As 2016 gets underway, payers and providers are faced with the challenge of “Uberization” -- leveraging technology, data, and communication preferences to offer consumers an optimized experience.
After all, few examples highlight the differences between the analog and digital worlds as traditional taxi cabs vs. the ride-sharing company Uber.
With taxis you take whatever you get—often a vehicle that looks and feels like it’s overdue for maintenance—then waste time paying by cash or credit card.
Compare that with the digital experience of Uber. Using mobile app, you can quickly view Uber drivers in your area, select a car and driver, and set a pickup location. When you reach your destination your credit card is automatically charged. Everything about the experience makes it clear that Uber appreciates your business and wants you back.
The Affordable Care Act (ACA)—and the shift to value-based care—has changed the fundamental dynamic of healthcare purchasing, motivating health plans to focus on proactively managing member health and retaining members by providing a satisfying experience.
Members purchasing health insurance on the exchanges will be faced with a choice each year, and those choices will be right in front of them for them to compare. A poor customer experience this year will increase the likelihood of finding a new payer next year.
Consumer choice and purchasing power have also dramatically impacted providers. A critical aspect of engaging patients is delivering a unified, seamless experience across the channels or devices of their choice. It represents the level of convenience and service patients have come to expect in markets ruled by the consumer experience across the economy.
There is an urgent need for health payers and providers to evolve and improve the member/patient experience. To deny or even delay this evolution could result in current market leaders being eclipsed by an innovative competitor.
How can payers and providers begin to prepare for this new paradigm?
Engagement & Activation.
Technologies that enhance and improve patient engagement and activation will be critical to healthcare moving forward. Through population health management we are learning more about how to create wellness strategies and to stratify patient populations based on their conditions and adjust for nuances in age, race, diagnostic groups, and the like.
Front Office/Back Office Integration.
Lowering administrative costs and enhancing efficiencies will be a priority for most health plans this year, as they seek to challenge new competitors, penetrate new markets, and assess strategies for creating an optimized customer experience. Realizing these goals will require health plans to rethink their business models—most notably, bridging gaps and uncovering integration opportunities between front office and back office processes.
Three elements are required for telehealth to become part of the mainstream of healthcare: It needs to hold healthcare costs down, providers must be reimbursed, and patients must be comfortable with remote visits.
The first and second requirements are being taken care of by the Centers for Medicare and Medicaid Services
(CMS) and its use of a code that pays providers to deliver remote care management services
to patients with two or more chronic conditions.
As for the third requirement, teleconferencing applications are making consumers comfortable communicating electronically. The ability to visit a physician remotely creates convenience.
We’ve seen it happen in the realm of mass transportation. Uber is displacing traditional taxis in many cities as the preferred ride service on the basis of the customer experience. Healthcare payers and providers would be smart to learn from this example and ensure their own member experience meets the expectations of the digital age.
Anand Natampalli and Daniel Schulte are executives with HGS, a provider of services for numerous health insurance companies.
Source: Payers & Providers