It’s all About Relationships: How Care Managers Can Increase Patient Activation, Lower Healthcare CostsCommunication, trust and mutual respect are important in any relationship, and that’s certainly true in healthcare. Patients with complex needs or chronic illness who feel heard, valued and respected by their care managers are more likely to take an active role in their own care, leading to improved outcomes and lower costs, research shows.
The authenticity of the care manager-client relationship—how genuine and consistent the patient perceives the provider to be—also makes a difference, some studies have found. And though learning how to build relationships takes time and training, the investment pays off in several ways.
For instance, a 2013 study published in Health Affairs looked at 33,000 clients in a large healthcare system and found that costs were 8-21 percent higher for clients with very low activation levels compared to costs for clients with the highest activation levels. What leads to higher activation? Relationships.
Care Manager Relationships Empower, Motivate
A 2016 study on “The Role of Authentic Relationships in Caring for Patients with Frequent Hospitalizations,” published in Population Health Management, underscores why relationships between care managers and clients matter so much. It noted that good provider-patient relationships are “associated with improved quality of care and decreased likelihood of future hospitalizations.”
The study focused on 30 former clients of the Camden Coalition of Healthcare Providers and their experiences with Coalition care managers. The researchers found that “although participants mentioned a number of task-based services provided by the Coalition care teams, (they) spent the majority of the time and emphasis recalling and describing the relationships formed with their care team members. This relationship often was linked with motivation to engage in and sustain active health management.”
Ingredients of an Authentic Relationship
In the Camden study, investigators identified security, genuineness, and continuity as crucial ingredients to authentic healing relationships. “Secure” meant the patient felt the care manager was accepting, reliable and attentive; “genuine” meant the care manager was perceived as honest, respectful and interested in the patient.
The study found participants also placed great value on care managers continuing to follow up with them and maintaining the relationship. One participant reported that “[Knowing that the care team was] interested in me … it’s like wow, me? I felt good, I felt better, I felt somebody really cares about me … And I think that what’s made me, you know, actually do it … I started takin’ my medication, I started, you know, getting out.”
Relationships Enhance Patient-Centered Care
Care management relationships can also play key role in patient-centered care, ensuring that treatment and care decisions are shaped around a client’s values, goals and wishes.
A 2016 spotlight report by the National Committee for Quality Assurance noted that “person-centered care planning requires that the individual be at the center of care planning. To facilitate care planning efforts, the care manager often sits alongside the individual at the center of a network that constitutes the care team. In this capacity, the care manager’s relationships with the individual and other members of the care team are essential to providing person-centered care.”
Training Makes a Difference
As the evidence base grows, programs like Care Excellence have begun to address the power of authentic and strong client relationships in care coordination, with new curriculum that builds critical skills like communication, empathy and teamwork.
Relationship Building for Care Managers is a self-paced online course that offers 10 CEs or CCMs for care managers working to engage and activate clients facing health challenges. The curriculum delivers skills, tools and resources in areas such as interdisciplinary care teams, member relationship and engagement, community partners, and patient activation principles. For more information, call 760-750-7288.
Grinberg, C., Hawthorne, M., LaNoue, M., Brenner, J., & Mautner, D. (2016). The Core of Care Management: The Role of Authentic Relationships in Caring for Patients with Frequent Hospitalizations. Population Health Management, 19(4), 248–256.
Hibbard, J.H. and Greene, J. (2013). What the Evidence Shows about Patient Activation: Better Health Outcomes and Care Experiences; Fewer Data on Costs. Health Affairs, 32: 2, 207–214