Better Tools Needed to Evaluate Health Care Consumer Engagement Strategies

Consumer engagement has become a health care priority, but it is difficult to evaluate the effectiveness of strategies and organization-level plans developed to achieve that goal.

In a recent blog post for Community Catalyst’s Center for Consumer Engagement in Health Innovation, authors Marc Cohen, Erin McGaffigan and Danielle Skenadore argue that “consumer engagement” itself is a term of art and can mean many different things.

“While the concept appears to have many supporters, how [it] is defined and applied in practice is much less clear,” they wrote. “Moreover, evidence-based strategies for successfully engaging consumers that are linked to clearly articulated and specific outcomes are few and far between.”

Cohen is co-director of the LeadingAge LTSS Center @UMass Boston. McGaffigan is a LTSS Center fellow and founder of Collective Insight, a stakeholder-engagement firm. Skenadore is a research associate at Collective Insight.

Identifying the consumer engagement problem

The authors noted that health care organizations are devoting significant time, money and other resources to consumer engagement initiates but often are unsure what, if any, impact they are achieving. The key problem: A lack of reliable analytical tools.

They pointed to a 2017 survey of more than 300 health plans and providers that reported value-based care and competitive pressures led them to invest in consumer engagement measures. A third of their health care information technology budgets were being dedicated to that goal. But a majority of 800 consumers polled in the same study said the quality of their experience with health plans or providers had remained unchanged or declined.

Engagement challenges on three levels

Cohen, McGaffigan and Skenadore focused on consumer engagement efforts on three different levels: systems, organizations and individuals. The ability to evaluate results on all three was found to be lacking.

They said measurement practices are nearly non-existent in system-level work, which involves making policy. Another problem: Consumers are often under-represented in system-oriented work.

The authors said organizational-level consumer engagement efforts routinely solicit feedback, but the results are unclear. They said even the most comprehensive analysis tools lack “credible evidence” to determine if engagement strategies work.

They said engagement methods at the individual member level were generally better developed and effective. But they typically focused on non-participatory, one-way communication, such as patient outreach and education. This also posed evaluation challenges.

“Ultimately, we need to address this void in measurement tools: Given the investment that organizations are making to improve engagement, it would certainly be helpful to know if greater engagement is leading to the cost, quality and health outcomes that these organizations are striving to achieve,” the authors wrote.

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