In today's competitive healthcare marketplace, plans and provider organizations must manage mounting regulations and mandates to provide value instead of volume and to focus on patients instead of processes. With more access than ever before to member data, this is the perfect time for health plan engagement to take the lead in data innovation and further enrich their insight with the right data partner's assistance. Health plan engagement is about augmenting current data assets and analyzing them to improve plan and provider performance.
The triple aim for optimizing health plan engagement is to improve the patient experience, improve population health and reduce per capita cost. However, there is a struggle in health plan engagement to convince providers to use owned data to better manage members and an astounding 40% of healthcare executives gave themselves a grade of D or F when it comes to preparedness to turn data into revenue. Hence, the movement toward consumerism in health plan engagement is changing its view of patients from cost exposures to risk management opportunities. While health plan engagement has been focused on immediate outcomes, member identity data can now be viewed as a source of potential operational and thus cost improvement through tailored outreach for customer satisfaction and future needs.
As consumerism leads the way in health plan engagement, plans and IDNs can use the information they gain from augmented member data to develop stronger provider networks, anticipate costs in targeted geographic regions, expand population health disciplines, prevent and detect fraud and evaluate provider performance. There is a shift in the focus of health plan engagement from enrollment data and claims data to managing provider behavior and risk-adjusting patient caseload by analyzing data on adherence, lifestyle and socioeconomic factors. By leveraging both plan and provider data with added insight there is virtually no operational process that will not experience added value for health plan engagement.
Download this e-book to see how LexisNexis can turn data into the strategic intelligence that powers population health, provider relations and patient satisfaction that improves outcomes and drives revenue.
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