Dialing for Sick-Care Dollars

Many IT data, analytics, and patient experience companies are in the business of creating products and services designed to help clients, increase participation in bundled payment environments, cut costs, maximize revenues, and avoid payment penalties. Some use the data to identify patient and doctor “frequent flyers,” who are outliers and responsible for spending patterns that are outside of some predetermined norm. Once they do, they use different tactics, like texting or calling patients, to modify their behavior in the hope that they can avoid readmissions and inappropriate ER visits or change toxic behaviors.

Unfortunately, the dialing is done mostly for dollars and to check off some IT mandate compliance and reimbursement boxes instead of using interventions to permanently and meaningfully change patient and doctor behavior. The likelihood is that when the rules change, so will the dialing driven by an obsolete business model.

The last mile and the Holy Grail of sick care is to identify valid strategies and interventions that change doctor and patient behavior. While recent lessons from behavioral economics, irrational biases, consumer buying habits, social media, social contagion, and gamificiation have given us new and revealing lessons about how people buy emotionally and justify rationally, sick care is many years behind other industries when it comes to making lasting change in patients and doctors.

Having data is worthless if you don't know what to do with it. The working assumption is that raising low health IQs through education leads to more engagement which translates into behavior change that lowers costs. In some instances, for various reasons, it works. In other circumstances, it does not.

We still have a long way to go to understand why and when. In the meantime, many people will be dialing for dollars hoping it will make a difference.