Innovation can be compared to farming. A farmer tills and preps their fields, so that once seeds are planted, they have the best environment to take root and grow.
As they grow, farmers evaluate and cultivate their crops and take risks to harvest the greatest yield. Innovators create the groundwork to generate new concepts, thoughts, and programs. Data points serve as seeds, which provide trends and emerging changes that can upend traditional business models. Innovators recognize these variances before the market and innovate to drive transformation.
Health Action Council challenges industry orthodoxy, identifies opportunities to overcome dated thinking, applies fresh ideas, and rearranges conventional approaches resulting in a new framework to improve employee benefits and healthcare. Innovations are measured for their creativity and their ability to increase efficiency and improve outcomes. At our core, we innovate to enhance human health and create healthy communities where business thrives.
Health “Buddy” Model
A unique, personalized service model that puts consumers at the center of care. Focusing on interpersonal relationships and preemptive care, this direct engagement model encourages employees to own their own health while reducing overall care costs. The model also utilizes technology and data analytics to help employees better understand their benefits, stay healthy, monitor decision-making, improve care integration, and drive waste out of the healthcare system.
Emergency Room (ER) redirection program
Working with employer members and community leaders Health Action Council studied ER use patterns and identified an opportunity to direct individuals to the right place for care. Health Action Council developed a targeted ER redirection campaign aimed at members that had a number of inappropriate visits to an ER department and communities with higher incidents of ER usage. In 2020 the program advanced with the addition of an artificial intelligence (AI) symptom checker which prompts individuals to input and receive feedback on their symptoms. The tool then provides the best care option available based on the condition. Since the campaign’s inception in 2017, ER visits were reduced, individuals accessed the needed care at the right place while saving time, and employers and employees achieved savings.
Patient-Centered Medical Home (PCMH) project
Research indicated that employees who received enhanced primary care through medical homes achieved better care experiences, better health outcomes, and lower costs than patients cared for in traditional delivery models. Health Action Council facilitated an employer-sponsored primary care initiative to deliver an enhanced care experience to patients and their families. This PCMH project was a pilot program launched in collaboration with member organizations and community leaders to provide patients with coordinated care and support, and ROI for employers. The program applied data and analytics to identify health issues and at-risk patients with chronic conditions or behaviors, such as obesity, tobacco use, high blood pressure, and diabetes. Patients and their families received support to find the right care, at the right place, at the right time.
The health system’s primary care practices achieved National Committee of Quality Assurance (NCQA) patient-centered medical home certification during the pilot. The adoption of medical best practices played a key role in achieving improved quality of care, better health outcomes and patient experience, lower costs, and reporting transparency benefiting individuals, employers, and the community. This project drove health improvement for patients with diabetes and high blood pressure.
Custom clinical service model to address health inequities within member populations
Analyzing member population data revealed that 36% of members have at least one Social Determinant of Health (SDoH) risk and are 24% more expensive than those without a risk. Responding to this trend and an employer’s desire to control cost and keep employees healthy, Health Action Council implemented a dedicated clinical team and custom clinical model within its medical plan offering. The team includes dedicated advocates, nurses, case managers, and social workers who are equipped to address the social disparities within the population. The model includes increased engagement with members who have been identified as having clinical and SDoH triggers. Understanding and addressing these barriers helps improve employee well-being and eliminates the 24% benefits cost differential.