4. Managing Medical and Behavioral Risk - Rodney Hart (ODS Health Plan) at Models for Change '11

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We had a good read. For the benefit of yourself. Be sure to read to the end. I want you to get good knowledge from Ehealth Insurance . THE PATIENT ACTIVATION MEASURE Rodney Hart, RN, COHN, attributes insurer ODS Health's success in decreasing urgent care utilization, length of stay and readmissions and increasing medication adherence among its members to patient activation. Regardless of where a person is on the health continuum, the objective, advised Hart, "is to help them reaffirm, understand, reflecting on with whom and how they want to interact with the healthcare system and helping to build that confidence and as a result of that activation, becoming more self-reliant." One of the tools used by ODS is the Patient Activation Measure (PAM), a diagnostic that categorizes a person in terms of ability and interest to participate in their own medical care and self-care. The insight that PAM affords in the way of baseline and activation progress helps ODS to build and refine customized interventions for its members. "What we really need to do [first]," explained Hart, "is truly understand people at a granular level, who they are...and then start to develop disease management and services around that." Hart has found success in using Motivational Interviewing and other coaching tools to help move members to higher activation levels. A major focus is on members at low levels who fall within the 20% of members who are driving 80% of the costs. Hart cautioned that it is critical to get patients to really understand things from the aspect of confidence, knowledge and skill sets, and their ability to see ...

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