The Connection Between Patient Engagement and Health Outcomes
The Critical Role of AAAs
Wednesday, September 25, 2019
by: Sandy Markwood, CEO, n4a

Section: n4a Blog




Every day health care professionals work to make improvements, to drive better health outcomes, and to create high quality and cost-effective care for their patients. Clinicians and integrated care professionals can work diligently to improve clinical settings, develop new diagnostic tests or improve treatment, but patient engagement will always be a central factor to patient health and the overall success of the health care system.
 
What is patient engagement, and why is it so important to improving health outcomes?
 
Engaged patients are ones who are:
  • educated about their health plan benefits,
  • actively involved with their health providers, and
  • following the care plan developed by their health providers.
 
Why is it so important to overall health and well-being to be actively engaged in our health care? Well, research shows that people who aren’t engaged in their health care are more likely to have worse health outcomes and higher out-of-pocket medical costs than those who are actively engaged. But why?
 
Here’s how that usually happens. Non-compliance with health plans often results in avoidable Emergency Room visits, other treatments and additional health care spending. For example, only 12 percent of Medicare beneficiaries maximize their pharmacy benefits1 meaning 88 percent of individuals with Medicare do not take advantage of Medicare Part D cost savings or extra benefits. And poor medication adherence results in up to $290 billion in avoidable health care spending in the United States each year.This scenario holds true for consumers who miss their annual check-ups or important diagnostic tests that could improve their health outcomes and ultimately prevent ER visits or other undesirable health outcomes.
 
So how do we, as an Aging Network help ensure that older adults are engaged in managing their health?
 
The first step to patient engagement is educating beneficiaries to help them choose the Medicare plan that best helps them meet their health needs. Once they’ve chosen a plan, post-enrollment education about the specific benefits is a critical step to helping consumers understand and use their benefits. 
 
According to the recent Anthem, Inc.–n4a survey, conducted by The Harris Poll, 59 percent of older Americans find it difficult to understand their bills and benefits, and 41 percent of retirees say they need help understanding their benefits once they have chosen a plan. And, let’s not forget caregivers, as they are our country’s first line of defense for keeping our older population healthy and living successfully at home. Eight in 10 caregivers surveyed believe they would be able to better manage their loved one’s health if they better understood their benefits. Beneficiaries, and their caregivers can contact their local Area Agency on Aging (AAA) for Medicare education and help with enrolling in a Medicare plan. Find your local AAA by calling the federally funded Eldercare Locator at 1-800-677-1116 or visiting the website at eldercare.acl.gov. Medicare beneficiaries should also contact their health plans to ensure they fully understand their benefits and ask questions about their specific health care coverage and how it affects their unique health needs.
 
Patient engagement also means successfully navigating the system, deciding on treatment and showing up for diagnostic tests. Sometimes a lack of understanding of a diagnosis and treatment plan prevents a patient from follow-up care, or sometimes it’s the lack of a ride or another challenge outside of the clinical setting. Consumers facing these or similar situations often need additional support to navigate the many barriers that can occur along the health care journey. But they aren’t alone—navigating the health care system is difficult, even for those who work inside the system. 
 
The Anthem-n4a Survey found that 59 percent of older Americans find it difficult to understand their bills, benefits and diagnosis—and many of them need help deciding on treatment and how to communicate effectively with health care providers, all common problems for individuals trying to navigate the health care system.  
 
In our 45-year history caring for the nation’s older population and working closely with their caregivers, n4a and its members have seen that these barriers often are insurmountable. Often, consumers need to speak with their health care provider to better understand their diagnosis and treatment and have this information in writing. Sometimes something as simple as a ride can be the cure-all that helps ensure that a patient can comply with their care plan. Patients and their caregivers should call their health care provider, their insurance provider or their case manager with questions about their care, and also explain any problems that prevent following their health plan. Together these professionals can work to help beneficiaries and their caregivers understand their health care plan, and how to best solve problems that prevent seeking treatment.  
 
And, yes, they can even help find you a ride if that keeps you from seeking treatment.  After all, finding a ride is better for your health, and wallet, than a costly ER visit.
 
And that’s what Area Agencies on Aging and the entire Aging Network, are here for—to help ensure older adults can continue living in their homes and communities for as long as possible. And that means helping older adults take charge of their health by becoming actively engaged in their health care. As the n4a-Anthem survey results show—we have work to do. But as our history shows, with the right tools, we can get it done.
 

 

Abaluck J, Gruber J. Choice Inconsistencies among the elderly: evidence from plan choice in the Medicare Part D program. Amer Econ Rev. 101(4):1180-1210.
 
Thinking outside the pillbox; a system-wide approach to improving patient medication adherence for chronic disease. New England Healthcare Institute Web site.
http://www.nehi.net/writable/publication_files/file/pa_issue_brief_final.pdf. Accessed July 7, 2015.