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Payer Perspective | Value-Based Care

By Becky Teng & Matt Jones, MS

The future of digital health at scale

Early in 2021, Becker’s hosted their first-ever Payer Virtual Summit. The event hosted executives and clinical care leaders from the largest commercial insurers and health plans who met to collaborate on building a sustainable strategy for the future of health at scale. As the pandemic has presented numerous challenges, payers and health plans have had to quickly adopt innovative changes to the way they deliver care. Top-of-mind for many of the healthcare leaders were solutions surrounding patient engagement, intraoperative data integration, value-based care, and telehealth.

What's missing from the member digital experience?

Navigating healthcare is difficult and requires a mixture of administrative and clinical input to help individual patients receive the best care, at the right time, and in the right place. In the session What’s missing from the member digital experience?, Dr. Rodrigo Cerda, Vice President, Clinical Care Transformation, Independence Blue Cross, explained how digital tools can help enable healthcare leaders to have an end-to-end vision that can bridge the gap between the clinical and administrative sides of healthcare. Likewise, Lisa Davis, Chief Information Officer, Blue Shield California, stated that the digital health ecosystem needs to take a highly personalized and holistic engagement approach, leveraging a “high-tech high-touch” modality.

Transition to value-based care

There was consistency across the board on the goals the speakers hope to tackle next and how they impact affordability, simplicity, and predictability for consumers of healthcare. The digital experience is evermore important with respect to the transition from fee-for-service models to value-based care organizations. By building these digital ecosystems, there will be a direct positive impact on health outcomes, payment models, reduction in costs, and improved access, and quality of care.

Today’s members seek a heightened experience

Executives from Blue Cross Blue Shield shared their insights on which strategies will help organizations excel in 2021. A major challenge healthcare has faced is how to couple technology with care delivery models, and the pandemic has accelerated the awareness and adoption of digital health. Steve Anderson, Vice President, Provider Contracting & Network Administration, stated that we have an “affordability crisis”, and today’s members seek a heightened experience driven by convenience, affordability, and reputation when choosing where to receive care.Payers now play a key role in accelerating this very innovation, and it’s a quest that won’t be accomplished alone. It requires close collaboration with providers, hospitals, payers, digital health suppliers, etc., to tackle initiatives to build sustainable, long-lasting impacts that will change the way we deliver care. If we want to do more for our patients, we will need to hire additional staff or embrace digital care in order to make meaningful connections.

With patients at the center of everything we do, “How do we continue to build trust with members?” Sukanya Soderland, Senior Vice President and Chief Strategy Officer, Blue Cross and Blue Shield of Massachusetts.

The leading insurer Chief Medical Officers also reflected on the key opportunities there are to engage with members and to ensure that the care that is delivered meets the care that is needed.

“The myth of communication is that it actually happens” - John Bulger, DO, MBA, Chief Medical Officer, Geisinger Health Plan.

How Force provides digital solutions

At Geisinger Health, the team has completely changed the way they communicate with every person involved in the consumer journey. They’ve achieved this by finding various modalities to enhance communication with patients and providers through telehealth, bricks and mortar, and various teletechnologies to wrap their arms around their members especially throughout the pandemic. As one of the nation’s most innovative health service organizations, Geisinger has partnered with Force Therapeutics since 2015 to standardize care with a seamless virtual experience and optimize care management for the entire care team. By leveraging technologies and solutions, the integrated delivery system at Geisinger Health was able to stay connected with members and deliver high-quality care in a safe and accessible manner to a predominantly rural population.

Evidence-based public health interventions

Payers and health plans are uniquely positioned to address these challenges and integrate end-to-end solutions that can provide evidence-based public health interventions. Through synergistic partnerships across the public and private sectors, payers and health technology companies can build a digital health ecosystem to deliver equitable care and improve health outcomes, especially among vulnerable populations.

Join thousands of healthcare executives, orthopedic surgeons, and care team members who trust Force as their digital care partner.

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