Marty: Thank you for joining us today for Engagement Health Group’s webinar on the importance of engaging PCPs in wellness. My name is Marty Solomon, and speaking are our 2 co-founders, Jack Curtis and Dr. Jen Musick. We are so excited you joined us here today. In April, we conducted our first webinar to introduce the marketplace to EHG. Based on the tremendous response to that webinar, we have decided to conduct another one today on a topic of great interest – and that is how to successfully include and engage with PCPs in population health management solutions. While this is such a hot topic today, it is certainly not new to EHG, and both Jack and Jen, who have not only believed in this for 20 years but have developed creative ways to achieve this goal and have embedded these ideas. Our goal here today is to share with you these insightful strategies to help you create a true culture of health.
A couple of quick housekeeping items before we get started.
- We will limit this to 30 min only because we respect how valuable your time is.
- We’re hoping to leave a couple of minutes at the end for a few questions.
- If you have any, please submit them through the chat function and direct them to the host. For those that we don’t get to, we will follow up via email to you personally.
And on that note, we are recording this, and we will be sharing this recording with all of you next week. Let’s hit the agenda, Jen, please. Over the next 30 min, we will share with you why we believe that healthcare and population health management solutions are broken. How engaging with PCPs is a major way to solve that. And share with you successful strategies we have incorporated to achieve this. It’s now my real pleasure to turn this over to a great friend of mine – Co-founder and CEO of Engagement Health Group, Jack Curtis. Jack, take it away.
Jack: Yeah, thank you very much, Marty. We’re just really glad to have you leading the charge for our sales growth. And thanks to all of you who have signed up and showed up today. We really appreciate you. I see some old friends and also some new ones. So, thank you very much. I hope all of you will jump in and join the conversation. As Marty pointed out, this is not a sales pitch. This is sharing what we’re doing to tackle a couple of big problems in the industry. We don’t have all the answers to the big problems. So, if you see something, please speak up, but we are making progress and we’re making a difference. Please don’t hesitate to share your feedback if we got it right, say that. If we should change something. Let us know. Is there something else that we could do? But I did want to tell you before we jump into that a little bit about Engagement Health Group since we do have some newcomers today.
Our mission is to inspire and empower people when life is at a time to be their best. We formed EHD earlier this year with the merger of Corporate Health Partners and Health Solutions and between us, we each had 20 years of experience so combined 40 with 75 Long-standing clients across the nation.
We offer a very comprehensive suite of services from health promotion on one end of the spectrum to serious risk management on the other end.
And our goal is to be a long-term, highly valued partner of our clients and benefits advisors. Next, Jen.
My bio and I’m not going to go through all of this, but I founded Corporate Health Partners over 20 years ago and a been very blessed to have 17 years and counting as a leader at HERO helping to move the needle nationally in employee health and well-being.
I’m very purpose driven. To use the blessings that have been given to me to help thousands of others optimize their health and well-being is really what gets me going. And today I’m proud and pleased to introduce Dr. Jennifer Musick, my partner, a kindred spirit, and our president at EHG. I’d ask her to go a little deeper than I did in her bio because it’s truly relevant. Sharing her story as a clinician, and her inspiration from the Asheville project just helps to give a great perspective and understand her motivation on this topic. Jen.
Jen: Thank you so much, Jack. And thank you, Marty, for such a great intro.
I’m excited to be with all of you this afternoon and really happy to share our insights and strategies into how we bring personal physicians into the conversation and into the strategies.
As a trained clinical pharmacist, I consider myself a wellness and industry outsider. After receiving my Pharm D from the University of Iowa I completed an ambulatory care community practice residency that really taught me through focus on community and commercial practice of condition management.
The three most important things that I learned during my residency training that created my passion for starting Health Solutions, which has now become EHG, is that health care is really good at taking care of us when we’re sick. We have the best hospital specialist equipment. It’s just not really great at helping us manage chronic disease when it occurs. On the other side of the spectrum is wellness and wellness is really great at keeping healthy people healthy, educating, raising awareness, and preventing disease, but also not great at helping us manage chronic disease. And then I came across the Asheville project as a young clinical pharmacist.
The Asheville project for me validated that pharmacists engaged in chronic disease management can help improve health. I started Health Solutions in 2004 using the Ashville model to solve the gaps in health care and wellness. Our mission is to provide the right care to the right member at the right time, by using a care team model that includes the member and their PCP. And then using this model, Health Solutions has really become known to our consultant partners and clients for behavioral health coaching and disease management that delivers measurable health impact with an average ROI of 3 to one. I’m going to kick it back over to Jack and he’ll get us started here.
