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Politics aside, the Affordable Care Act (ACA) aims to provide more people with access to healthcare. With a larger population of people insured, the ultimate goal — and the only way to keep costs down — is to improve the health of the overall population.
To do this, the ACA seeks to realign incentives that were once at odds with each other. Providers, under a fee-for-service model, were incentivized to provide and recommend more services because they would get paid more. Payers would want to limit those services because they hit their bottom line, so any services whose clinical or economic benefits were questionable would not get reimbursed. Patients would get caught in the middle of these misaligned incentives; not only would their healthcare experience suffer, but their outcomes were also at risk.
The ACA turned this on its heel by enforcing the “Triple Aim” of healthcare — improving the experience of care, improving the health of populations and reducing per capita costs of healthcare.
[We’ll be discussing the importance of mobile data and personalization at MobileBeat 2014 in San Francisco on July 8-9. Grab your tickets now!]
Economic penalties around poor patient outcomes were mandated. If a hospital discharged a patient and he or she ended up being readmitted within 30 days for the same issue, the hospital would be penalized. And doctors, hospitals and other healthcare providers were encouraged to form networks — Accountable Care Organizations (ACOs) — to coordinate care and align their economics around improved care and outcomes.
The good news: economics are aligned around improving patient care and outcomes. The bad news: a problem remains — once a patient leaves the doctor’s office, it becomes difficult to see what’s going on with his or her health. Therefore, it’s hard to react quickly when there are changes in health conditions, which could land the patient back in the hospital or (at a minimum) back at the doctor’s office. Both of these scenarios drive costs up.
Brands and healthcare organizations are realizing the potential of mobile apps — and increasingly, wearable devices — to engage with and influence the behaviors of millions of Americans. According to a study we recently conducted, 73 percent of people who use mobile to track their health/fitness now believe they are healthier than they used to be as a result.
Mobile in (medical) practice
When it comes to healthcare, mobile enables interactions and insights that were previously unimaginable, including:
- Tracking of patients’ data through wearables and biometric sensors. Healthcare providers can tell if the health of a patient at home is declining, and can proactively intervene, preventing a readmission and also improving the patient’s care.
- Improved communications with patients. Healthcare providers can send app-based reminders or text messages to patients to take their meds, and also learn how the patient integrates healthcare into his/her life. In addition, patients who track their data can have a more detailed conversation during visits, hopefully resulting in a better care plan.
- Self-care and virtual consults with clinicians. Healthcare providers can enable faster access to care so people don’t let their health languish.
While people are starting to use mobile devices more and more to manage their health, it is still not the norm. This is largely due to patient confusion around — or unawareness of — the many mHealth options out there.
This is where healthcare providers have a golden opportunity to step in as trusted clinical experts who can “prescribe” apps or wearables for the population they serve. In fact, according to our study, 34 percent of people said that if their doctor recommended they do so, they would use their smartphones to track their health and fitness even more.
By leveraging the convenience, ubiquity and increasing intelligence of mHealth tools, we will not only help the Affordable Care Act achieve its goal of supporting the healthcare “Triple Aim,” but will also transform the industry in ways we’ve not yet even imagined.
Nirav Desai is the Principal Healthcare Strategist at Mobiquity.
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