A Digital Path Toward Improving Health Outcomes

By Susan Beaton, RN, Vice President of Health Plan Strategy, Wellframe
Twitter: @wellframe

The ongoing pandemic has ushered in many changes within healthcare, from the way care is delivered to how patients interact with the system. One prime example of this change is the massive surge in telehealth usage and the growing need, and appetite, for digital healthcare experiences. While telehealth is an important step toward improving access to care during the pandemic, it is still episodic in nature and has not addressed the need for more continuous healthcare support in between care encounters.

Individuals are also avoiding routine care at alarming rates. Specifically, 54 percent of respondents from a survey commissioned by Wellframe said they’ve delayed healthcare as a result of COVID-19. Simply put, the healthcare system needs a way to ensure that these individuals do not fall through the cracks. Now more than ever, there is a heightened demand for a personalized and holistic care experience, but at a time when the system is under enormous strain and providers are spread thin, how can this need be met?

Health insurance companies have a unique opportunity to leverage member data as well as technology such as digital health management platforms. By embracing a digital path moving forward, they can improve members’ healthcare experiences, fill gaps in care, and do their part to support the system during an unprecedented and precarious time.

Room for improvement
Recent research commissioned by Wellframe underscores key problems consumers face with their healthcare experiences. The survey of approximately 1,100 U.S. individuals with health insurance revealed that 60 percent think a lot of the information they receive from the healthcare system is “too generic and not personalized to me.” These frustrations lead to general dissatisfaction, but it can also have negative consequences on one’s health. For example, 42 percent of those surveyed forgot to take a dose of their prescription and 34 percent missed one or more appointments with a healthcare provider. Preventive care is always important, but missed doctor’s appointments are especially concerning for individuals with chronic conditions, as they often face a variety of complex issues that require guidance from a medical professional. If they’re unable to access a trusted provider, some of these concerns may remain unaddressed and could potentially accelerate their disease progression. With the healthcare system already overstretched, it’s clear that individuals need more personalized support in between healthcare encounters to close care gaps.

Rising to the occasion
Although it may seem like a large undertaking to improve the overall consumer experience and fill gaps in care, health insurance companies possess both the tools and insights needed to lead this charge. Firstly, insurers have unparalleled data about their member base, positioning them to identify members in need of health care and support, as well as inefficiencies in how care is being delivered. By identifying members with gaps in care, health insurance plans can proactively work with members and help them navigate their healthcare journey to ensure they get the care they need to feel their best. When it comes to keeping these members healthy in between appointments, many forward-looking insurers leverage technology to communicate more frequently and proactively through digital channels such as two-way messaging. Health plan care managers can check in with members virtually to see how they’re feeling and promote medication adherence, proper nutrition, exercise and other lifestyle factors. This communication may also provide members with the accountability and motivation to stay healthy. A care management team can even identify potential mental health issues that may exacerbate a medical condition. Additionally, if a member is struggling with social barriers to health, such as a transportation issue or language barrier, health plans are positioned to intervene, either with their own resources or by referring the member to a local community organization or nonprofit. Based on recent survey data, insurers can expect their members to show interest in this type of digital health support. Specifically, 72 percent of survey respondents said having increased access to a virtual care team would help them stick to their doctor’s recommendations during the COVID-19 pandemic.

Closing thoughts
The pandemic has exacerbated the challenges faced by the healthcare system in providing holistic care and improving health outcomes. COVID-19 has presented an opportunity for health plans to rise to the occasion and deliver digital solutions to serve the healthcare needs of their members. By leveraging data and technology such as digital health management platforms, health plans can realize their potential to keep members motivated and accountable on their path to better health.