The healthcare system once operated without really having to consider what patients and members wanted, instead focusing on taking care of what was needed. Now, patients and members have become savvier and more involved. They have more choices for plans and care. They are more involved in their own health. They have become healthcare consumers. For plans looking to respond to their members’ needs, we absolutely support you in this endeavor.
Today’s consumers are more involved in their own health than ever before, and patient-centered, holistic approaches to care are paying off. Consider the following:
- Health systems are beginning to offer more high-touch primary care services. In these care models, interdisciplinary teams serve smaller groups of patients with the aim of providing more holistic care. A recent study found that high-touch care models for Medicare Advantage beneficiaries leads to lower healthcare costs and fewer hospitalizations; critically, research concluded that better medication management contributed to these positive results.
- The Centers for Medicare & Medicaid Services (CMS) has expanded Medicare Advantage coverage for certain technology-enabled services beginning in 2020. Services such as remote patient monitoring are now covered, and rural and home restrictions for stroke care, dialysis care, and substance abuse treatment have been lifted. Add to that growing utilization of telehealth for treatment of low-acuity conditions and it’s clear that consumers will be looking for convenient high-tech care options.
Plan Today for Success Tomorrow
This healthcare future is neither care delivery as usual nor health plan selection as usual. Before long, plans that are unable to support high-touch and high-tech care – as well as a carefully thought-out combination of the two – will lose members to plans that can.
That’s why analytics once used to do little more than retroactively review will have to be used to proactively identify, intervene, predict, and inform care delivery. MAPD plans who use analytics in these ways are laying the groundwork for this future. They are customizing and scaling, using the right information to inform flexible strategies. These plans are positioning themselves to be strong, consumer-centric organizations, providing services that members want, need and benefit from.
But predictive analytics for MAPD plans is more than just addressing the approaching future of healthcare. Proactive use of analytics also helps plans better react to incremental changes to Star Ratings that are here today. If plans are in the habit of assessing their performance on a regular basis and making changes accordingly, they are demonstrating a commitment to ongoing quality improvement efforts.
When plans make this work part of their long-term strategy, then responding to new Star Ratings measurements is likely to require midstream adjustments as opposed to wholesale changes. What’s more, plans with assurances of Star Ratings bonuses can be nimble in pursuing the forward-looking high-touch and high-tech care options that customers have come to expect.
Want to be one of those plans? Talk to us about the best way to make analytics work for you.