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    Four priorities your health plan must embrace to thrive in the future


    Priority #3: Digital strategies


    “Regardless of what may happen to healthcare during the Trump administration, the fact remains that consumers are growing more and more accustomed to easier experiences and greater choices in all aspects of their shopping experience, says Dan Hughes, managing director of sales at Softheon. Healthcare is no exception.

    “Health plans of the future will not only need to be web-based, but will certainly need to have mobile capabilities and offer a variety of options to consumers with greater appeal to the individual,” he says. “The process will also need to be easier in a variety of ways, and made more interesting for the consumer. These can include wellness and incentive programs that promote healthy lifestyles, real-time outcomes such as instant insurance quotes, and plan management via 24-hour self-servicing channels.”

    With wearable technologies such as Fitbit being increasingly available, Hughes predicts there will be a greater emphasis on “well care,” which emphasizes healthy lifestyles, rather than the traditional model of “sick care,” which only focuses on covering treatment after a patient has already become sick.

    HealthPartners agrees. This is another reason the organization is focused on online and mobile technology that improves health and supports care.

    Clover is also focused on using technology to fill gaps in members’ care and improve their health outcomes, according to Keenan. The plan is building a data analytics platform that continuously embeds insights into the system. This requires pulling charts and combining data streams from lab companies, pharmacies, electronic medical records, and from its own nurse practitioners and customer experience team to get the best possible understanding of members.

    “By creating a deep engagement strategy with our members and collecting data around their risk factors, we can drive proactive outreach informed by data,” he says. “For example, our member outreach work flow is run on real-time data, and our call queue is prioritized based on the risk of the members. Our nurse practitioners use an iPad app during home visits that is synced into the system so they have the most up-to-date information about the person they’re seeing at their fingertips.”

    Next: Keep it personal



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