Managing Medical and Behavioral Risk. Rod Hart, RN, COHN Health Promotion & Wellness ODS Health

1. MANAGING MEDICAL AND
BEHAVIORAL RISK
Rod Hart, RN, COHN
Health Promotion & Wellness
ODS HEALTH
October 13, 2011 – Seattle

2. Typical clinical coaching
approach…
2

3. Healthcare continuum
Healthy Acute
At Risk Chronic Disease Disability
and Well Illness/Injury
85% of employees 15% of employees
15% of costs 85% of costs
Behavioral Risk & Activation

4. Patient Activation Measure Personas
Starting Building Acting Maintaining
Level 1 Level 2 Level 3 Level 4
Promote belief that an Support the building of Initiate new Resilience even under
Activation Consumer Profile
Objective
active member role is confidence and behaviors and stress & able to plan
important, starting with knowledge necessary to improve health for difficult situations
self-awareness take action
 Does not understand  Lack knowledge  Has minimal  Has made most of
the role they should play about their condition, confidence in the necessary
in managing their health treatment options, handling certain behavior changes, but
 Does not believe or and/or self-care options aspects of their may have difficulty
understand that they hold  Has little experience health maintaining behaviors
the key to their health or success with  Has the basic facts over time or during
and functioning behavior change of their conditions stress
and treatments

5. Engagement and activation
 Must assess three core domains
 Knowledge, skills and confidence
 Promote healthier behaviors and foster positive
outcomes
 Treatment compliance, medication adherence, re-
admission prevention
 Critical transition and acute care episodes
 Outpatient - long term chronic disease
 Inpatient - pending discharge outpatient referral
 Urgent care - keeping primary provider engaged

6. How Coaching works?
Current lifestyle
What works or sustains it
Future vision
What do you really desire
and inspires you
Activation
What changes are required
and what is your action plan
Life barriers
What tends to get in your
way and who’s in charge

8. Patient activation measure update
Starting Building Acting Maintaining
Behavioral-based
model
Patient Activation Measures
 Targeted
Pre/Post PAM's by Level (N=704) interventions
 Risk segmentation
Total - Pre 90 130 249 235  Outcome measures
Level 1
 Length of stay
Level 2
 Medication adherence
Level 3
Level 4
 ER, urgent care
Total - Post 45 83 215 361  Readmissions
0 200 400 600 800
# Surveys

9. NCQA Leadership Series
Quality Profiles™
Features the ODS behavioral
and evidence-based approach
Innovative case study
supporting health care self-
management
Practical examples of
successful interventions

10. Thank you!