Electronic Health Records

Use & Optimization News

Why are payers concerned with patient engagement strategies?

By Kyle Murphy, PhD

While healthcare organizations and providers are addressing strategies for engaging patient populations in the pursuit of incentive or value-based reimbursements, payers are actively looking for ways to engage this same population as consumers in the name of healthcare reform.

“I see it becoming increasingly important and payers will spend more money on consumer portals and mobile strategies all aimed at consumer engagement but also look at what is happening with the public exchanges,” says IDC Health Insights Analyst Deanne Kasim.

The Accountable Care Act (ACA) is responsible for removing barriers between payers and consumers and as a result payers have had to identify methods for engaging these individuals directly.

“It is forcing insurers to think of becoming more consumer-centric and giving IT tools to consumers to support their decision-making and keep them more engaged because just like retail at the end of the day you want repeat business, you want retention,” Kasim explains. “We used to say that if you’ve seen one HMO, you’ve seen one HMO. Today, we say that if you’ve seen one patient or consumer, there is not one approach that is going to appeal to everybody.”

Dealing directly with consumers means approaching them in a way that is convenient to them, which starts with a recognition of all the difference among segments of the population:

For instance, in the Medicaid population, beneficiaries want to enroll by phone. Many of them need to have that phone contact, particularly with lower-income, female, and African-American populations. However, they do like the option to look up things online to find out about their health benefits and for them, their only readily-available internet access is a smartphone. That means that the apps need to be scalable for mobile and provide that information.

This differs from how other consumers may prefer to be reached. According to Kasim, it comes down to the fact that consumers “want that ability to pick and choose when and how to engage with the health plan.”

Those most successful payers at the moment are those that have made engagement a priority and adapted quickly to feedback from the consumer population, such as the creation of the chief engagement office position.

Data collection and analysis play an important role in navigating a relatively new healthcare landscape where much remains unknown. Payers, therefore, are looking to invest in solutions that give them a high- and low-level view of consumers.

“They are going to need actuarial and risk analytics as well as consumer engagement analytics because this is a whole new world with the public exchange marketplace,” maintains Kasim. “I see it becoming increasingly and payers will spend more money on consumer portals and mobile strategies all aimed at consumer engagement but also look at what is happening with the public exchanges.”

Health systems, hospitals, and physician practices have a ways to go in terms of their understanding of patient engagement, but they are not alone. The challenge ahead focuses on knowing what patients/consumers want and expect from their healthcare experience.

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