Delivering ROI on Member Communications is Mission Critical for Healthcare Payers

A recent report on U.S. healthcare outcomes confirmed what previous studies have indicated—American health outcomes lag behind those of other high-income countries across several measures.

  • US life expectancy declined between 2016 and 2017
  • Substance abuse and mental illness have reached epidemic levels
  • The US has a higher rate of disease burden and mortality rates compared to other high-income countries

What makes this news a particularly bitter pill to swallow is that US spending on healthcare outstrips that of other nations. In 2017, the U.S. spent $3.5 trillion and that figure is expected to reach $5.3 trillion by 2025. By contrast, New Zealand and Australia spent just 9% of their GDP in 2018, compared to 17% for the US.

To combat the rising costs of healthcare and improve patient outcomes, the federal government tapped the Office of the National Coordinator for Health Information Technology (ONC) to draft a strategic five-year plan to provide a roadmap for federal health information technology. A joint effort between 25 federal agencies, the 2020-2025 Federal Health IT Strategic Plan was released on January 15, 2020.

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The strategic plan places digital transformation front and center in the race to combat spiraling healthcare costs and improve patient health. By leveraging open API’s, smart phone apps, and other smart technology to increase patients’ access to their health data, the ONC envisions greater transparency about pricing and plan benefits for the American consumer.

Four overarching goals lie at the heart of the plan:

  1. Promote health and wellness
  2. Enhance the delivery and experience of care
  3. Build a secure, data-driven ecosystem to accelerate research and innovation
  4. Connect healthcare and health data through an interoperable health IT infrastructure

While these goals lay out the overall vision, it’s the strategic initiatives that expose the plan’s connective tissue. Underlying the drive to improve health IT is an awareness that patient engagement and awareness are the true cures for U.S. healthcare’s many ills. One of the plan’s core strategies is identifying what information patients need to make informed decisions about their healthcare and the best way to present it. Communicating how to access and use health information is another important component.

Although the strategic plan is directed toward the development of a federal health IT infrastructure, it clearly envisions healthcare as a partnership between the public and private sectors. The strategic plan also makes clear that in this 21st century partnership model, delivering value for care is not just an aspiration, it’s a mandate. In this respect, the ONC’s mission aligns closely with trends in healthcare over the past five years. In 2015, just 38% of public and private healthcare spending adopted value-based payment models. By 2018, this percentage had climbed to 61%.

Healthcare payers who want to keep pace with the ONC’s strategic vision will need to invest in digital transformation that integrates with federal systems while providing members with targeted, personalized information on their health data and plan benefits. With very little margin for error, healthcare payers must anticipate a high return on investment in their technology investments, particularly when it comes to member communications.

Many payers are looking to digital platforms to create targeted, personalized communications and marketing materials. However, to realize maximum ROI, payers will need a technology partner that can automate the content lifecycle and create timely, accurate member communications.

To accurately assess the ROI of technology investments, payers must carefully assess their objectives and how they differ from other stakeholders. While patient outcomes are driving innovation for the healthcare industry as a whole, ROI calculations for each stakeholder can vary widely. For example, payers that have a direct financial interest in improving outcomes will have a different set of economic priorities than stakeholders whose reimbursement is based on fee-for-service or alternative payment models.

For healthcare payers looking to capitalize on the ONC’s strategic vision, digital platforms that quantify ROI can provide a digital snapshot of the effectiveness of member communications while improving employee experience through increased productivity and time-saving efficiencies. As demand for value drives innovation in healthcare, quantifiable ROI is a winning outcome that any healthcare payer can appreciate. 

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