more active role in improving medication safety during care transitions; this could lead to a reduction in hospital readmissions and improved quality of care.

Pharmacists serve as quarterbacks of a patient’s at-home-care team, providing essential help to those who are taking multiple medications. We are medication safety experts and have access to sophisticated and innovative tools to better manage the medication-related needs of patients and mitigate adverse drug events (ADEs). Ultimately, engaging with your local pharmacist can reduce the burden placed on a patient’s family and the primary caregiver, while making the transition to at-home care manageable.  

Photo: JohnnyGreig, Getty Images

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Self Care

Blue KC, HealthMine’s expanded partnership will extend digital rewards program to ACA members

by Bailey Amber
written by Bailey Amber

Blue Cross and Blue Shield of Kansas City expanded its partnership with HealthMine, a technology company providing member engagement solutions, to build a rewards program for the payer’s individual and family Affordable Care Act members.

The Missouri-based payer, also known as Blue KC, has an existing partnership with HealthMine to offer a rewards program for its Medicare Advantage plan members. The program focuses on encouraging preventive health actions, such as annual wellness visits, flu shots and breast cancer screenings, by offering the ability to earn rewards in the form of gift cards to national and local retailers, Jenn Ader, senior director of client services at HealthMine said in an email.

“The program has also continued to evolve to provide additional features, including a digital health risk assessment delivered through the program application to help Blue KC better understand their members’ health status and risks,” she said.

Members interact with the program through a mobile app, web portal and live customer service support, she added.

Through the expanded partnership, HealthMine will build an incentive and rewards program for the insurer’s ACA members similar to the one for its Medicare Advantage members, giving the ACA members incentives to complete health actions and digital health risk assessments.

“The rewards program helps our MA members engage with their healthcare decisions and develop an ongoing relationship with their primary care providers,” said Lori Rund, vice president of government programs at Blue KC, via email. “We expect it will do the same for our ACA members, ultimately giving them the tools they need to successfully navigate the healthcare system and reach their long-term health goals.”

Creating incentive programs for ACA plan members is especially important, because these members tend not to seek routine medical care as they previously may not have had health insurance coverage, James Haskins, HealthMine’s director of government programs, said in an email.

These programs, “by rewarding preventive visits, encourage members to establish a relationship with a provider — this relationship is a launching point for the member on a journey of engagement in managing their health,” he said.

Engaging plan members in preventive healthcare has become even more challenging amid the Covid-19 pandemic, as the fear of contracting the deadly new coronavirus has kept people from routine care visits. By June 30, an estimated 41% of U.S. adults had delayed or avoided medical care due to concerns about Covid-19, according to data from the Centers for Disease Prevention and Control.

“There are ways to minimize the effects of Covid-19 on preventive care by providing a solution that seamlessly connects members to the care they need and incentivizes them to get needed care — that’s where rewards programs can come in,” Haskins said.

In addition, as the Covid-19 vaccine becomes more widely available, health plans need to be able to communicate with its members, especially the younger and healthier members that tend to have ACA plans, to give them information about vaccine availability and safety, he said.

“Offering an associated reward helps increase member interest and move those who may not have sought this vaccine otherwise,” he added.

Photo credit: ljubaphoto, Getty Images

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Self Care

UnitedHealthcare offers certain members free access to Apple Fitness+

by Bailey Amber
written by Bailey Amber

UnitedHealthcare is providing members of its Motion program access to Apple Fitness+ workout classes, powered by Apple Watch, for at least six months and at no additional cost.

UnitedHealthcare Motion is a well-being program that enables people to earn over $1,000 per year by meeting certain daily activity goals, Rebecca Madsen, UnitedHealthcare’s chief consumer officer, said in an email. People in the program have access to several wearables, including Apple Watches, at no additional cost and as buy-up options.

Beginning Jan. 1, UnitedHealthcare Motion enrollees with Apple Watches will have access to Apple Fitness+, which provides a variety of studio-style workouts, including high-intensity interval training, yoga, dance and cycling.

“UnitedHealthcare and Apple share a joint mission to help people live healthier lives,” Madsen said via email. “By making Apple Fitness+ accessible to UnitedHealthcare Motion members with Apple Watch, we are helping achieve that goal. Plus, with interest in at-home fitness resources surging amid Covid-19, this collaboration is another way to support our members on their journeys toward health.”

Eligible members will gain free access to Apple Fitness+ workouts for six months, after which they will be able to buy a six-month subscription using program earnings, a credit card or a combination of both.

Providing access to Apple Fitness+ is a part of the insurer’s broader effort to offer people digital resources and financial incentives that can help them better manage their health, especially their chronic conditions, Madsen said.

“UnitedHealthcare is dedicated to creating seamless, integrated health programs and resources that empower people to take charge of their health, more easily navigate the health system and help make care more affordable for all Americans,” she added. “We are helping accomplish those goals with UnitedHealthcare Motion and the new collaboration with Apple.”

A recent study, which followed 44,370 men and women for 4 to 14.5 years, showed that people who spent more time being sedentary faced a higher risk of death as compared to people who spent more time being physically active.

UnitedHealthcare Motion enables members to earn financial incentives based on reaching daily fitness targets, which include completing 300 steps within five minutes, six times per day, at least an hour apart.

Since the launch of the program, UnitedHealthcare Motion participants have collectively walked more than 511 billion steps and earned $60 million in rewards, Madsen said.

Photo credit: martin-dm, Getty Images

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