Next-generation member engagement during the care journey

Article Synopsis :

Insurers understand the importance of engagement in improving the value of care, particularly for traditional care and disease management. Despite this, their efforts rarely bear fruit.

Data and engagement will drive behavioural change 

Yet member engagement throughout the care journey will drive impact especially in terms of data liquidity, advanced analytics, and digital solutions, says this McKinsey report.

Big money

It is estimated that digitally enabled capabilities could reduce medical costs in the United States by as much as $175 billion to $220 billion annually. Yet few insurers are aggressively targeting next generation personalised engagement through a member’s care journey.

It is understandable they will be cautious because the benefits of engagement have not been delivered in the past. And until now, the primary focus has been on encouraging members to modify their behaviour to improve their health and thereby reduce risk.

It’s starting to work

This is beginning to gain traction. Those paying for the medical insurance are seeing signs of behaviour modification and it is thought this will continue as individuals take greater control over their health.

Health insurers are now beginning to make use of advanced digital analytics and personalisation capabilities developed and refined in other industries to create new, more effective digital member support tools and to scale the member engagement solutions already available.

These are beginning to have an effect on improving clinical outcomes, enhancing member experience, and to reduce immediate medical costs.

A pain in the back

The paper looks at how health insurers can improve the value of care through member engagement. It uses lower back pain to highlight the value of next-generation member engagement in the context of a specific care journey.

Lower back pain is a major top contributor to US healthcare spending and costs more than $100 billion annually when medical spending, lost wages, and reduced productivity are accounted for.

The research shows that many members with lower back pain have been through surgery without being offered a less invasive first or second line therapy first. Fever than half who had undergone surgery had been offered a spinal injection.

Had a data driven patient journey been used, the health insurer might have identified opportunities to improve care while reducing unnecessary medical spending. If nothing else, it could allow insurers to illustrate options to patients and place them into higher value facilities that use evidence-based protocols.

On their best behaviour

Insurers should look to apply behavioural economics to healthcare. Insights from behavioural economics can be used to guide human behaviour and perceptions via unobtrusive ‘nudges’, which is being used increasingly to improve satisfaction.

It can help to promote healthy behaviours such as smoking cessation and weight loss, but it is difficult to show any greater impact. But combined with advanced analytics and digital consumer engagement capabilities the value of behavioural economics can be tracked and optimised.

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