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