How can managed care organizations promote preventive care?

Following international health calender, services can be offered at institutions at reduced costs : Like world heart day-cholesterol check ups Diabetes day -blood sugar chek ups October- breast cancer month -mammograms TB day - Lung x rays Of course the marketing department have to advertise the events to motivate the community to take part in the check ups.

In my opinion, cost and access are two major factors to consider. By lowering financial obstacles like copayments, deductibles, there's a chance to make preventive care services more accessible within MCOs. This could motivate more people to go for screenings, immunizations, and health assessments, promoting early detection and intervention. Then we need to talk about access. Blending improved access along with added incentives encourages a proactive healthcare approach, possibly cutting down on the long-term medical costs linked to untreated conditions. And yes, it's also important to strike a careful balance to ensure that reducing costs doesn't put the financial stability of MCOs at risk or compromise coverage for other crucial needs.

Let’s get real! The best doctors in the world today run cash practices and no longer deal with insurance companies. That’s because they fix people’s problems and deal with highly motivated patients that want to get well and are willing to pay for it.

Financial incentives programs often yield temporary patient behavior changes and diminishing motivation. A more sustainable approach entails non-financial incentives, aligning providers' values with organizational outcome goals, and employing generative augmented technologies for Clinical Decision Support and interoperable data systems to foster wholistic evidence-based practices. In an Alternative Quality Contract by BCBS of Massachusetts, a blending of financial and non-financial incentives demonstrated a more effective path of enhancing healthcare quality and efficiency. To achieve lasting improvements, monetary incentives must be part of a broader strategy focused on motivating and sustaining behavioral change.

In my experience people should make aware of the healthy lifestyle and combined with regular food health check ups as preventative measures should be taken.

In the current direction of the pay for performance approach, I think empowering healthcare beneficiaries to speak up and planning for a comprehensive healthcare educational program may be a magical solution to effectively establishing the concept of preventive care. The unprecedented evolution of communication means made it easier to target various population segments according to the desired public health objectives.

Bringing focus back on preventive health with a holistic view of the individual’s health (one at a time) is in benefit of everyone. Managed Care Organisations (MCOs) have a responsibility towards their members and now there are numerous tools and channels possible for this. Some issues remain e.g. there are just so many digital apps, that look at one condition at a time, without a view of the individual as a whole person. Also, it is not a ‘one size fits all’ solution. In my view, convergence towards preventive health with holistic approaches, and personalised to specific user groups is the way to go.

In my experience, a proactive approach by MCOs in educating and engaging enrollees about preventive care can make a significant difference. Personalized reminders and alerts about upcoming or overdue preventive services are effective, but combining these with educational content can enhance their impact. For instance, sharing simple yet informative articles or videos on the importance of regular health screenings or vaccinations through various platforms like social media or apps can increase awareness and motivate action. Involving enrollees in setting their own health goals and providing consistent support and feedback can also foster a sense of ownership and commitment to their health

What if we (as healthcare professionals) have forgotten what prevention can be? As a doctor, my training 40 years ago taught me that disease prevention has three tiers: 1. Primary Prevention: I’m fit and healthy and want to stay that way, or get fitter and healthier (It’s difficult to get people to engage at this level - it feels too far away until health deteriorates) 2. Secondary prevention: early intervention. Things have started to slip. Maybe I’ve a bit overweight, a bit of blood pressure, a bit of cholesterol or blood sugar and I want to reverse that 3. Tertiary: I’ve had a heart attack. Stroke. Cancer. Diabetes. I want to live my life to the full despite that The real opportunity is secondary prevention. Empowering behaviour change.

I think that partnering with primary care providers, community organization, social and religious organizations to promote preventive care work best. In Muslim and Roman Catholic community, message from religious leader to access preventive care works best because religious leaders have lot of sway in these communities. As well as health promotion posters in public transportation, schools, NEWS media, TV, social media must be used to deliver messages to each section of society.

MCO should work out plan to work with influential people,NGO,Religious leader, political people, academic organisation to give input to the community for preventive measures like councelling, vaccination,life style diseases knowledge,NCD screenshot etc.

MCOs should be community centred with enrollees from the community for easy communication and understanding of the community culture and people's behaviour

MCOs play a pivotal role in promoting preventive care through strategic partnerships. Collaborating with primary care providers ensures adherence to best practices, guidelines, and fair reimbursement for preventive care services. Engaging with specialty providers enables a holistic approach, addressing preventive care across various health domains. Networking with community organizations facilitates outreach to diverse and underserved populations, addressing social determinants of health. By employing these strategies, MCOs not only enhance individual well-being but also contribute to elevating the overall quality and efficiency of healthcare.

Este tipo de parceria também me parece algo extremamente interessante, principalmente, quando se fala de população de baixa renda. Mesmo que o OCM seja uma organização particular, poderia se beneficiar do marketing positivo ao prestar serviços gratuitos à população de baixa renda.

To ensure patients adhere to preventive care, Managed Care Organizations must tackle barriers head-on. From food insecurity to medication costs, addressing these real-life issues can dramatically increase compliance. Key factors influencing patient engagement include ease of access, competing life responsibilities, financial constraints, and emotional and cultural considerations. Proactively supporting patients in these areas isn’t just good practice—it’s a cornerstone of effective managed care.

Least that could be offered in underprivileged populations is point of care vital signs, BMI calculations Hb esp in ladies, RBS, HbA1c, Lipid profile, urine albumin and of course dipstick spot drug screen.

I think before any organization plan for preventive care of employees, they need to communicate with employees in groups and one to one via their team leaders who are already communicated by Hierarchy. Once an open communication is established then depending on the various responses of employees, a proper preventive care can be planned and implemented. I feel it's win win situation. Actually when we go with team approach everyone feels that they're part of decision making and then we can whole hearted involvement of everyone.

There are some areas of Goalpara district which are having resistant groups of people for vaccination.They don't believe in vaccination as a preventive measures.Hence it is very difficult for front line health workers to vaccinate those people.

Most organisations have staff newsletters or websites - primary prevention ( to quote my doctor colleague) starts with simple advice - like adding an extra vegetable with your main meal, taking the stairs rather than the lift, dancing in the kitchen - simple steps that make a big difference. Make simple health checks accessible - bring a nurse in to do BP and BMI checks during lunchtimes for a week. It's not rocket science - nor is it particularly expensive (I'm prepared to negotiate costs!)