Promoting consumerism in healthcare starts with adopting a retail mentality

Adopting a retail mentality that puts patients at the heart of innovation could help drive healthcare consumption in the future.

“Bring your customers closer than ever. So close that you tell them what they need long before they know it themselves.” In his quote, Apple founder Steve Jobs defines the essence of the retail mentality. Just think of the positive impact that building this customer intimacy can have on the healthcare industry. By adopting a consumer-centric approach, healthcare will be better able to improve quality, increase satisfaction, eliminate waste, and improve the overall care experience.

A 2020 survey of health finance executives showed that organizations that embrace consumerism and proactively meet members’ needs are more likely to be successful than those whose consumption efforts are reactive. According to the same survey, technology is critical to creating positive consumer experiences. Respondents who prioritized finding the right technologies to support consumer behavior likely reported tremendous success in terms of member experience, transparency, and engagement.

Motivated in part by the increasing emphasis on experience and satisfaction measures in the CMS star rating system, health plan leaders work to influence behavior and outcomes by presenting personalized, relevant decisions to each individual member. Consider the impact that providing highly curated member experiences can have – personalized experiences lead to increased engagement; increased engagement reduces churn and builds loyalty; The longevity of the health plan increases member understanding and improves the quality of care.

As retailers and other consumer-facing organizations increasingly offer flexible, efficient, and timely services to their customers, they are raising the bar on consumer expectations everywhere. Personalized services are becoming increasingly important, making it imperative for healthcare plans to do the same. Healthcare plans that can offer consumer-centric experiences to their members today will have a competitive advantage over plans that continue to operate with an outdated mindset and a one-size-fits-all approach.

As health plans adopt a retail mentality and work towards providing consumer-centric experiences for their members, they can take inspiration from leading retailers. Additionally, these companies offer a model for success – ensure efficient access to data, know how to turn that data into information, and use rich consumer intelligence to drive action.

Simple connector: integration, not disruption

The healthcare industry is surrounded by data. It is constantly being captured by people, systems and devices. Despite a wealth of data, the industry faces very real challenges – systems are disconnected, solutions are not always scalable, information delivery can be slow. The usual suspects—accessibility, timeliness, and completeness—get in the way. However, by solving the problem of siled data and developing a holistic understanding of their membership, healthcare plans can implement personalized solutions that were previously not possible.

The building blocks are in place to create a connected healthcare data ecosystem with the potential to deliver personalized and integrated experiences for members. The shift from episodic interventions to a continuum of care based on a holistic and comprehensive view of a member encourages personalized care and allows health plans to improve member experiences. The CVS Health 2022 Health Care Insights Study found, “People want theirs [primary care physicians] knowing and understanding their lifestyle choices, personal health goals, family medical histories and more, and being open to having their health information shared across care facilities to ensure seamless continuity of care.” A connected data ecosystem is the answer.

Simple insights: Personalized, not generic

Viewing members holistically allows healthcare plans to address their needs more quickly and further leverage technology to do so at scale. By applying predictive analytics, plans can create multiple value segments from their joined data. Historical data is important to understand what happened, while real-time data allows plans to see what is happening. By leveraging both sets of data with artificial intelligence and machine learning techniques, plans can predict what is likely to happen and then use next best action technology to effectively dictate what should happen next.

In practice, the connection of electronic health records would allow plans to see scheduled appointments in real time and proactively trigger pre-visit support, e.g. B. Free transportation, and a post-visit survey to collect feedback immediately after an appointment. This provides the plan with an opportunity to intervene immediately and fix any issues before the next visit.

This is the same mindset that retailers use to understand their consumers. Relying on mock surveys to understand member satisfaction presents a challenge because they provide only reactive data and it requires waiting months or longer to understand a member’s experience. Plans that take retail inspiration and enable real-time data collection can meet member needs faster and improve experiences, ultimately increasing engagement and satisfaction.

Effective Outcomes: Transformational, not transactional

Members who care about a plan are easier to retain, and effective engagement drives happiness, a powerful antidote to churn. A recent study of nearly 7 million Medicare Advantage members, 25% of whom opted out in the last 18 months, found that engaged members are less likely to churn than the rest of the population.

Using a connected population-level data strategy helps health insurers understand where and why their members are churn. When members leave a plan, it’s critical for health plans to use this historical knowledge to implement strategies to increase engagement and improve satisfaction in the future.

By leveraging connected real-time data, plans can identify members who are likely to churn, e.g. B. those who express grievances or are affected by social problems and barriers such as food insecurity and loneliness. Armed with this knowledge at scale, health plans can quickly identify the levers they need to pull to solve these root cause issues, prevent churn, and improve member experience and satisfaction at scale.

Consumption in health care: innovative, not conventional

Delivering consumer-centric experiences starts with knowing your members. Health plans should recognize the importance of their role in managing the well-being of their members and begin implementing strategies and technologies that provide deeper insights into member needs, engagement and satisfaction.

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