Keeping your Members Happy: The Importance of Transparency in Member Engagement

Keeping your Members Happy: The Importance of Transparency in Member Engagement

Throughout the healthcare system, patients, providers, health plans, and PBMs are looking for ways to reduce the costs of health care through a variety of means. With the costs of providing care to an average American family surpassing $25,000 in 2016 for the first time and overall costs in the United States at over $1.21 billion dollars in 2016, the continued rise in healthcare-related expenditures is an ongoing burden for all involved. Transparency and Member Engagement

For patients, being able to make informed decisions regarding the price and quality of health care is one of the most important factors when it comes to deciding which for health plan options are best for them and their potential out-of-pocket expenses each year. For healthcare providers, health plans, and PBMs, offering patients personalized information helps build a sense of trust with patients, as well as alleviating issues related to patient compliance to help improve the quality of their care and reduce their ongoing healthcare costs. One of the most important factors for improving patient compliance and achieving better patient healthcare outcomes is through personalized and transparent communications when engaging with members.

What is transparency as it relates to health care?

For patient communications, transparency helps patients find answers easily to their most commonly asked questions regarding their health care options, their expected costs for using their plan benefits, which includes medications and physician charges for services and procedures, and knowing which healthcare programs and physicians are considered “in-network” for the member’s plan benefits.

Easy to find answers to the following questions improve the patient’s overall healthcare experience: What are my actual out of pocket costs going to be for a certain procedure or office visit?

Health plans need to begin active efforts to communicate more clearly and personally to their members in order to encourage a more trustworthy relationship with their members. A recent study suggests that the public’s confidence and trust in their healthcare providers continues to erode, in that only 49% of respondents said that they trust their health insurance plan.

To help increase the level of transparency for patients regarding their plan benefit options, some healthcare organizations are offering website tools and applications in the hopes of building more trust with patients. United Healthcare offers an online cost estimator for members to understand potential costs for certain procedures. In addition, organizations like Texas Children’s Hospital are publishing quality performance information online to allow patients to compare their quality performance against other similar hospital organizations.

A study by ITOnline showed that two-thirds of Americans indicated a preference for telehealth care management options that accommodates their need for convenience rather than physical examinations by their local physician. A willingness to incorporate mHealth diagnostics is indicated by study results that show that 79 percent of Americans are willing to use a wearable mHealth device to manage their personal health, while 45 percent would use a mHealth wearable to track symptoms and 43 percent would be willing to use mHealth to manage personal health issues or conditions.

As patients look for simplified, transparent solutions for their questions, a collaboration between Cigna and Granite Health in New Hampshire on behalf of member engagement showed promising results. Quality and cost scores for the partnership were better than state averages, with medical costs trending 1.2 percent lower, ED use down 4 percent and advanced imaging costs down 7 percent during the time frame. The lowering of costs and the sharing of these results have helped patients better engage with payers and providers in the study, although there are still significant barriers in transparency that need to be resolved to see true transparency take hold.

As patients, providers, health plans and PBMs look to work together to lower costs related to health care, embracing platforms, tools, and applications that enable better transparency between all parties will lead to lower costs and improve member engagement.  RxEOB offers a full suite of services that are designed to help improve member engagement and increase transparency to promote better patient outcomes for all involved. The products that RxEOB has to offer for member engagement, including MyDrugBenefit®, EmWellics®, Mercury MessagingSM, RxMonitor® and RxReferenceSM, are all designed to enhance the patient experience by increasing  the level of transparency regarding plan benefit options and related costs. To learn more about the products that RxEOB offers that can help drive higher levels of consumer satisfaction, please contact RxEOB at 888-648-0989 ext. 226, or email us at info@rxeob.com.