Part 1: Applying 5 health consumer engagement trends in the Year of the Monkey

2016 is the Year of the Monkey in the Chinese calendar. While monkeys are hailed as innovative and quick, we are starting to see the healthcare industry adopt these traits as well. Every year, healthcare pundits release their annual predictions, and I’m not exempt. In the first part of this two-part blog series, I discuss two top topics that I predict we’ll see unfold in the next 11 months: the Medicare Star system, along with other quality measures, will drive more major business decisions, and digital population health tools such as virtual assistants and text messages, will become more widely adopted.

Yes, you read the headline correctly – and you might think “Vance just ran a bit late on his blog post and is trying to cover it with this Year of the Monkey business.” And at that point, I’d say, “Considering the horrible pun you just made, we’ll call it even.”

Each year – Chinese or not – healthcare pundits submit their predictions and trends for the coming year, and the last several years have seen an increasing focus on health consumer engagement as one of these trends. Considering Nuance’s status in the industry as a leader in intelligent self-service solutions, I’m taking this a step further to examine how consumer engagement impacts top healthcare issues for organizations in the coming year. These are the topics I’m seeing come up most often on the dozens of calls I have had with industry executives in the past year.

With executives and teams at many organizations dedicated solely to customers’ engagement and experience, those two interlocking concepts are no longer a trend, issue or challenge, but threads that run through most other industry issues, manifesting in tangible applications for each.

So, against a broader backdrop of healthcare consumerism, here are the first two of five top engagement-related issues I’m seeing as we enter the Year of the Monkey:

  1. Quality measures, with Medicare Advantage as the “Star”: The recent CMS-AHIP agreement on a unified set of measures for the health insurance industry highlights how achievement of high compliance rates and overall ratings is increasingly driving business decisions and initiatives for plans, providers, PBMs, pharmacies and others. Fully 40 percent of all commercial payments to hospitals and doctors are now “value-based.” But the Medicare Star ratings system has become the most popular topic that I encounter as I speak with plans, providers and pharmacy-related companies across the country. These organizations are all looking for tools to boost quality ratings in a scalable way. This often takes the form of leveraging proactive engagement to reach out and nudge members to get a mammogram, refill a prescription, or complete a post-discharge assessment on their phone. Just as often, insurers have their call center and CAHPS-related measures in mind as they redesign their IVR routing or implement conversational IVRs. And one top three health plan we’ve worked with has made great use of web and mobile-based virtual assistants to better guide members to resources and answers. Most progressive organizations are already implementing solutions like these – look for this to be a hot topic in the coming year.
  2. Scaling adherence and tools in chronic health management – Formalized chronic disease and wellness programs, while a staple for population health managers and plans for some time, are experiencing accelerated momentum in many forms. While most plans have been using these methods for years, I’m still surprised at how many top plans are just now discussing the use of text messages and automated voice calls to boost adherence around scheduled nurse and health coach calls, or using this form of outreach to improve enrollment in programs. In the coming year, more plans will try to increase efficiency by gathering biometric data and other information through self-service methods like virtual assistants and coaches. Top PBMs and pharmacies I’ve spoken with recently are working with us to uncover applications that can assist them in the specialty pharmacy arena, as well. One example is the use of both texting and virtual assistants to help patients find videos about how to self-administer a particular type of injection. Providers are rapidly implementing chronic disease programs, and many are just now starting to entertain the notions above.

While these two broad topics are enough to keep all of us busy, I have three additional important issues I’ll be discussing in my next blog post. It should be more fun than a barrel of monkeys.

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Vance Clipson

About Vance Clipson

Vance Clipson, senior principal, industry solutions for Nuance Communications, focuses on vertical-specific strategy and marketing with an emphasis on healthcare, financial services and government. Clipson brings 25 years of experience translating industry needs and data into market strategy and programs for Milliman, PacifiCare Health Systems and other organizations.