There is a consistent misalignment of expectation and experience in the health insurance industry resulting in low customer satisfaction. As the health insurance industry quickly shifts to a consumer-driven market, it is crucial that carriers embrace innovative technology in order to compete. The rise of big data and predictive analytics will lay the foundation for the empowered healthcare consumer, creating a more personal experience and encouraging consumers to make better decisions. Innovative products that make effective use of data will be instrumental in decreasing wasted healthcare dollars by offering some sense of predictability and aligning available information with real-time patient experiences.
Enrollment in high deductible health plans has been on the rise, mainly due to their lower price tag and the opportunity for consumers to manage their own healthcare costs. Since the burden of managing healthcare costs falls on the consumer in this case, many will forego necessary treatments unless they are particularly savvy and able to shop for doctors and services. Even those individuals that would be considered savvy consumers are met with the realization that prices can vary and that there is no correlation between the cost of a service and the quality of that service. This lack of transparency in the health insurance industry leads to sick and frustrated customers, a combination that most carriers would like to avoid. Cost transparency products that provide cost and quality data, will help the consumer to save money while receiving the best care. A satisfied customer is a loyal customer and carriers who adopt the use of cost transparency products, will see the benefits in the form of increased customer retention. Additionally, greater transparency brings greater market pricing alignment to the healthcare industry and saves consumers and carriers money.
Assessing the cost of healthcare procedures occurs when it is time for the consumer to use a selected health plan. What is paramount, and not typically understood, is how to proactively assess and select the “right” plan. Offering customers a way to assess and enroll in the most appropriate health plan is the best way for consumers and carriers to save money. When the current state of a members’ health aligns with the best plan to treat existing, and potentially related, conditions everybody wins. Predictive analytics, which provides a glimpse into the probable future through statistical analysis of large pools of historical data, is key to building the tools necessary for consumers to make the right health plan decisions and strike the right patient-plan balance. The rising popularity of high deductible consumer-driven plans and employer-defined contribution means that the individual, not the employer and HR department, is now in the drivers’ seat. As the individual’s responsibility to make healthcare buying decisions increases, the more critical these tools become.
Carriers that recognize it is in their best interests to put these tools in the hands of consumers will benefit from healthcare consumer self-management. These advancements will provide consumers with an avenue to appropriate coverage, superior care and better-managed cost. The more responsible statistical guidance a carrier can provide that reflects value and quality for the consumer, the more the patient, the insurer and the healthcare industry as a whole, will benefit.