Jack: Thanks, Jen. The problem that we want to talk about is health care is broken. It’s fragmented and it’s frustrating. We realize this is not breaking news. However, it’s a big problem that’s just not going to go away. It just keeps getting bigger. If you haven’t experienced it, yourself, you surely have friends and family that have. The solutions, including most health and well-being programs, live in silos that are separated from the problem they’re trying to address.
They often mistakenly put the responsibility of communicating with their PCP on the member. And that only further fragments health care. Next slide. Fragmentation continues to drive up cost and complexity and it drives down trust and outcomes. The second problem is that population health management is also broken. Member engagement is lacking. Even engaged members are not getting the help they need. PHM programs are siloed, not engaging the PCP, who can actually make a difference. Employer-sponsored programs are often not rewarding the right action or behaviors. They’re complicated and not viewed as meaningful and result in disengagement or not engaging to begin with.
PHM problems are not addressing the whole person and they’re not really including social determinants of health and member purpose, which is a big mess. Next slide, Jen.
Again, so what? To whom does this matter to? To employers. This fragmented system is leading to an unhappy and unhealthy workforce that looks to the employer. There are 157 million lives in the US that are covered by employer plans. So that’s a big, big opportunity for employers. However, the healthcare system’s broken down and resulting in further disengagement. And that’s why employees are often left looking to their employer to help address some of this with their health plan. Money talks sick employees if left unaddressed lead to higher costs and lower profits and that impacts organizational success and sustainability. Let’s go to the next slide.
The solution to at least a big part of addressing this fragmentation is engaging and complementing the primary care providers and that’s really the focus of today’s meeting and Jen I’ll turn it over to you to do a deeper dive there.
Jen: Sounds good. Thank you so much, Jack. At EHG, as Jack has just mentioned, we understand the importance of the role of the PCP and the patient-provider relationship. And so, we’ve designed our solutions to do just that. Promote the role of the personal, the member’s personal provider as part of our population health management programs.
What do we do with EHG? And what do we care about? We understand that making a choice of provider is very personal. We don’t use a network of providers. We don’t force your members to change providers. And in the coming slides, we’ll discuss just how we’re able to engage the member’s personal position beginning with program design all the way through our critical care management program.
Engaging the PCP is important, then starting with your program design and rewards is the first and most important step.
We know from research that members that complete annual preventive care spend less than members that don’t.
Designing your program to encourage the right behaviors and then rewarding members for engaging those behaviors like establishing care with a provider, completing annual physicals and other recommended care, and then engaging in resources that help address any areas of concern or need, can really help, improve those outcomes.
We know that programs with a hybrid approach, a small impactful list of prescribed actions coupled with a personal choice like the example provided here on this slide really do yield the best engagement and satisfaction and also and most importantly long-term health impact. Keep your lists short but meaningful and that will really help. The right program design can truly reinforce the patient-provider relationship and the completion of recommended care, including preventative care.
Let’s talk about the individual services that are part of that program design and reward structure. It is extremely important to keep providers informed right from the start.
We have 2 strategies at EHG that start by engaging the member’s personal physician beginning with biometrics. We advise all of our clients to include the provider form as an option for members to complete their annual health screening. The provider form allows members to complete their annual health screening with their personal physician by downloading the provider form from our participant portal.
Then they work through collecting the required biometric data with their physician and uploading those results to the platform so that we can align a member with their ongoing program resources and support.
The second strategy is when clients want to offer other screening options like screening events, lab vouchers, and guided home test kits. Members can complete their health screening using one of the available options and then have results sent to their PCP or download results for themselves to share with their PCP to keep their providers informed. Or sometimes in lieu of completing lab work with their provider to save out-of-pocket expenses. For the member, and even the health plan. This is an important first step.
Now, let’s talk about our physician referral process. Our physician referral process continues to keep members engaging with their providers when needed and also keeps their providers informed.
Physician referrals really begin with the health screenings and are integrated throughout the coaching programs. Members are informed of the need to follow up with a provider by the EHG team.
By educating the members and providing support for them as needed through the referral process.
We have 3 types of referrals. As you can see here listed on the slide. Immediate referrals and physician referrals are really leveraged through the screening phase of the program.
Immediate referrals really are aligned with urgent situations when we collect abnormal biometrics and we really are advising the members to visit their provider immediately. Physician referrals are again also used as part of the screening phase but are reserved for situations when there are abnormal biometrics collected and we’re advising members to see their provider soon, within the next few days, but not as urgent or immediate as immediate referrals. And then we use health coach referrals as part of the health coaching program throughout the wellness program year throughout the coaching year.
