Press Release

For Immediate Release Contact


Erica Garland
(202) 745-5119


Sue Ducat
Director of Communications
(301) 841-9962


Health Affairs Explores Whether "Patient Activation and Engagement" Are Panaceas in February Issue


Emerging Evidence Shows Promise and Challenges of Approach to Care


Bethesda, MD --The February issue of Health Affairs explores the burgeoning field of activating and engaging patients in their health and health care. Studies show that more informed and empowered patients have better health outcomes, and there is some evidence that they also have lower health care costs.


The issue, which discusses the challenges and opportunities for engaging patients, was supported by the Robert Wood Johnson Foundation, the Gordon and Betty Moore Foundation, the Patient-Centered Outcomes Research Institute, and the California HealthCare Foundation. Another featured article in the issue reports on how offering online health care for patients with simple conditions saved money for a prominent Minnesota health plan.


Patients rated lowest in terms of their involvement with their care have substantially higher health costs than those rated more highly, at least in the short and medium term. A featured study by Judith Hibbard of the University of Oregon and coauthors found that patients with the lowest level of "activation"--that is, those most lacking in the skills and confidence to be actively engaged in their health care, had average costs that were from 8 percent to 21 percent higher compared to patients with the highest level of activation. Using the Patient Activation Measure that assesses beliefs, knowledge, and confidence in managing health-related tasks, the researchers found that patient scores on a questionnaire that ranks patient activation showed that patients' responses in effect predicted their overall care costs, even when adjusted by the severity of patients' health conditions, age, sex, and income. The researchers recommend that health delivery systems consider assessing these patient activation scores and supporting patients to become more engaged in their health and health care, as a way to both improve patient outcomes and lower costs.


Online health care for common conditions typically cared for by primary care providers has the potential to help meet the "Triple Aim" of better health, better health care, and lower costs--and lead to more satisfying customer and patient experiences. Patrick Courneya of HealthPartners in Minneapolis and colleagues report on the experience of HealthPartners' online clinic, called "virtuwell." Launched in 2010, virtuwell provides twenty-four-hour online access, diagnosis, and treatment (including prescriptions) by nurse practitioners for about forty simple conditions, such as sinus infections, urinary tract infections, and pink eye. The authors note that virtuwell is the first online service to be authorized for coverage under Medicare. After 40,000 cases of patients using online care, HealthPartners saw an average savings of $88 per episode over traditional care settings--plus evidence that the care was clinically effective, and that 98 percent of patients were willing to recommend the service. The authors caution that these findings may not apply to all online care models, but they recommend that policy makers examine various regulatory barriers that prevent expansion of these promising online practices.


Private and public sector leaders weigh in with their perspectives:


  • Ten Strategies To Lower Costs, Improve Quality, And Engage Patients: The View From Leading Health System CEOs, Delos Cosgrove of the Cleveland Clinic

  • The Best Way To Improve Outcomes Research: Engage The Patient, Rachael Fleurence of the Patient-Centered Outcomes Research Institute
About Health Affairs

Health Affairs is the leading journal at the intersection of health, health care, and policy. Published by Project HOPE, the peer-reviewed journal appears each month in print, with additional Web First papers published periodically at The full text of each Health Affairs Web First paper is available free of charge to all website visitors for a two-week period following posting, after which it switches to pay-per-view for nonsubscribers. Web First papers are supported in part by a grant from The Commonwealth Fund. You can also find the journal on Facebook and Twitter. Read daily perspectives on Health Affairs Blog. Download our podcasts, including monthly Narrative Matters essays, on iTunes. Tap into Health Affairs content with the new iPad app.