Health plan measurements that matter

I firmly believe we all have the right to live our best lives regardless of the circumstances to which we are born, live, work and age. While this statement may seem lofty, I believe we can and will see major progress toward realizing it in our lifetimes.

As the president of a nonprofit health plan, what I find particularly exciting is the unique and important role health plans have in making this vision a reality across our state and country.

I view this as a remarkable opportunity for Priority Health. However, to advance and ultimately fulfill the vision will require adopting a new orientation. It will require infusing community impact and health equity into every element of our work. An underexplored, important component of this reorientation will be how we strategically leverage data to drive progress.

Truth be told, I am a self-admitted data geek. Data highlights problems to solve and opportunities to realize, and ultimately holds us accountable. For far too long, health plans have lagged many industries on how to leverage data to improve the health of our communities. Much of our industry’s orientation has been on how we run our business, often missing why we run our business.

At Priority Health, we are beginning by gathering a baseline. We have partnered with Socially Determined, a vendor that utilizes more than 400 data points to create a risk profile. We can now create a personal risk profile for every Medicaid member over the age of 18. We have also partnered with SameSky Health to make outbound social needs data collection calls to 2,000 members per month. We are proud to be the first payer in the state to incentivize providers who collect information from members about the current state of their social needs such as access to healthy foods, childcare, transportation and more.

We have started putting that data to good use to identify where differences in our outcomes exist and build out tailored interventions to close the gaps.

One of my favorite examples is our Asthma Home Intervention Program. Data pointed to a problematic overuse of emergency rooms among asthmatic individuals in Kent County. We worked with community partners to tailor and implement interventions for specific households over an 18-month period, including education and home improvements such as addressing mold, lead, pests, and draftiness. The program resulted in a 61% decrease in overall emergency department visits and a 25% decrease in each member’s medical spending.

I view this as a critically important and deeply meaningful program. If we strategically and thoughtfully leverage data, we can implement programs that make members and their families healthier.

I am also excited about our role as the official state health sponsor of the National Fitness Campaign in Michigan. We began this partnership in 2019, and we’re on track to build 45 free, zero-barrier accessible Priority Health Fitness Courts? statewide by the end of 2025. Priority Health Fitness Courts? will reach approximately one third of Michiganders and provide free access to wellness opportunities within a 10-minute bike ride from where the courts are built. We’re not only tracking data on access, but we’re also tracking usage, calories burned and correlation to weight loss.

Priority Health Fitness Courts? are a great example of the types of programs that will be critical to realizing the vision of the Department of Health and Human Services Healthy People 2030 project. Healthy People 2030 sets data-driven national objectives to improve health and well-being over the next decade. The objectives acknowledge that the neighborhoods people live in – the built environment – can have a major impact on their health, and there is importance in creating neighborhoods and environments that promote health and safety.

Ultimately, we are in the business of doing good for people.

Ultimately, we are in the business of doing good for people. These programs are just a few examples of how we are working toward making an impact. Progress won’t happen overnight, but it is happening. I look forward to sharing our updates as we continue to focus on making Michigan communities healthier.?

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