It’s no secret that better provider-member relations can often lead to better health outcomes for the member and improved financial performance for the health plan.
Building trust, enhancing communication, and personalizing care through health information technology not only fosters better provider-member relationships but also improves health outcomes and the financial performance of health plans.
When trust is built, communication flows, and care is personalized, patients are willing to follow the care plans put in place more closely. With providers having shorter appointment times to spend with patients inside the exam room, most of this relationship-building needs to be focused outside of that small window of time.
Health Technology Connects Providers and Patients
Providers can tap into digital health technology at their fingertips!
We are walking (okay, maybe running) into a time when healthcare will be no stranger to digital transformation nationwide.
The latest HIMSS State of Healthcare Report says, “Digital transformation is a top-level priority for health systems, with 99% of U.S.-based health system leaders agreeing that it’s important for their organizations to invest in digital transformation.”
Payers are also in alignment, with 74% of U.S.-based payers reporting that their organizations have a dedicated core team focused on digital transformation.
With so many invested in bringing health technology to the forefront of their patient care, the question is how?
3 Ways Technology Improves Health Outcomes
1. Leverage Patient Data to Offer Personalized Care
In a time where personalization is becoming the norm in so many areas of our lives, it’s about time that healthcare gets into the game. The 2022 State of Healthcare Report found that “roughly 25% of patients or less completely agree that their provider personalizes care based on their current health, lifestyle and unique health goals.”
With so much room to grow, it’s time to tap into the data available on each patient to create a truly tailored healthcare experience. As a health plan, offer a single location where physicians, members, and the plan can see a comprehensive, action-oriented view of their patients/members.
The EHRs today are not integrated with the health plan, and to improve care, we need to ensure that all three are in the know. Knowing everything they can about a member, such as diagnosed conditions, known allergies, immunization records, and medication history, will help them develop a plan that makes the most sense for each person.
A disease or condition could affect one patient very differently from how it affects another. Because of this, treatment options and care plans cannot be treated as a one-size-fits-all approach if we want to see the healthiest outcomes for each patient. They need to consider a person’s unique health history, behaviors, and preferences.
When personalized care becomes the norm, everyone wins. Patient satisfaction increases, and the potential to improve health outcomes grows exponentially.
2. Provide the Right Tools to Help Members Manage Their Health
Patients often need ongoing support with health management between office appointments. As a health plan, your members will turn to you, and it is important to ensure that both providers and members have access to the resources they need to make this support a reality.
Using digital health technology, patients can improve their health in the comfort of their homes, leading to better clinical outcomes. Giving them access to tailored self-management tools and providing personalized health education materials are two great ways to help members stay the course.
When health plans, healthcare organizations, and providers can come together to implement patient-centric education strategies, members may become more inspired to make changes that better their overall health. A 2018 study published in the Journal of the American Osteopathic Association showed that just 45 minutes of patient education can improve chronic disease management
3. Strengthen Communication Through Secure Channels
Regular check-ins with physicians can keep members on track once they leave their appointments. With connected and HIPAA-compliant patient and provider portals, physicians can send secure messages to members about their progress regarding any current care plans or wellness programs. Sending these timely and encouraging messages demonstrates to members that providers are still within reach outside of the office and are dedicated to helping them along their health and wellness journey.
Are you ready to elevate provider-member relations and enhance health outcomes with digital health technology? Discover how mPulse’s provider and member portals can transform your health plan today!
This article was originally published on healthtrio.com.
7 Ways to Meet Healthcare Consumers Online and Boost Your Member Experience
“Healthcare consumerism” – it’s a buzzword heard a lot over the past few years as the healthcare industry has evolved to be more consumer-centric, and all healthcare professionals should know and understand it. Patients are taking a more proactive role in their own health and wellness (long overdue), acting as purchasers and turning to digital solutions for quick and convenient access to healthcare information, products and care. As consumers, they now demand more control and responsibility for selecting the right health plan that best fits their needs and the needs of their families. Once a member, they want relevant and timely information regarding their plan and benefits at their fingertips.
It’s important to ensure health plans are providing the support and resources needed for healthcare consumers to make educated and informed decisions about their health and benefits.
The first question to ask: what are the key resources to provide?
1. A Digital Front Door
In a recent article, Advisory Board identified four main goals of the digital front door:
improve satisfaction with a simplified member experience
expand access to care
optimize resource allocation (often through self-service tools)
reduce unnecessary treatment through better care coordination
For these reasons, investing in digital front doors should be the highest priority for health plans and other healthcare organizations. Consumers today expect a digital experience in many elements of their lives, and their health is no exception.
To achieve these goals, health plans can focus on providing digital resources through their portals, such as care team messaging, helpful chatbots, pre- and post-visit or operation educational resources, disease management tools, and online premium payments. The more a member can do online and through their portal, the happier they are as a healthcare consumer.
2. Omnichannel Digital Engagement
Omnichannel engagement strategies are used by successful brands to lure customers, learn about their behaviors, and drive loyalty. They allow brands to create a series of touchpoints and to reach people through their preferred channels. Obsolete methods of communication, such as direct mail, lack personalization and the ability to collect data at scale.
