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A call to action: women’s health is more than maternity

Dr. Lia Gass Rodriguez, Chief Medical Officer

March 21, 2024

Here’s a challenge for you. Go to your search engine and put in “pregnancy” as a search term. I got over 10.6 billion search results in half a second. There’s a lot of information out there and maternity programs are common employee benefits. Better health outcomes for parents and babies also lead to fewer lost workdays and lower costs for prenatal care, deliveries and postpartum care and deliveries.

Now, put “menopause” in as a search term and see what you get. My search results dropped by more than half to 395 million results – and even more to just 34.6 million when I searched on “perimenopause.” The average life expectancy of women in the U.S. is around 79 years1 and the average onset of menopause is about age 51.2 Thus, the average woman will live in post-menopause for almost 30 years. Many of them are working years.

There are plenty of familial, cultural and religious taboos that make discussing menopause uncomfortable – even when the conversation just includes women.

There are plenty of familial, cultural and religious taboos that make discussing menopause uncomfortable – even when the conversation just includes women. That’s why 58% of women over 40 who are in perimenopause say they were “not at all prepared” for what to expect during this stage of their lives.3 Consider that for a moment. Perimenopause can last up to 8 years, and women may live in post-menopause for decades, and yet the majority of women don’t feel prepared for it at all.

When it comes to menopause, turning to a health care provider may or may not be helpful. Specific education on menopause is largely absent from medical school training. That’s consistent with my own experience in medical school. I didn’t receive specific instruction on menopause beyond the basics of hormone replacement therapy. Lack of education explains why menopause is often misdiagnosed. There are around 30 symptoms associated with menopause; they’re not limited to hot flashes and night sweats. Many symptoms are also associated with conditions like depression – loss of appetite, mood changes and trouble sleeping to name a few.

Menopause is a popular request when we ask members what topics they’re interested in, and one report showed that 64% of working women are interested in menopause-specific benefits.4 Employers are less sure. Only 24% of employers offer menopause support as part of their benefit strategies.5

However, menopause does have an impact on the workplace. About 40% of women in one survey reported that their menopause symptoms interfered with their performance and productivity at work.6 In fact, research estimates that missed work and lower productivity related to menopause cost U.S. businesses $1.8 billion annually.6 Many women also consider leaving work during this time – costing employers mature, talented employees with valuable institutional knowledge.4

Every day, we empower people to improve their health in body, mind and spirit. We recognize that addressing symptoms of perimenopause and menopause can be an important part of that work. That’s why ActiveHealth is committed to providing holistic support for our members through all stages of their lives. We’ve done training with our clinical team to help them identify and address menopause-related symptoms when working with members, are pursuing documentation and outcomes reporting and recently added a six-week group coaching series on menopause.

Almost half the population will go through menopause at some point in their lives – whether it’s natural or medically induced. Women spend almost twice as many years post-menopause as they do in their active reproductive years. Yet within employee health benefits, the focus is almost exclusively on maternity. You have the power to ensure that your employees aren’t in the majority of people who don’t know what to expect during perimenopause and menopause.  You can start by assessing your health strategy to ensure that your programs include supportive, evidence-based programs that address the full spectrum of women’s health.

 

 

1 FOR LIFE EXPECTANCY SOURCE: Centers for Disease Control and Prevention. Life Expectancy in the U.S. Dropped for the Second Year in a Row in 2021. Accessed March 19, 2024.

2 FOR AVERAGE AGE AT MENOPAUSE SOURCE: The North American Menopause Society. Menopause 101: A primer for the perimenopausal. Accessed March 19, 2024.

3 FOR MENOPAUSE PREPAREDNESS SOURCE: Tariq B, Phillips S, Biswakarma R, Talaulikar V, Harper JC. Women’s knowledge and attitudes to the menopause: a comparison of women over 40 who were in the perimenopause, post menopause and those not in the peri or post menopause. Accessed March 19, 2024.

4 FOR EMPLOYEE MENOPAUSE SUPPORT SOURCE: Bank of America. Break through the stigma: Menopause in the workplace. Accessed March 19, 2024.

5 FOR EMPLOYER PROGRAM SOURCE: Bratton L. Companies that want better recruitment should consider menopause benefits, report says. Qz.com. February 14, 2024. Accessed March 19, 2024.

6 FOR MENOPAUSE-RELATED COST SOURCE: Peck E. How menopause costs the U.S. in lost productivity. Axios.com. May 3, 2023. Accessed March 19, 2024.

