Bringing Consumer Intelligence to Health and Care Management

Simply knowing what consumers cost, their care utilization patterns, and what conditions they have doesn’t provide enough information to support consumers in changing behavior. Finding consumers earlier, and getting them to change their lifestyle choices, requires different data and methodologies than health and care management uses today -- especially as the industry focuses its efforts across the entire health continuum and not just on those who are already sick.

Taking a new approach

“It’s time to turn the industry upside down,” says Ingenix Vice President of Health Management Solutions, Stephanie Pronk. “We need to apply more meaningful data to new solutions that focus on truly engaging and changing consumer behavior in significant and personally relevant ways.”

To that end, Ingenix has developed the Ingenix Health Manager, an innovative product that provides 360 degrees of consumer health intelligence to better understand and influence health behavior. The product is designed to optimize the process of changing population, target group and individual behaviors across the entire health continuum.

Ingenix Health Manager’s unique Individual Lifestyle FactoringTM system provides insights on health needs and gaps for populations, target groups and individual consumers. The product identifies, matches and prioritizes individuals for intervention. It also creates individually-tailored messages and health profiles to drive consumer engagement and support behavior change.

In a closed-loop, continuous learning environment, Ingenix Health Manager provides comprehensive reporting on intervention activity, integrated health and financial outcomes. It also measures the effectiveness of specific intervention program components and characteristics for ongoing improvement.

Four key industry challenges

To create an effective solution, you must understand the problem. So, in developing Ingenix Health Manager, Ingenix first evaluated the health and care management industry to identify issues that needed to be addressed. The goal was to create a platform that would address those challenges effectively and cost-efficiently, while prompting the industry to think and act differently.

Four key issues emerged. First Ingenix found that “payers and employers do not understand health consumers in a way that facilitates behavior change, and in addition, have a limited ability to identify, reach and engage consumers across the health continuum,” says Pronk.

The second challenge is that the industry is not well connected and integrated, especially as it relates to a comprehensive health improvement program that focuses on healthy, at-risk and disease populations. This simply impedes and limits the effectiveness of these programs. “Creating a product that figures out how to make these programs work together and eliminate redundancies would add significant value to the industry,” Pronk explains

The unique characteristics of populations led Ingenix to the third challenge: programs are not currently customized to meet the needs of specific populations, target groups, or individuals. As a result, the team used existing and new Ingenix technologies and the Individual Lifestyle FactoringTM system to develop a product that allows cost-effective customization at all levels of a given population.

The fourth challenge that Ingenix pinpointed is the current lack of integrated reporting. Pronk says, “Ingenix Health Manager was designed to create an integrated reporting system that not only demonstrates improvement in health, but also shows bottom-line financial return on health.”

Understanding the consumer to drive engagement, improve health

Ingenix turned to the retail and financial services industries to learn the art, science and data needed to understand consumer behavior. In addition, the team learned how to leverage these proven models for engaging consumers and activating behavior change.

Contrary to popular belief, more data and information does not always translate into behavior change. The industry has to learn not only what data and information is important and relevant to a consumer but, more importantly, how to present the information in such a way that it motivates consumers to take action.

“Ingenix Health Manager uses a variety of new and established consumer data sets to identify the right intervention and a messaging activation plan that consumers will find personally relevant and non-intrusive,” Pronk explains. “We want the consumer to say, ‘This is right for me!’ and take action to maintain, improve and manage their health.”

The value of health and care management

Pronk says the value proposition is clear. “Ingenix Health Manager enables organizations to identify unique characteristics of a population, select target groups and specific individuals with a higher level of predictive accuracy, and create more robust activation rates. This leads to higher engagement of individuals who are willing to maintain, improve and manage their health.” She adds, “Using the 360 degree consumer health profile, health intervention specialists can tailor programs to drive more successful behavior change. If consumers make positive change in their health behaviors, there will be a direct effect on health outcomes and on health care’s bottom line.”

References:
McGinniss, Health Affairs, 2002
Hibbard, Annual Review of Public Health, 2003
McGinniss, Journal of the American Medical Association, 2004
Maibach, Journal of Health Communications, 2006

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