Specialized and high touch point solutions are a cornerstone of health plan performance, but that is quickly changing. Point solution fatigue is an ongoing roadblock for managed care health plan operators, employers and benefits coordinators who struggle to effectively coordinate multiple programs at once. As health plans contend with tougher quality measures and limited funding, vendor consolidation is one opportunity for plans to reduce costs and improve efficiency.
Unfortunately, addressing point solution fatigue can be complex to unwind. Without finding an adequate partner like Healthmine to fill the gap in performance, plans risk the continuation of increasing workloads for staff, overburdening internal programs and limiting their effectiveness.
However, improving cost-savings and performance at the same time is absolutely possible. When plans focus on consolidating vendor partnerships and internal outreach with a comprehensive technology suite like Healthmine’s Quality Relationship Management™ (QRM) platform, they are better equipped to move into the digital world, while addressing organizational and member needs at once.
How to Reduce Point Solution Fatigue
Overcoming the challenges of point solution fatigue starts with understanding which solutions a plan currently manages, how these solutions overlap or are redundant, and where solutions can be consolidated to have the biggest impact on performance.
To help plans navigate these questions, consider a few common problems plans experience and ways to resolve them.
Centralize Fragmented Data
Problem: Point solutions divide member data into different silos and systems that must be manually synchronized with health plan records.
Solution: Use real-time data feeds to develop longitudinal member records, monitor quality measures in real-time, predict member behaviors, create personalized care plans and improve data interoperability.
Members live in a digital world. To meet them where they are in their health journeys, plans need to become just as integrated with technology. Plans can start by establishing a centralized database for managing all member data and using application programming interfaces (API) to align all data feeds under Fast Healthcare Interoperability Resources (FHIR) standards.
Under FHIR, API data feeds standardize data across multiple, divided healthcare systems by enabling them to easily and rapidly share information without the need for manual processing. Centralized databases for managing API feeds can be built in-house, but will require significant resources from IT teams. To save time and resources, plans should partner with vendors who can rapidly scale databases and establish API feeds between vendors.
Simplify Analytics
Problem: Quality and risk adjustment legacy strategies are divided across multiple point solutions to address different measures and programs without clear oversight. Staff lack clear insights into which solutions are achieving results and how to effectively coordinate improvements. Each solution has its own analytics dashboard, but the information is siloed and not actionable to drive the desired outcomes or deeper insights.
Solution: A single dashboard should be used to manage all member engagement touchpoints and analytical reports, including:
- Star Ratings
- Medicaid quality measures
- Healthcare Effectiveness Data and Information Set (HEDIS)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS)
- National Committee for Quality Assurance (NCQA) requirements
- Retention rates
- Outreach performance by channel and campaign
Ideally, analytics should be built directly into a centralized database, but even if it’s managed with a separate point solution, consolidating fragmented data will lead to a deeper understanding of plan performance and member behaviors. These insights will allow plans to determine which programs are necessary for continuous health outcome improvements, where they can reduce costs and how they can streamline quality strategies.
Consolidate Touchpoints
Problem: Staff cannot keep track of what messages members are receiving from point solutions and are worried about members experiencing abrasion. Members are confused about what programs are covered under their benefits and who to call for assistance. Ineffective outreach is contributing to high rates of waste.
Solution: Streamline member communications under a dedicated engagement dashboard that executes and monitors all communications, including emails, direct mail, mobile applications, text messages and outbound calls.
Managing outreach from an all-in-one platform like Healthmine’s QRM enables health plans to access an enterprise view of all communications, enforce brand guidelines and implement efficient engagement strategies. When backed by real-time data feeds and behavioral science, plans can leverage a more targeted approach to determine the best method of interacting with members.
These tactics may include increasing or decreasing the amount of outreach they receive, A/B testing messaging and using more high-touch approaches to help members better navigate their health journeys. By taking a more coordinated approach to outreach, plans can enjoy better control over budgets and member experiences. Consolidated digital outreach and real-time feedback also provide plans with more insights into member behaviors to guide future improvements.
Apply a Human Touch
Problem: Staff have too many tools to manage at once and not enough guidance to understand how to effectively use them.
Solution: Partner with the right strategists and consultants to better understand how to use digital tools to improve processes.
As valuable as digital tools are for automating manual processes, plans also benefit heavily from insights from clinical and quality experts. By partnering with the right healthcare consultants, plans can access first-hand accounts of how to use technology to enhance performance. Their insights may include analyzing vendor portfolios to eliminate redundancies, developing engagement strategies to optimize outreach or using tools like the Healthmine QRM platform consolidating point solutions.
When appropriate, reach out to a healthcare consultant for a one-on-one planning session to learn how to best use the tools available on the market.
Streamline Plan Performance with Healthmine
Through Healthmine’s QRM platform, health plans can move from inefficient point solutions to comprehensive plan performance strategies.
At Healthmine, we deliver personalized engagement at scale, continuously guiding members through each moment of their healthcare journey. Plans can easily build longitudinal member records, identify opportunities to improve performance and initiate targeted gap closure initiatives with omnichannel outreach. QRM uses real-time member data, behavioral research, and tailored outreach, driving action by delivering lasting behavioral change.
Our personalized care plans cover up to 67% of all Star Ratings measures and empower members to self-manage their health goals without the need for additional vendors. As the only member engagement vendor with an internal team of consultants, Healthmine equips plans with the right tools and knowledge to maximize plan performance.
Start building comprehensive strategies with the aid of a dedicated technology suite, delivering personalized engagement that matters. Contact us for a demo.
Healthmine is the leading member engagement and rewards solution focused on empowering people to take the right actions to improve their health.