Behind the screens: research as the foundation of design

Kevin Deevey, Design Strategist, and Julia Milner, Design Researcher

February 23, 2024

Designing world-class digital products requires more discipline than you might think. When you look at a minimalist app design or a slick web portal, you might not think about the work it took to make the experience user-friendly. And that’s how it’s meant to be.

The pretty surface hides a nerdy core. The human-centered design of MyActiveHealth℠ is fueled by research, because we know that you get better results if decisions are based on facts, not instincts. Strategic design teams are constantly testing ideas, learning, making changes and taking risks to create products that feel effortless to use.

Besides running our own research, the User Experience team learns from the latest academic research, adapting to industry trends and collaborating with subject-matter experts from across the company.

The insights we gain from this process drive our design work for the reimagined MyActiveHealth platform. We use a variety of research methods to discover members’ needs and priorities, get feedback and evaluate how well our solutions work for all users.

Besides running our own research, the User Experience team learns from the latest academic research, adapting to industry trends and collaborating with subject-matter experts from across the company. Colleagues with deep experience in clinical care, behavior change, technology and data science have all contributed to making this a platform that supports lasting, healthy changes for our members.

Research-informed design is an emerging state-of-the-art practice for modern product teams. We used it in our approach to recreating MyActiveHealth to be a more compelling, intuitive and personalized wellness platform. Major benefits included:

  • A better insight into what real users value when interacting with our digital products and services
  • Digital experiences that feel natural, easy to use and relevant to daily life
  • Creative new features that address unmet needs by learning from diverse user perspectives

We’re committed to providing the best possible outcomes for our members, so we’re making decisions with all the data, evidence and experience available to us. We’re excited to see our design for MyActiveHealth come to life. It’s designed to help people build daily habits that can improve their health – and have some fun while they’re doing it!

 

MyHealth100: goodbye mental math, hello empowerment

Shanthi Narra, Director, Digital Product Strategy, MyActiveHealth℠, and Tobin Sebastian, PharmD, AHEOR, Lead Director, Clinical Analytic Products

February 22, 2024

How can you distill the very complex and nuanced nature of health into something that’s easy for clients to understand and act on? That question is what led us to develop the Active Health Index,* a metric that shows the health of individuals or a population on a scale of 0 to 100, with 100 being an ideal state.  It’s a fascinating, multi-dimensional algorithm that produces a simple score that makes it easy for our clients to understand the health of their population while also generating individual-level insights that help care managers address specific health opportunities for our members.  

Within the health index, there are dimensions of health that are established – like age and underlying health conditions. There are also things that vary based on how a person manages their health – factors like lifestyle risks and medication adherence. We wanted to carve out just the dimensions people control and create a new score that helps our members understand, in an easy way, what their health is and how they can change it. That was the genesis of MyHealth100. 

It’s not enough to just give a metric without helping people understand how to change it. If a member gets a health score of 80, the AI behind MyHealth100 also delivers a plan to improve it.

With MyHealth100, everyone starts at 100, but then we look at how they’re managing their health. Every time they miss an opportunity to improve their health, it takes a little away from their score. It could be a treatment they’re not taking as prescribed or a preventive screening they could benefit from.  The more gaps and risks the member has, the more the score deviates from 100. But as they tackle and resolve them, the score goes back up. Members can see their score, and ActiveHealth clinicians they’re working with can too. Everyone is on the same page and they can work together to develop a plan to get the member to their best possible health.

It’s not enough to just give a metric without helping people understand how to change it. If a member gets a health score of 80, the AI behind MyHealth100 also delivers a plan to improve it. They’ll see pathways they can take to raise the score. Before they choose to go down one path or another, they can tell how much impact each one would have. For example, the reduce the risk for diabetes path may increase the score by 10 points while managing stress might increase it by 5 or 6. The score, the pathways and the curated content within them, combine to help the member understand their health and how to improve it.

Once members start working on their health and we get new data, either from work in MyActiveHealth or from connected devices, MyHealth100 recalculates. Members can see their progress and build their confidence to continue.

The beauty of MyHealth100 is that it takes out the mental math for members. It shows a simple score and offers weighted ways to improve it. At the same time, the choice of what to address first belongs, as it should, to the member. They can start a journey with a lower weight because it addresses a health issue they feel is more urgent. They can work on a shorter goal instead of a longer one. MyHealth100 helps create a personalized, focused experience that drives toward a clear goal while preserving the member’s sense of control and building a sense of empowerment.

*FOR MORE INFORMATION ON THE ACTIVE HEALTH INDEX: Watch our video on YouTube, read our article “The quest to quantify health,” read our article “Physical and social factors that affect health.”

