What You Need to Know
- Patients who trusted their health plans might be more interested in hearing about wellness.
- Primary care physicians would have an easier time steering patients away from the emergency room.
- People who need mental health care would be more likely to get it.
The fundamentals of the health care insurance industry are shifting post-pandemic. How the industry responds to consumers’ new expectations and changing needs could unlock huge value for the health insurance ecosystem.
The future of health care insurance depends on exploring new models of doing business, something the industry has been slow to embrace. Proactively reinventing their business models helps insurers get closer to consumers, as many show willingness to consider alternative distribution channels.
In the near term, business models that capitalize on the benefits digital technology can bring for insurers while meeting a changing set of consumer demands will help insurers not only to remain relevant but also to grow. This shift could also help create trust and encourage a more intimate relationship between consumers and insurers.
Here are four steps the insurers you and your clients are working with should take.
1. Embrace alternate care models.
As people return to their “normal” levels of health care consumption after months of uncertainty, they’re more conscious of and willing to be proactive about their options for preventive care and holistic wellness. While insurance has always rewarded consumers who actively seek preventive care, employers and insurers alike can do more to connect people with the resources they need (and provide the coverage to do so).
For example, many consumers have often defaulted to using the hospital, specifically the emergency room, as their go-to for receiving treatment. In a primary care physician-led model, patients are in more frequent communication with their primary care physicians and will work with them to find the right place for treatment (often not the hospital).
With the primary care physician’s guidance, patients will feel more confident to embrace procedures and therapies administered outside of surgery centers. This not only saves the patient (and the insurer) money but by encouraging a stronger relationship between the primary care physician and the patient, could lead to better health outcomes — rather than waiting until the condition is so bad that the patient needs hospital care.