When healthcare organizations use omnichannel digital engagement, they are able to reach consumers in the way they prefer and provide a more enjoyable member or patient experience. Without an omnichannel communication strategy, it’s impossible to effectively deliver appropriate resources and education to a broad member database.
Below are just a few examples of digital ways to engage and activate more consumers and engage them about impactful topics that have significant impact on the member experience.
Interactive voice response (IVR)
Email
Mobile web
Short message service (SMS)
Multimedia message service (MMS)
Rich communication services (RCS) channels
3. Tailored Plan Shopping
Each healthcare consumer has a unique set of needs to be met and features that are important to them when searching for a health plan. Desired monthly premiums, copay and deductible amounts, in-network doctors, hospitals, and other health care providers, chronic illness support, and so much more. Searching through and finding the right health plan based on all of these things can be an overwhelming and complicated process.
According to the 2023 KFF Survey of Consumer Experience with Health Insurance, nearly one in three adults with Marketplace coverage (31%) found it very or somewhat difficult to compare copays and deductibles under their plan options, and one in four (25%) found it very or somewhat difficult to compare monthly premiums.
Simplify the plan shopping process through an intuitive questionnaire that gathers information from the consumer that can then be used to present them with the health plan that makes the most sense. Taking the burden off the consumer to do the hard work boosts their confidence in making the right selection and will lead to higher member satisfaction down the road.
4. Provider Search
Consumers spend a lot of time online researching practices, providers, and more. In fact, more than 3 in 4 patients (77%) look for doctors online often according to Tebra’s 4th annual Patient Perspectives survey. One of the top places patients start looking is their online insurance directories, with 53% of patients saying online insurance directories contribute to their doctor selection decision.
Providing correct and updated information for all providers, as well relevant search filters such as location, type of provider, gender, language spoken, and whether they are accepting new patients, are helpful in a consumer’s search. The easier you can make it for a member or potential member to find the information they need, the happier they will be with their health plan experience.
5. Price Transparency Tool
Health plan price transparency tools help consumers know the cost of care or service before seeing a provider. The State of Patient Access 2023, completed by Experian Health, found that:
65% of patients said they did not receive an estimate prior to care, with 41% of those respondents said final costs were more than expected
40% of all patient respondents said they were likely to cancel or postpone care without an accurate estimate
79% of all patient respondents say an accurate estimate helps them better prepare to pay care costs
88% said receiving a price estimate before care is important
Not having the cost estimates they need is leading healthcare consumers to defer treatment and avoid the care they need, leading to increased hospitalization and complications from preventable diseases.
By providing a price transparency tool and giving members the opportunity to access this information before a visit, procedure, or purchase, health plans are giving consumers the ability to make informed decisions that best meet their needs and financial situation and help improve health outcomes.
6. Easy-to-Understand Member Statements and Benefits Overview
A recent KFF Survey of Consumer Experiences with Health Insurance asked insured adults about how well they understand key aspects of their health insurance. Half (51%) of insured adults say they find at least one aspect of how their insurance works at least somewhat difficult to understand.
These items caused the most confusion:
What insurance covers – More than one-third (36%) of all insured adults say it is at least somewhat difficult for them to understand what their insurance will and will not cover
Out-of-pocket costs – Thirty percent of insured adults overall say it is difficult for them to understand what they will owe out-of-pocket when they get health care
Explanation of Benefits (EOB) – Three in ten insured adults say they find it difficult to understand whether or how much insurance will pay for care from looking at their EOB
Basic health insurance terminology – A quarter of all insured adults say they have difficulty understanding specific terms, such as “deductible,” “coinsurance,” “prior authorization,” or “allowed amount.”
Health plans can alleviate this confusion by providing resources that help their members understand their coverage. Through the member portal, plans should show up-to-date information regarding what is available to members with their benefits or even plan discounts, explain and outline their deductible and out-of-pocket maximums in a member-friendly manner, and inform them of their benefit accumulators for both in-network and out-of-network services. Using a built-in glossary to define key terminology can also help members as they sort through the information being presented to them.
7. Member and Patient Education
One major factor impacting the member and patient experience is health literacy. With 35% of the adult US population having basic or below basic health literacy, education is vital to ensuring a positive member or patient experience.
To combat the health literacy challenge, the healthcare industry must reimagine what member and patient education looks like. Healthcare consumers are, at the end of the day, simply consumers, and consumers ingest content and information continuously every day from a multitude of sources: short, bite sized videos on social media, streaming services for shows and movies, a large volume of self-produced content, and more.
And this type of streaming health content has proven to be an effective method of capturing the health consumer’s attention. One large national plan which partnered with mPulse on digital outreach saw a 274% increase in link clicks to schedule their annual eye exam when this video was utilized vs when no video was sent.
Getting Started
The second question to ask: why should a health plan make the commitment and investment to provide these resources?
Health plans who implement these tools for their members can gain:
Increased member acquisition and retention
Higher member satisfaction
Operational efficiency
Competitive advantage
How can health plans get started if they already aren’t doing these things?
Reach out to mPulse to learn more about our product offering and how we can help you answer the demand for healthcare consumerism. Our products are built to provide your members with the resources they need to be educated, informed, and proactive about their health.
