Insight to Action

Data is Powerful. But Don't Underestimate the Power of Personal Contact

18 January 2017

Adventist HealthCare of Gaithersburg, Maryland, has been a pioneer in the drive to achieve the Triple Aim of healthier populations, improved patient experience and lower overall cost of care. Through our work with Adventist, we have helped them pursue these goals for their self-funded plan. Careful data analysis, risk stratification and strategic plan design were central to our approach. But so was the human factor.

A key element of Adventist’s strategy was the establishment of Personal Health Nurses (PHNs). The PHNs served as liaisons between the patient and the provider, working to ensure that each patient received the right services at the right time.

The success of this approach hinged on forging good working relationships between PHNs and providers. PHNs meet with providers in person quarterly and have frequent telephone contact. While building any good working relationship takes time, providers soon recognized that the PHNs had a good handle on their patients’ needs and played a valuable role in improving members’ health. Over time, physicians came to see that the PHNs saved them time and added value to their practices, without adding cost.

The human touch also came into play when creating relationships of trust with members. The PHNs were introduced to members through a variety of communications and in-person meet-and-greets at employee benefits fairs. Every contact with a member is an opportunity to create a relationship. When contacting members identified for outreach, PHNs focus on setting members at ease, making them feel comfortable and earning their trust.

Experience has taught the PHNs to immediately address any concerns a member might have. They assure them the service is confidential, voluntary and free, and clearly explain how the PHN can help the member. If necessary, the PHN will contact the member’s primary care provider to enlist his/her help in persuading the member to accept the services. Over time, Adventist members have forged strong bonds with the PHNs as they realize that the PHNs have their best interests at heart.

As with any population health management initiative, sustained effort is essential to success. A solid commitment to the approach has helped Adventist HealthCare achieve impressive results: 84% of eligible plan members who were contacted work closely with PHNs, versus less than 25% nationally. Among members engaged with PHNs, compliance with evidence-based metrics exceeds regional National Committee for Quality Assurance (NCQA) data in every category.

Adventist’s results are among the best in the industry. Its cost trends are stabilized well below the national average, and plan members are actively engaged in improving their own health.

While data is extremely important in helping identify members at risk, healthcare remains a “people business.” When charting a course for improving population health, don’t overlook the value of personalized care.