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The Social-Validation Feedback Loop

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Recently Sean Parker, the first President of Facebook, issued some harsh criticism of social networks in an interview on the website Axios. He claims they work to exploit “a vulnerability in human psychology” and that those networks will eventually “consume as much of your time and conscious attention as possible.”  He claims the networks do this by creating a system to generate addictive loops that “sort of give you a little dopamine hit every once in a while, because someone liked or commented on a photo or a post or whatever.”

That “social-validation feedback loop”, as Sean called it, is very powerful and used by all of the major social media sites which continue to grow and consume our time and attention. But what if we could take those same techniques Facebook used to grow to over 2 billion active users a month and applied them to something positive, like health education?

Recently, Tom Chamberlain, PharmD, CEO and Founder of EdLogics gave a presentation to the Global Action Summit on the Gamification of Health.  In his presentation, Dr. Chamberlain described various types of gaming technologies, such as Video Games, Mobile Apps, Virtual Reality, Augmented Reality and Interactive Learning, and how they are being used in the medical field

Gaming Technologies

Chamberlain went on to discuss the key principles of gamification including instant rewards, milestones, status and competition and described how a “little dopamine hit” is generated through playing these games and through the use of gamification techniques.

Gamification Principles

Driving engagement and facilitating behavior changes are the “holy grails” of health improvement programs. If we can get individuals, employees, plan members, and/or communities more engaged in understanding and acting on their own health, we can see vast improvements in a population’s health and lowered costs. This is why the area of gamification is so exciting.

EdLogics is applying this “social validation feedback loop” to the problem of health literacy – the major issue associated with poor health outcomes and higher costs. It’s pretty clear that if a person does not understand their health, their health issues, the healthcare system or their health insurance, they won’t be able to maintain or improve their health, select the right provider, adhere to treatment, or more.

These approaches are not just fun and games when it comes to health, they are using real science in an effort to drive behavior change and improve one’s life.

If you’d like more information on the EdLogics platform for your employees, health plan or as a broker/consultant, please use the contact page.

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Fred Goldstein is the founder and president of Accountable Health, LLC, a healthcare consulting firm focused on population health. He has over 30 years of experience in population health, disease management, HMO and hospital operations. He is an expert in population health, care management…read more

The Potential CVS and Aetna Merger

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The healthcare industry, the retail pharmacy industry and in fact lots of industries, were buzzing with the news that mega pharmacy chain CVS was pursuing a merger with Aetna, one of America’s oldest insurers. While the trend toward consolidation in healthcare is not new, a deal this size would be unprecedented in multiple ways. And the combined entity would have far-reaching implications for consumers, for employers and even the US government.

The negotiations are highly confidential, so any details about the deal, or the motivations behind it, are purely speculative. But Fred Goldstein, founder of Accountable Health Inc., offers a unique viewpoint on the merger. Goldstein points to a flaw in the Affordable Care Act known as the Medical Loss Ratio requirement.

“This requirement was put in place as a way to ensure that health plans did not make money by underutilizing medical care.  But it had the unintended consequence of insuring that costs never went down and here’s why.

Let’s assume that a hypothetical health plan offers a product at a $5,000 premium.  Based on this premium, they must spend 80% or $4,000 on Medical Care and the remaining $1,000 goes to cover administrative expenses and profit. At the same time, it’s fairly common knowledge that 30% and possibly more of healthcare costs are associated with waste, fraud and abuse.”

Visit The Health Care Blog for the full story.

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Jerry Gulley currently serves as EdLogics’ Chief Content Officer. He trained at the Culinary Institute of America in Hyde Park, New York and has held positions with Cooking Light, Health, and AllRecipes. 

Preventing Emergency Department Visits With Education

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Hospital emergency departments, as the name implies, are meant to be used for true emergencies. Unfortunately many trips to the ER are not life-threatening and are in fact both unnecessary and avoidable. A study published in 2013 found that only 29% of ER visits reviewed were actual emergency situations. Less than half of those visits that were not an emergency required medical attention but could have been treated in a primary care facility. One in four did not require immediate attention.

