The Health Care Industry Levels Up On Member Experience

posted by Alicia Caramenico

on November 6, 2019

Health care technology is more than gadgets and apps. It’s fundamentally changing the role of health insurance providers.

“There is a lot of health care that hasn’t changed in 150 years,” says Dr. Vindell Washington, Chief Medical Officer of Blue Cross Blue Shield of Louisiana. “Should we be providing primary care in the same way that we’ve always been providing it? Should we have a larger role for virtual care, should we have a larger role for home monitoring devices and other tools?” he asks.

The answer is clearly yes … The time is now, the urgency is now to make those changes.

To drive change across the health care system, health insurance providers are concentrating more on the member experience. That means using technology to make it easier for people to manage their health and access care when and where they need it. It’s a fundamental change in how we think about health care.

New policies from the Centers for Medicare and Medicaid Services are opening up opportunities for innovation as well, this year allowing Medicare Advantage plans – including Blue Cross and Blue Shield of Louisiana – to offer telehealth, or virtual doctor visits to their Medicare Advantage members.

Virtual office visits and fitness trackers are just the tip of the data and technology iceberg. The real work is being done beneath the surface, where companies like Oscar Health are analyzing information to identify opportunities to engage and improve the experience of their members. As their members use the apps and tools to manage their care (Oscar say as much as 63% of their members’ interactions with the health care system are virtual) the company then uses that data to fuel iterative improvements. The same way Uber or Lyft analyze customer activity as well as trends to help people get rides when they need them, health insurance providers can help members get high-quality care that they can afford at the right time.

Another health insurance provider Harvard Pilgrim Health Care, for example, recently announced a program that leverages data to help ease the transition of new members into their health plan to avoid disruptions in care. SmartStart seeks to engage new members even before their effective date – providing “a digital welcome experience” to help them get up to speed on their plan as well as clinical transition support that includes prior authorizations and pharmacy coverage.

Today’s health care technology solutions aren’t impersonal. They are tools that make a member’s experience more tailored to their individual needs and easier for them to access on their terms. It’s what we mean when we talk about the right care at the right time, and it is one way to address the social factors that impact people’s health and access to care. The same machine learning principles that makes it easier to for a time-strapped business traveler to take their medication per their doctor’s instructions can be employed to help a mobility-challenged Medicaid patient access a ride to get a flu shot.

Ninety percent of banking went from being in the bank to being at home,” says Dr. Stephen Klasko of Jefferson Health. “We have to start preparing for a future where 50% of health care that’s currently happening in a doctor’s office or a hospital an imaging center will happen at home.”

Interested in Hearing More?

Join us at AHIP’s Consumer Experience and Digital Health Forum and hear more about telehealth and how health insurance providers have placed a greater emphasis on empowering the consumer, giving them a variety of tools to control their coverage and care.

View Sessions on Digital Technology and Tools for Collaborative Care