Navigating the complex health care system isn’t always easy, especially for newly enrolled consumers who are using their new benefits for the first time. But health plans are there to help these new consumers sort through the system and prepare them to take charge of their health coverage and care.
As a recent report from the Center for Advancing Health (CFAH) highlights, health plans are well-positioned to help consumers find their way through the health care system and achieve better outcomes. Health plan leaders interviewed by CFAH gave a glimpse inside the wide arsenal of tools and support that plans use to promote consumer engagement – which leads to better health outcomes, higher quality of care, and lower medical costs.
For example, some health plans use patient portals that help patients and their families make good treatment decisions. Through these portals, patients can communicate with their providers, view their lab tests, and schedule appointments. The portals also allow patients to set health goals as well as prompts that will help users achieve them, according to the report.
Health plans also do work around health record-keeping and care organization, helping patients find their way through the fragmented health care delivery maze. One leader in the CFAH report pointed to Medicaid coordinated care plans in Oregon, which use specific quality metrics that track care improvements for vulnerable populations and reduce gaps in care by addressing language needs.
Another tool to foster active engagement in health care, plans offer useful information and services that are relevant to particular consumers, such as reminders about prescription refills and care management support when needed. Efforts to support informed, engaged consumers also involve plans providing accessible, understandable, and up-to-date information about which providers are in a network and timely notice to consumers when providers leave the network.
As you can see, health plans are going above and beyond to empower consumers so they can benefit more from their insurance coverage and be healthy. But the shift to more affordable and consumer-focused health care can’t happen without other industry stakeholders joining in.
