5 Changes Health Plans Need to Make to Adapt to an Ever-Shifting Industry

Health insurance is a constantly evolving and complicated industry that continues to change with the needs of the people, and it’s only getting more complicated by the day. With new regulations and guidelines, new technology for data management, and emerging preferences for user experiences, it’s easy to feel lost as you navigate this evolving landscape with your business. But there are some changes health plans need to make in order for them to adapt and stay relevant. In today’s discussion, we’re going to explore five significant changes health plans need to be implementing so they can best serve their customers during these ever-changing and unprecedented times.

1. Transparency as a Company

Transparency is one of the most significant values in any professional environment. When businesses are transparent, it demonstrates the caring attitude they hope to promote in their product or service. Transparency is often seen as an honest and open way of doing business. A professional company that embraces transparency will not have anything to hide from its customers, partners, or even competitors. Not only does this improve service conditions for a more uncomplicated relationship between these groups, but it also means the bar rises to a higher caliber of service delivery. Health plans can better serve their customer bases by being honest about what they provide, how they offer it, and how they charge for it.

Health plans in today’s changing landscape should be prepared to embrace a transparent business model in new ways. Savvy consumers will want to understand their coverage options and handle health-related information in convenient, data-filled dashboards. And healthcare providers will look for clear paths of communication with health plans and patients alike. Improving the clarity and transparency at the health plan level will only increase the efficiency in which patients seek and follow through on healthcare services.

2. User Experience Enhancements

User experience describes the way customers interact with professional services and how this interaction can affect whether or not they return to use those professional services again. In healthcare and with health insurance, user experiences are especially important because of the sensitive nature of medical needs and data involved. For example, if a health plan makes it difficult for patients to refill their prescriptions on time or pays too much attention to unnecessary paperwork rather than helping members get better quality care, then they will be viewed as unprofessional or unreliable and lose clients to those who provide them with a smoother user experience. Patients will also be insistent that their health insurance provider outline claims processes, costs, and authorizations in an easy-to-browse platform. Solutions representative of seamless claims processes, frictionless customer experiences, and better communication between health plans and customers, will be paramount for health insurance providers moving forward.

3. Better Interoperability

Interoperability refers to the ability of professional services to work together with ease, and it’s an area that Softheon is most passionate about improving. If healthcare professionals are unable to communicate seamlessly with one another, then they cannot provide the best possible care for their patients. Therefore, whether or not a professional service is “compatible” may be determined by how easy it is for professional services to work together in order to provide better quality care.

During the Special Enrollment Period this year alone, health plans encountered 30 million uninsured Americans. That kind of volume, representative of browsers, enrollees, and renewals, demonstrates a greater need for interoperability solutions to keep up with billing, reconciliation, and financial management. The use of cloud technology solutions and automation, like those provided by Softheon, will continue to be the new way forward to adjust to industry growth.

4. Cost-Effective Coverage Options

As mentioned above, the medical needs of patients can be incredibly expensive, which means that there’s no room for unnecessary costs. Health insurance customers should have the option of getting the most out of their coverage without having to worry about costing themselves too much when they need professional services. And part of this movement includes a great shift in cost efficiencies for providers and health plans alike.

Today’s health insurance companies should be looking for new ways to cut their own costs as a method for sharing better enrollee pricing. Some of the traditional overhead can be reduced by leveraging better use of cloud technology, data management transferability solutions, and more digital communication efforts. The additional benefits of relief funding and pandemic-related resources will help to bridge those price gaps now. But in the months to come, when those resources expire, health insurance plans will need to be ready with competitive pricing to maintain enrollment levels.

5. Support at Every Level of Engagement (Providers & Customers Alike)

A professional reputation is determined by the quality of care and service provided to customers and nothing more. If a professional service does not uphold their professional standards, then they can end up losing patient trust, which will affect their professional credibility for years to come. This is especially important today when information travels faster than ever before through social media outlets such as Facebook and Twitter, and others. If a professional service fails to earn the trust of its customers through the way it manages them, then word of mouth will spread this news like wildfire and cripple their network of business connections before long.

Health plans today should be preparing for new ways of connecting and supporting customers, including some of the non-traditional digital methods. Customer service will be responsible for driving enrollment and revenue. Improving how your company engages its audience can ensure your service efforts remain up to your standards.

There’s a lot that health plan providers can’t predict in the coming months and years, post-pandemic shifts. But the narrative over the last year has lifted a veil on a few key elements most plans should prioritize. If your health plan-providing company is looking for better ways to cut costs, improve communication, streamline interoperability, or support participants, let Softheon help guide you forward with the most strategic improvements to continued health plan success.

Download our recently published Whitepaper to learn more about how health plans can improve their processes to capitalize on growing industry opportunity.


Source Link