The U.S. healthcare system is growing infinitely more complex, and the digital health industry is working hard to keep up. From choosing a health plan, to understanding and managing benefits, to finding a care provider – the process can be frustrating and challenging, with lots of jargon and little transparency. Like every other industry in recent years, technology has risen to prominence in healthcare to streamline the experience, especially with artificial intelligence being even more accessible and applicable. But, in an industry traditionally dominated by face-to-face interaction, where human expertise, compassion, and connection is so valuable, the question must be posed: what role should technology play versus that of humans.
Healthcare: Increasingly complicated & costly
With the Rise of AI, What IP Disputes in Healthcare Are Likely to Emerge?
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
Today, many point solutions exist to address people’s health and wellbeing – from telehealth to activity tracking apps. However, patients often must scour through multiple disconnected resources to find the support they need. With an average interaction rate on healthcare apps of only 13%, nearly 9 in 10 people are not using modern solutions to engage in preventative care, manage chronic conditions, or participate in other activities vital to their wellbeing. Navigating various specialties and platforms to find appropriate individual or family care and support is time-consuming and patients often feel frustrated or lack confidence that they’ve found the best option. Studies have shown that more than half (56%) of U.S. consumers feel lost trying to understand healthcare, and 52% of Americans have low healthcare system literacy, which costs the industry an estimated $4.8 billion annually in administrative expenses alone.
That brings us to the issue of rising costs, another significant barrier to care. As healthcare becomes more complex, expenses rise for all parties. Health spending in the U.S. increased by 9.7% in 2020 to $4.1 trillion. Employer health costs were projected to increase an average of 6.5% this year, and more than 50% of employers expect their costs to be over budget. Additional cost responsibility is being placed on patients themselves, too: the average family premium has increased 20% since 2017.
On top of direct cost increases, the World Health Organization (WHO) found $1 trillion worth of lost productivity due to anxiety and depression from stressful work environments; and the next generation of employees is in an even more difficult position, with 23% of Gen Z workers reporting stress and 98% feeling burnt out. Furthermore, delayed care typically results in more intensive treatments, which are more expensive and have poorer outcomes: a National Institutes of Health (NIH) study found nearly 18% of people delayed care and experienced adverse health impacts.
Technology is critical, but it’s not the only piece of the puzzle
A Personalized Approach to Medication Nonadherence
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
There is a clear and compelling need for patients to have better guidance and support while making healthcare decisions, and more transparency into their responsibility. Technology can alleviate some of the pain, especially a comprehensive navigation platform that streamlines multiple healthcare and benefits tools, putting them all in one place. This approach, typically provided by an employer, can eliminate some of the confusion around a person’s available benefits and health options by helping them find a care provider, understand where to locate necessary healthcare services, and help reduce healthcare costs by providing greater pricing transparency.
As the country’s second largest buyer of healthcare and the channel through which many in the U.S. have insurance, employers play a critical role in making it easier for their people to take needed health actions and use their benefits. They also have a vested interest in supporting employee total wellbeing and improving health outcomes, which will improve loyalty, mitigate attrition, and manage costs. MetLife’s U.S. Employee Benefit Trends Study reports that 80% of employers believe meeting the needs of employees across all life stages and lived experiences is an important benefits objective.
But technology alone, even with thoughtful benefits package design, cannot solve the challenges at-hand. A human connection – arguably the core of healthcare – makes a significant and meaningful difference. Nurses, benefits experts, and certified coaches can bring the human element back to healthcare, demystifying options and helping people optimize their use of digital health tools. These experts, often referred to as advocates, provide people with personalized support at every point of their healthcare journey, offering clarity and a sense of calm in confusing times. They provide guidance on overcoming barriers to care, improving compliance, and enhancing care coordination. Experts can help people find and access affordable, quality care – and do so through conversations via convenient channels like text messaging, which offers a familiar digital experience with a real person on the other end. They can also provide 1:1 sessions on many topics, including chronic condition management, trauma therapy, mental health services, holistic health guidance, and direction for a specific health concern, among others.
I speak from personal experience. Over the past year, I’ve been engaging monthly with a health coach to address a challenging aspect of my personal wellbeing. Through my regular interactions with a coach, I am getting the direction and accountability I need to take action and improve my health. The accountability aspect is particularly important. While digital channels can be very effective at reminding us what we need to do, there is nothing that replaces the accountability that exists when two people make an agreement about personal actions that need to be implemented. That human connection creates a powerful motivator that so many patients need to initiate healthy actions or close gaps in their personal care.
The tangible impact of clinical & benefits experts
Proof that human interaction and support works is in the numbers: nurses, benefits experts, and coaches have a definitive impact on employee health, happiness, and productivity. A live expert saves people time and eliminates endless searches for high-quality, in-network care that take away from other important tasks; Virgin Pulse research found that 74% of members are more focused and present at work when working with a coach. They clear up the confusion and ease the anxiety and frustration associated with navigating the healthcare system, with 84% of members feeling more confident in managing their health and wellbeing. They also help decrease care avoidance, with 86% showing improved health status and 69% of previously physically inactive members becoming more active after 3+ coaching calls.
Advocacy services, in concert with health management and navigation solutions, not only drive better health outcomes but lead to improved satisfaction and costs – all important metrics for employers. It’s no surprise that 41% of employers either already offer or definitely plan to offer member advocacy, a significant increase from 28% in 2019 according to the 2022 McKinsey Employer Health Benefits Survey.
While digital health technologies can improve efficiencies and health outcomes, the best, most meaningful results will only come in combination with expert human support. Advocates can bring digital health technologies to life and make it easier for people to access and utilize their healthcare benefits and services to their full potential. And, with so much on the line, this is one industry where it’s essential that people continue to feel the connection that only another person can provide.
Photo: zhaojiankang, Getty Images
With a 30-year career focused on the health and human capital industry, Chris provides deep healthcare, technology, and HR industry insights and leadership experience. At Virgin Pulse, Chris is combining passion with purpose, leading the company’s global growth strategy and helping clients unlock the full value of their healthcare investments to change lives for good.
Before joining Virgin Pulse in 2021, Chris served as CEO of Alight Solutions, a $2.3B leader in benefits, payroll, and cloud solutions. He was previously the global chief commercial officer for Aon Hewitt, where he led sales operations, marketing, and account management. Additionally, Chris serves on multiple boards of directors, providing strategic counsel.
A firm believer in the correlation between health, wellbeing and successful outcomes, Chris also served on the board of directors of GENYOUth, a leading national youth health and wellness nonprofit dedicated to creating healthier school communities.