 

Connecting for change: a way to mitigate rising health care costs

Lia Gass Rodriguez, MD, Chief Medical Officer, and Larry Siegel, Executive Vice President, Informatics

February 19, 2024

Though it’s usually thought to be an issue related to aging adults, the reality is that even if your population looks young and vital on paper, you’re not immune to the risk of impacts from chronic conditions. In 2005, 36% of adults between 18 and 34 had at least one chronic condition, and 14% had more than one.1 By 2019 those numbers had risen to 54% and 22% respectively.2 Younger adults with chronic conditions are also more likely to have unhealthy habits like smoking and lack of physical activity than their counterparts without chronic conditions.2 Two of the top three conditions in this age group are obesity and high blood pressure. Both are associated with the development of other serious chronic conditions like diabetes and heart disease.2

Now here’s the good news – unhealthy habits can be changed. People can modify their lifestyle and impact their health.  They can quit smoking, become more active, learn to manage their blood pressure and lose weight, especially with support from holistic wellness programs that support long-term lifestyle behavior change and leverage digital tools to do so.

Our data-driven clinical models integrate diverse data sources, including lifestyle and biometric risk factors, as we assess the health of our population.

Helping people make these changes is more critical than ever because chronic conditions are not just serious from a clinical perspective. They’re also connected to 90% of health care spending in the U.S.3 – which rose from just under $2 trillion in 20054 to $4.5 trillion in 2022.5 Today, 22% of employers in the U.S. attribute the increase in health benefit costs to the cost of treating chronic conditions.6

Our data-driven clinical models integrate diverse data sources, including lifestyle and biometric risk factors, as we assess the health of our population. Then, we can take what we know about how people are likely to engage to offer support that fits naturally into their lifestyles and habits. Adults in the U.S. between 18 and 29 spend more time online than other age groups. In fact, 48% of them describe themselves as almost constantly online.7 This comfort with life online is reflected in ActiveHealth engagement data which shows that members in this age group are open to using digital wellness tools and engaging in group coaching sessions.

Extending the scope of our clinical analytics beyond identification into engagement allows us to deliver personalized, relevant and actionable digital content, right up to recommendations for community-based support. We can optimize daily online usage patterns to include evidence-based health information that can help them articulate a vision for their health and then set goals to achieve it. We can also gently introduce live coaching interactions by recommending live, online group coaching series.

When we engage members in modalities that are a natural fit for their habits and preferences, we have the best chance of creating lasting changes that will positively impact their health.

These series are a hybrid of digital coaching and one-to-one coaching. They offer participants a chance to engage with experienced coaches, in real time, in a group format that’s convenient and may feel less stressful than connecting live, one-to-one with a coach on the phone. Our data shows that adults between 18 and 45 are more likely to engage in group coaching than other age groups.8

Holistic, multi-modal programs can make a difference. As an example, our Lifestyle and Condition Coaching program has shown that members are five times more likely to quit smoking with program support than on their own, and 83% of members with hypertension keep their blood pressure below 140/90 mmHg.9 However, the first step toward achieving these results is connecting effectively with the people we serve. When we engage members in modalities that are a natural fit for their habits and preferences, we have the best chance of creating lasting changes that will positively impact their health.

 

1 FOR 2005 CHRONIC CONDITION PREVALENCE SOURCE: Agency for Healthcare Research and Quality. Health Care Expenses for Adults with Chronic Conditions, 2005. Medical Expenditure Panel Survey. Issue Brief #203. May 2008. Accessed February 7, 2024.

2 FOR CHRONIC CONDITION PREVALENCE SOURCE: Centers for Disease Control and Prevention. Chronic Conditions Among Adults Aged 18─34 Years — United States, 2019. Morbidity and Mortality Weekly Report. July 29, 2022. Accessed January 25, 2024.

3 FOR HEALTH CARE SPENDING ON CHRONIC CONDITIONS SOURCE: Centers for Disease Control and Prevention. Health and Economic Costs of Chronic Diseases. Accessed February 7, 2024.

4 FOR 2005 HEALTH CARE SPENDING SOURCE: Muñoz E, Muñoz W 3rd, Wise L. National and surgical health care expenditures, 2005-2025. Annals of Surgery. February 2010. Accessed February 7, 2024.

5 FOR 2022 HEALTH CARE SPENDING SOURCE: CMS.gov. National health expenditure data: Historical. Accessed February 7, 2024.

