At the 2016 Consumer Electronics Show (CES) in January, UnitedHealthcare launched Solutions for Caregivers, an online program that provides resources for caregivers and their family; personalized information, a discounted marketplace of products and services and care circle community for ongoing support.

UnitedHealthcare is addressing the evolving needs of a large population of caregivers. According to the Caregiving in the U.S. 2015 report by the National Alliance for Caregiving (NAC) and AARP Public Policy Institute, an estimated 43.5 million adults have provided unpaid care during the prior 12 months,  34.2 million (79%) offering care for an adult age 50+.

“Many caregivers are searching for relevant resources but often don’t know where to start. Solutions for Caregivers addresses the needs of family caregivers through case management services and online resources that help caregivers more effectively care for their loved ones,” shares Dr. Richard Migliori, EVP and Chief Medical Officer, UnitedHealth Group.

Caregiving Burden

According to the Caregiving in the U.S. 2015 report, caregivers spend an average of 24 hours each week helping their loved ones. Many caregivers experience their own physical, emotional and financial strain as a result of their caregiving role. Half of the caregivers indicated “they had no choice in taking on their caregiving responsibilities,” and 40% report being in high-burden situations. When asked about their health, 17% said ”it is fair or poor”, compared with 10% of the general adult population.

Many caregivers (60%) admit they had to make a workplace accommodation, such as taking time off or reducing work hours. On average, caregivers assist with “4.2 out of 7 Instrumental Activities of Daily Living (IADLs),” including transportation, grocery/other shopping, or housework. Most caregivers (84%) report an interest in receiving more information such as “keeping their loved one safe at home” and “managing their own stress.”  

UnitedHealthcare has conducted extensive research with family caregivers to understand their challenges around caring for a loved one. Vidya Raman-Tangella, M.D., head of UnitedHealthcare’s Innovation Center of Excellence, explains, “We heard that each journey is a ‘unique’ and ‘personal’ experience. Family caregivers are often not prepared and do not know where to begin, which causes anxiety. Some caregivers need support recognizing ‘what is good’ when making decisions for their loved one. Finally, UnitedHealthcare heard that the family caregivers did not want to feel alone and wanted to work together with others in their care circle.”

CAREGIVERS MARKETPLACEVidya and her innovation team set out to define a solution based on these caregiver needs. The team started with a portal front end to house a set of tools to help caregivers:

Personalized Information – educational articles and videos that are tailored to the specific medical issues and needs of the care recipient and caregiver. UnitedHealthcare’s articles support the topics requested by caregivers (i.e. safety, stress). Users can save an article for future reference or share with others (i.e. siblings, health coach and clinician).

Marketplace – set of vetted discounted products and services to support the caregiver and care recipient’s conditions and challenges. Product categories include “assistive products”, “home monitoring”, “home safety” and “medication management.” Service categories span “financial”, “in-home care”, “nutrition” and “transportation”. Regarding “nutrition,” caregivers can order meals that are tailored to the care recipient’s health condition (i.e. low salt, low sugar). UnitedHealthcare’s marketplace is designed to support caregivers for activities they undertake on a regular basis, including transportation, shopping and house work. 

One service option is for a “Care Manager” who can help the family plan or respond to care recipient/caregiver needs, via online, phone or consult (secure messaging). Some caregivers may have a health plan benefit that covers the care manager service, while others have the option of paying the hourly fee.

Currently, UnitedHealthcare has mostly national companies and a growing number of regional and local offerings in the marketplace. Based on the care recipient’s zip code, there may be a national service provider such as CareLinx, which offers services in the specified geography.

Community Support – centralized place where caregivers and friends of a loved one can connect, share insights and concerns (i.e. how does mom look today), add and view medical appointments & meetings on a daily/weekly/monthly calendar, post and assign tasks (i.e. a ride to the doctor’s appointment) and access a library of documents such as medication lists, doctors list, health records and a living will. The solution serves as a repository of this information, however there is no integration with the EMR or any clinical information 

Caregivers can also invite others, such as clinicians and in-home caregivers, and enable them to securely access information and communicate on a common platform.

Although other companies promote online caregiver offerings today, UnitedHealthcare has designed a 'personalized caregiver solution'. During the sign-up process, the caregiver creates a profile by responding to set of questions about the care recipient; relationship, age, zip code, conditions and challenges. The caregiver also indicates their own health conditions and challenges. 

