Accelerated by the Covid-19 pandemic, healthcare innovation has skyrocketed over the past few years to meet the changing demands of Americans who want personalized, affordable and quality healthcare. While this innovation has brought many benefits, including addressing consumer demand, it has also exacerbated existing challenges, such as continued rising healthcare costs, and accelerated the shift to value-based care models. While these changes can be difficult to keep up with, health plans must recognize them and adapt accordingly to improve member outcomes and drive business growth.
Health plans are in a unique time of change and have an opportunity to be seen as partners for success with employers and providers. Here are a few key health care trends that health plans should watch in the coming months:
Embrace the power of personalization
Consumers are accustomed to convenient digital tools in all areas of life, including shopping, ordering food and groceries, and banking, among many others. With an abundance of curated social media content, playlists, shopping lists and more at their fingertips, consumers expect this type of personalization in healthcare as well.
The data shows that 88% of consumers prioritize personalization as much or more than a few years ago, so it is imperative that health plans offer their members personalized support that targets their individual health risks, wellness priorities and health goals. To successfully engage and activate these members, health plans can use the power of data and predictive analytics to gain valuable insight into what offerings will resonate with certain populations and create personalized experiences that meet their unique needs—perhaps even before they know they will need it. Not only will this meet consumer expectations, but it will drive better results and create more brand loyalty.
Prepare for rising health care costs
Financial i fall out of Covid-19 is causing healthcare organizations to experience increased costs for resources, salaries and supplies. In addition, they must also manage more expensive patient care and a sicker general population due to delayed examinations and diagnoses. To prevent lost revenue, excessive costs, and declining quality outcomes, health plans must strategize how they will manage these costs in both the short and long term.
Technology is an effective way to support members’ health and wellness journeys. Digital platforms that provide personalized, accessible and timely health information can encourage members to get back on track with regular checkups and appointments and lead healthier lives. Plans can also maximize the use of telehealth and other virtual and remote tools to shift care to lower-cost environments. Taking a proactive approach will help health plans anticipate and manage high-cost events, as well as avoid costs associated with member attrition and acquisition.
Understand the population to drive health equity
Equity in health care may be difficult to achieve, but it is an incredibly important movement that health plans must embrace. CMS recently announced his approach to advancing health equity, along with challenging health leaders to make similar commitments. To do this, health plan executives must fully understand their members and what they need to achieve their personal health and wellness goals.
Consumer and Social Determinants of Health (SDOH) data must be analyzed and incorporated into any successful health equity strategy – a one-size-fits-all approach will fail. SDOH data enables health plans to better understand their members and communities beyond surface-level insights, helping to identify solutions that help them overcome barriers to health. For example, some people may need transportation or planning support to get to medical appointments, while others may need guidance on nutrition and exercise or prevention and screening programs. Once these programs are established, health plans must also invest in strategies to educate members and drive engagement and adoption.
Go beyond enrollment to activation and engagement
Starting something new is hard, and health and wellness practices like better nutrition and exercise plans are no exception. A study shows that 80% of people will give up a new habit within the first 30 days. Health plans must be strategic about how they promote these initiatives. It’s not enough to simply offer a health and wellness program or service, health plans must go one step further to educate members and help them understand the next best course of action to achieve their goals by driving engagement.
This requires health plan executives to adopt a data- and science-based approach. By understanding what resonates most with members through data analysis, they can make communication strategies personal and relevant, encouraging members to take the next best step and connecting them with resources they both need and are likely to they use. Understanding how to drive sustained engagement and what sustains long-term behavior change is critical to achieving this success.
Consider the evolving definition of value
As the healthcare system evolves, so does the concept of value and what it means in terms of value-based contracts. From 2021 to 2025, value-based contracts are is expected to grow to cover 22% of insured lives in the US – nearly 65 million people.
Health plans can help providers deliver value to patients while supporting the shift to value-based care. This includes working with providers to assist patients with telehealth and other digital health tools. It also includes meeting the unique needs of members to incentivize actions such as completing a missed cancer screening or attending a prenatal care appointment. To contribute to the success of value-based care, health plans can enable healthy actions and long-term behaviors by simplifying how people navigate their benefits and interactions with the larger health system. Better navigation leads to more engaged consumers who adhere to preventive care recommendations, adopt healthier habits, manage their chronic diseases and reduce overall risk.
To successfully achieve better health outcomes and business growth, health plans must pay attention to and address industry trends. Innovations in digital health are pushing the healthcare industry to develop at a rapid pace. By embracing these improvements and adapting them to address and solve member needs, health plans can provide personalized health experiences that drive value and improve member satisfaction and health outcomes.
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