Whenever a health coach may be informed of or they observe abnormal biometrics during a coaching session, then that health coach is working with that coaching member and advising them to follow up with their primary care provider or that follow up with their provider is a recommended step.
Referrals are monitored and measured as part of our PHM reporting process, and we’ll discuss more about reporting here in a few slides.
Now let’s talk about engaging the PCP as part of our behavioral health coaching program.
We know that the lack of success in healthcare and wellness is really a result of member disengagement and fragmentation much like Jack alluded to earlier.
At EHG we start by returning relationships to health care and wellness. These relationships allow us, you know, they start the path to success or allow us to succeed.
By engaging your members and their personal providers. In addition to your members having a dedicated health coach through EHG to help them navigate behavior change and begin building healthy habits using smart goals and planful follow-up we use the physician referral process as a key strategy to our health coaching model. That really does result in improved member engagement and health impact.
You’ll see how again integrating the provider continues through our coaching programs. Now talking about our disease management model, the disease management model really is a pharmacist-managed chronic disease management program that leverages a care team approach.
It was modeled after the Asheville project. It includes the members and their personal medical providers to improve health and reduce risk and cost.
Much like the image here shown on this slide. We leverage data from health screenings and claims. We identify members with uncontrolled chronic diseases.
Around heart disease, heart disease-related conditions, diabetes, and or members with high-risk screening results in those same areas of risk and we assign them to an EHG health coach and pharmacist to work with the participant.
And equally as important, their personal physician on a monthly basis. The behavioral health coach is responsible for working with the participant on support. Self-care and behavior changes that impact the member’s conditions. And the clinical pharmacist is responsible for working with the health coach, the participant, and more importantly the employees or members’ personal physician on a monthly basis to provide disease management and medication therapy management by providing observations and suggestions to the provider to get the condition or conditions quickly under control.
I want to really highlight what this has done while keeping the member’s personal physician directing the treatment plan. Our EHG pharmacists will provide insights and information to the provider between patient visits regarding things like lifestyle choices, goal progress, at-home monitoring, new symptoms, and new issues. Identified gaps in medications and or monitoring of medications and or conditions. Will provide suggestions regarding adjustments to medications, you know, as needed or if appropriate. And the result of all of that really is avoidable visits, ER visits, complications, and more.
All while keeping the patient-provider relationship intact.
Much like our behavioral health coaching and disease management services differ in the market. So does our critical care management model.
Our program also starts with relationships and engagement of the members. And their personal physician.
It starts with a relationship with our multidisciplinary team and your highest-risk members regularly, daily if needed. To design and deliver personalized care plans and care coordination between their personal physician or providers and specialists and even arranging second opinions and referrals to Centers of Excellence if needed.
That model delivers impactful health outcomes that mitigate costs by decreasing ER visits, lowering inpatient admissions and readmissions, and reducing stop-loss coverage costs. You can see a list of the top 10 conditions that we manage through our critical care management program listed there. That’s how we integrate a member’s personal physician into all of our services again even starting with program design all the way through critical care management.
But again, you can’t manage what you can’t measure. And at EHG, we truly believe in data-driven decisions.
Monitoring PCP engagement will allow us to measure the impact of engaging your members and their personal physicians. We start by tracking engagement with the PCP completion of recommended care, including preventative care, completion of referrals to engage those members not engaged, and then really measure the impact of engaging the PCP and your member’s health and medical claims. Really what we’re trying to do here is track those that are engaged. But really allowing us to engage those members that maybe aren’t doing what they need to. All in an effort to, again, engage all members and as many members as possible to really improve member health and claims.
It starts with tracking so that we can report back to you. Population risks for those members in engaging their PCP versus those not establishing care with a provider, much like the research has shown, we know that members that do engage with their PCP spend less and are healthier overall.
We want to report back to you specifically what that looks like for your population. Reporting the health impact of members that complete a referral versus not as advised because we’re tracking that, will able to then report back to you the health impact of those members that complete that referral process of those 3 referral options, complete that referral process versus not as advised. And finally, reporting the health impact of those members that are engaged in our health coaching programs if they’re available versus those members that are eligible for those programs and not engaging.
Again, we’re able to report the health impact of, those populations and those target populations because of the tracking that’s done throughout the program then finally reporting back to the health plan. So that we can measure the impact on medical plans again for resources like again completing referrals and engaging with their provider and other health coaching programs, disease management, and critical care management.
The key to success is engagement. But not just by engaging your members. But also engaging with a member’s personal physician.
We allow members to engage in the wellness program and keep their PCP while we take on the responsibility of keeping their provider informed and engaged throughout the phases of the wellness program.
