Responding to the demand for care anywhere

For all the innovations in clinics and hospitals, patients on average spend no more than a handful of hours per year in a health care setting. Players in public health are taking note: As pharmacies like CVS blur clinical and retail functions, community health plans are particularly poised to support members and their health by bringing care beyond the doors of the traditional doctor’s office. It is a process best performed in direct dialogue with consumers.

Last summer, Fallon Health brought 300 Massachusetts residents into an online conversation about how they would make their health plan better. What became clear was that members were concerned about the complexity of products and craved a reliable place to get answers about their insurance and their health. Fallon leaders began conceptualizing a retail store modeled after Apple’s Genius Bar. Within 90 days, Fallon staff members were inviting community members in for help clarifying coverage issues – and for yoga, nutritional and fitness classes. “They gave us a road map, and all we had to do was follow it,” David Przesiek, Senior Vice President of Sales and Marketing, says in an online video that documents the process.

A similar partnership led to better health at Madison College, which launched a “Healthy and Well Campus” initiative in 2012. College officials approached Group Health Cooperative of South Central Wisconsin (GHC-SCW) to launch the campaign’s piece de resistance: an on-campus clinic, which opened this past August. The center is open 40 hours a week and offers primary care, lab and X-ray services, wellness consultations and health education opportunities at a proximity previously unavailable to the 9,000 students, employees and retirees of the college.

UCare’s “Ask the Pharmacist” is a traveling educational team – pharmacists plant themselves behind a booth at senior centers and the Minnesota State Fair (where there is certainly no shortage of health questions). A pharmacist describes a typical question-and-answer session on UCare’s blog Health Smarts.

UPMC Health Plan offers Pennsylvanians access to a health care 24 hours a day, seven days a week through an online program called AnywhereCare. A UPMC medical professional makes a diagnosis and develops a treatment plan via virtual appointment. Pediatricians are available for children ages three and older.

As demand grows for care beyond clinical walls, community health plans have the resources and local recognition to put themselves where they are most needed. ACHP plans not only serve the individuals who make up their membership, but also are committed to strengthening the health infrastructure in the neighborhoods where their members spend time.


Sophie Schwadron