4. Managing Medical and Behavioral Risk - Rodney Hart (ODS Health Plan) at Models for Change '11





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Published on Dec 1, 2011

Rodney Hart, R.N., C.O.H.N, attributes insurer ODS Health's success in decreasing urgent care utilization, length of stay and readmissions and increasing medication adherence among its members to patient activation. Regardless of where a person is on the health continuum, the objective, advised Hart, "is to help them reaffirm, understand, reflecting on with whom and how they want to interact with the healthcare system and helping to build that confidence and as a result of that activation, becoming more self-reliant." One of the tools used by ODS is the Patient Activation Measure (PAM), a diagnostic that categorizes a person in terms of ability and interest to participate in their own medical care and self-care. The insight that PAM affords in the way of baseline and activation progress helps ODS to build and refine customized interventions for its members. "What we really need to do [first]," explained Hart, "is truly understand people at a granular level, who they are...and then start to develop disease management and services around that."

Hart has found success in using Motivational Interviewing and other coaching tools to help move members to higher activation levels. A major focus is on members at low levels who fall within the 20% of members who are driving 80% of the costs. Hart cautioned that it is critical to get patients to really understand things from the aspect of confidence, knowledge and skill sets, and their ability to see themselves playing a role in their own health care. Added Hart, "confidence is the most important part because people are stuck without that level of confidence in yourself and your abilities, and in the people caring for you, [and without it] you're going to be reluctant to take steps that are going to be helpful."

However, one can't afford to not engage those without pressing health problems, especially with the influence of negative environmental factors and at risk behaviors. "The reality is, at any point in time," warned Hart, "what is this year's low burden of risk is going to be next year's moderate to high burden of risk."

Hart's talk was given at Consumer-Centric Health: MODELS FOR CHANGE '11, a conference that featured more than 20 presentations on all facets of health behavior change. The presenters represented diverse fields of medicine, employer health, mobile technology, health insurance, gaming, public health, research, and anthropology. The 1½ day conference, held at Seattle University in Seattle, Washington, began with an opening keynote on Oct 12, with the main sessions on Oct 13, divided into three sections (1) WHAT'S WORKING IN BEHAVIOR CHANGE; (2) HOW TO SCALE BEHAVIOR CHANGE; and (3) WHAT ELSE IS NEEDED TO MAKE BEHAVIOR CHANGE MORE EFFECTIVE AND SUSTAINABLE.

Models for Change '11 was convened by Health Innoventions with support from Bastyr University's Center for Health Policy & Leadership and Seattle University's Organization Systems Renewal Program.

Health Innoventions (http://www.healthinnoventions.org) is a non profit that serves the public good by promoting the translation and dissemination of actionable consumer-centric information to support health-enhancing programs, technology and policy.


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