Good health and well-being do not just happen.
Good health and well-being occur when we all work together: patients, doctors, nurses, hospitals, family caregivers, pharmacists, employers, health plans, and local communities. It is widely understood that health plans process and pay medical claims and build networks of doctors and hospitals. These essential services help make coverage more affordable for over 200 million Americans and provide financial protection against the high costs associated with serious illnesses and injury. And that’s just the beginning.
Health plans play a unique role in bringing together all of those involved in health care. This coordination of care is central to health plans’ value in the system. Patients receive better care when it is coordinated seamlessly across multiple doctors, facilities, and prescriptions or treatments. Health plans also have access to clinical data from millions of interactions with health care professionals. These data give health plans invaluable, fact-based insights into our health care system-insights that are used to guide system-wide improvements in patient care. For example, health plans can look at data from their entire patient populations and update doctors about what cancer drugs or treatment patterns work best, an invaluable tool in helping physicians decide what to prescribe for their patients. Health plans are arming patients directly with essential information about the quality and safety track records of hospitals on certain procedures. This information helps patients and doctors make better decisions about where to have surgeries, tests, and other services.
Employers are increasingly looking to health plans as well to help improve the quality of care that patients receive. Improved quality not only results in healthier individuals, but also holds down cost increases and allows workers to get back on the job sooner. A healthy workforce and more affordable health care are critical to making American companies competitive in the global economy. Health plans are improving quality of care through investments in prevention and wellness and programs that encourage patients to utilize evidence-based preventive services. Prevention comes in many forms, including vaccinations and immunizations, annual check-ups, and patient counseling to encourage healthy eating and exercise.
For those individuals already living with chronic conditions, care coordination and prevention are core components of health plans’ efforts to help them manage their conditions and reduce or avert complications. Patients may not be fully aware of the role their insurer is playing to encourage these interventions – but health plans are working every day on exactly these efforts in every community. To be successful, these efforts have to involve almost every element of our health care system and, increasingly, of our communities. That’s why you so often see health plans sponsoring breast cancer awareness runs, or partnering on smoking cessation efforts, or helping local organizations sponsor after-school sports so that kids stay fit and we reduce childhood obesity.
While health plans have helped make progress, they also realize that much more must be done. Our society must address the challenges associated with an aging population, the growing incidence of chronic disease, and surging demand for new treatments and medical technologies. Breakthroughs with new medicines, surgical procedures, and devices must be paired with innovations in how health care is delivered to produce lasting results and tangible value.
To achieve these innovations in how we all receive our health care, health plans employ thousands of doctors, nurses, and other clinicians who are making a real difference– sometimes by working directly with individual patients or by helping design better ways to coordinate and deliver care that can help improve your own care as well as benefit millions of patients.
Whether it is through our support for greater access to information for doctors and patients about what treatments work best, or our innovative use of health IT, or our investments in new team-based health care models, America’s health plans are committed to driving the innovation needed to allow every American to live the healthiest possible life.
We invite you to learn more about what we are doing every day to promote good health and well-being for everyone.