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Health Plans Need Patient Data for Future of Patient Wellness

A new Deloitte report outlined what it will take for health plans to drive patient wellness, including revamping their patient data use.

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Source: Thinkstock

By Sara Heath

- The healthcare industry is continuing to evolve in a more consumer- and patient-centric direction, requiring key stakeholders to adopt hyper-personalized engagement strategies. For healthcare payers, this will requires a deep understanding of plan members using patient-centered data to drive patient wellness, according to a recent report from Deloitte Center for Health Solutions.

Using a crowdsource research methodology, Deloitte researchers, led by company principal David Biel, determined that a better handle of patient data will help deliver on more consumer-driven models.

Specifically, the report sought to answer questions about the direction the healthcare industry is set to take, and the specific business decisions healthcare payers must make to survive in a changing landscape.

Feeling the pressure from non-traditional healthcare players, health plans will begin to adopt more consumer-centric models and hyperpersonalized healthcare, the researchers said.

“Thousands of innovative solutions that enable consumer experience have been introduced into the marketplace, some of which are being enabled by digital and consumer giants such as Amazon, Apple Inc., and Google,” the report authors wrote.

READ MORE: AHIMA, AMIA: HIPAA Overhaul Needed for Patient Data Access

“Health plans will shift to a focus on well-being and care using multidimensional data,” they continued. “Products will balance traditional population-level risk with being hyperpersonal and easy-to-understand, based on consumer need. Moreover, health plans will have learned how to engage and influence consumers toward better health through a high-touch experience with digital devices.”

Healthcare organizations and payers will need to overhaul their business strategies to adjust to these industry changes, the report authors asserted. These overhauls should focus on three central areas: using patient data, adjusting to different care delivery models, and reconfiguring the financial role of the healthcare payer.

As organizations strive for better patient experiences, patient-centered wellness goals, and a more high-touch and personalized experience, they will need better access to patient data.

However, more will be demanded of the data analytics platforms that most organizations have already begun to adopt.

Tools that cut costs, create administrative and process simplification, and drive health outcomes will no longer be enough. Instead, health plans will need analytics platforms that help comb through even more patient data that can provide specific insights about individual members, the Deloitte report noted.

READ MORE: Health Systems Boost Patient Data Access with Apple Health Records

Having access to such patient data will require strong patient education, Biel explained.

“Data and data interoperability will be the key to improving wellness and care for members,” Biel said in a statement. “But consumers will own their data and will need to see and harvest the value in sharing it with health plans. Health plans will want to educate their members on the potential benefits of data sharing and alleviate concerns in order to build the level of comfort and trust required to access their data.”

In addition to ample patient data, payer organizations will need to forge deeper relationships with contracted providers. Both payers and care delivery teams are seen as stewards of patient wellness, and their collaboration will be central to making that happen. Ideally, this will foster “wellness hubs,” the report said, including delivering digital care, home care, and other consumer-centric options.

Finally, health plans can anticipate new demands in their business and finance models.

Previously, health plans have been in charge of judging and ultimately paying claims. But as payer organizations become the gatekeepers of patient wellness, their financial systems must evolve and they must lean into the industry trend of value-based care.

READ MORE: How Patient Health Data Access Drives Patient Engagement

With value-based care, payers can expect to see their financial roles grow, taking on risk for patient wellness and other key healthcare processes.

Biel and colleagues outlined a series of steps to deliver on these goals, including the following:

  • Creating a culture of business transformation
  • Shifting focus to smart capital investments
  • Prepare and plan for new hires
  • Create strict but agile data governance policies
  • Monitor ongoing risks for further changes

This report, which will also be available next week at the 2019 HIMSS Conference, aligns with the overall trend toward patient- and consumer-centricity in healthcare. Health plans, hospitals, and physician organizations alike are facing demands to promote more value-based care and patient wellness. Central to that is a positive patient experience.

Organizations certainly have the capability to deliver those positive experiences, so long as the have the requisite patient data available to them in a usable format. This information can inform individual and population-level decisions.

As payer and provider organizations begin to encounter this shift – it’s in its nascency now, Biel said – they should begin to tap the best technologies for delivering patient-centered data insights.

“The transformation to the health plan of tomorrow is just a steppingstone on the journey to the future of health — a future that health plans should begin to prepare for by making strategic decisions now,” Biel concluded.

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