THOUGHT LEADERSHIP
Robin Kingston, Senior Vice President, Health Plan Strategy and Growth
Health plans are under mounting pressure to meet rising consumer expectations for a better member experience. Today, the average U.S. adult spends about 8 hours per month coordinating healthcare for themselves or their families.
As younger generations raised in a digital world become primary healthcare consumers, the industry is seeing a shift in demand for better experiences engaging with care that more closely mirror other daily interactions. Patients want and expect simple, convenient and connected experiences that make obtaining care easy, efficient and productive.
Consumer dissatisfaction with the current, disjointed experience is well-documented. Friction in care coordination remains high—and it negatively impacts member satisfaction and retention. A recent study shows that nearly half of patients surveyed say they face pre-appointment roadblocks, and these issues are tied to a 13-point drop in satisfaction.
Satisfaction scores aren’t the only measures that suffer. Unsatisfactory experiences lead to delayed or avoided care, resulting in poor clinical outcomes and higher costs.
At Teladoc Health, I have the privilege of working with health plans every day to help them reimagine their use of virtual care to deliver simpler care experiences that meet and exceed members’ expectations, and amplify the impact of their own innovative care programs. Here are three common challenges I often see health plans facing when it comes to member experience, and how virtual care can play a role in boosting member experience and satisfaction.
Many health plans have invested in medical centers to help drive convenience for their members. A number of plans like Florida Blue, Premera Blue Cross and United Healthcare own or partner with provider clinics, emphasizing strong patient-provider relationships and high-quality, coordinated care.
Early results show growth in patient visits and high satisfaction. As a result, these medical centers have emerged as a strategic priority for health plans and are becoming increasingly central to their ecosystems; however, they still do not reach all patients.
Virtual care extends convenience and helps reduce barriers, providing or increasing access to care for members who live in rural areas, face transportation challenges or work-life balance conflicts with normal office hours.
By offering a digital front door to services like urgent care, primary care, chronic condition management, mental health and preventive care, a full-spectrum virtual care partner can serve as a referral pathway to plan-owned medical centers.
Convenient 24/7 access to care is used to complement and extend health plans strategies, offering a frictionless consumer experience and care continuity across virtual and in-person care that members are demanding all while reducing costs, improving outcomes and helping to keep patients in the plan’s network.
Navigation platforms are intended to help simplify the member experience, guiding members across multiple tools and point solutions. For many members, though, they are just an additional step in an already overly complex care journey. When confronted with yet another solution, a lack of trust and awareness can result in low member engagement rates.
Navigation platforms often fall short in integration, too. They coordinate across platforms but fail to connect members across care modalities. This creates new issues as care journeys evolve—especially for members with complex and chronic conditions that require coordinated care across multiple providers and settings.
Proper care orchestration can deliver guided experiences members need to be able to live their healthiest lives. At Teladoc Health, our proprietary, market-leading care delivery platform allows us to provide a broad spectrum of care and coordinate care across in-person care and other virtual resources.
Our technology strengthens connections between health plans, digital and in-community care providers, and other care partners to improve care coordination, elevate the member experience, and support stronger provider-member relationships.
The latest data from the Office of Disease Prevention and Health Promotion shows only 5% of adults have received recommended preventive services. Contributing barriers include lack of a primary care provider and limited access to care. Removing these barriers is a strategic priority for health plans, because closing these gaps in care can positively impact member health and business outcomes, as well as CMS Star Ratings. To help close these care gaps, health plans are using data-driven outreach to identify and engage high-risk members and expanding at-home testing to make care more convenient.
Virtual care can be a force multiplier for those efforts. Through virtual primary care, at-home testing and remote monitoring capabilities, virtual care can help health plans empower more members to complete recommended care and program adherence by mitigating scheduling burdens and reducing the need for provider visits, travel, and time off work.
Additionally, with a unified and current view of the member across providers and care settings, we give care providers the information and insights they need to help reduce member confusion and close gaps in care.
Teladoc Health unlocks the full power of virtual care, helping our clients create simpler, more engaging and effective member journeys—where care flows seamlessly across time, conditions and care settings—so plans can maximize convenience, streamline member navigation and close gaps in care even with hard-to-reach Medicare, Medicaid and rural populations.
By bringing our leading technology and services together, we’re enabling seamless referrals and care coordination that break down traditional silos—fostering a seamless connected care experience for health plans that exceeds member experiences and drives better health outcomes.
Partnerships are the foundation of orchestrated care, and Teladoc Health is proud to partner with leading health plans, dedicated community care providers and best-in-class partner programs.
