How Healthcare Payers Can Unlock More Effective Motivational Interviewing

Healthcare payers can help members improve health choices with digital tools and key motivational care management strategy

Motivational interviewing (MI) is an evidence-based method of helping members overcome resistance to positive behavior changes that are critical to improving their health. Through effective MI, care managers can empower members to

  1. Identify personal barriers to better health choices and behaviors
  2. Increase the likelihood of successful behavior changes
  3. Improve adherence to care plan instructions or medication regimens
  4. Achieve better clinical outcomes and quality of life

Despite these benefits, carrying out effective MI can be challenging for some care teams. Find out how healthcare payers can better equip care managers to leverage motivational interviewing by clarifying what MI techniques to use, and by leveraging the right health technology tools.

What Are the Right Motivational Interviewing Techniques to Use?

People with unhealthy behaviors are not necessarily unmotivated to change, but ambivalent about making changes – they have their own “good reasons” for not wanting to give up a hazardous behavior.  Failing to recognize this ambivalence can make well-intended advice seem tone-deaf to the member’s challenges, values, circumstances, and life experience. The result? Disengagement and decreased adherence to treatment plans and lifestyle modifications. 

To solve this challenge, care teams use MI to affirm members’ strengths, accomplishments, and their efforts around positive change. MI is a non-judgmental, empathetic approach to communication that puts the member at the center of decision-making. 

Some best-practice motivational interviewing techniques include: 

  1. Open-ended questions. Ask questions such as, “What potential negative effects do you see resulting from this behavior?”
  2. Reflective listening. Phrases like “It sounds like…” followed by a summary of what the member has just related show the care manager is authentically invested in understanding the member’s perspective.
  3. Respecting resistance. Instead of immediately challenging a member’s resistance to change, talk to them about the reasons causing their hesitation.
  4. Encouraging “change talk.” This involves getting the member to identify why change is a good idea and verbalizing their own desire to make a change. Asking questions like “What are some positive outcomes of quitting smoking?” is a way to elicit change talk.

How Motivational Interviewing Benefits Healthcare Payers

Motivational interviewing techniques can be very effective at driving better health outcomes. MI is a valuable tool to help payers create more sustainable, cost-effective care processes, and a range of studies supports the effectiveness of MI. Here’s a sample of research findings:

When care managers consistently use MI, healthcare payers can see results such as:

  • Improved health outcomes
  • Reduced hospitalizations
  • Reduced costs associated with expensive interventions and treatments
  • Increased member satisfaction thanks to an emphasis on collaboration, patient-centeredness, and improved outcomes
  • Stronger care coordination, where care managers can better identify and address health concerns

What Are Some Barriers to Motivational Interviewing?

Despite the evidence supporting MI, care managers can run into some challenges that limit the technique’s success.

  1. Lack of trust on the part of the member, which can be exacerbated by stigma and shame associated with the behavior in question. A strong alliance with the care manager is critical to the member expressing their true feelings around ambivalence to change.
  2. Lack of a complete understanding of the member’s health. Underlying complexities such as unaddressed trauma, a mental health condition, or even an undiagnosed physical condition can inhibit the effectiveness of MI. 
  3. Time constraints that limit the care manager’s ability to communicate frequently with the member, which can prevent an authentic relationship from forming. 
  4. Social determinants of health that act as barriers to engagement for the member, such as lack of transportation to reach appointments.

How Technology Can Unlock More Effective MI

Thankfully, the right medical management platform can help solve for many of the barriers that can limit MI. A care management platform like HELIOS with customizable and automated workflows, assessments and triggers, as well as telehealth and member engagement tools, makes MI a much more feasible tactic for care managers to pursue. HELIOS’ data centralization and interoperability capabilities also help save time and optimize patient views for care professionals and teams. 

Let’s look at two examples of how the right health tech solutions can improve MI.

Using Assessments to Enhance MI

HELIOS can host thousands of assessments that are customized for each payer’s unique population health needs. These assessments are designed to help care managers uncover clinical and lifestyle factors that influence a member’s level of change resistance (or readiness for change). Assessments can cover behavioral health, SUD (substance use disorder) management, chronic disease management, long-term services and support management, and more.

Leveraging these assessments can help with MI by:

  • Establishing trust and collaboration. Assessments give care managers a starting point for building rapport and trust, crucial to overcoming any shame or stigma that could be inhibiting engagement. Assessments help care managers understand a member’s readiness for change, filling in gaps on the member’s history, preferences, strengths, resources, social determinants of health, and individual challenges. 
  • Enabling tailored care planning. Care managers can design a care plan that incorporates personal aspects of a member’s overall picture of health, with realistic goal-setting and interventions tailored to the member’s needs. 
  • Guiding goal setting and follow up. Assessments help care members and members collaborate on achievable goals. Care managers can also use them as a tool to track progress toward meeting those goals. 

Using Video-Based Telehealth Tools to Strengthen MI

HELIOSvisit provides easy-to-use virtual appointments and telehealth capabilities. Built-in chat can aid in documenting key points, summarizing information, and reviewing progress, which can reinforce MI principles and interventions.

Here’s how care managers can leverage these tools to assist with MI:

Provide flexibility and convenience. Telehealth can eliminate common barriers that prevent members from scheduling or keeping appointments – lack of transportation or taking time off work. They’re also easier for members with mobility challenges. With flexible scheduling, members are more likely to keep appointments, leading to better consistency in the MI process, deeper trust and engagement, and overall better continuity of care.

Aid in building rapport and trust. Talking with a care manager from the comfort of their own home can help members feel more at ease sharing potentially sensitive information. Also, as mentioned above, virtual visits may be easier for members to keep on a consistent basis. The more frequent the communication, the faster care managers can establish a relationship. 

Involve key players in the member’s health. Once trust is gained, telehealth capabilities allow care managers to invite others to participate in follow-up sessions. For example, a member working on weight loss could benefit from a virtual conference involving their nutritionist or fitness coach. If family members play an important role in addressing a drug or alcohol addiction, they can join a virtual session to learn how they can best support their loved one.  

Learn how HELIOS helps payers deliver streamlined, person-centered care here.

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