Member Engagement: A “Must-Have” for Health Plans Today

As Health Reform continues to unfold, the pace of change is picking up speed, as new models of reimbursement, care delivery and access are taking shape.

These shifts on the provider side should represent good news for millions of Americans that need better support from the healthcare system, especially since many of those with chronic disease aren’t currently getting recommended care caseearn.com . Coupled with the fact that most patients do not adhere to their medication and treatment regimens or recommended lifestyle and health behavior changes, and it’s easy to spot some of the challenges ahead.

Health plans have ready access to claims data and other relevant clinical information plus a direct line to their members for targeted messaging and clinical interventions. While not a traditional strategic imperative, health plans do have a significant opportunity to help drive behavior change, reduce risk, and produce positive health outcomes for their members.

Most plans already provide member portals and other helpful resources, and many have begun to focus on enhancing these activities and initiatives to enhance their value and impact. But, to compete effectively, in this rapidly shifting market, they will need to re-orient their mindset and approach to be far more consumer-centric.

After a decade of slow growth, Healthcare Consumerism has begun to take hold. Participation in high deductible health plans (HDHPs) is at a record level with 23% of all those with employer-sponsored insurance now enrolled in an HDHP. Other emerging factors such as price comparison tools, quality ratings, and retail health alternatives will continue to put more power into the hands of consumers.

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