Self-reported health confidence predicts utilization

July 5, 2016 / By L. Gordon Moore, MD

Achieving Triple Aim outcomes is more likely when interventions reach people who are likely to have better outcomes because of those interventions.  This has been described as Impactability:

“[B]y stratifying populations according to each person’s risk and anticipated response to an intervention, health systems could more effectively target different preventive interventions at particular risk strata.”

Working with Iowa Medicaid Enterprise (IME), we have been looking into the relationship between patient self-reported health confidence and utilization.  IME has a health risk assessment in place that asks individuals to report their confidence in self-management.  It turns out that self-reported health confidence is predictive of utilization (table below) and it is amenable to brief interventions.

*Adjusted for age, sex and total illness burden

Judith Hibbard et al demonstrate the same in a March 2016 Health Affairs study.

The health confidence/patient activation score is a powerful tool for identifying impactability:  specific actions for specific people, where those actions have a greater chance of leading to Triple Aim improvements.

L. Gordon Moore, MD, is senior medical director for Populations and Payment Solutions at 3M Health Information Systems.