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Health Plan StrategiesTo fully understand the priorities of those leading the payer landscape, HealthEdge, in partnership with Survata, an independent research firm, interviewed 73 health plan strategies executives to determine what are the top goals, challenges, and strategies to meet those challenges for health plans in today’s market. For the first time, when asked what their most important goal is for 2018, health plan executives cited member satisfaction. Payers seem to understand that increasing member satisfaction – and the resulting loyalty that comes with it – is the top goal for the next year.

These executives are now ready to embrace the third component of what was always valued in the Triple Aim – patient experience. Health plans are realizing that “members” are customers whose needs must be met. Members hold health plans accountable for the availability of accurate data delivered on demand and look to their health plans for less costly care options. Customer service ratings for health plans have traditionally ranked below many other industries such as retail, travel and financial services in consumer surveys. A positive member experience must include effective customer service, with ably trained and technology-savvy customer services representatives, and consistent, accurate information available to internal staff, providers and members in real-time.

When asked what the single greatest barrier to achieving member satisfaction and other top organizational goals, 62% (nearly two-thirds) of survey respondents cited cost structures that are preventing innovation. The health plan executives see prohibitive costs standing in the way of necessary innovation. Health plans leaders recognize the need and value of transformation, but current administrative and healthcare costs are preventing them from taking the first step and allocating precious resources for innovation. The lack of ability to lower administrative and healthcare costs is keeping them awake at night and preventing them from taking the critical steps to move their organizations forward. The response citing cost structure barriers was followed up with concerns around lack of alignment between stakeholders and failure to make internal processes assist with new ways of doing business.

Download the HealthEdge survey report to learn:

  • What Health plans consider the single greatest barrier to achieving member satisfaction
  • How health plans intend to modernize technology to lower costs and transform

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