Thank you for joining us for today’s webinar:
Financial Coaching and Medication Adherence: The Potential for a New Model
The webinar will begin promptly at 12pm CT(1pm ET, 11am MT, 10am PT)
Financial Coaching and Medication Adherence: The Potential for a New Model
June 28, 201712pm-1pm CST
Brought to you by:Center for Financial Security
at the University of Wisconsin- Madison
Financial Coaching and Medication Adherence: The Potential for a New Model
Hallie LienhardtOutreach Specialist
Center for Financial SecurityUniversity of Wisconsin-Madison
• Welcome• Presentations
• Study Overview & Findings• Covering WI Insights• Asset Funders Network Insights
• Q & A • Sign off
Our Presenters
Allison EspesethDevelopment and Operations Manager
Covering Wisconsin
Abby Hughes HolsclawDirector of Membership Engagement
Asset Funders Network
Collin O’RourkeSenior Research Specialist
Center for Financial SecurityThe University of Wisconsin-Madison
J. Michael CollinsFaculty Director
Center for Financial SecurityThe University of Wisconsin-Madison
Sarah WillisProgram Manager
MetLife Foundation
Financial Coaching and Medication Adherence:
The Potential for a New Model
Thank you for supporting this project.
Health Treatments Require Payments in Advance
> Not medical collections
Co-payments
Deductibles
> Uncovered, even if insured
Principle economic problem is moral hazard: consumers will overuse something if they do not pay part of the costs.
If we face some part of the costs, we will be more discriminating.
Upfront Payments Can Discourage Care
Avoid treatment
Delay treatment
Skip treatment
Medications are Common Example
Average prescription drug costs $283 out of pocket
53% of people earning less than $25,000 struggle to pay out of pocket costs
Recent studies suggest out of pocket costs are increasing
Q. How well do households manage their finances as they take on more costs?
A. Some families really struggle.
Diabetes Cardiovascular Hypertension
Diagnosed in the last year $433 $547 $314
Source: 2014 MEPS
Out of Pocket Costs on Average for a Patient with a New Diagnosis
Emergency Room Expenditures More Likely If Report Missing Prescriptions
Source: MEPS 2014
5 times higher10 times higher
0.290.16
0.510.59
0.750.83
0 .2 .4 .6 .8 1Percent
Spending exceeds income
Set financial goals
Good at dealing with finances
Source: National Financial Capability Study(2015).
No Rx cost problemsRx cost problems
Financial Capability and Non-Adherence for Prescription Medications
0.510.18
0.320.66
0.620.82
0 .2 .4 .6 .8 1Percent
Turned down for credit
Confident in credit approval
Have at least one credit card
Survey of Household Economics andDecisionmaking (2016).
No Rx cost problemsRx cost problems
Liquidity and Non-Adherence for Prescription Medications
Source: 2013-2016 SHED Panel Survey
Following Families up to 4 years…
A change in insurance status
Worsening credit score
Worsening financial status
Which of the following best describes how
well you are managing financially these days?
No Prescription Cost Problems Prescription Cost Problems
Monthly Medication Spending
$1–$20 63% 30%
More than $20 27% 58%
Ability to Make Ends Meet in a Financial Emergency
Not at all confident 41% 53%
Any Late Payments in the Last 30 Days 71% 82%
Credit Score 628 604
Consumer Credit Counseling Clients Who Have Ongoing Prescription Medicines
Source: Clarifi Data 2016
FINMed: Financial Interventions Nested into MEDical Practices
Intervention: Brief, Solution-focused Financial Coaching
Telephone-based, with electronic follow-up (SMS or email)
Target: insured patients with a recent change in out of pocket medical costs or problems paying for co-pays
Intensity: about 30 minutes with 2-3 follow-up
Goals:• Patient discovers own health goals and motivation to change financial behaviors• Based on goals, support patient to plan for payments for medications by next refill• Check in to make sure plans to have the liquid funds before the refill is due
Next Steps: FINMed
Further Development
• Designing program & training
• Targeting
• Marketing
Testing
• Take up in health setting
• Randomized trial among financially vulnerable families
Predicted Outcomes: Patients will enroll (est. 40%)
Offer of FINMed will:✓ increase refills✓ improve health status✓ reduce health costs to system✓ reduce financial stress
Implications• Financial coaching embedded into systems
• Financial capability as a means to an end: increased well-being
• Using evidence to shape very focused intervention
• Intentionally designed with precision targeting of clients
• Developing sustainable model for service delivery
Making it Easier to Make Sense of Health Insurance
CFS Webinar June 28 2017Index
• Introduction
• HI Complexity
• Literacy
• Literacy project
• How-to sheets
IntroductionIndex
Allison EspesethCovering Wisconsin
Development and Operations Manager
• Introduction
• HI Complexity
• Literacy
• Literacy project
• How-to sheets
Health Insurance is ComplexIndex
• Introduction
• HI Complexity
• Literacy
• Literacy project
• How-to sheets
Health insurance is difficult to understand and use. Words and plan descriptions are too difficult for most people to understand.