6 FOR EMPLOYER ATTRIBUTION OF HEALTH CARE COSTS SOURCE: International Foundation of Employee Benefit Plans. Health Care Costs Pulse Survey: 2024 Cost Trend. Accessed February 7, 2024.

7 FOR TIME ONLINE SOURCE: Statista. U.S. internet user demographics – age groups – Statistics & Facts. Accessed January 25, 2024.

8 FOR PROGRAM ENGAGEMENT DATA SOURCE: ActiveHealth outcomes data from a large state government employer in calendar year 2022.

9 FOR PROGRAM RESULTS SOURCE: ActiveHealth outcomes data from a large national employer with engaged members targeted for specific program interventions in calendar year 2022.

Rewarding healthy behaviors

September 30, 2023

How do employers use incentives? Do they work? And what types of incentives have been effective for ActiveHealth’s customers?

Go deep on the why’s and how’s of well-being incentives with our easy-to-read white paper.

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How AI is transforming individualized member education in population health management

Aurel Iuga, MD, MBA, MPH, Medical Director

February 14, 2024

Author’s note: I would like to thank my AI assistant for helping me craft this post on the role and value of AI.

Artificial intelligence (AI) has the remarkable ability to process extensive data, extract insights and tailor educational content to meet the specific needs of patients. It is reshaping clinical practices and revolutionizing the way health care providers deliver patient education. This personalized approach is particularly pivotal in the population health management space as it relates to chronic disease management, where ongoing member engagement and adherence to care plans are critical.

The expanding role of generative AI is transformative but must also be subject to limitations.

In this context, the expanding role of generative AI is transformative but must also be subject to limitations. Generative AI can analyze patient data, including medical history and personal health preferences, to generate tailored educational materials. This not only enhances the learning experience for the members but also ensures that the information is relevant and easily comprehensible.

However, the limitations of generative AI cannot be overlooked. Despite its advanced algorithms, generative AI may lack the nuanced understanding that clinicians possess, especially in interpreting complex medical conditions and emotional nuances of members. Additionally, the quality of output from generative AI heavily depends on the quality and quantity of the input data, which raises concerns about data biases and inaccuracies. While generative AI offers promising prospects in revolutionizing member and patient education, its deployment must be carefully managed, considering these limitations and ethical considerations.1

At the forefront of this innovation, ActiveHealth is developing patient education content recommender systems, using AI technology to prioritize clinician-curated educational content based on individual health risk factors and medical diagnoses. These systems aim to:

  • Automate and optimize content delivery
  • Complement human-led member coaching with smart, scalable digital tools and strategies
  • Provide a more personalized and effective member experience
  • Enhance the value delivered to both members and clients

Furthermore, AI’s potential to integrate social determinants of health could enhance population health outcomes. It provides a clinical-community linkage that is crucial for effective health education and management.2 By considering factors such as socioeconomic status, lifestyle and environment, AI can offer more holistic and individualized educational interventions for patients.

AI’s integration into individualized patient education signifies a new era in health care. This evolution promises enhanced patient engagement, improved health literacy and optimized health outcomes. The future of health care is likely to witness AI becoming increasingly ingrained in patient education strategies. The role of AI in revolutionizing patient education within population health management is set to expand, paving the way for a more informed and health-conscious population. This will not only benefit people in managing their health more effectively but also empower members of the health care team to deliver more targeted and effective educational interventions.

 

1 Paranjape, K. Implementing Artificial Intelligence in Health Care: Data and Algorithm Challenges and Policy Considerations. American Journal of Biomedical Science & Research. January 8, 2021. Accessed January 17, 2024.

2 Kwon, IG; Kim, SH; and Martin D. Integrating Social Determinants of Health to Precision Medicine through Digital Transformation: An Exploratory Roadmap. International Journal of Environmental Research and Public Health. May 10, 2021. Accessed January 17, 2024.

 

Effective coaching: a mix of digital and personal support

Christie Kress, Principal Clinical Leader

February 7, 2024

The MyActiveHealthSM wellness platform is often a member’s first exposure to ActiveHealth, and for many it’s the first time they’ve ever had a coaching experience. Because that’s what MyActiveHealth is. It’s not just a website where you can go and find information. It’s a digital coach doing many of the things that a live person would do in a coaching interaction. It’s gathering information about them. It’s learning what their hopes and goals are for their health. And then it’s helping them articulate those goals and put together a plan to achieve them.

The MyActiveHealth wellness platform is a convenient, useful tool for members working on their own. But it’s just as valuable for people working with clinicians.

