Payers and health plans need to meet shifting consumer expectations. By addressing key challenges, they can move towards a more personalized and improved member experience.
As healthcare is rapidly decentralizing, health consumers are in the center of it. For example, 58% of Americans are likely to seek non-emergency care at a pharmacy instead of going to their primary care physician, according to a recent Wolters Kluwer sponsored survey.
Consumers are dictating new trends, which requires payers to adjust their operations to facilitate these new health experience expectations. As payers adapt they’ll need to address some key challenges along the way to build member trust and ensure long-term growth.
1. New delivery mechanisms for health information
The COVID-19 pandemic changed how and where health consumers receive care and health information. Accelerations in telehealth and digital platforms and new preferences in health education have led to increased expectations of personalized and convenient care.
To meet changing expectations, payers will need to find solutions that can equip members with personalized health education content with flexible delivery mechanisms that supports where and how members prefer to access information.
2. Continued rising health costs
Healthcare costs continue to grow through more complex medical procedures and advanced drugs, and payers are feeling the impact. In 2021, the US spent $4.3 trillion on healthcare with private insurance companies paying 28.5% of the total. According to the Centers for Medicare & Medicaid Services (CMS), national health expenditure is projected to grow an average of 5.4% through 2031.
The shift towards value-based care is focused on better outcomes and focusing on the whole patient – while that can help curb costs, payers will need to find ways to engage their members in their own health journey to improve adherence and reduce unnecessary spending.