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According to the Centers for Disease Control and Prevention (CDC), Americans use preventive healthcare at half the recommended rate. Health plans have been working to close these gaps in screenings and immunizations by investing heavily in data analysis and outreach programs but, as the numbers show, there are still opportunities to do much more. A white paper released today by BioIQ, Finding People in the Gaps: Delivering Better Preventive Care by Humanizing the Problem, the Solutions and the Data We Use to Reach Patients explains how health plans can use advanced data analytics to better understand individual members and the barriers that keep them from getting care. This knowledge can help plans deliver tailored interventions that close the gaps.
The new white paper begins by acknowledging one of the biggest challenges that health plans face: how to convince members, especially those with the greatest health risks, to engage with the healthcare system. Sending generic reminders by mail, email, text and IVR has a notoriously low success rate. Frustrated, health plans grapple over whether their messages aren’t resonating with members, or if people simply fail to act in their own self-interest.
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According to Joshua Sclar, MD, MPH and BioIQ’s chief medical officer, changing the way we look at healthcare gaps is a first step toward closing these quality gaps and improving outcomes. Instead of wondering why some members resist our best efforts, we need to shift our focus toward helping them get a difficult job done. “Take colon cancer screening, for example,” says Sclar. “No one wants cancer. It’s something everyone takes seriously. People sometimes need help overcoming confusion and fear, which can prevent them from getting that cancer screening. But a lot of the time they really just need an easier way to get screened. Today’s healthcare system has not made it easy, by anyone’s measure, to get screened.”
The new BioIQ white paper explains how health plans can use data to predict health risks on a community level, then go granular enough to reveal the kinds of interventions that are most likely to help individual members get care—from receiving care at a retail pharmacy, an at-home test kit or a workplace health event.
Beyond learning how to reach people, the data can also help health plans predict who will and will not close care gaps on their own, which allows plans to allocate resources for the most impact. For example, when advanced analytics predict that someone is both likely to benefit from a gap closure and unlikely to respond, plans can dedicate more rigorous, higher-touch resources right away.
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