By Abhishek Danturti Sharma, assistant general manager and lead data scientist for business transformation, HGS.
Abhishek Danturti Sharma
Health plans are all too familiar with the challenges of member experience—that perfect storm of call/processing volume surge, staffing challenges, and critical moment-of-truth engagement pressures. According to JD Power research, the stakes are even higher for 2021.
The organization’s fourth annual study found that member satisfaction averages dropped from 712 on a 1,000-point scale in 2009 to 701 in 2020. J.D. Power and Associates measures health plan satisfaction of 133 health plans in 17 U.S. regions in seven areas: coverage and benefits, provider choice, information and communication, claims processing, statements, customer service, and approval process.
To be successful, today’s digital-led member engagement must meet the needs of Generation “C” – the “connected” customer demographic that spans generations. These consumers make purchasing decisions based on brand reputation and a more personalized experience. A strong digital toolkit, containing interaction analytics; AI-powered data capture; and automation, will elevate and customize engagement to earn and retain these buyers. It may be counterintuitive, but digital enablers such as analytics, AI-powered intake, and bots can deliver a more empathetic, customized member enrollment experience—one that earns and retains customers for life.
Utilize Interaction Analytics
Interaction Analytics solutions offer key advantages along all consumer journey touchpoints, delivering essential ROI with voice of consumer insights related to preferences and experience enhancements to drive higher CSAT and NPS. Contact centers have a goldmine of customer feedback. Insights can be built from speech data that is a valuable information source of customer sentiment and intent. The data tells the unbiased story here – to avoid missed opportunities or misalignment of feedback. The proactive insights built at the crucial open enrollment phase are actionable by helping health plans to tailor their product development to consumer choice across key member demographics.
Apply AI-powered data capture
Today’s cutting-edge machine learning, optical character recognition (OCR), and intelligent character recognition (ICR) for cognitive intake have elevated the document management process once considered highly burdensome for payers. The open enrollment process is a touchpoint ideally suited to intelligent data capture. Open enrollment is a highly paper-intensive process that presents an excellent opportunity for improvement. With the inherent paperwork and processing, AI-powered innovation provides tremendous opportunity for workflow enhancements to minimize subjectivity of structured/unstructured data—for faster turnaround and cost savings.
Are the basic finances and operations systems your business used to use are no longer efficient enough? Maybe it’s time to think about adopting a more modern and more ergonomic Enterprise Resource Planning (ERP) system! In this context, one of the best possibilities available to you is to opt for Microsoft AX software, an efficient solution, the many advantages of which will optimize the main areas of development of your company.
Microsoft Dynamics 365 is the new business cloud-based solution that combines classic ERP and CRM functions with modern Business Intelligence (BI) functionality, Office 365 integration, and complementary applications designed to meet specific business and industry requirements.
Microsoft Dynamics 365 Finance and Operations: a cloud migration for Dynamics AX customers
No more server rooms and heavy IT investments to using Dynamics AX! Since AX joined the Dynamics 365 family, a simple browser allows you to use all the functions and modules of the solution via a simple internet connection. Dynamics AX has transformed and become Microsoft Dynamics 365 Finance and Operations. The ultra-powerful ERP with extensive features has joined the Dynamics 365 environment to integrate it as a functional suite dedicated to finance and operations.
The internet has been the greatest force on the planet to get vast amounts of information out to the public. However, its decentralized, leaderless structure means there is no gatekeeper to determine whether information is factual or credible before it is published. This is especially problematic for medical information, given the potential repercussions of following incorrect or misleading medical advice.
Many articles related to health on the internet are produced by content mills and individuals with no medical training. Even so, this does not mean that the internet is devoid of reliable health information. It’s all about knowing how to find it. Here are some practical tips.
1. Prioritize Health Search Engines Over Google
Google is the undisputed king of internet queries. No one can match the sheer scale of online information the search giant has indexed. But Google is akin to a fishing trawler. Whileit has gone to great lengths to improve the quality of its search results, it is extremely difficult for Google to exhaustively review the trillions of indexed pages for content reliability.
You can use Google and other mainstream search engines to search for health information online. However, it is best to do so only after you have exhausted other sources, such as a reliable health search engine or portal like MedlinePlus. Health search engines are devoted to medical-related information only and have taken time to provide accurate, proven and reviewed content.
What is senior life insurance? It is an insurance policy aimed at covering expenses that come with old age like medical costs, nursing care costs, remaining debts and burial or funeral expenses.
Senior life insurance for that reason, should be purchased to ease the financial burden that comes with old age, and ultimately, death. The insurance is ideal for those in retirement especially if they don’t have permanent life insurance or their employers stopped paying for life insurance after they retired.
Senior Life Insurance Is Not Necessary If:
You have saved enough to cater for your final days and burial expenses.
You have no credit card debts, loans or mortgages that will require to be settled before or after your death.
You have already made burial arrangements with a funeral home of your choice.
What Exactly Is Meant By Final Expenses?
