When individuals struggle to navigate complex health systems, health outcomes decline while costs of care rise. Will digital solutions that help customers manage their chronic conditions and stay healthy prove to be the fix? Healthcare veteran Steven Auerbach, who recently joined Sidekick Health as the company’s Executive Chairman, recognizes digital therapeutics (DTx) as an opportunity US payers should seize.
There is an old saying: health, wealth, and happiness. Without health, wealth doesn’t matter, happiness doesn’t exist, and quality of life is reduced. Even despite the latest advances in medicine, managing conditions or integrating prevention into everyday life is challenging for many people. Why? According to Auerbach, it’s because they don’t get the support they need when they need it most.
What should I be doing to achieve my optimal health? Am I on the right track? Are there other things I could be doing to improve my health? These unanswered questions and doubts lead to uncertainty and confusion, becoming, for many, an obstacle to health.
Today’s empowered consumers want to proactively co-shape their help, get involved in the therapy, keep the chronic disease under control, and do something more than just taking a pill. Over the past few years, there has been an evolution in patient expectations where the “guide me and deliver results and value for my time and dollars” approach is becoming dominant. And it’s time for payers to adjust to this massive socio-behavioral shift.
“The market is changing,” Auerbach emphasizes, “and the US-based payers need to evolve their products to deliver the maximum value to the consumers they are caring for.”
Is there anything else I can do for my health?
Other industries have already leveraged technologies to guide customers toward results. The digital transformation has been quickly embraced and widely welcomed because people gravitate to the things that they understand and that make their lives better.
“Do you remember what airplane travel was like a decade ago?” Auerbach asks. “First, you had to call or go to your travel agent, and rely on their expertise to book the ticket. Then, before departure, you had to check in to get a boarding pass and bag tags. Nobody informed you when the flight was delayed or canceled. Now, just one app accompanies you in all of these steps, saving your time and making it all easier.” He then goes on to outline similar changes that the tourism, banking, retail, and entertainment industries have been going through.
Fortunately, healthcare is also catching up with the ability to streamline the experience and personalize the communication with individuals. The opportunities to increase the value of the care being delivered are enormous.
For example, healthy people with no major disease could get advice regarding fundamental health determinants: weight, physical activity, nutrition, and sleep. It’s not about providing raw data or numbers but a complete personalized experience embedded with gamification. Patients diagnosed with a chronic condition could get more than just a pill—they could get comprehensive instructions explaining how to continue living a good life by tracking the disease and following evidence-based guidance.
“Patients get standardized information that often doesn’t match their individual situation,” Auerbach explains. “Therefore, many individuals hunt online desperately for relevant help. This is where Sidekick comes in with personalized support, guiding you to the best outcome, helping you to navigate through the bumps you are going through.”
Auerbach also believes that having someone to guide people through chronic conditions and track their progress is where the technology and the advancements have the most significant impact.
Optimizing health to break the 5/50 rule
US payers have significantly improved their ability to serve their populations. They’ve been improving the scalability of preventive care, annual screenings, and health risk assessments. However, Auerbach is quick to point out that what they are still struggling with is the 5/50 challenge.
He goes on to explain: 5% of the population—patients with chronic diseases—drives 50% of the costs. Most people in this category have multiple conditions that they have to navigate through. For that part of the population, the care plans should be focused on supporting customers to get the best possible health outcome. Digital therapeutics fit perfectly here, as it brings individuals closer to their physicians, motivates them to adhere to their drug therapy, and shows them how to improve their health.
“I think this is one of the top priorities of US payers: connecting with the consumer population that they are responsible for, guiding and optimizing their health—in a way that engages the consumer,” Auerbach asserts.
He goes on to explain how digital therapeutics align well with the transformation toward value-based care where the physician gets compensated based upon the results, not the activities or number of patients seen. Especially since medications often have a limited effect, a lot also depends on lifestyle changes and adherence to preventive recommendations. These can be accelerated by introducing DTx: “The role of the payer is to optimize a person’s health, not just to pay claims. People buy a policy that helps them navigate through different medical conditions, and minimize health risks. The payer is there to advocate for them, support them, coordinate therapies, treat the person holistically, and guarantee proper medication accelerated by behavioral change. All of the components of care can be put together by adopting digital solutions.”
The payers tailor their strategies to digital transformation
Healthcare stakeholders need to update their products to deliver the maximum value to consumers. Looking at the health system’s transition and considering the rapid development of digital technologies, Auerbach advises US-based payers to become early adopters of digital therapeutics. It’s an investment in health and their future competitive advantage.
“If your offering doesn’t follow the growing expectations of the consumers, you risk being left behind,” says Auerbach. “If you don’t start addressing chronic diseases, you risk your costs growing out of control, decreasing customer satisfaction, and reducing the health for your population. As people are getting more health-literate, they are shopping for healthcare based upon what they think will give them the greatest value. We see many health plans rapidly evolving their offering to include digital therapies, digital engagement, support, and personalized care. DTx fits into that solution set.”
There is one more argument that Auerbach highlights: the healthcare system is becoming more connected than ever before. Coordination between the providers, doctors, nurses, payers, pharmaceutical companies, employers, and consumers is improving. Patient-generated data is gaining importance, allowing them to track health and well-being in real-time. Thus, payers should be rethinking their role. What will soon matter most are close relationships with customers based on trust and co-creation of health.
The new model of care consists of guidance, feedback, measuring results, evaluating treatment and prevention planning according to the progress, and rewarding the outcomes. But to implement a new approach, digital solutions are essential so that customers are continuously covered with care—not once a month or a quarter when they visit their doctors.
Integrative, software-driven therapies
“There is so much opportunity to continue to streamline the US healthcare system. Digital therapeutics like Sidekick Health help people to unlock additional high-quality years of life. Therefore, they are also strategic for the payers. Hopefully, one day we will be able to calculate the ‘added healthy years’ precisely by implementing DTx-driven personalized treatment or prevention plans.”
Auerbach continues, transitioning the conversation back to Sidekick Health.
“At Sidekick, as we continue to grow and scale, we are impacting the consumers that have trusted us to optimize their well-being. We are co-creating their better lives. In practice, it’s adding value that matters for all of us: more time with the grandkids or grandparents, for things we love to do, and to enjoy life; and less time on struggling with chronic conditions.”
We are heading to a future where drug and digital therapies are correlated based on the best outcomes for the consumer. By aligning market strategies to technological evolution, pharmaceutical companies and payers can become accelerators of digital healthcare transformation.
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