Nashville, Tennessee-based Healthways, one of the largest companies developing wellness programs today, recently announced plans to rollout its suite of wellbeing tools to employees working at Arizona healthcare system Carondelet Health Network, which is a part of Ascension Health. This is just the latest of many customer rollouts for Healthways, which now serves more than 1,000 employers and about 200 health plans around the country.
Carondelet employees will use the program for an indefinite period of time before Carondelet makes the tools available to its patient population, Healthways Director of Commercial Strategy Reggie Ramsey told MobiHealthNews in a recent interview.
"Hospital systems have long had a focus of taking care of the sick, but have not necessarily had as much of a focus on keeping people healthy," Ramsey said. "As they move to take on more risk, it is going to be an important factor... [What Healthways offers] is not just a wellness program or a disease management program -- it is broader than that. We think about it on three levels -- keeping the healthy healthy, mitigating behavior risk, and then helping care for those with no disease. We are looking at doing all three of those. This will be a couple year phase to implement the tools and get Carondelet ready to do the full population health implementation."
The tools that Carondelet employees will begin using include:
Gallup-Healthways Well-Being 5. Ramsey said this is Healthways' newest wellbeing assessment. "We don't have just a health risk assessment that looks at health risks. We've really broadened it out to five areas of a person that really make up the total person: their purpose, social wellbeing, financial wellbeing, community wellbeing, and physical wellbeing." This take on a traditional HRA asks patients questions to help identifiy risks in any of those categories. Ramsey said the company has also recently added risks related to stress that comes from financial issues to its program.
Well-Being Connect and wellbeingGO. These are two of Healthways' web-based and mobile tools. They include an individual's wellbeing plan that will identify their risks for them and help address some of those risks. They also aim to make it easier to track things like exercise, diet, smoking cessation, and more. The smoking cessation tools is a lighter version of QuitNet, which is described below, because Ramsey said some people aren't ready for a "heavy" intervention. The smoking cessation tools included here are for onboarding: "You can't try to move people when they aren't ready," he said.
The Daily Challenge. This is the social wellbeing tool created by Healthways' subsidiary MeYou Health, which Ramsey called a "think tank" based in Boston. The Daily Challenge is how Healthways hopes to get people to make small steps toward behavior change each day. It starts with a reminder at the beginning of the day to do something small like eat a leafy green, park farther away from the front door at work, or try a particular yoga pose: "It's just [suggesting] small things that could add up to make an impact," Ramsey said. More on this tool below.
Health Risk Coaching. Healthways has multiple call centers around the country with nurses and health risk coaches on staff. They make calls based on information identified in the health risk assessment to help people address some of their risks. "If I have high cholesterol, they might call and ask me how I'm doing with my eating habits and my exercise," Ramsey said. "That would be identified through biometric screening or their wellbeing assessment."
QuitNet. This is Healthways' smoking cessation program and it includes a combination of an online tool and nurse calls.
Innergy. Ramsey said this is the weight loss program Healthways developed in partnership with Johns Hopkins. "It's for people who are obese or have BMIs over 30," he said. "It helps them to make lifestyle changes -- it's online and involves coaching."
High Risk Cost Avoidance. "We also have a set of predictive models that we will run the Carondelet medical claims through," Ramsey said. "So, rather than just looking at a cost event that happened last year and saying, OK, everyone that had a high cost event last year [is flagged as having higher risk] going into next year. So, rather than backward looking, Healthways can say that this group of people are at a high risk of having a high cost event in the next six to 12 months, based on a set of over 200 factors that were run through the predictive models." Ramsey said the 200 or so data feeds come from the HRA and the medical claims. High risk patients are then set up with a coaching program that aims to help mitigate that risk.
Currently, people using Healthways suite of tools are able to feed data from their connected health devices into the Well-Being Connect portal or wellbeingGO app. That data is then tracked and in the line of sight of nurses, Ramsey said. Connected device data is not being used "on that frequency to update the High Risk Cost Avoidance models," he said. However, Healthways is always fine tuning its predictive models, he said, and it would make "perfect sense" at some point in the future to use that kind of information. Ramsey said that everything Healthways does is science-based and proven first.
Last October Healthways announced that The American Journal of Preventive Medicine had published a study that evaluated its Daily Challenge program. The study used the Healthways Well-Being Assessment to assess change in both the intervention and control groups: "At 90 days, Daily Challenge was effective in improving well-being by 2.35 points over control, while participants who engaged socially with other program participants showed a 55 percent greater improvement in well-being compared with program participants who did not form social ties," the company wrote. Based on existing research, the company claimed that "each point of improvement in well-being equates to a 2.2 percent lower likelihood of hospital admission, a 1.7 percent lower likelihood of emergency room visits and 1 percent lower healthcare costs."
Those are the types of numbers Ramsey said Healthways uses to measure its success. All population health strategy goals should include reduction of health-related risk, reduction of prevalence and incidence of chronic disease, reduction of morbidity rates, reduction in utilization of healthcare services, reduction of total medical costs, reduction of unplanned absences, increase in engagement and performance of the patient population, and improved longevity.
"We also focus on having the right touch for the right person at the right time," Ramsey said. "As the population moves more towards these mobile tools we still need to get the right touch at the right time, which most of the time will be a mobile tool. Almost -- what -- 30 percent of the population doesn't have a home telephone anymore? So we are reaching them via their mobiles to have calls, but also using wellbeingGO, because people are drawn to those tools on their phones. MeYou Health's tools are mostly accessible through the phone, too. We are constantly improving and moving more towards the utilization of those mobile tools."