The 360 Solution
5 to 10% of your population account for more than 50% of the dollars spent on healthcare. They are the bleeding arteries in self-funded plans. They are as obvious to all of us as a punctured artery in a room with all white walls, carpet, and furniture.
Why isn’t this the priority for every self-funded plan manager?
The high cost of treating the few is not new. It is common knowledge today and it has been for years. Numerous efforts have been made with little to show for the effort. The solution lies in two technologies. Remote Patient Monitoring, also known as RPM, combined with Artificial Intelligence supported Communications and Chronic Care programs.
Wellness programs and wellness apps have failed to show an ROI or to benefit more than a few. These are passive programs that require the user to be highly motivated to change their behavior. The Killer Cocktail has three ingredients Diabetes, Hypertension, and Obesity. Imagine if you will, you have all three. You wake up every morning feeling poorly. It takes effort to just get out of bed. You drag yourself to your place of employment and struggle through the day. Exactly when did you feel motivated to open your wellness app and exercise?
Passive wellness programs are not the solution.
AI-based communications that initiate a conversation regarding your Killer Cocktail through HIPAA compliant chat or SMS is at the core of your solution. Personal coaches for fitness or health are also highly effective, but they are prohibitively labor and expense-intense. Once developed, an AI-based coach is highly cost-effective and scalable. The cost comes down to fractions of a penny in bandwidth.
With an engaging and dynamic AI-based communication platform in place, the next step is condition-specific Chronic Care Programs.
Chronic Care programs are developed by clinical need, programs originating out of necessity from a physician’s perspective not a programmer with a cool idea. Cool ideas from a developer sitting in a room with tin foil covering the windows are rarely effective. Programs originating out of clinical need and developed with physicians in clinical trials are the Holy Grail of solutions.
360 deploys Chronic Care Programs that were developed through clinical need with the input of physicians and nurses, then validated in clinical trials, across our AI-based communications platform that delivers personalized mass scalability. We repurpose clinical solutions developed to support physicians and nurses in a hospital or treatment center to support the insureds on your self-funded plan more closely adhere to the care plan prescribed by their doctor.
Couple that style of personalized messaging with RPM, the collection of clinically relevant metrics in a structured pattern to track A1C, blood pressure, weight, heart rate, oxygen level, and more depending on the condition and program.
What happens next is mission-critical. Using AI, big data, small data, and machine learning our programs are smart enough to read the vitals and notify the primary caregiver as designated by the insured of readings that require human intervention. 360 literally will send an A1C chart to the insured’s appropriate clinical care provider.
RPM does more than notify an insured’s clinical care provider. It reminds the patient that they are being watched by a digital physician’s assistant to help them improve their health 24/7/365. The Individual suffering from the Killer Cocktail has a partner that works with them to get incrementally better. They have a partner that they invited to help them. They opted-in to the program because they want to get better. They begin to understand they can control their conditions. As those initial incremental gains accumulate, they begin to feel better, and the momentum to take even greater control of their health. As the sponsor or manager of a self-funded program, your fiduciary duty to control healthcare expenses is clear.
Crunching numbers in one way to control healthcare expense, but it is a task as daunting as Hercules Fifth Laborem – Cleaning the Augean stable.
There is only one solution that can deliver long-term cost reduction in care and that is supporting and assisting the insureds on your plan become healthier and require less care. How rewarding is it that the solution to stopping the bleeding is to help those who cause the sea of red ink to get healthier, to lead richer fuller lives, to be more effective and efficient at work?
Health and Economic Costs of Chronic Diseases https://www.cdc.gov/chronicdisease/about/costs/index.htm
Multiple Chronic Conditions in the United States (PDF Download) https://www.rand.org/content/dam/rand/pubs/tools/TL200/TL221/RAND_TL221.pdf
The High Concentration of U.S. Health Care Expenditures (PDF Download) https://meps.ahrq.gov/data_files/publications/ra19/ra19.pdf
360 New York, 1180 6th Ave, New York, NY 10036 Main Line (917) 983-0525