Health Management Program Provider Evaluation

8/9/2019 Health Management Program Provider Evaluation

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How can your organization eectively compare oerings and identify the most eective solutions for improvinthe health and well-being of your population? What are the most important distinctions among programs anthe companies who provide them?

By asking the questions in this worksheet, you will discover important dierences between providers, dierencthat eect the likelihood of achieving signicant results. Look for responses that exhibit the ability to:

Howarethegreatestopportunitiesorsavingsidentifedwithinyourpopulation?

Eighty percent of a populations medical costs are typically produced by 20 percent of the people, and that 20 percent

changes each year. Reaching those people before adverse health developments escalate medical costs is critical to

making a signicant impact. Consider the following when evaluating a provider:

-- Whatsourcesodataareusedtounderstandyourpopulation?

-- Aremoreresourcesocusedonthepeoplewhoneedthemmost?

-- Howarepeopleidentifedintimetopreventavoidableproblems?

-- Pleaserateproviderssavingsopportunities: .......................................................... POOR EXCELLE1 2 3 4 5

SavingsSa

Support well-being across the total population

Identify, prioritize, and prevent the highest-cost

health developments

Motivate individual change with personalized

support

Deliver truly integrated services

Measure performance with clear metrics linked

to customer priorities

Align revenue with customer results

Operate programs without bias toward other

products and services

Shape solutions to customer populations and

unique needs

Demonstrate the use of valid, current behaviorand medical science

Providername __________________________________ TotalScore(from last page; 45 possible)___________

HealthManagementProgramProviderEvaluation


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Whatdoyoudotogenerateparticipationandsustainengagement?

People most in need of making healthy changes are least likely to respond to announcements of new programs

An attractive, functional set of Web resources isnt enough to involve participants, much less change their behavior

Personalized outreach is a growing trend. Consider the following when evaluating a provider:

-- Whatlevelsooutreachandmethodsocommunicationareusedtoreachpeople?

(Onlineonly?Telephone?Textmessaging?Interactivevoiceresponse?)

-- Whataspectsooutreacharepersonalized?(Communicationvehicle?Messagecontent?

Messagerequency?Messagetone?)

-- Dointerventionsreectanindividualsliteracylevel,language,personality,andpreerences?

Individualrisks,goalsandimprovementplans?

-- Aremeaningulrewardsandreinorcementincorporatedandtailoredtotheindividual,then

adjustedtoreectprogress?

-- Pleaserateprovidersengagementcapabilities ................................................... POOR EXCELLE1 2 3 4 5

EngagementEn

Areservicescondition-specifcoroeredtothewholepopulation?

Nearly half of all Americans suer from one or more chronic diseases, and each year, millions of people are

diagnosed. Health support programs that serve only on a subset of the population, traditionally dened as those

with existing chronic diseases or high health risks, can fail to prevent those new diagnoses and signicant associated

costs. A comprehensive, three-pronged strategyoptimizing care for those with chronic conditions, reducing and

eliminating health risks, and sustaining good healthserves the total population and prevents both short- and

long-term avoidable costs. Consider the following when evaluating a provider:

-- Aresolutionsdesignedtokeephealthypeoplehealthy?Eliminatehealthrisks?Sloworstopthe

progressionodisease?

-- Areindividualscategorizedbyconditionoraddressedasawholeperson?

-- Areactorsbeyondphysicalhealthtakenintoconsideration,suchasemotionalhealth,social

support,andtheworkenvironment?How?

-- Pleaserateprovidersabilitytooera comprehensivesolution ............ POOR EXCELLE1 2 3 4 5

ComprehensiveSolution

Co


3/5

Whatbehavioralandmedicalsciencebacksthesolution(s)?

Its become popular in the health management industry to talk about behavior change. Its fundamental to improving

health and preventing costs. Look for substance beneath the speech. Consider the following when evaluating a provider

-- Doproprietarysystemsorpartnershipsexistwithrecognizedbehavioralandmedicalexperts?

