Activating Consumers To Seek Evidence Based Preventive Care
Evive Health developed a proprietary preventive care reminder system for leading companies that provide health and productivity services to employees and their family members. Customized tailored reminders significantly increase the number of people that properly complete preventive screening services such as colonoscopies, mammograms, immunizations, and lipid profiles in accordance with evidence based recommendations from the US Preventive Services Task Force, NCQA and HEDIS.
About You
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Focus of activity
Service/process
Year the initiative began (yyyy)
2007
Positioning of your initiative on the mosaic diagram
Which of these barriers is the primary focus of your work?
Patients not empowered
Which of the principles is the primary focus of your work?
Center consumers in business model
If you believe some other barrier or principle should be included in the mosaic, please describe it and how it would affect the positioning of your initiative in the mosaic:
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Name Your Project
Activating Consumers To Seek Evidence Based Preventive Care
Describe Your Idea
Evive Health developed a proprietary preventive care reminder system for leading companies that provide health and productivity services to employees and their family members. Customized tailored reminders significantly increase the number of people that properly complete preventive screening services such as colonoscopies, mammograms, immunizations, and lipid profiles in accordance with evidence based recommendations from the US Preventive Services Task Force, NCQA and HEDIS.
Innovation
Define the innovation
Evive Health developed a proprietary preventive care reminder system for leading companies that provide health and productivity services to employees and their family members. Customized tailored reminders significantly increase the number of people that properly complete preventive screening services such as colonoscopies, mammograms, immunizations, and lipid profiles in accordance with evidence based recommendations from the US Preventive Services Task Force, NCQA and HEDIS.
Context for Disruption:
Employees and their family members are being asked to take more self responsibility for personal health withe more cost sharing between employers and employees as well as the advent of consumer driven health plans. However often, they do not know what to do, when to do it and what it will cost. And, for the most part, their physicians do not have the time or tools to tell them.
Even with coverage for preventive care, this results in very low adherence to recommended preventive services:
•Overall 52% of population receives some recommended screenings (NEJM)
•37% of adults 50 - 64 years of age and 24% of high risk adults receive annual flu vaccine (AJPM)
•35% of high risk adults for colon cancer receive regular screening (Milliman)
•Just over 50% of women report getting a mammogram in the last two years (2003 HINTS)
•Only 35% of high risk individuals received a flu vaccine (2003 BRFSS).
Traditional health plans are transaction based rather than patient centric. They have low trust or brand equity amongst members. They also have little interest in prevention especially in the self insured market. The average lifespan of a Third Party Administrator is 2 years at a particular employer and the financial risk is borne by the employer. So the incentives are not aligned for them to focus on long term prevention activities as it does not benefit them.
Delivery Model
Evive Health delivers highly customized, timely preventive care reminders via direct mail to covered employees and their family members. Individually tailored elements include:
• Persuasive messaging based on specific age, gender, income, geography and cultural factors and behavioral learning theories/models
• Informed medical decision making information based on medical history and target segment
• Relevant images based on age, gender and cultural factors
• Individual specific plan coverage to remove knowledge barriers about costs
• Company specific branding and integration with aligned services
In addition, Evive Health delivers a set of calendar stickers for each family to place of their home calendars to plan their health activities just like their vacations, sports practices etc. This engages the entire family (as a social support network).
Currently, Evive Health has created a library of over 1,000 different segmented messages for tests endorsed by the USPSTF as A and B recommendations and is in active discussions with some of the world's most admired companies and recognized leaders in health and productivity management.
Under a Business Associates agreement, Evive Health applies very sophisticated software that mines and merges Medical, Pharmacy, Eligibility and Health Risk Appraisal data to create a member preventive profile. The preventive profile includes important data such as medical history, previous tests, dates of service, physician of record, and family history of certain diseases. Based on these factors applied against the USPSTF guidelines, the system triggers timely reminders to both patients and physicians. Direct mail was chosen as nearly 90% of individuals reported that they prefer to receive personal health information via this channel as opposed to internet/email (HINTS 2003).
Outcomes are measured based on filed medical claims to gauge the effectiveness of the reminders on various target segments and tests.
Key Operational Partnerships
Key partners for Evive are large self insured employers that are investing in health and productivity management for their workforce. Evive's periodic reminders unlock the value of client benefits in the minds of employees throughout the year, value that is often hidden in unread Summary Plan Descriptions. Employee satisfaction and goodwill generated enables companies to be employers of choice, while reduced medical costs and reductions in absences and presenteeism generates savings beyond the cost of the Evive reminder system. We are currently in negotiations with over 20 Fortune 100 companies (including some of the most admired companies in America and past WELCOA award winners) to provide these services. With Evive's founders having worked with all of these companies before on other health initiatives, we are confident that Evive's services will be added to their health and productivity management programs.