Low health literacy leads many patients to the ER when they could have received care at a less expensive setting – like at their doctor’s office or at a walk-in clinic. It’s also known that patients with low health literacy are more likely to make return visits to ERs within two weeks. Some barriers for patients with low literacy include:

  • Not understanding or following doctor’s instructions for managing chronic conditions.
  • Misunderstanding information they find about symptoms online.
  • Not recognizing the importance of proper preventative care.

More recent research, presented at the Society for Academic Emergency Medicine Annual Meeting in Orlando, explored how low health literacy was related to preventable ER visits. The study looked at over 1,200 participants and a total of 4,444 ER visits. Over 10% of the visits were found to have been preventable.

Of the preventable visits, over 60% led to hospital admission. (The average cost of a hospital stay is estimated to be close to $10,000.) When researchers looked at the health literacy of the participants, those with lower health literacy were over twice as likely to have made a preventable ER visit. Having below an eighth-grade reading level was the definition used for low literacy.

The most common preventable conditions leading to ER visits included chronic obstructive pulmonary disease (COPD), urinary tract infections and long-term complications from diabetes.

While not surprising, the study illustrates that patients with low literacy are more likely to make preventable visits to ER and other emergency services. And increasing the literacy of patients can help dramatically decrease unnecessary healthcare costs.

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Jerry Gulley currently serves as EdLogics’ Chief Content Officer. He trained at the Culinary Institute of America in Hyde Park, New York and has held positions with Cooking Light, Health, and AllRecipes. 

14 Smart Ways to Save Money on Healthcare

Drowning in medical bills? These tips can help.
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My wife and I are generally pretty savvy shoppers. Well, she is – and I get the benefits. She clips coupons, looks for bargains, and buys certain items only when they’re BOGO (buy one, get one free). Why pay full price when you don’t have to?

In healthcare, we’ve rarely had that option. For a long time, the cost of a healthcare treatment or test didn’t even come up until after the bill came. For most of us, health insurance covered the majority of the cost, and our responsibility was limited to a small co-pay.

That’s changing now as the trend toward consumer-directed health plans (CDHPs) grows, and many of us are spending more out of pocket. In 2016, nearly one-third of all employer-sponsored health plans were CDHPs.

As a result, patients are getting choosier. And as the healthcare system continues to evolve, we need to be more proactive. We need to get smart about where to go for care, how to pay, and how to prepare. These tips can help:

How to Save

Your primary care physician is likely your go-to source for most of your healthcare needs. But there are times you may want to consider these alternatives:

  • Some health plans offer telemedicine, which can give follow-ups, help manage chronic conditions, monitor medications, and provide other clinical services all through electronic communication. Depending on your condition, telemedicine can save you both time and money.
  • For problems that are serious but not life-threatening, such as a sprained ankle, bad cough, or fever, urgent care centers can be a good alternative to the emergency room. Be sure the center is in network for your insurance plan. Co-pays for visits should be listed on your insurance ID card or on the plan’s web portal or mobile app.
  • Websites like FAIR Health may help you figure out the costs of some medical care.
  • Teaching hospitals in some communities may offer discounts for certain medical needs.
  • For prescription drugs, ask your doctor or pharmacist if generic versions are available. They’re often a fraction of the cost of a brand-name medication.

How to Pay

Using credit cards to pay off big medical bills may be tempting, but it can add up to mountains of debt. Make sure you know your options:

  • If you have a high-deductible health plan (HDHP), you can open and put money in a Health Savings Account (HSA) with pre-tax dollars. Many employers will contribute to your HSA as well. HSAs can be used for a wide range of healthcare expenses – from sunscreen to X-rays – and the balance carries over year to year.
  • With Flexible Spending Accounts (FSAs), you can use pre-tax dollars to pay for most healthcare-related products and services. Some FSAs operate on the “use it or lose it” rule, meaning you must spend all the money in your account by the end of each year or lose any remaining balance. There are exceptions, though, so check with your employer.
  • Hospitals and certain providers may consider payment plans for larger expenses. Be sure to ask about them if you anticipate big bills or find yourself with higher-than-expected costs.
  • Finally, keep in mind that most healthcare organizations will take into account your ability to pay. You may be able to negotiate some expenses, or they can suggest programs that can help out.

