Healthcare Consumerism: Why Providers and Payers Should be Thinking About Patients Differently?

If there is one statement on which we can all agree, it is that COVID-19 has made many lasting impressions on our healthcare industry. From the emergence of telehealth to “drive-through healthcare,” the way in which patients consume healthcare has forever been changed.

For many, the pandemic has pushed healthcare diagnoses and procedures out of the health system, causing many to eagerly wait for re-entry once conditions return to “normal.” 

Common procedures like joint replacements, cancer screenings and treatments, chronic kidney disease, diabetes, lung conditions…and the list goes on…have been asked to hold while the industry grapples with the crisis. 

With daily fluctuations in COVID cases and treatment success, ICU beds and the treatment of infectious disease is the industry’s current priority.

Today, the pandemic appears far from over. And while our nation’s health system is far more aware, educated, and capable of managing the pandemic. As patients re-enter health facilities, there is still work to be done towards a vaccinated public that will lead to the eradication of this vicious disease. 

Nevertheless, census counts are starting to bounce back. Patients are once again undergoing preventative treatments. And in some cases, elective procedures are starting to rebound. It will take time to get back to full capacity, but it would appear we are trending in the right direction.

Where Does Healthcare Go From Here? 

But as these patients begin to get reacquainted with healthcare, they can now evaluate their options with greater access to information to help inform their approach. 

Where do they go? Who should they see? What will they pay? Who is the best at delivery? What should their outcomes be? 

Defined as “consumerism,” this access to data and choice is the new normal for both providers and payers alike. 

The Future of Healthcare Technology  

This healthcare consumerism is being driven by a wave of new technologies designed to provide patient access to healthcare. 

From digital front doors to way-finding, the go-forward patient experience is changing. This change primarily comes from a digital wave focused on putting a patient’s data and health information on mobile phones, tablets, and wearables. These devices operate in harmony to help inform decision-making.

Healthcare Consumerism’s Impact on Providers

Review the strategic imperatives of any hospital these days and you are likely to find “patient engagement” and “patient acquisition” in the top 5. But why is this the case? 

The health system C-suite is increasingly aware of the strong presence of healthcare consumerism and the role data plays in healthcare consumption. 

Today, performance at the service line, diagnosis, and physician level are readily available to the patient. This informed consumer is increasingly astute at using available data to make informed decisions. 

Linked is the patient experience and the manner in which data and information is shared with patients. Web pages are quickly becoming passe, a relic of a bygone era. 

Engaging Patients Through Mobile

Today, patients are looking to health systems that provide integrated mobile applications that offer robust data and information on their phones, at their fingertips, often informing their care, their plan, and their obligations to pay.

Underpinning all of this is a digital experience made up of a number of mobile applications. These mobile apps not only brand the health system, but also provide a unique, customized user experience that creates stickiness and loyalty with patients. 

Aptly named, the digital front door is a concept of electronic patient engagement that reaches the patient before they even leave their home. 

This digital experience provides all relevant information including the patient’s name, address and health plan information. It also includes the reason for the visit, doctor’s name, procedural information, pre-procedure instructions, the location of the appointment, and even an interactive map that guides the patient to the location of their appointment. 

What’s more, all of this occurs in a simple, easy-to-use application that is pre-configured to the individual patient’s experience.

Digital Transformation is Key to Healthcare Consumerism

Digital transformation is the change from manual processes involving human face-to-face interactions to an electronic collection of applications. 

These applications are designed to streamline the patient experience, create efficiencies in data collection and sharing, and minimize manual processes and paper forms. 

Ultimately, what patients receive is a digital experience aligned to the preferences of their demographic and the way in which they prefer to consume information. 

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Healthcare Consumerism’s Impact on Payers

Similar to providers, health plans (a.k.a., payers) are focused on patient engagement as well. 

But unlike providers, payers are focused on a suite of solutions centered around a patient’s interaction with their health plan. The goal is to help them navigate their wellness at the lowest possible cost while driving the best possible outcomes. 

Focus on Experience 

Payers are increasingly focused on improving the experience of their covered life (the patient who is a member of the health plan). 

This improvement is achieved by ensuring that patients are consuming healthcare via providers that are covered under their plan, leveraging pharmaceuticals that are on formulary, engaging in tests that meet medical necessity (and are therefore covered), and working with specialists that are also within the patient’s networked health plan.

The Role of Healthcare Technology

In addition, payers are increasingly looking to digital technologies to help patients with chronic conditions monitor and treat their diagnosis. 

They are also looking for ways to reduce the likelihood of comorbidities that are often attributable or linked to the principal diagnosis. Here, payers are increasingly turning to patient monitoring (for example, through wearables) to help discern a patient’s condition, reactions to treatments, and propensity to heal. 

The Health Plans’ overall goal is to create more healthy patients and improve the likelihood of favorable outcomes. All while reducing the costs of care whenever and wherever possible.

Similarly, payers are looking to digital transformation and mobile applications as a means to interact with patients. These initiatives are all focused on improving brand awareness, patient retention, and overall wellness.

Aligning Perspectives Around Healthcare Consumerism

So what does healthcare consumerism mean for the care continuum? 

Patients want a better experience and better tools that are tailored to their personal care experience — and that goes beyond just the treatment and payment processes. 

The technology driving the healthcare industry has become the cornerstone of success for payers and providers alike. 

From maintaining regulatory compliance and data-driven requirements to automating manual processes, sustaining a seamless tech-enabled experience is fundamental. 

In such a high-stakes industry, slow platforms, processing errors, or development bottlenecks are detrimental. 

Implementing best practices in automation, data processing, artificial intelligence, and cloud computing assist both providers and payers in delivering secure, cutting-edge platforms and solutions. 

Plus, healthcare organizations will be able to better exchange Electronic Health Information (EHI) and meet critical 21st Century Cures Act deadlines

At KMS Technology, we are committed to delivering compliant, cutting-edge healthcare solutions. We offer test management and automation, digital transformation, AI solutions, and more. 

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