Increasingly, healthcare and insurance providers are turning to environmental intelligence to reduce the burden of unnecessary healthcare costs and optimize patient outcomes and satisfaction. Let’s explore the ‘whys’ and ‘hows’ of this approach.
What is ‘Value-based Medicine’?
Value-based medicine emphasizes saving costs and optimizing patient outcomes. To do this, insurance and health providers have to identify the most effective treatment methods to utilize. Predictive models are nothing new to the world of healthcare practices, but as a recent IBM white paper report highlights, with Big Data technologies, there is now major growth potential. Shareable data analytics can create ideal clinical workflows and help index patients at different risk severity levels and determine the best course of action for individuals. From calculating the chances of hospital readmission to predicting progression of clinical conditions.
One of the main goals of event prediction is to reduce as many preventable outcomes as possible. By leveraging big data for this purpose, it’s possible to feed hundreds or even thousands of inputs into risk assessment and regression models to find optimal outcomes and the most cost-effective healthcare plans for patients.
The High Cost of Breathing Unhealthy Air
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Short- and long-term exposure to poor air quality and pollen contribute to a range of adverse health outcomes. In turn, the increased demand for treatment and doctor/ER visits ultimately leads to increased spending from health insurance providers:
The cost of short-term exposure to US wildfires occurring between 2008 and 2012 that led to premature deaths or hospital admissions is estimated at $63 billion; the cost of long-term health exposure was estimated at $450 billion. (NFPA Journal).
Estimates state the total cost to the UK’s public-funded NHS and social care as a result of air pollution exposure could be as high as £5.56 billion for the period between 2017 and 2025.
In a study conducted by Johns Hopkins University of Baltimore, 25 to 30% of those suffering from COPD (contributing to approximately 726,000 annual hospitalizations and over $32 billion in estimated costs) were also found to suffer from allergies, 82% pollen-related. (Source)
How Do Health Payers Reduce Costs with Environmental Intelligence?
Health payers, providers, and patients share a common interest in wanting to manage environmental exposure to prevent symptom flare-ups and disease exacerbation. However, it has historically been difficult to achieve this because the information simply didn’t exist in real-time or at the hyper-local level. BreezoMeter’s health-focused environmental intelligence now solves this challenge.
Healthcare players are rapidly understanding the benefits of accuracy-backed, real-time, and hyper-local environmental reporting for the delivery of preventive medicine and cost-saving in healthcare:
1. Warn Individuals about their Environmental Exposure
By alerting individuals to air quality changes and wildfires at their location and telling them which actions to take, providers limit the risk of symptom flare-ups and preventable doctor visits – saving costs on avoidable treatment and healthcare provider visits.
2. Notifying Allergy Patients Ahead of Time
Pollen forecast information can be used to warn allergy sufferers of location-based pollen increases ahead of time – empowering individuals to limit exposure and take allergy medicine in a timely fashion. By helping individuals better manage their seasonal allergies, both patients and health payers limit the likelihood of worsening symptoms based on environmental triggers, keeping potential health-related costs down.
3. Understanding a Person’s ‘Environmental Risk’
As the links between poor air quality exposure and health are so clear, insurance providers are turning to environmental intelligence for an increased level of understanding about a person’s overall lifestyle and risk factors. For example, a provider may interpret an individual who lives in a highly polluted area differently from one that lives in a maintained clean air zone.
In this scenario, health payers save costs through increased understanding about individual patients, relative to overall population health and environmental exposure over time. By monitoring the correlations between environmental exposure and healthcare payouts over time, insurance providers can more accurately predict the impact of environmental factors on individual health costs and price plans more accurately.
4. Encouraging Healthier Daily Behavior & Engagement
Air quality information delivered at the street level and on an hourly basis offers healthcare players new opportunities to engage their audience and promote healthy living. For example, through companion apps providers can reward customers for choosing cleaner commuting routes and promote brand loyalty.
Cost-saving here comes from increasing the number and frequency of healthy behaviors, discouraging more risky behaviors, and reducing the likelihood of customer churn – keeping individuals as customers for longer.
Covid-19 is Accelerating the Adoption of Value-based Care
The Rise of Telehealth
The US spends nearly 11,000$ on healthcare per capita, far higher than any comparable country. However, COVID-19 has understandably shaken ‘business as usual’, helping to prompt the meteoric rise of telehealth solutions as providers seek to keep hospital and clinic numbers down.
The rapid adoption of telehealth has opened new ways to increase value for patients than ever before, extending to remote monitoring and virtual nurse and doctor consultations in fields that have been mostly in-person before.
Growth in Preventive Medicine in Response to Air Quality
COVID-19 has helped to shine a spotlight on the air we breathe, especially as new links between Coronavirus severity, potential transmission, and long-term exposure to air pollution emerge all the time.
Environmental trends are also increasing the urgency for preventive medicine solutions based on the air we breathe: Worsening wildfires present a public health issue as more people are exposed to toxic smoke, while climate change is serving to lengthen allergy seasons, putting more people at risk from extreme symptoms.
Going forward, expect to see more insurance providers build environmental factors into their models, as payers seek to better estimate environmental risk factors and save costs by alerting customers to poor air quality.