Insurance is not fun. It is boring, complicated, and seemingly purposely confusing. It is no wonder that many consumers actively avoid it. And when it comes to health insurance – including Medicare and Medicaid – it seems even harder to manage. When consumers need to tap into health insurance they are often not at the best health and they are going at it alone, trying to face a confusing system all in an effort just to feel better in the end.
Innovative Players are Leading with Solutions
To help pull consumers out of the darkness, new entrants are entering the market at a rapid pace to help bridge the gap and create that much needed human touch that has alluded insurers for decades. One company that has set its sights in entering the space is Amazon. Amazon is making a historic investment by acquiring One Medical – a leading name in concierge primary care. At a price tag of $3.9 billion One Medical comes with 188 offices across 28 markets, serving approximately 767,000 members.
Following this announcement, CVS Health unveiled its plans to acquire Oak Street Health for $10.6 billion. What makes these care models different? They provide no-hassle access to primary care physicians when you need them. Office locations are set up in more urban areas and are meant to be inviting to the patient to provide a care experience. And the insurance aspect is already taken care of at the start and members set up care in more of a subscription model to obtain care. All of this is meant to put the patient at the very center of the care experience, eliminating barriers and making it easier for them to get the care they need, at the time that they need it the most.
Traditional Insurers Need to Keep Up
Traditional insurers are starting to catch on that they are a linchpin to a patient receiving care, but also end up being an unnecessary roadblock in making that happen. As such, many insurers are instituting elevated service models to help reduce some of the stress that members feel and help them navigate a complicated system to get the care that they need. Whether it is called a care concierge, care coordinator or care navigator the end goal is ultimately the same – focus on the member in their time of need.
Companies like Quantum Health have created entire businesses around care navigation to help guide patients and health insurers are finding that they must operate in the same way to help and support their members—guiding them in their times of need. This is extremely telling how confusing the entire industry is that members regularly need help connecting to pharmacy, community resources, administration, and provider services. Confusion is the name of the game of insurance, and additional service is needed to help facilitate the right level of care.
Understanding the Patient Experience is Critical
The only way to build the right services and solutions is to truly understand what a patient goes through—how they think, feel and live. And the way to get there is through in-depth explorations of their experiences—walking through step-by-step explorations of where they turn and how they experience different service interactions. It is one thing to hypothesize what we think a patient is going through, it is another thing to face a patient directly and “get under the hood” of their experiences and interactions – how they are feeling and thinking. By pinpointing the positives and negatives it can be clear how solutions can be designed to make things better in the end.
As omnichannel interactions become more commonplace, it is important to move past old hypotheses and explore the interactions that are occurring in today’s post-pandemic world.
Where empatiX Comes In
We live and breath the patient experience, partnering with our health insurance clients to design in-depth human-centered programs that look to uncover the nuances of the patient experience and focus on what is absolutely needed when it comes to healthcare. Accessing the right audiences is critical and we work to ensure we have the right people engaged from the very start.
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