Guest post by Anand Natampalli, MBA, vice president, global business development, HGS, and Daniel A. Schulte, MBA, CHFP, senior vice president, provider healthcare, for HGS.
If there is one constant in healthcare and health IT it’s change. Technological advances, growing workforce needs, regulatory reforms, and the continued shift to value-based care will all continue to have a profound impact on the industry in the coming year. Here is what we think will be the major changes affecting payers and providers:
Data Grows More Critical in a Value-Based World
Payers used to leverage analytics to look for ways to reduce operational costs. In 2016 and beyond, the focus will be on creating highly targeted products, channels and service offerings that keep patients healthier. For example, payers will use highly personalized behavioral data to make wellness recommendations for members. This targeted approach of wellness is possible with analytics resulting in higher adoption rates compared to a traditional outreach.
Greater Focus on the Customer Experience
Members purchasing health insurance on the exchanges will be faced with a choice each year, and those choices will be right in front of them for them to compare. A poor customer experience this year will increase the likelihood of finding a new payer next year. Based on 2014-2015 data, 38 percent of members changed their health plans in state exchanges with in one year. With price points remaining comparable customers will continue to look to service and experience as key differentiators when choosing a health plan.
Engagement and Activation
Technologies that enhance and improve patient engagement and activation will be critical to healthcare moving forward. Through population health management we are learning more about how to create wellness strategies and to stratify patient populations based on their conditions and adjust for nuances in age, race, diagnostic groups, and the like.