Blog 10 Part III: Top Five Responses to Participants with Health Concerns
Continuing our Top Five series with Veritas Healthcare Management (VHM) Chief Medical Officer Ernie Vesta, MD, today we review the most common responses from VHM professionals to plan participants with health concerns. Our goals in this series, as we shared previously, are to help health benefit plan leaders consider their own programs and to illuminate further how VHM works to improve health and lower healthcare costs.
Rather than a hierarchy of distinct messages or prescriptions that apply individually to specific health concerns, this list is more like a set of ingredients that are combined in various measures to produce the most productive participant visit.
Keep in mind that VHM does not replace the plan participants’ physicians or other healthcare providers. Instead, Veritas’ Chief Medical Officer and nurses work with the plan participants and their providers to produce improved health, lower healthcare costs and better quality of life.
1) What did your physician say? Do you understand it? Was it insufficient information, or too much information to comprehend and retain? Do you have questions about it? Understanding what the participant heard and how they feel about it requires conversation, a dialogue. It is not a box to be checked. This is about assessing whether the participant has the needed information to act.
2) What have you tried? Did any of it work? These seemingly obvious questions are important to explore because choices matter. How? Individuals will typically be encouraged by their provider to do certain things, but that doesn’t mean they will respond by doing them. Consider the patient with a body mass index (BMI) of 35. Getting that down to a more reasonable level for good health is a daunting journey. The patient may simply give up hope, and they may not even care. The only way to help the participant progress from where they are to where they can be is by first asking questions and listening; that is the only way to get the picture they have of their own health, what they have tried and what they are willing to do.
3) Real change starts with assessing what you (the participant) think and working from there. So, what does the participant think? How you help the participant depends on their response to this question. Even if their response is totally negative, that is where the work must start. For example, of the participant cites dog walking as their means of getting exercise, we need to know more about it to determine if it constitutes meaningful exercise. We must start by learning what they are thinking and doing—in sufficient detail—to know where they are. Then, we work from that point.
4) Before we try to move forward, let’s take a look back and look around. Where have you been, and where are you now? How do you feel about it? Related but building from #3 above, this is what they are doing–thinking leads to doing. If you tried and failed, then maybe it was the wrong thing to try. Borrowing from what President Calvin Coolidge said, they may not be able to do everything at once but they can do something at once.
5) Small wins add up. So, what are you going to do next? Let’s work on one thing at a time, starting with something we can build on. A good example is the participant whose poor health condition prevented them from walking more than 30 seconds at a time. With the right encouragement, persistence and perseverance, that same participant eventually was able to walk as much as 26 minutes at a time. It was a long process and, at times, discouraging, but everyone has the ability to succeed, require less healthcare and improve the quality of their life.
Personalized coaching and assistance from a skilled professional can help the participant better manage their conditions, address their questions and navigate the healthcare system at every stage of the journey. VHM helps break down the complexities of the situation into smaller considerations and differences, particularly in large cases involving multiple specialists.
For more information on the concepts in this blog and/or Veritas Healthcare Management generally, contact Veritas at https://www.veritashealthmgmt.com/contact-us. To receive updates when new blogs or podcasts become available, please subscribe to our Resources page here.