5 Ways Digital Tools Will Help Payers

digital tools

Undisputedly, healthcare is lagging behind other sectors in its development and use of digital technology tools to meet the needs of its stakeholders, not the least of which is the consumer. The Affordable Care Act has transformed the patient into a true healthcare consumer, looking for the best value for the individual. In order to meet these needs, a script must be borrowed from the playbook of the retail, social, and finance industries, specifically regarding their use of digital technologies in meeting consumer needs. Ultimately, if these needs are met, payers will meet with success. Payers are key players in determining the adoption of mobile health technology. The first of this two-part article will focus on the payer’s perspective and the second will address specific customer needs.

  1. Mobile digital tools must connect at touch points. The touch point can be at the time of purchase or renewal of a health plan. A mobile app which compares coverage side by side by payers for a given procedure, medication, or care at an institution is no different than what we are used to at Amazon. A tool which via locator can automatically recommend a healthy eating option or a highly rated physician should not be seen as Star Wars technology. What if the insurer provided a patient with a set of questions to ask at a medical visit based on past history and medications via a simple text message? These types of scenarios play out every day in people’s lives. The millennial generation expects this sort of thing.
  2. Digital tools can address care delivery issues. Payers face daunting challenges today but are in a better position than even a few years ago to solve them due to market consolidation and a greater control over provider charges. Some of these problems include medication adherence and abuse, determining metrics of quality of care, and evaluating costs in a real-time manner. For example, a digital tool which can track medication adherence can potentially save all stakeholders (patients, payers, providers) healthcare dollars the hundreds of millions of dollars attributed to non-adherence.
  3. Digital tools can lead to more coordinated patient care. While electronic health records (EHRs) area first step in advancing the cause of care coordination, there remain many opportunities for healthcare IT to improve this. Interoperability (the ability of a product to work with other products or systems, present or future, without any restricted access or implementation) has been emphasized as a priority for the Department of HHS.
  4. Digital tools can increase subscriber health and satisfaction.The value proposition of mobile health technology has been realized by some payers already. Hard data demonstrating improved outcomes is available.
  5. Digital tools can develop better metrics. In the future, the collection of data directly from patients via wearable digital technology (ex. Apple iWatch, Fitbit) will supplant poor surrogates like claims data. Better digital communication tools at the point of care will provide more detailed information than a diagnosis. Real-time data acquisition with regards to healthcare resource utilization will be extremely valuable.

While there are substantial far-reaching potential benefits of insurer-based mobile apps, a recent survey by Reasearch2Guidance in its 2015 Health Insurance App Benchmarking Report demonstrated that only 70% of insurers have developed apps mostly one or two) and that apps developed by 67% were downloaded a total of 100,000 times. The success of the use of digital tools by insurers lies in their ability to target specific problems and achieve ease of use (via considering user experience and health literacy). This necessitates a multidisciplinary (software developers, clinicians, patients, analysts) design and implementation approach. Some insights were discussed in an interview with Greg Barnowsky of Independence Blue Cross. Digital technology utilization will continue to build as an imperative for survival in this fast-moving industry.

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Matt Bronaugh
Director of Client Engagements

Author: Digital Health Team
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