How Health Plans Are Empowering Consumers

by Stephani Simmons

March 21, 2017

As the health care environment continues to evolve, one change seen across the marketplace is an increased focus on the consumer. Health plans large and small have placed a greater emphasis on empowering the consumer, giving them a variety of tools to control their coverage and care.

Health plans demonstrate a consumer focus in a many different ways, with one of the most notable being patient portals where individuals can view the details of their plan, see messages from their plan, and pay their bills.

Providing patient portals has become common practice for health plans, and a benefit consumers have come to expect from them, which has led health plans to innovate what tools they provide to consumers. Some of these transformations have taken the form of: provider directories, mobile apps, and reward programs.

Provider Directories

Provider directories offer a comprehensive listing of physicians, clinicians, facilities and pharmacies that are contracted with a health plan to provide services to their members. Along with containing information such as provider address and specialty, an individual can find out whether his or her primary care physician is within a health plan’s network or if a nearby hospital or pharmacy is a part of the network. Previously, these directories were in print and only updated once a year. Now they’re posted online, in a format that’s accessible and searchable for consumers who need reliable information.

Mobile Apps

Health insurers have recognized the need for convenience. Many health plans such as Cigna, Humana and Oscar Health all provide mobile apps that allow consumers to do everything from making appointments to connecting with a doctor on call. These mobile apps empower consumers by placing the most basic of tasks (viewing coverage information) and more difficult ones (scheduling appointments) at their fingertips. Engagement from patients is evident in a recent poll from CDW Healthcare that showed that if given the digital tools, “64 percent of survey respondents said they would submit personal, real-time healthcare information to their provider.”

Reward Programs/Health Assessments

Health plans realize the financial burden that can be placed on an individual or family when a health care crisis occurs. Insurers try to lessen some of that burden in the form of health assessments and reward programs.

  • CareFirst BlueCross BlueShield provides a program called “Blue Rewards” that rewards individuals for taking an active role in getting and staying healthy. The steps required for receiving the reward include selecting a primary care provider, subscribing to wellness emails, filling out a health assessment, and completing a health screening. Upon completion, individuals receive a monetary award that can be used toward out-of-pocket costs and deductibles.
  • L.A. Care’s “Healthy Mom Program” rewards Medi-Cal members who visit their doctor three to eight weeks after giving birth with a gift card. This visit allows the doctor to check on the physical and emotional wellbeing of the mother and child.
  • Humana offers qualifying health insurance plans its “Go365” wellness and rewards program. This initiative provides individuals with a personalized dashboard, track apps and rewards that can be used on items ranging from gifts cards to electronic devices.

You can hear more insights from industry thought leaders by attending AHIP’s Consumer Experience & Digital Health Forum.