When health plan leaders embark on a search to add to their tech toolbox, numerous considerations must be weighed before a final decision is reached. They need to gain input, review performance and analytics capabilities, and critically assess the vendor’s cybersecurity functions. They also need to confirm that these digital health tools play well with other technology solutions in their portfolio. Perhaps most importantly, the technology needs to support the broader mission of reaching more members and improving the member experience.
As you explore a new digital health vendor, ask yourself these five questions along the way to ensure the technology aligns with your health plan’s performance goals and strategic direction.
1. Does it improve the member experience?
Tech vendors need to have a member-centric approach to their services since member satisfaction and member actions are the only way to improve performance. A key component of this is being able to communicate via their preferred method. Evaluate if your member engagement tech tool can capture member preferences and offer enough outreach variety though email, texts, in-app messages, mail or phone calls.
Having multiple outreach methods is also crucial for addressing health disparities and meeting the expectations of regulatory bodies like Centers for Medicare & Medicaid Services (CMS). Even if members are experiencing housing insecurities or homelessness, they may still have access to internet services through libraries, community centers and smart phones, making digital engagement critical for connecting them with care and resources. Conversly, members with lower incomes or in rural areas may rely on mailers and phone calls. Allowing members to choose their communication preferences is key to successful member engagement and closing care gaps for vulnerable populations.
Offering a rewards program could motivate members, improve their experience and simultaneously help address social determinants of health (SDOH) challenges. By incentivizing members to take certain health actions, plans can close care gaps, boost response rates and improve the quality of data sources. When selecting a digital partner, review their ability to offer incentives, the size and flexibility of their reward library, what formats rewards are available in and how easy it for members to redeem.
2. How robust are the analytics capabilities?
With so many regulatory changes in recent years and on the horizon, payers need access to intuitive dashboards to monitor registration needs, survey results, member-level data and quality measure performance in real time. A well-designed dashboard can help you visualize data to see the big picture and do a deep dive into specific measurement areas or member pain points to support coordinated interventions based on results.
Look for a partner who can collect accurate information and gather it from a variety of sources. Define reporting standards to help determine if the vendor monitors clinical, quality and financial performance and knows what data to collect.
Tracking member feedback is also another important analytical tool for improving successful plan performance. This should include surveying members for Consumer Assessment of Healthcare Providers and Systems (CAHPS), Healthcare Effectiveness Data and Information Set (HEDIS) and state-specific measures. Ask how a vendor evaluates how your members are feeling about their plan to know where your performance risks are and how to improve them during measurement periods.
3. Does it streamline or consolidate other tools?
Plans need to be able to seamlessly move data and processes between systems. Ask potential vendors about their integration capabilities and industry partnerships to determine how easily it is to implement their solutions alongside your current tools.
For plans that want to optimize their quality strategies, comprehensive platforms allow them to consolidate processes into a single dashboards. Look for a digital health tool that turns your data into action by deploying targeted member communication straight from the platform. Bringing data and member communications into a single platform gives health plans an ongoing feedback loop:
- Gather updated member health information through survey data, claims or self-reported data.
- Deploy targeted member health actions based on that data.
- Know how the communication performed and if the care gap was closed.
- Initiate appropriate follow-up outreach to improve response rates and collect additional data.
The goal should be to pull as many member touchpoints as possible into a single platform to minimize the lag time—and manual work—between data collection and outreach.
4. Will it improve plan efficiency?
Health plans need to ascertain whether a prospective vendor’s software will help relieve staff from time-consuming manual processes. Inefficient processes are costly for any organization, but especially for health plans that are trying to quickly adapt to changing regulatory environments.
Pay attention to digital health partners with an in-depth understanding of performance strategies across multiple lines of business, federal and state regulatory benchmarks, and how to meet emerging health equity requirements. Solutions should be supported by subject matter experts who have experience in healthcare quality and performance, especially during difficult periods.
5. Are plan and member data secure?
Every ransomware and phishing attack undermines the public trust in payers and providers’ ability to keep personal health information secure. Although these attacks on our infrastructure are not limited to healthcare, this industry has the most sensitive information aggregated in place. Health plans need to carry out due diligence of prospective tech vendors to ensure they can deliver on their security assurances.
Outline your plan’s security requirements and review a vendor’s certifications. If tech vendors don’t meet those standards, it’s better to find out early in the vetting process. Vendors with Health Information Trust Alliance (HITRUST) have proven their systems are compliant, up to date and screened for data security purposes. Certification will also provide guidance for tech partners to apply security protocols for third-party subcontractors. This knowledge and action plan builds the framework to keep your organization HIPAA compliant.
Lastly, talk with vendors about how they continuously assess security and data risks.
How Healthmine Can Help
Healthmine’s technology solutions serve as a health plan’s hub for continuous feedback from members, data collection and stratification, and targeted member communication. From a single HITRUST-certified platform, you can accelerate your ability to identify gap closure opportunities and inititate the appropriate outreach through omnichannel, rewards-friendly outreach. Contact us for a demo.