Payer execs most concerned about member satisfaction
Health insurance executives see technology as a way to reduce costs and improve member satisfaction, according to a new HealthEdge survey conducted in partnership with Survata, an independent research firm.
In interviews with 73 payer executives that explored goals, challenges and strategies, the report found payers' No. 1 goal for this year is improving member satisfaction.
They also said the biggest barrier to achieving member satisfaction and top organizational goals related to cost structures preventing innovation.
The report said executives now realize that members' needs are not being met. Members are looking for payers to provide accurate data and provide less costly care options. Customer service ratings are traditionally low for payers.
“A positive member experience must include effective customer service, with ably trained and technology-savvy customer services representatives and consistent, accurate information available to internal staff, providers and members in real-time,” HealthEdge said.
A little more than 60% of respondents said costs are preventing innovation. Administrative and healthcare costs keep payers from investing in new methods, according to the survey.
Providers are also faced with administrative costs because of payer initiatives like prior authorization. A recent American Medical Association (AMA) report found that nearly all of physicians surveyed said prior authorizations have a negative impact on patient clinical outcomes and are taking up a lot of time.
Health insurers apparently also feel these costs are causing problems. The AMA is working with Anthem and other major healthcare players on efforts to improve prior authorization processes.
The report said health plans are “struggling to align on priorities, lower costs to create resource pools to fund innovation and are facing challenges updating critical processes that will allow their people and technology to work effectively in concert together.”
More than half of respondents (59%) also said health insurers need to modernize technology. Next-generation technology was the most cited strategy for overcoming the industry's challenges.
There have been plenty of concerns about how changes in Washington may affect payers and the need to move from a fee-for-service model to a value-based system. A recent Healthcare Financial Management Association (HFMA) survey found that payers have been slower in launching value-based programs than expected. Yet those who moved to value-based payment programs achieved positive financial results, including return on investment, HFMA reported.
However, this survey finds payer executives are less concerned about those regulations and value. Instead, they're focused more on member satisfaction and innovation.
One reason for this might be that major retailers like Amazon and CVS are looking to move into healthcare. Those companies can bring their customer service experience to healthcare, which would make member satisfaction even more important across the board.