Payer Consumerism Strategies Rely On Data, SDOH, Simpler Language

Data sharing, social determinants of health, and simpler language are common priorities as payers seek to strengthen and expand their consumerism strategies, the tenth annual 2020 Industry Pulse Report from Change Healthcare found.

The study’s responses were gleaned from 445 payers and providers by InsightDynamo. This sample size is the Industry Pulse Report’s largest population yet, with almost 20 percent of the respondents identifying themselves as being employed by a payer organization.

Payers are recognizing their status in consumerism. They are shouldering the responsibility for distributing relevant cost and quality data to consumers. Over seven in ten payer participants (73 percent) thought that payers were in the best position to share this information.

But recognizing their responsibility has not just been an intellectual exercise for these payers. Rather, they are pulling together consumer-centered strategies. One hundred percent of the payers who participated in this study reported either having a consumer-centered strategy already in place or one in development. 

A deeper dive into the results reveals just how fresh the push for consumerism is.

Though all payers demonstrated a consumer-centric mindset, over three-quarters of the respondents indicated that their consumer-centered strategies were not yet a complete strategy.

Forty-three percent said that they had started targeting single-point consumer-centric strategies but did not have an overall strategy for their company. Meanwhile, 33 percent classified their plan as “intermediate.” These respondents have grasped the principles of consumer-centricity and had invested in tools to engage in consumer-centricity but could not yet provide measured results of these efforts from across the organization.

But the results also revealed a significant level of commitment in this area. A little less than one in four (24 percent) of participating payers embraced a full consumer-centric strategy. They had the tools and technologies in place to deliver quality and cost metrics to their consumers and they had measured the outcomes.

As payers seek to “consumerize” their roles, three methods of consumer satisfaction improvement emerged from this study.

First, they are providing more information to consumers. An impressive 84 percent of payers display government-driven ratings, such as HEDIS and star ratings. One in seven make patient satisfaction scores publicly available. Payers are even sharing health outcomes data.

Second, as payers look to engage in consumer-centric models, they are looking to expand their influence in certain social determinants of health. 

In particular, when compared to providers, payers focused more heavily on five social determinants of health:

• Income
• Housing
• Health literacy
• Education
• Food insecurity

The focus on these five areas revealed in this study are reminiscent of some major developments in social determinants of health efforts from 2019. That year, major payers were expanding their Medicare Advantage plans to provide more social determinants for health benefits and heavily invested in housing, transportation, and other social determinants.

Indeed, 30 percent of all respondents were providing some form of direct social determinants of health support and more than past years were coordinating with community-based organizations.

Third, among other non-clinical measures to improve patient satisfaction, payers this year emphasized the need to make healthcare insurance interactions more easily comprehensible to consumers. 

Payer participants asserted that putting benefits and invoicing in plain language, simplifying the explanation and navigation for benefits, and “translating” medical information into the vernacular were most likely to improve their patient satisfaction.

They also underscored priorities such as eliminating surprise billing and enabling online appointments and scheduling opportunities as key to better patient satisfaction.

As payers kick off 2020 pursuing a consumer-centric business model, the results indicate that they may put more effort into using more approachable language in their interactions with consumers and pushing to expand and empower their consumerism strategies.