Engaging Patients in Their Health: HealthPartners

Too often, people are left on their own to manage an illness or even to fight the daily grind in order to stay well. At HealthPartners, the experience is different. HealthPartners health plan proactively reaches out to help and support its members in their efforts to stay or get well.

The Problem: Today’s predominant fee-for-service system rewards sick care over health care. This results in unmanaged illness and leaves individuals and communities vulnerable to higher costs.     

The Solution: To boost individual and community health and to lower health care cost trends, HealthPartners has invested in Health & Wellness, a sophisticated system to identify members’ health status—whether they are well, not well or at risk for disease—then engage and support enrollees with an array of services and programs that meet individuals where they are on the health spectrum.  

HealthPartners’ Health & Wellness Results to Date:

• In 2009, disease management efforts prevented more than 1,400 HealthPartners members from having condition-specific events requiring hospitalization such as heart attacks, asthma attacks, out-of-control glycemic episodes and heart failure exacerbations, according to an independent analysis.
• Members with asthma who were engaged in an asthma control program had 58 percent fewer hospital admissions after participating in the program for at least 6 months.
• Enrollees who were at very high risk for diabetes and who were enrolled in the plan’s wellness program had a 55 percent lower diabetes incidence rate over 30 months of program participation.
• Members in participant-centered health coaching for weight management lost 6.5 pounds on average over the course of the program, while those coached about tobacco cessation showed a 65 percent quit rate at 6 months follow-up.

The Story: HealthPartners—Engaging Patients in Their Health

Things didn’t look good for Clarence “Bill” Doheny in 2008. The truck driver from Belle Plaine, Minnesota, needed an ankle replacement, but a doctor told him it wasn’t advised at that time. He was at risk of losing his foot, having recently been diagnosed with diabetes and being overweight. Then Bill got a call that changed his life.

A phone counselor named Theresa from Bill’s health plan, HealthPartners, reached out to him after a claim review showed he recently had been diagnosed with diabetes. She listened to Bill’s dilemma and told him if he got his diabetes under control, he could get his ankle fixed. 

“That got my attention,” he says. Working with Bill, Theresa crafted a plan so that Bill could reach his goal. She helped Bill alter his diet, encouraged him to exercise and told him it was important that he take his pills for diabetes. “I started going to a fitness center,” he says. “I couldn’t walk, but she suggested trying the recumbent bike. That worked well.”  Theresa gave him pointers, telling him he could still eat his beloved ice cream, just not as often, and encouraging him to substitute fruit for desserts.

“She worked with me,” Bill says. “I lost 60 pounds, and I got my ankle replaced. It was the best thing I did in my life.” Bill says he owes it all to Theresa. “Her calling every four to five weeks was quite a stimulus to keep me going.” 

Proactive phone counseling and coaching is just one way HealthPartners engages and supports members in their health. The plan has many arrows in its health and wellness quiver to engage members—telephone coaching, text messaging, financial incentives, benefit designs and many others—whether they have a chronic illness, are susceptible to disease or are currently healthy.

Member Engagement and Support Are Vital to Health

Engaging patients is hard for most health plans in today’s fragmented, fee-for-service health care system. But HealthPartners and other ACHP members are showing it can be done and done well. Along the way, such efforts are helping to make individuals and communities healthier.

HealthPartners stands out when it comes to reaching out and supporting members like Bill in their efforts to be well. HealthPartners offers a variety of approaches via its Health & Wellness program to engage members, including online tools and programs; fitness offerings; preventive outreach reminders for screenings; discounts on exercise equipment and programs; use of premium discounts and financial rewards; phone coaching for smoking cessation, weight management and other health concerns; on-site workplace screenings and more than 20 intensive disease and case management programs.   

“We are a not-for-profit organization with a consumer board,” says Babette Apland, HealthPartners’ senior vice president of health and care management. “As a result, our focus is on how we can support our members in empowering health and having an exceptional experience, as well as managing total costs.”

To do this, HealthPartners has invested in systems of care revolving around members. HealthPartners’ portfolio of comprehensive and integrated health, wellness, and disease and care management programs and services is available to its 1.3 million members.   

But just offering programs isn’t enough. Engaging members in their health requires outreach and support. Plan investments in fully integrated systems, processes and information platforms help ensure that members receive all the services they need to achieve their optimal health goals. HealthPartners’ patient registry provides all health coaches with access to each member’s detailed health and program information. The ability to see the full picture of health of an individual on nearly a real-time basis is powerful and becomes the trigger to refer members to appropriate programs. But it’s the ability to then reach out, engage and support members that makes the data and referral process meaningful.  At the heart of the plan’s member outreach and engagement are highly skilled health coaches.   

All health coaches have completed extensive training in “intrinsic coaching” and shared decision making. These coaching approaches are centered on the “whole person,” taking into account what is most important to the member. This allows the member and coach to work together to set and accomplish meaningful goals. When specialized support is needed, the coaches quickly refer members to their lifestyle behavior coach specialists through HealthPartners Connect—the centralized point of contact for all health and medical management program referrals. This ensures that a member’s health and wellness needs are fully integrated.

HealthPartners Connect is staffed by experienced nurses who use clinical, program and benefit eligibility knowledge to evaluate and seamlessly triage referrals to the appropriate program area. Processes and workflows are in place to receive referrals via an intake phone line, fax, e-mail or by secure mobile phone messaging. All identified members receive outreach.

Making Health Care Affordable

As HealthPartners sees it, engaging members in their health and providing supports for them to stay or get well reduces future claims, a key to saving money in the long run. That engagement and support is not a one-size-fits-all approach. Rather, HealthPartners uses a wide range of approaches to meet an individual’s needs. “It’s about figuring out where individuals are in their personal health journey and then to support and facilitate health improvement from that point forward,” says Nico Pronk, HealthPartners’ vice president of health management.

HealthPartners also is adept at customizing health and wellness offerings to match an organization’s culture. That outreach and support—and versatility—is a big reason Star Tribune Media Company in 2007 chose HealthPartners as its only health plan.

“HealthPartners has been a very good partner,” says Adrienne Sirany, vice president for human resources for Star Tribune. Consolidating its health benefits and health and wellness offerings with HealthPartners made sense for the company and its 1,100 workers. “We like their programs and approach,” she says. “It makes it easier to engage people.” That engagement and support of its workers allowed Star Tribune to save nearly $500,000 in 2009 by managing diseases, a 3-to-1 return on its investment. 

The ability to engage its members where they are has produced impressive results across the board. In fact, Alfred Lewis, president of the national Disease Management Purchasing Consortium—widely credited with inventing disease management—said HealthPartners’ disease management performance between 2001 and 2009 was “the best performance of any health plan” that it tracks.

"Supporting our population in staying healthy improves well-being and quality of life for our members and helps manage the affordability of health care," Babette Apland says.

A PDF of the study can also be found in the Attachments box on the right side of this page.