For example, when family caregiver Carla responds that her 86-year-old mother has hypertension and diabetes and is dealing with mobility issues, and she (the caregiver) is experiencing depression, Carla will see articles, videos, products and services that are relevant to both of their needs.

Caregiver Solution Pilot

UnitedHealthcare is providing the Solutions for Caregivers program to large employers at no additional cost for employees to access the online services. As of January 2016, Solutions for Caregivers is being promoted to over 1 million employees. Currently, Solutions for Caregivers is also accessible to the public. For people using the employer-sponsored version, the company can cover the costs associated with care management services, enabling caregivers to access more holistic support. In comparison, people accessing the consumer site, or instances where the employer has not purchased the additional care management services, can pay out of pocket for these resources. In both versions, caregivers can access customized content, shop from the marketplace, and use the myCommunity resources.

UnitedHealthcare has received positive comments about their Caregiver solution, that it “saves time” and they would “recommend it to other caregivers”.  To date, UnitedHealthcare has also noticed that many users are in the early stages of caregiving.

Future Solutions for Caregivers

“While it will take the rest of 2016 to build the volume of users, we will continue to grow our marketplace through strategic partnerships with product and service companies. We are especially interested in technology solutions for caregivers”, shares Dr. Vidya Raman-Tangella.

UnitedHealthcare is planning to leverage all customer service touch points to identify caregivers who are currently moving along the care journey or will be on the journey soon as potential users of the solution.

“Throughout the year, we will learn how this program is delivering value to caregivers and care recipients. With Boomers turning 70, we will be particularly interested to see how our offering will be used to support the boomers as they retire as well care for their loved ones”, explains Dr. Raman-Tangella.

“This program and others from UnitedHealthcare are making it easier and more convenient to people to take charge of their health and the health of their loved ones. By using technology and personalized resources, we are helping people to live healthier lives”, Dr. Migliori concludes.

Technology plays a vital role in Shared Decision Making. Join me as I lead this dynamic panel session and learn how you can leverage tools for improved patient centered decisions.

• Piloting and evaluating SDM tools in the Patient Centered Medical Home to drive physician- patient collaboration for better outcomes
• Leveraging a mobile decision support tool to effectively educate consumers and enable them to evaluate their care options anywhere, anytime
• Discovering and defining a Shared Decision Making opportunity to empower and engage seniors and their families

Moderator:

Sherri Dorfman, MBA
CEO, Consumer eHealth Engagement Specialist, Stepping Stone Partners

Panelists:

> Kyra Bobinet, MD, MPH, Head of Senior Care Solutions, Aetna Emerging Business Group

> David C. Judge, MD, Medical Director, Ambulatory Practice of the Future, Massachusetts General Hospital

> Zev Lavon, MBA, PhD, Director, Enterprise Solution Architecture, CareFirst BlueCross BlueShield

Join me and my panelists at the World Congress Shared Decision Making Conference. 

Last week, I attended Mass Technology Leadership Council’s event on the Emerging Technologies for the Silver Tsunami: Aging in Place through the use of Integrated Technology.  The room was packed with interested stakeholders from HIT technology companies, hospitals, home health agencies and senior living communities.

This is one of several events across the country focused on opportunities that will be brought in with the new waves of seniors.

Beginning in 2011, the oldest of the 78 million baby boomers will turn 65 years old. According to the Stanford Center on Longevity, the "number of older people (age 65 and over) will double over the next 30 years, from 40 million to 80 million, and the percentage of older people in the population will increase from 13% to 20%".

Given the size of this new segment of seniors, their education, affluence and comfort with technology, they will have a powerful impact on healthcare delivery, health plans and aging services.

Riding the Waves:

Leveraging my extensive consulting experience and knowledge about elder care technologies, I have defined five requirements for HIT solutions to meet the needs of seniors, families, caregivers and  the care team.

1. Extending Solutions for Care Management

“I want my mom’s doctor to know what is really happening when she is away from his office”.

Through acquisition and partnerships, companies are combining their “point solutions” to bring new capabilities to seniors and their care circle. HIT suppliers are also proactively seeking ways to tie their solutions into the EMR and Health Information Exchange to bring needed insight to the clinician and support the  medical home care team.

2. Expanding Solutions across the Care Continuum

“I do not want to have to purchase, learn and manage all different technologies as my father ages.”

