The era of consumer-driven healthcare puts the consumer in the driver's seat. However, the added responsibility can be daunting when you aren't sure where to go. They need guardrails.
So while consumerism in healthcare may mean a variety of things to different people, the one emerging challenge the entire industry must collectively address is consumer engagement. Consumers expect more – more access, more education, more transparency, more ongoing support, more urgency, more everything.
Healthcare decisions are confusing. The way insurance works with auto, home, life, etc. is less dynamic than healthcare, where everything can change in an instant. Even the most informed decisions could fail to meet an individual's needs due to an accident or unexpected diagnosis at a routine doctor's visit – healthcare is full of the unanticipated. Adding to the confusion, consumers are also trying to make sense of plan options, rising deductibles and a seemingly endless list of healthcare spending account and healthcare reimbursement account choices. With an ever-expanding list of options and no surefire way to make the right choice(s), it is easy to see why there is so much insecurity.
Ultimately, the biggest issue is consumer uncertainty. In previous years, consumers primarily relied on employers to make the coverage/spending decisions so they rarely spent hours studying the ins and outs of their policies. With the move towards public and private exchanges, consumers are making more healthcare decisions and taking on more of the financial burden, they need and expect more educational tools and ongoing support. Consumers want to make sure they are getting the most from their benefits. Instilling that confidence is the absolute most important component of the new consumer engagement imperative.
Employers and health plans need to empower consumers to confidently take control of their healthcare spending. The first step is empathy. The current avalanche of healthcare information, choices and responsibility has created a completely new world for consumers. Taking such a giant leap is hard for even the savviest person – people need ways to better understand all of their options, become educated about the benefits they choose and stay fully informed about what their decisions mean for their health (and their wallet).
But with more financial responsibility comes a higher expectation of exemplary service and support. Consumers need to trust they have what they need to make informed decisions and they are getting the most from their benefits. Providing financial tools, educational resources and reimbursement visibility will help them use the healthcare system in a responsible way – driving down overall costs for all parties involved, including consumers.
Consumer engagement can no longer be a one-time event during the annual selection process. The industry needs to realize the power (and importance) of continuous engagement.
Health plans, exchanges and employers need to drive brand loyalty and affinity more than ever before. To do so, they need to focus on earning consumer trust by making engagement a continuous conversation extending well past the enrollment period. Packaging educational and reimbursement tools into a central, branded portal not only gives consumers the easy and direct access they need to build confidence, but also drives loyalty by improving the user experience and creating ongoing opportunities to engage them.
People don't have time to hunt around trying to find information on what is covered, if a claim was processed or where to pay one of four bills for the same hospital stay. Effective healthcare benefit portals give consumers the complete financial transparency, professional support and payment flexibility they need in one comprehensive place.
With costs and responsibility shifting to the consumer, health plans and advisors need to give them the tools to simplify and consolidate the user experience. Providing easy-to-understand resources and easing the reimbursement process will give consumers the clarity and confidence to make sound decisions.
Seth Ravine is CRO at Acclaris.