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Why Payers Should Adhere to Patient Engagement, Consumer Choice

It is beneficial for payers to set themselves apart by providing more opportunity regarding consumer choice, patient engagement, and consumer experience.

By Vera Gruessner

Consumer choice in health plans and provider networks is becoming a more popular topic of late among payers looking to increase patient engagement. There is a growing movement around the nation aimed at improving consumer satisfaction and healthcare transparency.

Consumer Choice

In fact, a report from Strategy& at PwC  found that a large number of Americans are dissatisfied with the current healthcare system both on the provider and payer side. Only 49 percent of surveyed consumers reported being satisfied with their overall experience within the healthcare market. The consumers now hold more say in the future of the healthcare market, as patient engagement becomes further stressed by stakeholders. With consumers having such an impact, there is more potential for new companies to enter the market.

How new players can affect the market

The report finds that consumers aren’t concerned with entrusting their medical care to “less traditional sources” of healthcare services. One out of every three consumers reported being comfortable with entrusting digitally enabled companies like Google or Amazon with their health insurance options.

“In the New Health Economy, consumers are open to new, nontraditional solutions to meeting their healthcare needs. That means the market is primed for new entrants. Forty percent of consumers report that they’d trust large retailers like Walmart or Target to manage their health, compared with 39 percent and 37 percent who place that kind of trust in providers and insurers, respectively. 33 percent report that they’d trust Google or Amazon to deliver their healthcare,” the report from PwC stated.

READ MORE: How Payers Could Assist Primary Care Docs with Value-Based Care

“The primary reason consumers are willing to trust in nontraditional companies: They believe such companies can provide quality care and core benefits at a lower cost. For traditional players, this level of trust in nontraditional health delivery entities should be alarming.”

“Insurers, providers, and other established industry players will be forced to adapt today to provide consumers with the choices, engagement, and experiences they demand if they have any hope of keeping their turf tomorrow.”

Today’s consumers are expecting the healthcare market to operate with digital health solutions including user-friendly interfaces while offering multiple products with clearly defined and transparent pricing to meet their needs.

As such, patient engagement is reaching its potential for bringing the market to to serve its customers. The report also outlined how health payers can compete in the ever-changing and evolving healthcare market. It is beneficial for payers to set themselves apart by providing more opportunity regarding consumer choice, patient engagement, and consumer experience.

A study published in the International Journal of Health Policy and Management describes how patient and consumer choice may be a more complicated matter for all healthcare stakeholders. The reason patient choice is so complex is due to the fact those who employ medical services have multiple roles and identities including consumers, patients, and co-producers.

READ MORE: Top 4 Ways Payers Could Improve Patient Health Outcomes

The importance of individuality in consumer choice

As such, healthcare policies around the country should focus on providing “more balanced choice frameworks” that account for the several identities of healthcare users, the report argued. For instance, it may benefit health payers and providers to consider patients’ cultural backgrounds when administering services as well as their overall values and beliefs.

Incorporating patients’ individuality into administering health plans choices and benefits will be key to setting up a health payer as an innovator in the market. The report published in the International Journal of Health Policy and Management mentions that the patient ability to voice concern along with the need to have a trusting relationship with their physicians will need to be accounted for among health plans and hospitals.

“As co-producers, patients contribute emotional knowledge to the doctor-patient relationship. They alone know best ‘how it feels’ to be ill— an aspect that should be considered in the choice of medical treatments. However, patients remain merely ‘experts by experience’ and are therefore interested in close consultations with doctors,” the author stated in the report. “In this respect, choice becomes a relational procedure where it is less important who decides but how the decision has been developed.”

The idea of incorporating user voice in patient engagement protocols means that consumers are able to state dissatisfaction with benefit designs as well as have complete say in their health plan choices and provider networks. Instead of incentivizing consumers to choose certain disease management programs, incorporating voice will allow patients to truly participate in their medical decisions.

READ MORE: Shareholder Class Action Lawsuit Filed Against Aetna

Digital health strategies boost patient engagement

Finally, it is important to note the importance of digital health solutions in strengthening patient engagement and consumer choice. MedStar Health is one organization that incorporated a digital health system that moves beyond the typical patient portal experience. The platform manages multiple consumer capabilities within one interface including the call center and the online scheduling system.

“mHealth is less about doing a cool, sexy application than about providing a service to our patients no matter where they are,” Mike Ruiz, Vice President and Chief Digital Officer of MedStar Health, told “What we’re doing is providing a (platform) that aligns with what are patients are looking for.”

“We’re aligning the right patient with the right skillset,” Ruiz continued. “I think this is something that the healthcare industry has long struggled with.”

Health payers, providers, and other stakeholders will need to focus on consumer choice and patient engagement in order to compete effectively in the constantly changing healthcare market. This will include incorporating digital health strategies, the individuality of the consumer, and the patient’s voice.


Dig Deeper:

Why Payers Should Improve Cost Transparency for Consumers

Plan Member Satisfaction Reduced in Less Competitive Markets


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