HIMSS20: How partnerships with retail businesses and payers can increase member engagement

Update: HIMSS20 has been canceled due to the coronavirus. Read more here.

Commercial health plans, self-funded employer plans, and government agencies are fortifying their strategies for immunizations and other areas of preventive care. One opportunity to address these is to gauge the impact of an existing retail footprint as part of a patient-centric distribution approach.

In some cases, employers and commercial health plans have leveraged the clinical pharmacy services of a retail organization, and pursued partnerships with immunization registry data providers, commercialization agents, and patient-engagement technology platforms to address targeted needs within their member populations.

The challenge is how to tie consumer behavior into a profile that allows for the targeting of those members of a population most likely to adhere to a task.

It's a topic that has drawn the interest of Zach Clark, vice president of network development at BioIQ in Atlanta. Clark has examined several thousand data points collected over time, looking at utilization history to build a profile of someone likely to shop at CVS or Walgreens as opposed to utilizing home services.

The early results show that some patients are difficult to reach -- they have a diabetic incident, or they're not seeing a primary care provider, or are otherwise not integrated into the delivery system. But they shop at places like WalMart, and by engaging with them there, they're much more likely to do things like, say, get their A1C test. And it's often the highest-risk patients who are doing this.

If they go to a retail establishment to pick up their prescriptions, that often translates into an awareness of the importance of getting their A1C test or their blood pressure reading. Therein lies an opportunity.

"The results don't show 30 to 40% penetration of the population, but we are seeing at-risk patients are leveraging the service much more so," Clark said.

What this means is that to improve medication adherence among potentially vulnerable patients, payers are beginning to pursue partnerships with retail establishments such as WalMart and Walgreens to make screenings more widespread, and the data on this so far has been encouraging.

CVS Health, which recently acquired Aetna, is offering HealthHubs within some of its pharmacies, and plans to have 1,500 by the end of 2021.

"What you'll see over time is payers adopt opportunities to screen across broader networks, and providing that access is really key," Clark said. "Part of the journey is (that) the awareness of how you communicate with a patient is really important. We have an omnichannel approach -- text, email, phone -- and that flexibility makes for less abrasion with the patients or the employee. When you're thinking about communications, you have to take into account people's preferences.

"Then increasing the strength of the network across various retailers is important too," he said. "Not everyone shops at WalMart, so you have to build flexible health systems."

The engagement of various stakeholders -- payers, pharmacists and the like -- is paramount. And from the pharmacist's perspective, the level and quality of messaging is a critical consideration.

"Walmart's network is so broad, so it's important working with corporate and retail leadership so pharmacists know what's expected of them, and any other potential messages the payer may want to have instilled into the conversation," Clark said. "That level of training is real. It's meant to make the pharmacists feel comfortable in that role."

In that respect, education is a necessary piece of the puzzle. Stakeholders want to screen across large populations, so training the team on what to expect is a must if success is to be achieved. After all, not all patients are going to show up at the pharmacy saying they want to be screened; they have to be proactively engaged. BioIQ has integrated eligibility into the workflow that allows pharmacists to engage on that level with their patients.

Clark sees it as the way of the future.

"It won't matter who's in office -- pharmacy benefit managers are going to see some pressure to create value," he said. "Screening, both at a pharmacy window or in the home, will be part of a value-added package in many benefits moving forward. They'll be adopting retail services in a benefit structure quickly, and grow whenever there's financial incentives. We'll see growth and adoption very quickly."

Zach Clark will discuss "Increase Member Engagement by Offering Retail Convenience" from 1-2 p.m., Wednesday, March 11, in Room 311E, during HIMSS20 in the Orlando County Convention Center in Orlando, Florida.

Twitter: @JELagasse

Email the writer: jeff.lagasse@himssmedia.com