What does success look like? We created EHG to really help employers move from a fragmented, broken, healthcare and PHM model where services are siloed, and employees are left disengaged and unhealthy to an ecosystem that integrates the members’ healthcare with their employer-sponsored PHM benefits that result in engaged employees that are healthier driving down costs and improving your organization’s success.
Thank you for your time this afternoon. Hopefully, you found that information helpful, and insightful. As Jack mentioned, we’re looking forward to your thoughts and your feedback. But now, I’ll let Marty take it away.
Marty: Alright, well thanks, Jack. Thanks, Jen. Fantastic job. As you promised we were hoping for a few minutes to share maybe a handful of questions.
I’ve been monitoring the chat and I do have a couple of questions that I’ll pick from and ask our 2 Co-founders to answer them. Let me start with this one here. You can decide who answers it.
How did we pick this approach rather than using our own network of providers?
Jen: Happy to take that one, Jack. You know, again, as a trained pharmacist, and much like the Asheville project, you know, the goal of the pharmacist involvement and chronic condition management is not to replace a member’s position. But again, much like I described on our disease management slide, it’s leveraging, you know, the training of the care, the EHG care team to help keep a provide there you know that members personal physician informed provide them insights between their patient visits so that the patient can make really good decisions about the treatment plan, right? But we at EHG feel that keeping a member’s personal physician directing that treatment plan so that we can keep the patient-provider relationship intact while informing and engaging that member’s personal physician can really help us drive towards health improvement and claims impacted and we’ve been able to really demonstrate that over 20 years of experience.
Again, started and was launched by the results that were provided by the Asheville project, which also used that model right of allowing their employees to work with their own personal physicians, and then there that clinical pharmacist team really impacted health for the long term and then ultimately impacting ROI.
It’s you know personal belief of mine as I mentioned in the deck or during the presentation.
Picking a relationship with a provider is very personal. And so that can be very disruptive if we try to force members into our network or a network of providers that we’ve selected and or you know asking people to change their provider.
We’d rather just work with the member, and you know whom they’ve selected whom they trust as their provider to really help fill in the gaps where we can and move those members to an improved state of health and wellbeing.
Jack, I don’t know if you have anything else to add there.
Jack: No, I would just second what you said. I think it’s. You know, people like choice.
And they’ve done the research and they developed relationships and so, they have relationships of trust with PCP. That’s why they’re at the center of this. Of this, healthcare. Continuum or ecosystem. I think empowering them, complementing what they do, and giving them feedback on things that they won’t see once the patient leaves the office.
You know, half of them don’t remember what was said and they certainly don’t comply with everything that was said, and we can fill in those gaps and make the whole system work.
Marty: Well, I think we have time for one more before I just do some closing remarks. So, I thought this one was interesting.
How does this complement a DPC for those that don’t know the direct-to-provider contracting?
Jack: Yeah, great question. And Jen, I’m sure you’ll want to weigh in on it. I’ll be brief, but I think it’s a perfect complement. They, the patients, or the participants still have the choice. They’ve got a provider, that, hopefully, the employer has contracted with but we’ve got all the other parts that complement what the primary care physician is not going to have. We have coaching. We have ongoing health promotion and things throughout the year that we can provide to an employer to build that culture of health that a DPC is not going to have access to that. I think it’s a perfect complement. Jen, what do you think?
Jen: Yeah, actually. You know as I mentioned in one of my closing slides, we at EHG don’t want to be the ones to push members to a network of providers that we’ve selected. But you as an employer, again, covering a hundred 57 million plan lives in the United States. You know, if you pick a network of providers, we’re happy to complement that network of providers, right? Much like engaging the providers that we’ve already talked about in the slides here today, we’re happy to complement that network of providers that maybe you have selected through your direct, provider contracting strategy. And again, to Jack’s point you know you’re bringing the network of providers to your membership they still have the choice of which provider they pick and we’re happy to complement that, that network of providers, and as, again, your DPC strategy.
Marty: Well, we promised we would keep this to 30 min and we’re going to live up to that promise.
A couple of quick closing remarks and we’ll let you all go. Thank you so much for joining us today.
We know how valuable your time is. We’re glad you were able to spend this 30 min with us.
We’ll soon be sending you a copy of this recording. Please share it with your teammates, and so forth.
And finally, if you have any specific questions that you want to address by name, your email address is at the bottom here.
Please feel free to reach out to me. And I’ll end by saying on behalf of Jack. Jen, myself.
We wish you all nothing but a great, great Fourth of July holiday. And we look forward to, you know, talking to you again soon.