Monday, October 17, 2016

What are some ways payers can use digital to reinvent their business models?

As someone who's been working in healthcare, mainly for health plans, payers and risk-bearing providers for over 20 years, I'm always interested in what others have to say about health plans and those who assume payment risk.

One of the topics in last month's #HealthITChicks tweetchat, held on September 22, 2016, and hosted by Sukanya Soderland @SSoderland, Health & Life Sciences Partner at Oliver Wyman, caught my eye:

T4: What are some ways payers can use digital to reinvent their business models?

The need for healthcare payers to provide succinct, easy-to-understand information about benefits and payment made for member benefits dominated the conversation on Topic #4. Here are all the responses I was able to glean on this topic from those participating in the #HealthITChicks chat:

Stop with the fax machines! Seriously. Because I don't have one, and I'm not going to Kinkos to fax an auth form.
I've loved the fact that our health insurance offers telemed via @MDLIVEInc
Digital = less cryptic re: benefits, coverage, price transparency; easier, more frequent engagement w/ pts
Pretty low bar - nowhere to go but up! Step 1: Access to benefits, $ info, accurate provider directory for a start
Pricing that's easily understood. Tired of calling for preapproval only to be railroaded by some obscure fine print.
I think payers can play in pop health. I don't mind a prevention email. "It's that allergy time of yr again"
Can they work with providers on #pricetransparency? I want to know how much care will cost me up front please.
It's probably more like a billion $ question. The answer is the billions of $ hidden in those EOBs.
Online scheduling, for goodness sake!! I'm a working mom with 2 young kids. I don't have time to wait on the phone.
Yes! They often have the data needed to facilitate effective #PopulationHealth programs.
Payors lag behind. Need to invest in IT infrastructure to improve partnerships with providers and consumers
And payers, stop making the discounts not disclosable to patients until the bill. That's NOT transparent, it's misleading
Step 2 payers: getting care summary, plans, alerts to Mobile - NOT another portal (not to beat the portal prob to death)
Payers really don't have the trust of their members, because their business model focuses too much on $$, not enough on care
A story in Participatory Healthcare describes patient trying to get a cost estimate. Req 15 phone calls+web visits + emails
How about eliminating EOBs? What about providers/payers reconciling bills without patient in the middle? 1 process,…
What, do away with a whole "cottage" industry of healthcare bill navigators?! 😉 agreed - let's make EOBs way better
Yes! Neither doctor nor patient know how much the insurance will pay and how much will be "denied" and why

So thanks to all those who regularly share their knowledge, expertise and opinions about healthcare and healthcare IT - via tweetchats like #HealthITChicks and via Twitter and other social media channels. You can follow me on Twitter where I regularly share information about healthcare data, technology and services.

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