Coupling that information with individual health data rounds out the picture, giving providers the opportunity to head off conditions such as diabetes, heart disease, high blood pressure, high cholesterol, and cancer in their patients.
The more health data a patient shares with their provider — Do they smoke or use alcohol? How is their diet? How much do they exercise? — the better their health outcomes will be.
Ben Edelshain, VP of Clinical Engagement and Digital Innovation at Highmark, oversees a couple hundred case managers, many of whom are nurses who work for Highmark Health Plans. Their job is to analyze and act on patient data in real time.
For example, if a member is diagnosed with diabetes, within 24 hours the case managers reach out with programs that can help, offering the services of a diabetes educator and other resources that are part of the member’s benefits plan.
“The specificity of the data is important, so we contact the patient in the moments that matter,” says Edelshain. “We can take population health data on the incidence of disease in the patient’s demographic group and forecast how this person’s health is going to change based on action or inaction. Taking healthy actions while a diagnosis is new can lead to better health outcomes.”
Edelshain feels that his upbringing presented a duty to care for all people. Born in London, he received the nation’s universal health care benefits. He became a physician and, later, a management consultant. His consultancy work brought him to the U.S.
“The U.S. is wonderfully diverse,” he says. “But that comes with challenges. Everyone is different and deserves respect. Now that I live in the States, I have a weird accent. I’m also half Japanese and half Jewish. I’ve never looked the same as anyone — in my classroom, workplace, or friend group.”
Edelshain’s understanding of diversity, equity, and inclusion (DEI) drives his interest in personalized health care delivery. “The better the health data we gather, the more we can tease out how different each individual is,” he explains. “Not only their biological data, but also their family, cultural, socioeconomic, and lifestyle data.
“All those variables create the diversity of who we are,” he continues. “The more we know about a member, the more apt we are to give actionable advice that fits their unique needs and supports meaningful behavioral change. When we harness the power of data, providers and health plans become patient advocates and partners.”
Companies invest heavily in providing health benefits to their people. Helping employees get the most out of those benefits is a win-win. But it takes a three-pronged approach of awareness, engagement, and activation:
Companies play a crucial role in health care delivery, as millions of Americans are covered by employer health plans. Encouraging full participation can lead to better overall wellness for all workers — regardless of role, location, ethnicity, gender, and individual care needs.
All references to “Highmark” in this communication are references to Highmark Inc., an independent licensee of the Blue Cross Blue Shield Association, and/or to one or more of its affiliated Blue companies.
