Member Engagement Technology: How TPAs Can Address Point Solution Fatigue in Healthcare
Amid the hum of dehumidifiers, Jennifer, a dedicated restoration services worker in Connecticut took a quick break. Her smartphone buzzed with a text from her husband. “Another high-cost medical bill came in the mail.” She looked down and sighed, frustrated. Given Jennifer’s recurring health issues, this wasn’t new. But what was perpetually overwhelming was figuring out how to manage them.
Jennifer's employer provided a self-funded health plan that aimed to offer comprehensive coverage and easy access to healthcare savings tools. But, amidst her busy work schedule, Jennifer faced challenges in navigating her plan and the multiple apps on her phone associated with it. Each app catered to a different aspect of her healthcare journey, from billing to provider lookup to telehealth.
She began her quest by trying to find which app could help her address her high-cost bill. The first one seemed promising, but it was just a digital version of her insurance card. The second app was tailored for telehealth appointments. The third one appeared to offer navigation but led her down a rabbit hole of in-app purchases for third-party services. Growing frustrated, Jennifer decided to check her deductible. But which app held that information? After two incorrect guesses, she found one that displayed her deductible details. However, it didn’t provide any information or tools on how she could manage or reduce her bills.
Her exasperation peaked when she realized she had to remember different login credentials for each app. After being locked out of one due to multiple incorrect password attempts, Jennifer felt defeated. Her break was over. Resigned to her fate, she uninstalled all the apps. The complexity had driven her away from potentially beneficial tools that could guide her to more cost-effective care solutions. Jennifer defaulted to her old habits, seeking care from wherever she knew, regardless of the cost.
The ripple effect of Jennifer's experience reverberated at the organizational level. Her employer, despite investing in these digital solutions with the hope of streamlining care and reducing costs, ended up paying more. The intended savings solutions were there, but they remained untapped. Jennifer's actions were symptomatic of a larger issue – the daunting challenge faced by many like her who simply want easy, streamlined access to affordable care.
Changed Member Behavior Requires Changed Delivery Models
Plan members, when presented with choices, opt for high-quality, low-cost care less than 30% of the time. This behavioral mystery raises a fundamental question: Why, despite the technological advancements and array of options, are the choices often not optimized? The answer lies in the structure affecting behavior. To change member behavior, it's critical to fix the structure first.
The truth is, for the average health consumer, tasks as basic as identifying in-network providers or scheduling a medical test can feel daunting. Repeated interactions with disjointed systems leave members frustrated, eroding their trust in the healthcare system to deliver what they need.
So, how do we enhance the member experience? The increasing demand for seamless digital healthcare experiences underscores the need for systems that can interact seamlessly.
Member Engagement
Consolidating all of a member's healthcare needs into one central platform, accessible with a single login, offers a dual benefit. For Third-Party Administrators (TPAs), this unified system enables holistic reporting, pulling insights from every aspect of a member's health journey, offering a comprehensive view that individual apps simply can't provide. This bird's-eye view is invaluable in tailoring engagement strategies and interventions, ensuring lower healthcare costs and better outcomes. For employees, the streamlined access reduces the cognitive load of managing multiple apps and passwords. This simplicity can be a game-changer in increasing member engagement as it eliminates barriers and paves the way for seamless healthcare experiences. By centralizing access and enhancing reporting capabilities, we ensure that the focus remains on the member's health and well-being, reinforcing the importance of personalized, human interactions in the healthcare sphere.
In an era where artificial intelligence is apparent in almost every facet of our lives, healthcare is no exception. Advanced AI algorithms can predict a member's needs based on their interactions and history. But instead of limiting interactions to automated responses, AI prompts can be designed to lead members directly to real human experts for assistance. This seamless transition from AI-driven insights to human touchpoints ensures that members get timely, personalized assistance when they need it most. The future of healthcare hinges on harnessing technology not just for operational efficiency, but to facilitate genuine, meaningful human-to-human interactions.
Getting More out of Your Benefits Package
Maximizing the value of employee benefits goes beyond merely offering a diverse package. It's about ensuring accessibility and consistent utilization. By integrating all benefits into a single, cohesive digital platform, enhanced with AI-driven insights and peppered with human touchpoints, the intricate benefits landscape is simplified for employees. This consolidated approach not only increases employee engagement and satisfaction by aiding informed decision-making but also substantially reduces the administrative burden on HR teams and TPAs. Fewer queries, less repetitive outreach and streamlined processes mean that HR can pivot to other strategic endeavors while TPAs can efficiently manage their portfolios. The overarching aim? To make benefits both intuitive for the end-users and manageable for those administrating them.
In the quest to offer members the best healthcare experiences, employers and the TPAs that support them have turned to digital solutions—from apps for virtual care and pharmacy to platforms dedicated to weight management and mental health. These innovations, born from the noble intent of elevating wellness and engagement, can sometimes lead to digital overwhelm, inadvertently causing users to quickly opt out. As we navigate the digital health landscape, it becomes crucial to strike a balance. While technology serves as the powerful backbone, the human experience must remain at the forefront. It's not solely about introducing cutting-edge platforms. It's about infusing them with empathy, understanding and a connected and meaningful user experience.
Editor’s note: Empara is a developer of mission-driven healthcare technology. We’re shaping the healthcare businesses of tomorrow – lowering costs and improving outcomes with hyper-intuitive solutions that make healthcare easy, rewarding and affordable. Acting as the bridge between sophisticated technology and the healthcare sector, Empara is the place where people and healthcare seamlessly connect.