Impact
Financial Model
Evive services are available on a per member per month basis. First year revenues represent about 75% of costs.In later years, as the subscriber base increases, with a large portion of costs being fixed, revenues exceed operating costs.
What is your annual operating budget?
1000000
What are your current sources of revenue? (please list any sources that are foundation grants)
Evive Health currently has not yet begun generating revenue. Service operations begin in January 2008 with the new benefits plan year.
Effectiveness
While Evive's reminder system is still under development, studies have already demonstrated the effectiveness of client reminders as well as physician reminders.
In a systematic review of published studies, the CDC’s Task Force on Community Preventive Services found strong evidence that patient reminders are highly effective:
•Patient reminders significantly raise adherence for breast cancer screening (+14.7%) and cervical cancer screening (+10.1%)
•Physician reminders increase adherence by 12%, on average, across various preventive screening services
Other studies have shown that tailored reminders are superior to generic reminders (Kreuter MW, Sugg-Skinner C, Holt CL, et al (2005) Preventive Medicine, 41, 53-62.)
Which element of the program proved itself most effective?
Based on Kreuter MW, Sugg-Skinner C, Holt CL, et al (2005) Preventive Medicine, 41, 53-62 and others, behavioral and cultural tailoring significantly enhances the effectiveness of the intervention. Additionally, advertising in various consumer industries and financial services has demonstrated the effectiveness of targeted messaging in direct mail campaigns.
Being a commercial enterprise in a competitive marketplace, we are happy to share a copy of our reminders confidentially.
Number of clients in the last year?
Evive Health commenced operations in 2007.
What is the potential demand?
Of the 245 million insured Americans, 70% carry employer sponsored coverage. Evive's initial target market is large innovative self insured employers, such as those that are members of The National Business Group on Health. NBGH is the nation’s only non-profit, membership organization of large employers devoted exclusively to finding innovative and forward-thinking solutions to their most important health care and related benefits issues. Business Group members provide health coverage for more than 50 million U.S. workers, retirees and their families. Together with these employers, Evive can create an enormous change in the utilization of preventive health services in the US population.
Scaling up Strategy
Our priority in the next 3 years is to tap the self insured employers market, then look beyond to health plans (particularly CDHPs), HSA providers and large physician groups. With over 25 years of background in employer based worksite health promotion and wellness programs, the two founders of Evive feel that they are well positioned to tap this group first. These employers have the most to gain both financially and from a well being perspective. Employee satisfaction and goodwill generated enables companies to be employers of choice, while reduced medical costs and reductions in absences and presenteeism generates savings beyond the cost of the Evive reminder system.
Stage of the initiative:
0
Expansion plan:
Our goal is to sign up 2 large employers for the plan year 2008, followed by 6 in 2009. Our focus is on gaining the best and brightest employers as reference accounts for others (fast followers) to then become Evive customers.
Origin of the Initiative
Healthcare, despite proclaiming itself as a consumer industry, was lagging behind all other sectors in consumer communication and empowering tools. Car companies reminded us about oil changes, vets reminded us about shots for our pets but our physicians did not. And even when they did, their reminders sadly were not consumer centric and did not drive action.
This Entry is about (Issues)
Sustainability
What are your two main challenges to finance the growth of your initiative
The primary challenge is to fund the infrastructure to support operations prior to revenue being generated. On an ongoing basis, the challenge will be to fund operating costs in the initial year, where the subscriber base is small and operating costs exceed revenues. In further years, as the client base expands, revenues are sufficient to support the company.
How did you hear about this contest and what is your main incentive to participate?
We are interested in feedback from experts as well as funding from the Robert Wood Johnson foundation to help drive this company that could very well change the face of public health by making prevention universal.
The Story
Do you have an annual financial statement?
Yes. We have projected proforma financials for 2007. Being a privately held company in a competitive market, we will be happy to provide the financials upon request.
Do you currently have an annual financial statement that tracks profit/loss?
Yes, we have three year projections available upon request.
Please describe the amount (and/or type) of funding you need to implement your initiative, at year 1 and at year 5.
$225,000 in Year 1, $75,000 in year 2. Evive Health will be self-sustaining thereafter.
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