There is an opportunity for health information technology firms to design their solutions with a set of capabilities that can be turned on as the senior requires the support. Considering the burden of the adult children and caregivers, the solution for this market will meet the needs of seniors across the care continuum; preventative, acute, chronic and long-term.

3. Guiding Care Decisions

“We are all taking turns caring for my father and we are exhausted since his health is deteriorating each day.”

Most of us have access to calendars and communication  technologies which we can use for personal reasons. The problem is that we do not know what to expect each day and find ourselves reacting instead of planning for the care of our loved one. When we have a few minutes, we call our friend who just went through this with her mom. Think about how social networking can be leveraged to help families anticipate, plan and make the best decisions with the guidance of experts and other experienced caregivers.

4. Supporting Service Delivery

“I need to know what our caregivers are observing and be alerted when mom needs additional care.”

Whether they are busy raising their own families or living in another state, adult children struggle to care for their elder loved ones. Professional caregivers including home health workers can use technology to record observations of daily living and engage in shared decision making with the family.

5. Supporting Self -Management

“My dad needs to be able to manage this diabetes on a daily basis”.

With the shortage of health care professionals, older consumers need to take care of their chronic conditions and understand how to make changes when they run into many different situations common to their condition. Technology can serve as an enabler by reminding the senior to take medications and perform certain behaviors, tracking these activities, educating them what to do when these activities are missed, monitoring their vitals  and alerting caregivers when problems arise.

Getting Ready for the Silver Tsunami:

As you define/refine your own product strategy for the senior market, think carefully about the steps you will take. The senior market is made up of many different “sub-segments". It is important to identify and understand how these sub-segments differ in their needs, behaviors, technology usage and preferences. This research will provide the insight to guide your product development to meet the requirements of your target audience(s). 

How can you prepare for the Silver Tsunami? Learn more.

Since returning from the Healthcare Unbound Conference in San Diego earlier this week, I have been asked  what has changed in the past year.

In his opening remarks, my colleague Vince Kuraitis, Principal of Better Health Technologies talked about the progress we’ve made with the technologies and experimenting with different business models, but the focus now is on the “value network”.

Steps Along the “Value” Brick Road

During the conference, one clear theme was that value is determined by the recipient and can be used to attract and engage consumers.

How can your organization create and lead with value? Here are the key steps which begin by identifying…

Step 1)     Who?

Consider how much your organization deeply understands the needs and behaviors of your target audience (Notice that I did not say understands the consumer’s feedback on your offering). This perspective is essential before you can define, develop and deliver value which is compelling to your target consumers.

Many companies use segmentation to focus in different groups of consumers and understand what each group values.

Several speakers mentioned segmenting the senior market. After all, the active 68 year old male is not the same as the 78 year old male trying to manage his health and the health of his 98 year old mother who happens to live three states away.

Within the corporate wellness market, we heard that employees have different motivations. Some employees are eager to participate in a company- wide competition tracking their activity weekdays and weekends, while others are interested in socializing at lunch time with their Walking Group. Employers have an opportunity to offer a set of programs with online tools to meet the needs of these different employee segments.

Step 2)  What?

After understanding the different segments of your target audience, it is important to think about ways you can bring value to each of them.

Liz Boehm, Principal Analyst at Forrester Research, discussed the “Four Pillars of Aging in Place” which included health, safety, connectivity (e.g. friends. family and community) and contribution (e.g. meaning/purpose).

Most companies in the senior market focus on health and safety, which happens to be the “stuff that people wish they did not have to think about”. Through research, Forrester has learned that the other two areas, to be connected and to contribute, are actually the “stuff that people want”.  These are two areas can be used to engage seniors in a way that is meaningful to them. Is this the consumer’s desire for “meaningful use”?

Step 3)  How?

Gordon Norman, Chief Innovation Officer at Alere challenged us with “Now that the we’ve unbound healthcare, who will put it back together?”

Think about the value network and the role that your company can play.

You may choose to partner to meet all of the needs of your target audience. With technology standards in place, you can design your product to connect in with a larger solution.  

Or you can lead the way and take on the “aggregator” role, building a hub to service the consumer/member/employee/patient. By becoming the aggregator, your company has an opportunity to deliver more value through data and analytics. Consider the holistic view that you can share, enabling your users to make better decisions.

I will leave you with two questions to consider. Where is your company on the “value” brick road? How far are you willing to go?