The January 2014 deadline for all states to implement a health information exchange (HIE) has put pressure on payers to optimize access to clinical data. Health plans that offer cutting-edge technologies for managing member services in an integrated, cost-effective and customer-friendly manner will not only differentiate themselves, but also provide the means for providing safe, timely and effective patient-facing care communication.
While health plans serve as a source of comprehensive patient data from multiple provider sources, they can do more in terms of patient engagement. As the consumer channel of choice, mobile devices and smartphone apps can play an important role in outreach efforts. The mobile channel is ideal for informing and influencing members or potential members — at their convenience.
Furthermore, mobile technology promises to offer an efficient means for streamlining applications for health coverage and subsidies, recertification and management of eligibility that will be generated by the Affordable Care Act’s (ACA) addition of 22.4million Medicaid recipients to the healthcare system. (1) Fortunately, this influx intersects with the enormous popularity of mobile devices. A recent study found that nearly 17 million consumers were accessing health information on mobile devices in 2011, representing a 125 percent increase from 2010.(2) This creates an opportunity for health plans to offer smartphone apps that can allow members to have plan and provider information at their fingertips for improved compliance and optimized health and wellness initiatives.
Health-related smartphone apps simplify the flow of information between health plans, physicians and patients, facilitating one-on-one exchanges that close gaps in care, create quicker care response and improve the overall healthcare environment. A number of mobile health website capabilities provide access to:
- Physician directories and directions to physicians’ offices
- Claims histories
- Eligibility and cost-sharing requirements for a doctor visit
- Drug prices of nearby pharmacies, including generic and therapeutic alternatives
- Self-diagnosis tools, including symptom and disease lookup
- Daily wellness self-management tools, including trackers for achieving health-related goals
- Information regarding a specific health-related condition
- Reminders and alerts regarding prescription drug compliance
- Options for in-home monitoring and in-home care
While federal law has prompted payers to develop new products that arealigned based upon the benefit structure and the needs ofa covered population, it has also opened up new opportunities for health plans to use consumer engagement to reposition for success in an increasingly innovative and competitive marketplace.
1. Policy Makers Should Prepare For Major Uncertainties In Medicaid Enrollment, Costs, And Needs For Physicians Under Health Reform
2. Dolan, Pamela Lewis; Dolan; Patients Expected to Use Smartphones for Health Monitoring; amednews.com; February 20, 2012; accessed April 10, 2012.
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