How to Prepare

Here’s the key to saving on healthcare: Do your homework. Costs for tests, procedures, and treatments can vary widely, regardless of where you live or what plan you use, so take these steps:

  • Choose the right plan based on your age, health history, and the care you expect you’ll need.
  • Be sure your provider is in-network.
  • Talk to others who’ve been through similar medical issues or procedures, and learn from their experiences.
  • Ask questions – not only about what to expect from the service, but about how much it will cost. Healthcare is one of the most expensive services we purchase, so don’t be shy about asking questions whenever your doctor recommends tests or procedures, or prescribes medications.
  • Be proactive: Practice good health habits, eat smart, exercise, and take advantage of free screenings, flu shots, and other preventive steps.

Paying for healthcare will never be like shopping for groceries. But as things continue to change, there will likely be more and more similarities – and in time, smart shoppers will get better deals.

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Frank Hone is a consumer marketing strategist who focuses on the business impact of engagement strategy for health and well-being improvement… read more 

Objective Versus Subjective Health Literacy

What You Know Versus What You Think You Know
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Mr. Garcia is a 65-year-old pre-diabetic patient. He’s just retired and moved to a new area. At his first visit with his new PCP, a nurse asks Mr. Garcia if he can usually understand a doctor’s instructions. “Absolutely,” he says. “I understand perfectly.”

But does he really?

Situations like this highlight the importance of distinguishing between two kinds of health literacy: subjective and objective. If doctors measure just one kind of health literacy, they may miss something.

Better understanding might allow Mr. Garcia to act sooner. He might get treatment or make healthier choices — and avoid diabetes. Smart changes now could mean avoiding the pain and expense of a chronic health problem later.

That’s why, when possible, it’s best to measure both subjective and objective health literacy.

Subjective Health Literacy: What You Think You Know

Subjective health literacy measures how health literate someone thinks they are. You can gauge subjective health literacy with questions like:

“How confident are you filling out medical forms by yourself?”

The nurse in the story above was measuring subjective health literacy, albeit informally. The questions don’t have objectively correct answers, which may be less threatening. It doesn’t feel like a test you’d take in school.

But there are disadvantages too. Patients often overestimate their own ability. And they may tell you what they think you want to hear—they may report strong health literacy even if they rarely understand or act on what a doctor tells them.

Objective Health Literacy: Measuring What You Know

A patient has to actually demonstrate knowledge to measure objective health literacy. One popular tool (The Newest Vital Sign) shows the patient a nutrition label, and asks how many calories they’d get by eating multiple servings, as well as other basic questions.

With objective health literacy, you know patients aren’t overestimating their own ability, or telling you what they think you want to hear. But because there are right and wrong answers, some patients feel like they’re back in school, and the memories aren’t always pleasant.

EdLogics’ Approach to Measuring Health Literacy

EdLogics measures — and strives to cultivate — both kinds of health literacy. We use only validated surveys. When we measure objective health literacy, we present questions a little differently, making them fun, adding graphics, and incorporating great design. It’s all gamified. You can win cash drawings — the more you play, the more likely you are to win.

Users do not feel like they’re back in school.

By measuring both types of health literacy, we put ourselves in the best position to understand how health literacy changes over time. This can help us further refine our suite of health literacy education games, and be even more effective in our mission to improve health literacy.

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Jerry Gulley currently serves as EdLogics’ Chief Content Officer. He trained at the Culinary Institute of America in Hyde Park, New York and has held positions with Cooking Light, Health, and AllRecipes.