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Advancing Health Care Consumerism Begins With Adopting a Retail Mindset

by Ozva Admin

Adopting a retail mindset, where patients are the main focus of innovations, could help promote healthcare consumption in the future.

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

A 2020 Survey of Healthcare Finance Leaders showed that organizations that embrace consumerism and proactively meet member needs are more likely to be successful than those whose consumerism efforts are reactive. According to the same survey, technology is crucial to creating positive experiences for the consumer. Respondents who prioritized finding the right technologies to support consumerism likely reported high success in member expertise, transparency, and engagement.

Motivated in part by the increased weight given to experience and satisfaction measures in the CMS Star Rating system, health plan leaders are working to influence behavior and outcomes by presenting options that are personalized and relevant to each member. individual. Consider the impact that offering a highly curated member experience can have: personalized experiences lead to higher engagement; higher engagement reduces turnover and builds loyalty; Longevity with the health plan increases member understanding and improves quality of care.

As retailers and other consumer-focused organizations increasingly provide flexible, efficient and timely services to their customers, they are raising the bar on consumer expectations everywhere. Personalized services are becoming table stakes, so it’s essential that health plans do the same. Health plans that can deliver consumer-centric experiences to their members today will have a competitive advantage over plans that continue to operate with a legacy mindset and “one size fits all” solution approach.

As health plans embrace a retail mindset and work to deliver consumer-centric experiences to their members, they can look to leading retailers for inspiration. Furthermore, these companies offer a model for success: they ensure efficient access to data, they know how to turn that data into insights, and they harness comprehensive consumer insights to drive action.

Simple connector: integration, not disruption

The healthcare industry is surrounded by data. It is constantly being collected by people, systems and devices. Despite the abundance of data, the industry faces very real challenges: systems are not connected, solutions are not always scalable, and information delivery can be slow. The usual suspects (access, punctuality, and integrity) get in the way. However, by solving the siled data challenge and developing a holistic understanding of their membership, health plans can implement customized solutions that were not previously possible.

The building blocks exist to create a connected data ecosystem in healthcare, with the potential to deliver personalized and integrated experiences for members. Moving from episodic interventions to continuous care built around a holistic, whole view of a member drives individualized care, enabling health plans to improve member experiences. the CVS Health 2022 Study Health Care Insights revealed, “People want their [primary care physicians] to know and understand your lifestyle choices, personal health goals, family medical history, and more, and are open to having your health information shared across care settings to ensure a seamless continuity of care.” A connected data ecosystem is the answer.

Easy information: personalized, not generic

Viewing members holistically allows health plans to address their needs more quickly and further use technology to achieve this at scale. By applying predictive analytics, plans can create multiple segments of value from their connected data. Historical data is important to understand what happened, while real-time data allows plans to see what is currently happening. By using both sets of data with artificial intelligence and machine learning techniques, plans can predict what is likely to happen and then effectively prescribe what should happen next using Next Best Action technology.

In practice, connecting electronic health record data would allow plans to view scheduled appointments in real time and proactively trigger pre-visit assistance, such as free transportation, and a post-visit survey to collect comments immediately after a date. This provides an opportunity for the plan to immediately intervene and correct any problems 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 as they only provide reactive data, requiring plans to wait months or longer to understand a member’s experience. By taking inspiration from retailers and enabling real-time data collection, plans can meet member needs faster and improve experiences to ultimately increase engagement and satisfaction.

Effective Results: Transformational, Not Transactional

Members who are committed to a plan are easier to retain, and effective engagement breeds satisfaction, a powerful antidote to turnover. A recent study of nearly 7 million Medicare Advantage members, where 25% disenrolled in the past 18 months, found that committed members drop out at a lower rate than the rest of the population.

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

By leveraging real-time connected data, plans can identify members who are likely to drop out, such as those expressing complaints or affected by social issues and barriers like food insecurity and loneliness. Armed with this knowledge at scale, health plans can quickly identify the levers to use to address these root cause issues, prevent churn, and improve member experience and satisfaction at scale.

Health consumerism: innovative, unconventional

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

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