Looking to the Year Ahead: Predictions for Health Care Navigation and Digital Experiences

Each day, our team at HealthSparq focuses on building software and programs to help our health plan clients make navigating the world of health care and their benefits a bit easier for their members. Since health care and technology are changing rapidly, we stay on top of the latest trends by attending industry events, reading a lot and meeting with clients to discuss their most pressing needs. Looking at what’s ahead in 2019, I see many new exciting opportunities and difficult challenges for health care. Below are some of my personal predictions for the rest of the year.

Health care costs will continue to dominate the headlines

The rising cost of health care will remain front and center in 2019. Research from a range of health care organizations, and even our own research, continues to highlight the significant financial impact health care has on consumers. New rules from the Centers for Medicare and Medicaid Services (CMS) to mandate price transparency at hospitals shows some of the pressure brought to bear on providers and health plans to improve consumer access to information that can help them understand the cost of health care.

In 2019, new steps will be taken to address the issue of health care costs by addressing price transparency. Payers will partner with their providers to get insurance-based out-of-pocket cost information to patients at the point of care or point of referral. Plans will also work proactively with providers to help them make quality and cost-sensitive referrals to help reduce unnecessary costs. This in turn will help providers better understand their influence on the costs incurred by their patients from referrals and prescriptions. Costs won’t only be accessed by patients, but directly by providers helping their patients make the best decisions possible.

Plans will have to continue work to help their members make quality, cost-conscious decisions when navigating their health care options. To facilitate this, health plans will do more to encourage members to shop for care, including rewarding quality choices and the use of cost-effective alternatives, such as telehealth.

Digital strategy is no longer an afterthought

Consumer satisfaction with the health plan industry lags behind other industries in terms of convenience, helpfulness, and the availability of user-friendly experiences and it’s time that health care starts to close the gap. Health plans are accelerating efforts to improve their digital experience to create personalized health care and support experiences.

So, what are health plans doing with their digital properties in 2019? They will integrate their digital properties, reduce the workload to find important information to accomplish tasks (fewer clicks), and empower members with access to information, care and more support than they’ve ever had online before. Plans are working hard to figure out how to come across as more human, while also making digital a more valuable and integral part of members’ interactions.

Guidance and education enter the mainstream

We have known for quite a while that health literacy is low and many health plan members don’t have a working grasp of many of the core terms they need to know to understand their insurance benefits. This hinders people’s ability to navigate their coverage and options. In addition to understanding their benefits, people face many tasks and options. Having so many options and choices to make can be overwhelming. Digital communication strategies will help people learn about their plan, as they need it, and plans will be rewarded with happier members.

It isn’t just understanding benefits and options that is challenging for people. People don’t always make the best choices for care when dealing with a pressing, but not life threatening, medical situation. For example, while emergency rooms (ER) are being used less, approximately 30% of ER visits could be handled at urgent care, retail clinics or via telehealth. This data point is important because avoiding and rerouting unnecessary ER visits would save the industry $4.4 billion a year. Providing guidance to help people find the most appropriate venue of care at the point of need will be critical this year.

Health plans will continue to get more personal – and more human

Good customer service that makes members feel valued and results in brand loyalty and retention will be a central component of member engagement and communication efforts in 2019. In fact, good customer service improves member satisfaction with health plans more than other engagement tools and strategies, according to research from Forrester.

The Forrester study also found that great customer service will be key to brand loyalty for health plans: “When customer service leaves members feeling valued and appreciated, nearly 87 percent of health plan beneficiaries will advocate for the health plan’s brand and 74 percent will retain their membership.”

We increasingly hear from users and members that they want a human experience and the opportunity to connect with someone who cares that can help them navigate any issues they are experiencing or questions they have with their health plan. That help can come from someone in-person, on the phone or even via online chat. Humanizing health care (and tightly coupling it with their evolving digital strategies) will be a core theme we see for health plans in 2019.

Convenient care options will continue to expand

It’s certainly not a new concept that consumers are looking for convenience. Providing accessible, convenient health care navigation, care coordination and administrative support can boost member satisfaction while lowering medical and administrative costs.

In 2019 we will continue to see an increase in adoption of new care options across retail, primary care and telehealth. However, people still need to help understanding how each works, when each service is appropriate for their needs and the cost for services. Folding these new care models into the mix will be an important factor in improving satisfaction and reducing health care costs.

Finally, consumers will take an increasingly active role in their health care

As we often say at HealthSparq, nothing is more personal than your health. And because it is both highly personal and very important, people need to take an active role in their own health and health care decisions. This can be tough to do when juggling work and family responsibilities.

But, this year people move beyond thinking about health relative to their diet and tracking data with wearables. The industry shift of financial responsibility for health care costs to consumers means people need to start using the control they have to manage their health and financial well-being. Patients will take an active role in the national conversation on health care costs and talk to their own providers about options. More and more people will find the voice to drive their health conversations, ask questions, and do their research.

And there you have it. We wish you a happy and healthy 2019. We’re looking forward to seeing what unfolds in health care this year.