These are generally funeral costs which include expenses on body dressing and viewing, transportation, casket, embalming and hospital bills included. Robert Schmidt of Burial Insurance Pro notes ” many seniors will use a whole life insurance policy, known as a burial insurance policy to address all of their funeral expenses. These policies generally provide coverage ranging from $10,000 to $25,000. At the time of their death, their family receives a lump sum, tax free payment that their family can use to pay for these types of funeral costs.
Cremation may not cover much expenses and it’s a bit economical.
What Life Insurance Offer To Seniors?
You may be wondering, what really constitutes life insurance for seniors and how you stand to benefit from it in this modern era.
Well, you are not necessarily the beneficiary of life insurance, but loved ones who are tasked with the facilitation of a decent send off.
Your loved ones are the same people who will make major decisions about taking you to a nursing home if need be, and settle involved charges. In details, these are the benefits of purchasing life insurance.
· Long-Care Financing
With old comes health complications like chronic illnesses and other medical issues. Most prevalent illnesses at old age include ALS, renal failure, cancer, stroke, organ transplant and more.
Your loved ones may also consider taking you to a nursing home if it happens to be the most logical option at the moment. All these expenses are catered for effortlessly when there is a term life insurance or a Medicare plan in place.
· Peace of Mind
How? Because of the fact that your loved ones will not struggle to cater for funeral arrangements after your death. So, much money goes into organizing and facilitating decent and modern burials, and a funeral life insurance compensation could come in handy. However, this type of life insurance is particularly helpful for seniors over 90 who can’t quality for a traditional plan.
· Debts Settlement
Death at times knocks when least expected but in old age, it is expected. However, you may pass away before settling debts leaving your loved ones with the task of settling them. Such debts could be medical bills, or estate taxes and loans. Part of the senior insurance compensation could be used to settle most of the debts, if not all of them.
By Mifan Careem, vice president of solutions architecture, WSO2.
Mifan Careem
In 2020, we’ve seen the pandemic accelerate the need for greater healthcare interoperability and digital solutions. Notably, providers that have offered telemedicine, virtual visits and other digital services fared better than those that have not.
At the same time, provider and payer organizations are now more focused on value-based care measured by patient outcomes rather than reactive patient care. Such innovations have been made possible by integrated data sources within and across the healthcare organization.
Too often however, the lack of interoperability continues to stifle innovation that would otherwise benefit the healthcare industry’s most important stakeholder: the patient. The Office of the National Coordinator (ONC) Cures act and the Centers for Medicare & Medicaid Services (CMS) Interoperability and Patient Access Final Rule (CMS-9115-F) set to go into effect on July 1, 2021, aim to change that.
The new ONC and CMS rules, which target U.S. organizations, require healthcare payers and providers to provide patients with open access to their data and a secure data exchange between the different parties. As a result, patients should have improved access to health information. Meanwhile, the improved interoperability among providers and payers is expected to trigger innovation and pave the way to a newer app ecosystem.
APIs are key to compliance
Interoperability is a critical component within the healthcare system as records are digitized and must be easily shared between institutions and payers to improve the overall care of patients. The lack of interoperability is hampering the industry’s ability to transform and streamline services. While there have been attempts by the organizations including Health Level Seven (HL7) to promote interoperability and responsible data sharing over the years, concerns and issues with granting patients access to their data remain.
To achieve successful interoperability, healthcare payers and institutions must use APIs—specifically those aligned with the Fast Healthcare Interoperability Resources (FHIR) standards—to exchange structured healthcare data, such as those used for electronic health records (EHRs), digital health applications and patient use.
The CMS rule is designed to help simplify how payers and providers use APIs to drive interoperability and data sharing. However, as with all regulations, CIOs need the right strategy to implement the technology and steps to ensure compliance. As this is a new rule, there are no prior examples to follow, and if CIOs do not effectively follow a strategy, they may be found at fault on July 1.
There are four challenges that healthcare CIOs will need to overcome to ensure successful compliance and more importantly the transition to a patient-centered approach—with services delivered when, and where, consumers want.
By Devin Partida, technology writer and the editor-in-chief, ReHack.com.
Healthcare providers commonly listen to heart and lung sounds when examining people. They aim to pick up on abnormalities that give them more insights into patients’ conditions, and those diagnostic methods aren’t going anywhere.
However, pioneering research suggests that screening could also happen by analyzing someone’s voice with the help of artificial intelligence (AI). Here’s a look at some ongoing developments.
A Collaborative Effort Looks for Vocal Biomarkers
Even the most skilled physicians can’t always detect signs of trouble during a patient’s routine examination. That’s especially true if a person does not have external symptoms. However, biomarkers indicate possible abnormal processes within the body. Scientists have linked some of them to cancer and high cholesterol, for example.
Researchers at the Mayo Clinic recently teamed up with an Israeli company called Vocalis Health. The two organizations initially worked together to learn about voice-based biomarkers for pulmonary hypertension — an often undiagnosed condition that causes high blood pressure in the lungs. The earlier efforts established a connection between the disorder and specific vocal qualities. This recent undertaking seeks to identify the specific vocal biomarkers associated with the medical problem.
