Health plans have improved their digital member engagement efforts, but they have more opportunities to tailor their activities to improve care management.
In 2021, Wellframe surveyed 1,126 health plan members across the United States to better understand the expectations of healthcare consumers. Respondents spanned three age groups 18–34 (32%), 35–55 (32%), and 55+ (36%).
While most respondents indicated positive experiences with digital advocacy and personalized care , a large minority wants more from the health plans.
Building on these positive experiences of digital advocacy can bridge the gap between what members want and what health plans can do to help. Digital advocacy can address all of these concerns by giving members a single person to reach out to from their smartphone.
When it comes to personalized care, 49 percent indicated they received health information that was too generic and lacked personalization. The majority of members are interested in services that enable them to find and schedule appointments with providers suited to their individual health needs. Something as simple as making care advocates available to these individuals could streamline this process.
Chronic disease is prevalent among the United States population. The Centers for Disease Control & Prevention (CDC) reports that 60 percent of adults live with one chronic disease and 40 percent live with two or more.
Managing chronic diseases is a daily activity, one which members often struggle to handle on their own. More than one-third of respondents say they are proactively managing their health “somewhat well” or “not well” between doctor’s visits.
Without a doubt, the COVID-19 pandemic has shone a light on challenges to accessing necessary care during a public health crisis. Mental health services are in high demand, with 38 percent of respondents seeking support from their health plans since March 2020. Of those with mood disorders, that percentage is nearly twice as high. There is much more that payers can do to address mental health coverage and access, especially in light of a growing body of literature indicating a strong connection between physical and behavioral health.
A lack of care access is an even greater threat to members facing a variety of barriers due to social determinants of health. Nearly a third of respondents have a household income below $20,000. Of these vulnerable individuals, nearly one in five had difficulty finding a provider and/or making appointments, and a similar percentage lacked availability to meet with a provider. Considering the prevalence of chronic disease and the risks associated with missed care, health plans must identify opportunities to support these members. Robust care management technologies can empower care plans to provide greater convenience and improve communication with members.
Members view their health plans as a means to a healthier life. The time is ripe for health plans to implement digital tools and services that eliminate the inefficiencies that have historically plagued the healthcare system and forced individuals to forgo care or neglect their health. The solution is to meet members where they are and provide resources tailored to their specific needs.
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