Data, technology strategies boost payer patient education

As a pediatrician with 15 years of experience in the pediatric emergency department, Cathy Moffitt, MD, recognized the value of patient education. Now, as senior vice president and Aetna chief medical officer at CVS Health, she brings that knowledge into the payer space.

“Education is empowerment. It is engagement. It is very critical to making patients more equipped to handle their healthcare journey, and, on a larger scale now overseeing a large payer like Aetna, I still believe tremendously in health education,” Moffitt said in an episode of Healthcare Strategies.

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At a large payer company, patient education starts with data analytics and understanding the member population. Through the data, payers aim to learn a couple of key insights. First, they can learn when members will be most open to educational materials.

“People are more open to hear you and to be educated and empowered when they need help right then,” Moffitt explained.

If payers try to offer educational opportunities or feedback at a moment when they are of no immediate use or when the member is focused on something entirely different, the recipient is less likely to absorb the information and act.

At Aetna, the Next Best Action initiative, which started in 2018, embodies the payer’s effort to reach members at the right moment.

In the Next Best Action initiative, Aetna employees reach out to members with certain conditions to communicate the next best steps to treat, recover from, and/or manage their diseases. Part of the next best step is typically to learn about the condition. As a result of the initiative, members receive patient education when they might be most open to it.

Second, payer data can impact patient education by informing payers about a member’s race, sexual orientation, gender identity, ethnicity, zip code, and other demographic factors. These facts can and should shape patient education efforts to ensure that all communication with that member is easily digestible.

To meaningfully connect with members from a variety of backgrounds, Aetna has incorporated translator services into its customer service. Customer service representatives also receive training around sensitivity to sexual orientation and gender identity.

Updating the provider directory is also a part of implementing demographical data and ensuring high-quality patient education. When members see providers who look like them, speak their languages, know their cultures, they may be more likely to observe the patient education materials and absorb the information.

“Understanding, in a multicultural and multifactorial way, who our members are and trying to help understand what they need…as well as understanding both acute and chronic illness from an actionability standpoint, where we can best engage to good effect as we reach out to people—that's the cornerstone of our intent and our philosophy around how we scrub data,” Moffitt shared.

With over 20 years in the industry first as a provider and now in a payer space, Moffitt has witnessed important trends and identified strengths and weaknesses in the industry’s approach to patient education.

She noted that patient education efforts have been most successful in two areas: mental health and preventive care. In both cases, technology has been a key factor in successful patient education.

Patient education efforts destigmatized mental healthcare significantly and highlighted the need for mental wellness care. Telemedicine has vastly improved access to care in this area, Moffitt noted.

In preventive care, more people are aware of the benefits of cancer screenings, vaccines, wellness visits, and other preventive measures. Moffitt suggested that increased use of home health visits and retail clinics may contribute to these improvements, at least for Aetna’s members.

Customized engagement is the next frontier for patient education, Moffitt predicted. Members want to receive educational materials in the way that best suits them. They want it to be streamlined and personalized.

Omnichannel engagement solutions will be critical to meeting this demand. Already, the healthcare world has made great strides in enabling members to receive educational materials in a variety of ways via email, text, phone call, and more. But Moffitt anticipated there is more to come.

“I can't tell you exactly where we're going to be in 10 years because I wouldn't have been able to tell you 10 years ago where we are now, but we will continue to respond and meet the demands with the technological commitments that we're making,” Moffitt said.