Challenge: affordability
Challenge: quality ACOmembers are more likely than those in open-access plans to get recommended cancer screenings. They’re also less likely to visit the ER or be readmitted after a hospital stay. Last year showed us another way the ACOmodel offers better results. During the pandemic, care shifted rapidly to telehealth. Phone calls, video visits, and remote monitoring helped patients stay in touch with providers and get effective care. Fewer in-person appointments let health systems protect staff and conserve personal protective equipment. While telehealth use rose among all of our members in 2020, those enrolled in ACO plans made the most use of the service.
One Iowa-based partner, UnityPoint Health, was worried that people who buy the most affordable type of individual coverage — a low-premium plan with a sizeable deductible —may skip or delay basic care to avoid the up-front costs. We shared that concern. Prompt, effective primary care can keep an everyday injury or illness from turning into a serious (and expensive) issue. Moreover, a health plan you can afford to buy but can’t afford to use isn’t an affordable plan. So we worked with UnityPoint Health to design a new low-premium ACO plan that covers primary care and mental health office visits, urgent care, and virtual visits with UnityPoint Health providers at 100% after the member chips in a $5 copay. We knew this approach also would meet needs in other places, so we shared it with other ACO partners. During the national open enrollment period for 2021 coverage, we introduced our new $5 Preferred Primary Care Plan for individuals and families in Iowa with UnityPoint Health, and in Kansas and Missouri with Saint Luke’s Health System. It was an immediate hit —more than 6,000 members enrolled across the three states.
2020 growth in telehealth usage
Challenge: experience
+30%
We launched a new ACO in 2020 with Hennepin Healthcare, a Minneapolis-based integrated care system. With the prevalence of diabetes among Minnesota adults at an all-time high of nearly 8%*, we identified this chronic condition as a clinical priority and member experience opportunity for the partnership. This ACO is our first to offer a virtual diabetes management system at no cost to members. Pops ® Diabetes Care lets members check blood sugar levels on the go using a mobile meter kit, get encouragement and reminders from a virtual coach available 24/7 through the Pops app, and share data with caregivers and health care providers.
+25%
Members enrolled in open access plans
Members enrolled in ACO plans
* Source: https://data.web.health.state.mn.us/diabetes_facts
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