The human brain is a marvel, but it does a pretty lousy job of weighing long-term hazard avoidance versus immediate gratification. C’mon, if we were really thinking clearly about consequences, would anyone start smoking? Finish the entire bucket of Kentucky?
But what if someone gave you money to put down the cigarette? Ah, that might change things.
Achievemint is betting on it. The startup app, part of a platform developed by Activity Exchange Inc., awards points for behaviors like a gym workout or nutritious food choice that can translate directly into merchandise or even cash. The platform has some 170,000 users. Achievemint gains by aggregating data anonymously for customers.
The company’s end target, though, is insurers, who stand to gain from improving preventive behaviors now that the Affordable Care Act put an end to pre-existing condition restrictions. In this scenario, users accrue discounts on their insurance premiums of up to 30 percent.
Mikki Nasch, Achievemint’s CEO, says most insurer wellness programs as yet have a poor track record of inspiring behavior change over the long run, with little research as to what actually motivates an audience and a general lack of truly targeted messaging. Instead, Achievemint aims to push age- and language-appropriate information relevant to a user, marketing health as a product one might actually like to buy.
Nasch dismisses gadgets and group competitions as interventions one might flirt with, but rarely marry.
“The whole notion of gamification and health undermines the intelligence of the consumer, to be frank. We don’t all rush to a reward portal every day to see how we’re doing against our five friends,” she says.
Money in one’s pocket is a different story.
“The way the ACA is written is very smart, because it incentives the payers to incentivize their populations. Regardless of what you want to do as a payer you’ve got to give those discounts intelligently, because if you discount the wrong 30 percent you’re going to lose your shorts,” Nasch says.
Patricia Meisner, co-founder and CEO of ActualMeds, also bemoans the difficulties of engaging patients.
“Today, there’s not a strong payment model or market model where consumers are used to paying for their own healthcare. They’ll buy their own running shoes but they won’t buy their own healthcare management tool,” she says.
Care managers, though, have all sorts of reasons to look for help, from avoiding risks to better outcomes and reduce costs. To those ends, ActualMeds is a web-based platform that helps them collect patient data and manage medications for those with chronic diseases. It provides medication reconciliation on demand at point of care and seamlessly combines medication information from the electronic health records, prescription claims, and structured patient interviews.
The company began life as NIH-funded research at the University of Connecticut, focusing on Medicare’s high-risk patients with seven or more medications to manage. Medicare’s way of helping ensure compliance involved matching patients with a random pharmacist for review, which brought in less than desirable results and low engagement rates.
“ActualMeds did not set out to disrupt that market model; we set out to change it entirely. You don’t need a clinical pharmacist to do all this. We can do a tool that aggregates the best possible medical history,” Meisner says.
ActualMeds also aims to provide a virtual safety net of reminders for areas that often escape attention, like over-the-counter meds.
“Acid inhibitors are powerful pharmacologic agents, as are antihistamines. And I want to go on records as saying statins will be next. People self medicate with these like crazy. Older patients will take things to help them sleep and they end up falling down. That’s the stuff no other claims database is going to give insight into,” Meisner says.
ActualMeds was part of the New York Digital Health Accelerator program (run by the New York eHealth Collaborative, another TEDMED 2013 Hive company), and recently won the 2014 Venture+Forum contest at the annual HIMSS conference. They’re currently working on a number of pilots on various facets of the platform, including testing its structured interviews for home visits and primary care, with results checked by case managers or clinical pharmacists.
Catalyst is an ongoing series about health innovation, focusing on companies from the TEDMED Hive. For more information and to apply for the Hive 2014, click here.