Network Health, a health plan providing coverage to more than 160,000 Massachusetts residents with low or moderate incomes, has partnered with Health Integrated, a leading health management solutions provider, to offer its members enhanced health coaching services.
Under the agreement, Network Health will integrate as a private label offering the Synergy Targeted Population Management program from Health Integrated. Using its proprietary data mining tools, Health Integrated will use Network Health’s member data to determine those that are most likely to benefit from its health coaching services.
“We have a comprehensive approach to managing our overall population, with a special focus on our high-risk and chronic population,” said Mary Jane McKendry, senior director of clinical affairs operations for Network Health. “Part of our comprehensive approach is to say, 'What are those improved outcomes, that can improve our members interaction with us and improve they quality of their lives?' Building on our successes we looked at what new partnerships cold we come up with companies that have similar thoughts and fit with enhancements we have planned. Health Integrated works very nicely for us.”
At the heart of the Synergy program is a focus on chronic ailments that often take up the bulk of healthcare dollars, including diabetes, chronic obstructive pulmonary disease, congestive heart failure and asthma. Synergy also focuses on patients that have co-morbid behavioral health conditions, such as depression and anxiety, or other psychosocial factors that negatively affect their physical health.
"Using care coordination and coaching, Synergy empowers an important patient base to be more knowledgeable about their own health, more motivated to follow prescribed treatments and better able to establish and achieve goals for healthier lives," said Sam Toney, MD, vice chairman and chief medical officer of Health Integrated.
The Synergy program, which includes access to care coaches to help with adherence to a treatment plan, can help to drive clinical improvement measures. Toney said deploying Synergy to focus on improving the health of low and moderate income residents is important since these members “disproportionately suffer from multiple chronic conditions with psychosocial factors that exacerbate physical symptoms and disease progression."
Health Integrated’s focus on behavioral health was a factor in it attracting interest from Network Health, McKendry noted. “Health Integrated’s approach works for us since it is a holistic approach that focuses on certain high risk members,” she said. “We also liked that they include behavioral health in their total holistic approach to managing members. They have a lot of Medicaid experience, which was very important for us.”
Health Integrated has proven its Synergy program is effective with its focus on behavioral health issues as a part of “whole patient” care via a peer-reviewed study it conducted in New York with health plan HealthNow. The study, “Care Coaching: An Alternative Approach to Managing Co-Morbid Depression” showed both improved health outcomes and a nearly 4-to-1 return on investment for these services.
“Most patients treated for chronic conditions, such as depression, are seen by doctors who don’t specialize in mental health,” said Karen Blount, vice president of health care services, HealthNow, NY. “This program, which focuses on supporting primary care physicians while empowering members to better self-care, has now been proven, with validation of results, to drive successful outcomes.”
For United Health, Health Integrated’s approach of putting people in the field to help providers understand both their approach and to help keep its low-income members and providers engaged was equally important.
“Working with a population that can move frequently and may not have access to a phone or may have to change their living arrangements in short order is a challenge for us,” said McKendry. “If our goal is member engagement that means we have to talk to them. Working with a company that understand these are potential barriers they need to address. They don’t just call the member, they are comfortable calling the doctor to help them reach that member.”
