Three strategies to improve engagement in the health care system

Author: William A. Breskin

As we approach our second year of the coronavirus pandemic, COVID-19 vaccines are beginning to roll out in larger numbers. Yet, while we enter this new stage with more familiarity, preparation and leadership, we are still a long way off from being virus-free.

For many of us, this means months of continued financial hardship, restrictions on the things we enjoy, and, at times, fear and uncertainty. For those of us in health care, it also means continued vigilance—and concern—about gaps in care. A recent study published in The Journal of the American Medical Association found that primary care visits decreased by 21.4% in the second quarter of 2020 compared to 2018 and 2019. This is accounting for virtual primary care visits. A similar study found that, between March and April of last year, mammograms fell by 67%, colonoscopies by 69.6% and A1c tests that measure blood glucose by 50.7%.

While these statistics aren't surprising, they are troubling. How many diagnoses were missed in 2020? And how many will be missed in 2021? We must get Americans back to the doctor.

The health partnership

In my role serving the Blue Cross Blue Shield Association's government programs, I have the honor of overseeing the 5.5 million-member Federal Employee Program® (FEP®)—the world's largest privately underwritten health insurance contract, serving federal employees, retirees and their families. More than just providing our members the coverage and peace of mind they need, we also proudly view ourselves as their partner in health and wellness.

We and our members share similar goals: maximizing the value of your health insurance coverage and navigating through the health care system so that members understand their treatment options and results, as well as what continuing care is needed. We’re doing more to help you understand the value of Blue Cross Blue Shield coverage, including our new Health care Cost Advisor Tool.

We also want our members to understand the health care journey every time they seek and receive care, and most importantly to get care when they need it. However, we know that gaps in care can occur for any number of reasons, ranging from a global pandemic to apathy/avoidance. For example, only 68% of millennials have a primary care physician. Why visit the doctor if you're 30 and feel good, right? Or I’m feeling “good enough”? Or “the problem will go away”? The answer in every case is obvious: good health doesn’t just fall from trees, you have to invest your time and effort into it. There is a direct relationship between the amount of attention given to your health and the quality of your health.

Right now, there are several reasons for avoiding necessary care: fear of going to a medical facility and contracting COVID-19; the craziness of working from home while managing a family; accessibility of health care providers in certain areas are just some of them. But it is important to remember that the medical conditions and needs you had before the pandemic are still there, and will still be there after the pandemic, and could be much worse if not treated during the pandemic. 

3 strategies Blue Cross Blue Shield Federal Employee Program is using for member engagement

1.  Meeting members where they are. In the early days of the pandemic, it became abundantly clear that, for many Americans, depression, anxiety and other struggles would be exacerbated as the result of physical isolation, worry for loved ones or economic uncertainty. To help our members maintain their mental health from home, we piloted a full-spectrum, digital behavioral health solution. It not only brings them one-on-one support at home, but also empowers them to take an active role in their health with self-monitoring tools and interactive programs. This year, we are excited to bring this solution to all of our 5.5 million members in 2021. This includes being able to have telephonic visits to your physical and mental health professionals with coverage the same as when you visit them in person.
2. Creating incentives. We humans often choose smaller, immediate rewards over greater, delayed rewards. For example, buying something immediately on Amazon without getting off the couch, versus working for months at the gym to lose 20 pounds. To help steer our members toward health decisions that will benefit them in the long run, we incorporate immediate incentives in their wellness plan. For example, if a member completes a health assessment or receives their annual checkup, they will receive a real-time, tangible reward.
3. Offer personalized support. While mental health and preventive care are great additions to anyone's health protocol, we recognize that our members' health is unique to them. Perhaps they are struggling to quit smoking or working to manage their diabetes. FEP offers comprehensive, personalized support for these members, too. For example, our members in our diabetes management program receive online coaching as well as free glucose meters and lancets. Those who have completed our tobacco cessation program receive their related over-the-counter and prescribed medications at no cost. 

About the Federal Employee Program
Since 1960, the Blue Cross and Blue Shield Federal Employee Program® (FEP®) has covered federal employees, retirees and their families. Currently, about 5.4 million out of the 8 million federal employees, retirees, and their families are covered by FEP through the Federal Employees Health Benefits Program (FEHBP), which makes it the leading insurer covering almost 65 percent of federal employees. FEP's broad benefits offer federal workers access to the most innovative care delivery programs around the country, which are being offered by Blue Cross Blue Shield companies.

About the BlueCross BlueShield Association
The Blue Cross and Blue Shield Association is a national federation of 36 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans.