Greater Patient Engagement for Lower Costs

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April 23rd, 2013
Categories: Healthcare Reform

patient engagementPatient engagement improves health outcomes and care coordination while reducing cost of care. Patients with low engagement typically choose inappropriate care settings, practice poor treatment compliance and avoid early health risk signs, which lead to high and unnecessary costs.

When making medical decisions about their health, patients can become overwhelmed or feel unqualified to make such important choices.  Patients can feel drowned in complicated procedures, diagnoses and high costs, and want to leave all final decisions in their physician’s hands out of fear.  Poor patient engagement leads to low patient compliance to treatment plans, higher costs and less than optimal health outcomes. That said, the most significant barriers to patient engagement are provider centered like lack of time due to sheer volume, insufficient training, or health information systems unable to properly track patients.

However, especially in this era of health reform, healthcare providers are looking for ways to overcome limitations, improve health outcomes and reduce cost of care.  Patients who are actively engaged in their healthcare receive higher quality of care, experience better health outcomes and are responsible for less health costs in the long run.  A facet of patient engagement, patient activation, is directly correlated to health costs. Patient activation scores are made up of a patient’s knowledge, willingness and confidence to become actively engaged in their healthcare.  One study found that patients with low patient activation predicted average costs to be 8% higher than patients with the highest activation in the base year, and 21% higher in the 1st half of the following year.  Patients with higher activation adhere to treatment plans and medications, get preventative care and are more likely to engage in healthy behaviors than those with lower levels of activation.

Providers can help patients become more engaged in their healthcare by involving them in making decisions about their care, providing information on treatment options, and encouraging healthy personal habits through education and continual communication. Patients who feel their healthcare provider is genuinely interested in their care by taking time to talk with them and weigh options are more comfortable taking ownership and making decisions for themselves.  In particular, medication management, medication reconciliation and pre-screening are practices that create high health and cost benefits by reducing hospital readmissions and other unnecessary costs.

Medication Management – Discussing medication schedules and associated risks with a patient before they leave the facility as well as a few days after ensures clarity about medications and can drastically reduce ED visits and its costs.

Medication Reconciliation – Medication reconciliation helps eliminate adverse reactions and offers cross-provider medication history. Similar to medication management, reconciliation considers the previously prescribed medications and how they affect the treatment plan given to the patient.

Pre-screening – Pre-screening in order to diagnose conditions like depression, ADHD, or breast cancer before they have the chance to grow into more serious conditions improves quality and avoid costs of more threatening conditions.

Patient engagement not only plays a part in our current healthcare delivery model, but will also play a major role in alternate care delivery models such as patient-centered medical homes and accountable care organizations.  Continuous communication and coordination between physicians and patients before, during and after care are key in building a stronger, more effective and efficient healthcare delivery system.