-- Howaretheseideasincorporatedintodailyinteractionsandprogramunctionality?

-- Whoprovidesoversightandcontributesexpertise?

-- Arethereinvestmentsinresearchandinnovation?Pilotsornewconceptswithacademic

institutionsorotherinnovators?Third-partyreviewsandpublicationoresults?

-- Pleaserateprovidersperormanceinscience ........................................................ POOR EXCELLE1 2 3 4 5

ScienceSc

Areservicesintegratedorcoordinated?

Providers may oer an array of services and solutions but fail to deliver the benets of integrated services to individuals

and customers. Without an integrated technology platform, the conversation that a nurse has with an individuaabout recent heart palpitations is not available to the tness program manager promoting high-energy workouts

Coordinating services through manual reports or periodic calls can minimize health conicts but alienate participants

by requiring them to repeatedly share the same information. Integrated services build on every interaction. Conside

the following when evaluating a provider:

-- Areserviceslocatedinseparateorintegratedlocations?

-- Aresystemsseparateorintegrated?

-- Pleaserateprovidersintegrationotechnologyandservices .......... POOR EXCELLE1 2 3 4 5

IntegrationIn


4/5

Whatperormancemetricsareprovided?

Many newer providers of health management solutions cite general industry statistics or quote studies of others

results. The availability of specic, measurable results for prior customers is a good indicator of the information a

company will provide to you. Consider the following when evaluating a provider:

-- Whatmeasuresosuccessareused?

-- Isthereonlineaccesstocurrentaggregateresults?

-- Isproooperormanceavailableorothercustomers?

-- Pleaserateprovidersperormancemetrics .............................................................. POOR EXCELLE1 2 3 4 5

MetricsMe

Howareyoursolutionsshapedtosuitmypopulationandneeds?

Customer populations are diverse. Management priorities dier. Health program budgets range in size. Just as

personalized outreach contributes to individual engagement, a solution shaped to customer needs contributes to

overall eectiveness. Consider the following when evaluating a provider:

-- Doprogramsandsystemshavetheexibilitytoaddressmypopulationshealthhistoryandtrends?

-- Canexistinghealthsystemsandprogramsbeintegratedwithproviders?

-- Addressshort-andlong-termmanagementobjectives?

-- Cantheprovidermeetbudgetparameters?

-- Cantheprovideraccommodatedierencesinorganizationbylocation,country,orworkteam?

-- Pleaserateprovidersabilitytoconfgureexiblesolutions ................ POOR EXCELLE1 2 3 4 5

FlexibilityFl


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Couldprovidersbusinessbiasinteractions?

Prescription drugs, medical devices, and home monitoring equipment are helpful resources for particular health

needs and conditions. A health program provider who makes and sells some of these resources may be predisposed

to recommending them. Consider the following when evaluating a provider:

-- Whatistheprovidersprimarybusiness?

-- Howaredierentdivisionsmanaged?

-- Doestheproviderhaveasolidtrackrecordooperatinginthebestinterestotheindividualand

othercustomers?

-- Pleaserateprovidersabilitytooperatewithoutbias ................................... POOR EXCELLE1 2 3 4 5

BiasBi

StrengthsandWeaknesses

Doesthecoststructuregiveyouastakeinmyresults?

Many solution providers charge up front, per person, for health programs. Like a tness center membership that goes

unused, this approach removes the nancial incentive to engage members. A health program provider with other

sources of revenue beyond the customer or memberfor example, online advertisingis similarly disconnected

from results. Consider the following when evaluating a provider:

Takeamomenttonoteprovider'sstrengthsandweaknesses

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-- Howdosolutioncostscomparewithcompetitors?Whatsourcesofrevenueinuenceyourcosts?

-- Isrevenuelinkedtomeasurablecustomerresultsrisksreduced,hospitaladmissionslowered?

-- Pleaserateproviderscoststructure: .................................................................................. POOR EXCELLE1 2 3 4 5

CostStructureCo

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TotalScore(45 possible)

Health Management Program Provider Evaluation

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