Talking with Health Plan Members: How Enhanced Member Experience Can Lead to Improved Primary Care Engagement

In our recent white paper, 'The Correlation Between Enhanced Member Experience and Improved Primary Care Engagement,' we address peer-reviewed studies that demonstrated that Medicare beneficiaries who see a primary care provider (PCP) regularly have fewer hospitalizations and lower health care costs. Yet, certain factors make it challenging for some individuals, particularly older Americans, to see a PCP regularly.

The Background

Six in 10 adults in the United States have a chronic disease, and four in 10 American adults have two or more chronic conditions. According to The Centers for Disease Control and Prevention, "A growing body of evidence shows that people with higher patient activation (i.e., the knowledge, skills, and confidence to engage in their health care actively) have better health outcomes. 33% of Americans do not have a PCP despite the fact that studies have shown that regular visits with a PCP can help to:

• Manage chronic conditions
• Prevent hospitalizations
• Lower health care costs
• Improve health care outcomes

However, few studies have addressed the impact of an enhanced non-PCP experience (at home) on individual engagement with primary care for improved health outcomes. As we addressed in the white paper, our data indicates exceptional health plan member experiences lead to greater member engagement.

Signify Health's In-home Health Evaluation

The In-home Health Evaluation (IHE) effectively introduces health plan members and their health care teams to the future of health care. Performed in the comfort of the member's home by a licensed clinician, Signify Health's IHE provides unparalleled insights into individual health plan members' health and resource needs, whether clinical, social, behavioral or a combination thereof. Because the IHE takes place in the member's home, individuals tend to be more comfortable and relaxed, which can lead to more productive conversations about their health.

On average, an IHE is 2.5 times longer than a typical in-office doctor's appointment. The IHE provides more opportunity for the clinician to complete a thorough and holistic assessment of the members' health and includes:

• Appropriate preventive and diagnostic screenings
• Chronic condition assessment
• Comprehensive medication review
• Comprehensive physical exam
• Fall risk screening
• Medical, social & family history
• Behavioral health screening
• Quality & care cap closure
• SDOH screening

The IHE additionally allows the clinician time to discuss the member's understanding of their health care status and the importance of preventive care, address any needs for educational resources, and include an understanding of the importance of medication compliance. With more time, members are encouraged to ask questions and express concerns, which is not always possible during a typical in-office visit. Signify Health's data shows that nearly 90% of members accepted a diagnostic test and lab collection during the IHE. With 21% of the preventive screenings performed during the IHE resulting in abnormal findings, health plan members and their PCPs can be aware of and address health concerns that may have previously been unidentified.

In-home Health Evaluation and Improved Health Plan Member Engagement

In a recent outcomes analysis, Signify Health measured the impact on the member's experience and engagement with primary care in a select Medicare Advantage (MA) population enrolled in a national health plan. The analysis included results from 10,000 individuals, 65 years and older, who received either a Signify Health IHE or a comparable in-home assessment. The study's results highlight the correlation between enhanced member engagement and improved primary care engagement and point to benefits for both the health plan member and the health plan.

Member Benefits

Our white paper reports that exceptional member experience has a robust and long-term link to value for health plan members. Due to the inherent ease, convenience, and value, highly satisfied members are 74% more likely to consider additional in-home health services. 97% of members who were highly satisfied with their Signify Health IHE said they would want another one in the future - indicative of individuals vested in and engaged in their health care. Notably, improvement in engagement was similar across all socio-economic demographics.

Health Plan Benefits

The benefits of health plans with engaged members were equally notable. Those actively engaged in their health care are more likely to schedule and complete an IHE. Better health care and improved outcomes for members receptive to an IHE help improve quality measures and Star ratings. Members experience earlier disease detection, interventions, and treatments, which helps to contain costs. Care gaps are identified and closed, which also result in savings. Data from our member experience study demonstrate that members highly satisfied with their Signify Health IHE are:

• 61% more likely to renew their coverage with their health plan.
• 26 times more likely to recommend their health plan to a friend or colleague.
• Six times more likely to report that their IHE has improved their health.

Health plans are uniquely positioned to optimize the benefits that result in a comprehensive - yet convenient - IHE. The potential for improved member engagement and better health care outcomes, including diagnostic and preventive screenings and tests, improving quality measures, increasing satisfaction scores, and improving Star ratings, is a value-added benefit for members. The IHE has improved communication and understanding for the health plan member, leading to improved engagement and helping to improve overall outcomes.

For more information about the analysis and benefits of the IHE, download Signify Health's recent white paper, 'The Correlation Between Enhanced Member Experience and Improved Primary Care Engagement.'

Signify Health is committed to value-based care practices that help to support patient and clinician engagement by emphasizing preventative, holistic practices. To learn more, below are additional resources.

Recording: RISE National 2024: Exceptional member experience that leads to growth, retention, and better care

White Paper: Analysis Affirms: In-home Health Evaluations lead to improved diabetes care in the Medicare Advantage demographic

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