The Alliance in the News


Health Improvement Partnership: We could all use some 'health care' reform

Santa Cruz Sentinel, May 31, 2011

By Leslie Conner

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Health Improvement Partnership

As health care reform continues to be debated and implemented, members of the Health Improvement Partnership HIP of Santa Cruz County have agreed to share some of their reflections and reactions. HIP is a local, countywide collaborative of health, foundation and government leaders dedicated to increasing access to care and building a stronger health care delivery system.

Alan McKay is the president of HIP's board of directors and is executive director of the Central California Alliance for Health, a nonprofit health plan serving 205,000 members in Santa Cruz, Monterey and Merced counties. Here is an edited version of a recent conversation between McKay and HIP Program and Policy Director Leslie Conner about incentives for better health care.

LC: A lot of the health care reform discussion is focused on what government, insurers, and health care providers can do to improve health care outcomes. Shouldn't patients be part of the equation, too?

AM: Absolutely. We know that better health and reduced costs can't be achieved through the medical system alone. No matter how well doctors perform, they still need to convince patients to access care and follow up on recommended visits, prescriptions, or referrals, and generally take better care of themselves. Many costly chronic diseases have a behavioral component -- such as diet, physical activity, or smoking -- that can be changed to prevent the worst health outcomes. We thought some incentives might help nudge members to participate more actively in their own care, and improve their health habits and their health in the process.

LC: What forms does that "nudge" take?

AM: If we called and left a message for a patient with asthma or diabetes to check on how they were doing, we used to cross our fingers and hope they'd call back. Now, we let them know that if they call back, they'll be entered in a raffle for a $50 gift card -- and suddenly, more people are returning those calls, which helps us monitor how they're doing more efficiently and effectively. Patients who answer a quiz about when to take a sick child to the emergency room also get entered in a raffle, and this helps them learn more about when to seek that type of care -- and when not to.

LC: Are your colleagues getting a nudge to be healthier, too?

AM: Along with the member incentives, we also added incentives for our health plan employees based on a couple of key ideas. The first is that if you get feedback on your activity levels, you're more likely to pay attention and stick with it. Our voluntary program gives staff pedometers with a sensor, so they can track how many steps they've taken that day, and compare them. That's really gotten people moving -- even those who say they haven't gotten off a couch in years. It's a little competitive, but also fun. The second part is that if you exercise as part of a social network, that's yet another reason to step away from your computer and take a short walk. I love to look out my office window and see pairs or groups of Alliance staff walking around, adding to their pedometer totals. And I was devastated when I went for a morning run a few weeks ago and realized I'd forgotten my pedometer -- all those wasted steps!

Health reform starts at home. At the Alliance, we thought we'd try some incentives as a little extra motivation -- and so far, so good.