Consequences: We may not take advantage of the best options.
Our choices may cost more money.
About Covering Wisconsin• Began in 2003, located in Madison and Milwaukee, WI
• Provide education and assistance with programs that support health
• Federal health insurance navigator entity
• Focus on consumer health insurance literacy
• Train professionals and educate the public on getting, using, and paying for coverage and care
What skills are needed for literacy?Index
• Introduction
• HI Complexity
• Literacy
• Literacy project
• How-to sheets
Math: Story Problems
Understanding health insurance plans and how much they will cost you is similar to doing complex story problems.
Getting the numbers wrong can have serious financial consequences.
Literacy in the U.S.
44%of U.S. adults at
Below Basic and Basic Literacy
(National Adult Literacy Survey)
Health Literacy
Covering Wisconsin’s Health Insurance Literacy Project
Index
• Introduction
• Complexity
• Literacy
• Literacy project
• How-to sheets
Literacy project funders: Wisconsin Department of Health Services, Wisconsin Health Information Organization, and the Baldwin Wisconsin Idea Endowment
Process: Developing Health Insurance Resources
1. Understand consumer’s needsa. Meet with community professionalsb. Talk with consumers with low literacy skills
2. Research topic (policy, consumer’s experiences)
3. Create content using effective strategies for all consumers
4. Consumer review of materials
5. Pilot test content
Index
• Introduction
• Complexity
• Literacy
• Literacy project
• How-to sheets
Marketplace BadgerCare Plus Using Insurance
Sound Financial Choices Signing up
Incorporation of Literacy Needs
To meet the needs of all audiences,materials use:
• Plain language
• White space
• Large fonts
• Relevant images
• Only pertinent information
• Action steps
Getting Started
Health insurance costs depend on the plan:
• Premium
• Deductible
• Co-payment
• Co-insurance
I Can’t Pay My Medical Bill
Understanding Rx Formularies
THE HEALTH & WEALTH CONNECTION:OPPORTUNITIES FOR INVESTMENT ACROSS THE LIFE COURSE
June 28, 2017
WE ARE
Asset Funders Network (AFN) is a membership organization of
advancing economic opportunity and prosperity for low and moderate income people through philanthropy.
ASSETFUNDERS.ORG
ISSUE BRIEFS
GRANTMAKER WEBINARS
REGIONAL & NATIONAL
GRANTMAKER EVENTS
foundations and grantmakers to leverage their resources to make more effective and strategic funding decisions, allowing each dollar invested to have greater impact.
ASSETFUNDERS.ORG
THE HEALTH AND WEALTH CONNECTION
ABBY HUGHES HOLSCLAW, MPPADIRECTOR OF MEMBERSHIP ENGAGEMENTASSET FUNDERS NETWORK
ASSETFUNDERS.ORG
How does wealth impact health?
Three explanations:
• Biologically: Stress pathway
• Education
• Greater future orientation
Persistent Stressors
e.g. financial instability
Unhealthy behaviors
(drinking, smoking, poor diet and lack
of exercise)
Hippocampal atrophy
Immune suppression
Release of stress hormones
Disease
Stress Pathway
Biological consequences
• Better access to and understanding of health information
• Changes in norms and behaviors (e.g. lower rates of smoking)
Education leads to…
• Savings allows one to envision the future
• Evidence to support savings in childhood associated with college attendance and completion
Greater Future Orientation
44
• 41 years in Southside neighborhood of San Antonio
• Transitioned to empowerment model in last 10 years
• Created Project Puente • Community Health Worker (CHW) Certification program
PRESA COMMUNITY CENTER
PROJECT PUENTE
• Job training: targets non-traditional learners
• Job creation
• CHW are members of the community
PROJECT PUENTE
CHW follow up with patients after discharge
• Readmission rates reduced substantially, only 7% among Project Puente patients
• Improves health of low income and high risk patients
• Cost savings per year about $360,000
Q & A
Allison EspesethDevelopment and Operations Manager
Covering Wisconsin
Abby Hughes HolsclawDirector of Membership Engagement
Asset Funders Network
Collin O’RourkeSenior Research Specialist
Center for Financial SecurityThe University of Wisconsin-Madison
J. Michael CollinsFaculty Director
Center for Financial SecurityThe University of Wisconsin-Madison
Financial Coaching and Medication Adherence: The Potential for a New Model
Please remember that today’s webinar was recorded and will be posted on our website: cfs.wisc.edu
within two business days.
Please contact Hallie Lienhardt with questions:[email protected]
608-890-0229
Thank you for joining the Center for Financial Security for today’s webinar:
