Choosing the right health plan model can be confusing (at best). When there are so many options out there and little information to help you understand the benefits available to you, it can be easy to just settle for the familiar fully insured option. But let’s face...
It’s time for healthcare to act humanly as we think digitally.
By Craig Maloney, CEO
Last year I wrote an article on the digitization of today’s healthcare experience. What started as a post to promote the good work our team is doing in the clinical care management space ended up being an ongoing dialogue around technology’s place in healthcare.
Technology, typically viewed as the ultimate enabler, can actually have an adverse effect when it comes to our healthcare journeys. For a system that’s supposed to be designed around people, we’re seeing the opposite when technology is overly involved or deployed in isolation.
That view is hardly universal and, in some ways, can be a little polarizing. So, we did some digging.
The team at Maestro Health recently surveyed more than 1,000 Americans about their experience with the U.S. healthcare system in our whitepaper “The Poor Health of America’s Healthcare System.” We learned that people feel confused, misinformed and unsupported by the healthcare industry.
While I consider myself to be a realistic optimist, the data that we’re seeing is disappointing. The healthcare industry has been trying for more than 25 years to convert a very emotional and human-centric process into a simple digital experience.
I’m not saying it’s easy, and some of the challenges certainly sit with individual members, but, as an industry, we’ve failed to make material and tangible progress.
We’re seeing the data play out in a pandemic.
Seventy percent of those we surveyed feel that today’s healthcare system is difficult to navigate—and the pandemic has really continued to confirm this.
Take COVID-19 testing, for example. Search for “COVID-19 test” on Google and you’re left with an overwhelming number of informational pages and places to go. But you won’t find a comprehensive answer about what your insurance will cover or what you can expect to pay.
But it doesn’t stop there. Understanding what your benefits cover can be difficult even after receiving a test, procedure or service. I was tested for COVID-19 and had a hard time interpreting the charges on my medical bill (and I work in the industry).
At a time when diagnostic testing is so important to our livelihoods and our health, you’d hope that the process would be simple and easy. Yet, when you look at the healthcare experiences people have had in the past few months, it’s no wonder that 65% of people don’t understand their medical bills or that 39% have fought an unfair medical bill.
The experience can be frustrating, especially when and where it matters most.
There’s a need for human connection through digital means.
The realistic optimist in me believes there is still time for us to get the healthcare experience right.
One of our opportunities lies in the fact that 36% of the people we surveyed said virtual access to their health providers improved their personal health journeys. And there’s no time like the present (or a pandemic) for us to really dive deep into the telehealth waters.
Although the recent digitization of healthcare has been an epiphany for many in the industry, we cannot overlook the importance of a human interaction. Technology is a driver—not a replacement—for quality, human-driven healthcare.
Don’t get me wrong—I think we should be inspired by the way technology continues to evolve healthcare. But the reality is, healthcare may never be completely digitized. The need for the human connection is still an important piece to the healthcare puzzle, even in the age of telehealth.
Leading with empathy is key.
At Maestro Health, we’re blending both technology and human touch by making our offerings human-centric, regardless of where connections are happening. Our people-first approach to healthcare extends beyond just my words on this blog.
Take our in-house call center, for example. When most people hear the words “call center”, the expectation is that the experience won’t be good—calling in for help has traditionally been an unhelpful and frustrating experience.
We’ve set up our call center operations to focus on quality and resolutions, not quantity. In moving away from the “churn and burn” model, we’ve created a structure that empowers our call center teams to help members resolve their issues on the phone or, if a quick resolution isn’t possible, set expectations about when we’ll call them back. The proof is in the data. Our agent promoter scores (how likely an employee would be to recommend working at the company) comes in at 62. Far higher than industry standard.
Our in-house clinical care team is also an area where we’ve been able to design a people-first digital model. The team uses data to help us target the right members at the right time with support and resources fit for their needs. Take our COVID-19 response for example.
As the pandemic ramped up, our claims and care management teams worked together closely to provide proactive and responsive support for both our clients and their members. Our outreach included calling members with conditions that put them at higher-risk to contract COVID-19 to advise them on their care plans, answer questions about safety and how to reduce their risk of exposure as much as possible. We were able to attribute this work to avoided admissions and healthier outcomes—all thanks to a human-centered approach.
I don’t think we need to ditch the technology or slow down innovation—actually we should be doing the opposite. But we can’t leave out the human side of things.
If you’re looking for ways to humanize your benefits offerings, drop us a note. Our team is doing a lot of work to really shine a light on the opportunities we have ahead of us to make healthcare easier to use and understand for everyone, and to make the experience, above all, more human.