Payers to focus on consumers, social media in 2012

It's a new year and, apparently, a world of the new health insurer. As we usher in 2012, I hope the health insurance industry takes the time to regroup, reassess and, most importantly, improve.

IDC Health Insights forecasts insurers will do just that as they rebrand themselves in 2012 to focus more on consumers. In fact, payers will allocate at least 70 percent of their business and technology resources (excluding those for ICD-10 compliance) to consumer engagement and care management strategies.

"The industry understands that care management is where the dollars are," Cynthia Burghard, research director with IDC Health Insights, said during a company-sponsored webinar. "That's where 80 to 85 percent of the expenses are."

She predicted that investments in care management and consumer engagement are going to drive the overall future investments of payers. Payers finally "seem to recognize that it's all about managing wellness and members and, to some extent, keeping them out of the healthcare system," Burghard said.

Another big trend that Burghard thought we'll see in the payer industry is greater integration of payment systems with clinical performance and outcomes. She predicted that 20 percent of health plans will begin to integrate care, network and payment strategies, which will help differentiate them from the competition while also allowing for more analytics to support outcomes-based payment programs.

Although this integration is an "arduous task," Burghard said, "we're seeing claims data being massaged differently to more fully understand the clinical implications of what is going on." She noted payers will invest in two major areas: care management and network management. "They tie together very well because if your network isn't right, you're not going to have the right healthcare outcomes," she said. Burghard said payers will build networks that support specific clinical and personalized programs, and they will focus analytics investment on outcomes-based payment programs.

The third prediction for 2012 is that health plans will deploy second-generation communication strategies to support consumer communications. Historically, consumer engagement occurred in many different places. For example, customer service handled administrative and financial issues, and the care management department sent out emails or alerts to patients. Because these communications lacked coordination, payers lost the ability to continually interact with consumers, Burghard explained.

Moving toward second-generation communication strategies means coordinating consumer engagement activities while meeting the patients where they are. In other words, payers will increase their use of social media and mobile devices to communicate with their members. "It's making it convenient for the member to get the information they need," Burghard said.

The other component of 2012-style communication, Burghard said, is "balancing the technology with a personal touch." Health plans must establish a fairly regular--but not annoying--interaction with their members to communicate that they are cared for.  

One way to achieve that goal is through social media. Because consumers increasingly are using social media sites, such as Facebook, YouTube and Twitter, to find health information, payers should use these sites to interact with their members, IDC Health Program Director Lynne Dunbrack said. She recommended using social media to positively affect health behavior by creating a virtual support network of people who encourage and applaud each other's wellness efforts.

Here's to the realization of these predictions. Happy New Year! -Dina (@HealthPayer)