Digital coaching gives members a chance to learn about us and what we can offer them in a self-directed way. A lot of people can be successful just with digital support, and we know that certain segments of the population prefer to engage that way. We have members who are hesitant to connect with a live coach; it can make them feel more vulnerable than they’re comfortable with. They can make a lot of progress digitally and they can do that in the privacy of their own space and at their own pace.  

Some people just do better when they’re connected with a live person. It can be in a group setting where they can contribute as much or as little as they want. They still see the coach’s face and they can interact with other people working toward the same goals. Especially for members in the age groups between 18 and 45, an anonymous group setting gives them both social support and evidence-based strategies they can apply in their daily lives.1  

Since we know there’s a degree of comfort using digital tools to get into the sessions, we offer them ways to learn more using other resources in MyActiveHealth at the end of each session. Encouraging people to learn more and become empowered to manage their health is a core part of what we do.  

There’s a role for MyActiveHealth even when a member is working telephonically with a nurse or coach. Let’s say you’re a member with a new diagnosis of diabetes. The nurse can walk you through how to prick your finger, but it’s so helpful to be able to send them a video that shows them how to do it.  

It may surprise you to learn that people can forget as much as 80% of what the doctor tells them in an appointment. And about half of what they do remember is incorrect.2 Our clinicians can help fill in those gaps and continue the education. Hearing information from a doctor and then again from their ActiveHealth clinician is an important part of learning about their health. Seeing it again in a digital format – whether it’s a video or an article – further reinforces what they’ve heard and helps them build their confidence to manage their health.  

Helping people make decisions about their health and health goals often takes a combination of digital and personal support. The MyActiveHealth wellness platform is a convenient, useful tool for members working on their own. But it’s just as valuable for people working with clinicians. Giving people a way to double-check what they’re learning from their health care team and enhance their learning on their own can go a long way toward establishing trust between members and the people working with them.  

 

1 ActiveHealth book of business data, January 2024.

2Agency for Healthcare Research and Quality. Health Literacy Universal Precautions Toolkit, 2nd Edition.
Accessed January 11, 2024.

Services are provided by ActiveHealth Management, Inc. Our programs, care team and care managers do not provide diagnostic or direct treatment services. We assist members in getting the care they need, and our program is not a substitute for the medical treatment and/or instructions provided by health care providers.

 

Get to know CareEngine technology

February 5, 2024

Get to know CareEngine® technology ... in just 90 seconds.

People are more than the data we know about them. But the data helps us to start to get people on their path to better health.

Watch this short video to learn more.

Communication: a digital first approach

Erica Fenwick, Lead Director, Marketing & Communications

November 16, 2023

It may be hard to believe, but email marketing has been around for over 40 years. We have now evolved into a technological landscape where 82% of Americans own a smartphone1 and 46% of emails are now viewed on a mobile device.2 This type of marketing isn’t going anywhere, but the opportunity to optimize the member experience continues to advance with the addition of tools like SMS text messaging and mobile push notifications.

Taking advantage of a digital first communication strategy can make a big impact.

Having a digital first approach in coordination with a personalized and segmented member journey allows us to connect in a timely way. By utilizing member preferences and leveraging technologies like send time optimization we are reaching the member when and how they want to interact. This helps us maximize engagement across our programs.

A combination of data, member activity and personal preferences provides ActiveHealth the insights we need to reach our population in the most relevant way possible and plays a critical role in the success of the member experience.  Taking advantage of a digital first communication strategy can make a big impact so it’s important to ensure that member email addresses are provided on the initial ingest files. In fact, our data shows that clients with 100% of available email addresses could experience digital engagement rates up to three times the engagement of clients with only 50% of available email addresses.3

Adding other digital modalities like SMS and push notifications only serve to enhance the member experience. New studies show that 95% of SMS texts are read and responded to within the first three minutes.4 By translating the opportunity of multichannel digital strategy into our member communications, we can also expect to improve health outcomes through increased member engagement.

 

1 20 Vital Smartphone Usage Statistics

2 7 Key Email Marketing Statistics for 2022 (Incl. Mobile) (drip.com)

3 ActiveHealth book of business data 2023

4 SMS marketing is still very effective (2022 update) – TASIL

Innovative, scalable solutions that can enhance your own

October 16, 2023

Health plans and third-party administrators work with ActiveHealth to:
• Improve health outcomes
• Expand health care quality analytics
• Lower health care costs
• And offer a wider array of products to clients and members

Our configurable solutions can help meet your members wherever they are in their health journey.

See how you can enhance your health solutions