US Healthcare Industry Blog Series Part 4: Growth Strategies and Technologies for Payers, Providers and Managed Care Players
This blog post is the last of a series of 4 where we discussed the challenges faced by the healthcare industry in the US, recent regulatory environment and trends emerging
due to the challenges and regulatory changes.

This post looks at the emerging trend from the previous post to put forth strategies that the Payers and Providers can adopt to not only cope with challenges and regulations but also seize some of the opportunities arising out of this scenario to drive efficiencies and greater consumer delight.

Payers Strategies

Although Payers have increased focus on Web Technologies like Customer Portals, Self-Help Portals and Mobile applications for enhanced consumer engagement, this area still remains significantly under invested as compared to investment in similar channels in other services industries.

Engagement with the consumers will not only help payers to cope with the open market scenario of Health Insurance Exchanges but also drive growth as the health insurance expansion takes place as a part of the health reforms. Some of the key channels of customer engagement are discussed below.

Web Based Collaborative Administration Portals

Portal solutions provide a channel for providing efficient co-ordinated care. As the voices for “meaningful usage”, “preventive care” and utilization of EHR increase, more and more payers will need to invest in Web Based Portals which act as a bridge between Members, Providers, Employers and other Brokers. This will help better co-ordination of healthcare delivery as the patient data can be made available more readily not only providing decision support but also reducing administrative overheads cropping due to frequent claim rejections, under payment, claims recovery. A seamless process of healthcare delivery will not only reduce the administrative overhead but also give a satisfying experience to the consumers and stake holders thereby increasing loyalty.

Wellness Management and Customer Self Help/Information Portals

The PPACA lays down explicit focus on prevention and wellness. This implies that payers will need to empower their customers to whole new level. Wellness management portals can provide members the tools through which they can be guided through and encouraged to lead a healthy life. For Eg. Wellness Management Portals can help consumers manage chronic disease conditions by providing facilities like, Diagnostics and Pill Dosage scheduling, Dietary management, interface to third party wellness services providers for specialized streams like behavioral health. Wellness management and information portals will also prove to be useful tools for payers to seek avenues for cross selling and other bundled offerings.

However payers will need to be judicious in deploying portals. Consideration should be given to few points mentioned below, which increase the efficacy of portals to enhance consumer engagement.

  • Web Experience Management
    • Intuitive Interface
    • Seamless Navigation
  • Comprehensive Services like symptom assessment, medication history, appointment scheduling etc…
  • Social Integration

Mobile Applications

It is estimate that 95% of Healthcare Insurance members are connected to the internet and about 50% actively use Smartphones and Mobile Applications. This scenario throws up an interesting opportunity for health insurance players to engage consumers on the move.

Some of the biggest healthcare players like Kaiser Permanente have already joined the Healthcare Mobile revolution by releasing iPhone applications for its memberscalledMyHealthManager.

However when it comes to mobile applications , payers should be careful to differentiate between making their portals available on mobile versus having highly user centric intuitive native mobile applications which enhance the customer’s experience of dealing with the insurance provider.

Date Published: January 22, 2013



All Categories:

Your digital transformation
is just a click away.

Get a callback from a senior solutions consultant from Congruent today.