The shift from fee-for-service to value-based care has precipitated a focus on patient engagement. A majority of healthcare providers are developing and implementing a strategy for patient engagement and tools to achieve higher levels of engagement to not only boost their bottom line and increase operational efficiency but also improve outcomes.
Why? Because patient satisfaction and quality outcomes are improved when individuals become actively engaged in their own healthcare. Engaged patients are three times less likely to have unmet medical needs and twice as likely to seek care in a timely manner when compared to those who aren’t active participants in their care. As a financial perk for hospitals, health systems, physician practices and other providers, improving patient engagement has been linked to substantially reducing healthcare costs.
It sounds simple, right? Engage patients, reap the benefits. Unfortunately, it’s not that easy.
A primary obstacle providers face when attempting to engage patients who have barriers to accessing care, whether it’s due to language or a lack of health insurance or appointment availability. For patients living in rural areas of the United States, physician shortages make it especially difficult to access routine medical care.
Many Americans own a car, so it might be surprising to learn that approximately 3.5 million patients go without care because they cannot access transportation to their providers. Studies have shown that the lack of transportation can result in skipped medication, canceled appointments and postponement of treatment regimens.
Other challenges healthcare providers face when attempting to engage patients include low health literacy, patient attitudes, lack of technology usage and high medical costs. In this blog, we’ll delve deeper into each of these obstacles and offer tips on how to overcome them.
Low Health Literacy
Health literacy is categorized as a social determinant of health (SDOH), which research shows can be more important than healthcare or lifestyle choices in influencing health. Basically, health literacy is the way information is communicated between providers and patients.
Providers must consider the economic, social, cultural and geographic barriers of SDOH to reduce health disparities. Patients with low health literacy may want to take control of their own health but might struggle with the steps to do so. Their lack of education might prevent them from comprehending medical information, processes and/or treatment options.
Having low health literacy has the potential to negatively affect patients by:
- Reducing their overall health and patient outcomes
- Increasing their occurrence of and severity of illnesses
- Lowering their levels of self-reported health and wellbeing
- Demonstrating a higher prevalence of chronic conditions, often associated with co-morbidities
- Increasing their hospitalization and readmission rates
- Producing a greater emergency care usage
- Increasing their chance of taking medication doses incorrectly
Poor Patient Attitude
This barrier is probably best explained using the concept of behavioral economics. As we discussed in a previous blog, behavioral economics explains why individuals may make irrational choices by demonstrating how their decision-making is influenced by biases, heightened emotions, faulty problem-solving, mental fatigue, perceived social norms, situational framing and context.
Six of the biggest behavioral economics problems applied to healthcare organizations are loss aversion, decision, fatigue, choice overload, information avoidance, bounded rationality and hyperbolic discounting. Although these issues aren’t the easiest for providers to address, improving patient engagement while leveraging behavioral economics is essential for improved healthcare outcomes.
High Medical Costs
Patients in the U.S. continue to face rising health insurance deductibles and high out-of-pocket costs. A staggering estimated 40 million patients who have health insurance tend not to use it due to high deductibles and cost-sharing. Almost 40 percent of U.S. adults have skipped a medical visit, test, treatment, follow-up or prescription fill within the last year because of cost.
Patients with low income have even more of a problem with the high cost of care in the U.S. — roughly 40 percent of them report struggling to pay their medical bills. Perhaps that’s the reason low-income adults in this country are more likely to be sicker than low-income adults in other similarly developed nations.
Frustrating for many patients is the lack of price transparency. As of July 1, 2022, the Transparency in Coverage Final Rule requires most group health plans and group and individual health insurance issuers to disclose price and cost-sharing information to participants, beneficiaries and enrollees. However, this information isn’t always in an easy-to-understand format for patients, and individuals don’t always pay the same amount of the same exact service because of cost variations from copayments and deductibles and providers’ varying contracts with payers.
Solutions for Conquering the Challenges of Patient Engagement
It’s easy to understand how some healthcare providers might be reticent to focus on patient engagement when these types of obstacles arise. There are solutions, though, that mitigate the severity of these problems.
For example, something as simple as frequent and clear communication with patients can make a huge difference for providers. Plus, it aids physicians in building and maintaining long-term partnerships with patients.
Another option is mitigating patients’ transportation barriers by taking ownership in minimizing them. Ridesharing services such as Uber and Lyft already leverage technology to connect people in need of a ride with a driver and vehicle. Partnerships with these companies allow healthcare providers to proactively ask patients if they need a ride to their appointment, and some technology solutions can even help identify which patients are more likely to need a ride.
Other solutions include proactive patient education — especially to address low health literacy – patient feedback, price transparency and technology. There isn’t a one-size-fits-all answer for providers to promote patient engagement, but combining these methods can put them on the right path.
Even the best bedside manner doesn’t matter if a patient doesn’t understand what he or she is being told. Healthcare is full of medical jargon and acronyms that not all patients know.
Providers and their teams should be empathetic and use plain language and give instructions that are actionable. If necessary, visual aids should be utilized.
Most patients prefer to receive information from a trusted source, whether it’s their healthcare provider or another clinician. That means clinicians can help patients identify the appropriate facility for their needs and whether or not an emergency department visit is warranted.
To foster effective patient literacy, it’s essential that providers know their audience, use plain language, connect the why, integrate creative teaching tools and confirm understanding. When appropriate, a patient advocate should be involved at the point of care.
One of the only ways to know what a patient wants is to ask him or her. This can be done through a survey, reading online reviews and paying attention to social media posts. Any negative feedback should be addressed immediately. Also, ensure there are enough resources in place to interpret patient feedback and act upon it.
Along with reducing the cost of healthcare, price transparency has the potential to provide numerous benefits to both patients and providers, such as real-time online access to estimated out-of-pocket costs, enhanced patient engagement and reduced market prices for various procedures. It also helps patients make more educated healthcare purchasing decisions and be more aware of their payment responsibility to their provider.
Specific engagement-related solutions used in patient engagement platforms include case management tools, patient clinical improvement programs, portals, assistance with appointments and scheduling, mobile health monitoring, telehealth and advocacy. They enable clear and timely communication between providers and their patients and help to close any gaps in care.
Some digital tools enable patients to schedule appointments and pay bills on their own time, offering them the convenience they prefer while reducing the administrative burden on practice staff. Using ones that aren’t designed with the patient in mind, though, often results in more work for clinicians and staff, adding to their burnout.
The best digital health tools enable providers to promote patient interaction and engagement without taking more time out of their daily workflow. For patients, mobile health (mhealth) devices and apps are beneficial because they help improve access to care and can be used by patients from various backgrounds and socioeconomic statuses.
A popular digital health resource is HIPAA-compliant two-way text messaging because it gives providers and patients the ability to securely converse for appointment reminders, patient outreach, population health and more. Messages can be customized for each patient, but provider staff also can send out the same message to a specific patient population. In addition to driving usage of patient portals and reducing no-shows and cancellations, this real-time text messaging provides patients with appropriate, accurate and up-to-date information about treatment and safety issues in a user-friendly language and format.
No matter what solution(s) providers utilize to engage with their patients, their staff should be educated and trained on them. Extending that education and training to patients is essential for a successful engagement program. The overall patient engagement strategy should be assessed regularly to ensure it still aligns with the goals of the provider.