Vocalis Health’s technology works on any connected device, and it provides a noninvasive way to check for medical problems. Although this current initiative focuses on only one disorder, there are plans to expand the technology to apply to other issues.
Researchers Working on a Voice-Based COVID-19 Screening Tool
Predictive analytics tools have furthered impressive progress in the medical sector. However, they are not free from bias. Some medical technology companies strive to build algorithms that treat the data as objectively as possible. For example, one company combines three models to get a more holistic view of patient outcomes. It also identifies people across diverse populations to avoid overlooking underserved groups.
By Dr. John Showalter, MD, MSIS, Chief Product Officer, Jvion.
COVID-19 catalyzed a rapid shift to telehealth that was years in the making. Reimbursement, once a barrier to adoption, was overcome when CMS announced that Medicare would cover telehealth to allow socially-distant care to continue. As a result, 69% of all patient encounters were done via telehealth in April, with that proportion even higher in areas with severe outbreaks of COVID-19.
Today, April feels like a lifetime ago, and telehealth accounts for only 21% of visits. But the consensus is clear: telehealth is here to stay.
A recent survey found almost 70% of providers were more motivated to continue using telehealth after the pandemic, citing better access to care (68%), more timely care (83%), improved patient health (60%), and improved financial health for their practices (57%). And now that CMS has permanently expanded telehealth coverage, any uncertainty over the long-term financial viability of telehealth can be put to rest.
Of course, not everything can be done via telehealth. Telehealth works great for chronic disease management, behavioral health, hospital/ED follow-ups and preventative care, but there are many procedures that can only be done in person. How then can providers determine which patients should be seen in person and who can be seen via telehealth?
This question is now more urgent than ever, as hospitals nationwide confront a surge in patients admitted with Covid-19. To manage capacity and keep patients safe, providers will want to see patients virtually whenever possible.
Deferred care is another concern for providers. Some 41% of US adults deferred medical care they needed this year to avoid the coronavirus. To prevent these patients from deteriorating and suffering worse health outcomes in the future, it’s critical that providers re-engage with these patients as soon as possible before it’s too late. Telehealth is often the safest way to do so.
When the COVID-19 pandemic first came into the country and hit hospitals like a tidal wave, we saw a rapid shift to digital care. More than half of consumers say their providers now offer virtual care. And use of digital tools like telemedicine increased by 50% during the first quarter of 2020, compared with the same period in 2019. These stats are a sign that providers must work to truly understand the importance of digital-forward engagement strategies when it comes to building strong patient relationships.
Although recent vaccine approvals have brought some much-needed good news, the U.S is currently reckoning with the deadliest wave of the pandemic. This means that in addition to a continued public health crisis, patients and providers alike will still be faced with significant economic hardship as we enter 2021 – intensifying the need to improve the healthcare financial experience.
How can this be done? Here are three trends that I see coming to fruition as we continue fighting this pandemic in 2021:
2021: The Year of Smarter Heath-Tech Adoptions
The economic hardship brought on by the COVID-19 pandemic has affected both the patient and provider. With the highest unemployment rates since the Great Depression this year, patients are feeling more cost-conscious about care decisions than ever. According to our recent consumer survey, 84% of respondents are worried about paying their healthcare costs in the next year.
What do you do when you’re on a budget? You shop around for the best price. Patients were already increasingly expecting healthcare to mirror their experiences with e-commerce and shopping before the pandemic. The financial strain caused by COVID-19 simply exacerbated this shift, lighting a fire under providers to adopt smart technologies that can consolidate patient information and “consumerize” the experience. Cohesive, consolidated and consumer-centric digital access points for all patient interactions have become the norm, and providers will need to adapt to meet these expectations.
As for providers themselves, pandemic-related shutdowns and stay-at-home orders caused financial strain for these organizations, with millions of elective procedures cancelled. This alone resulted in an estimated loss of $16.3 to $17.7 billion per month in reimbursement and $4 to $5.4 billion per month in net income for health systems.
In response to this financial strain, providers will increasingly look to invest strategically in tools that support their business goals and help them gain a competitive edge. Over half of consumers have delayed care due to fear of catching COVID-19, so getting patients back in the “door” – whether it is physically or virtually – will be crucial. Think about it from the point of view of ap patient – wouldn’t it make a difference to you if your doctor had the option of filling out paperwork and insurance information online, as opposed to waiting in a crowded waiting room?
Healthcare providers commonly listen to heart and lung sounds when examining people. They aim to pick up on abnormalities that give them more insights into patients’ conditions, and those diagnostic methods aren’t going anywhere.
COVID-19 catalyzed a rapid shift to telehealth that was years in the making. Reimbursement, once a barrier to adoption, was overcome when CMS announced that Medicare would cover telehealth to allow socially-distant care to continue. As a result, 
When the COVID-19 pandemic first came into the country and hit hospitals like a tidal wave, we saw a rapid shift to digital care.