Payers well-positioned to transform healthcare industry in 2015

Three areas for payers to focus on this coming year

Good news, payers: You are well-positioned to save a somewhat struggling health insurance industry.

With 2015 comes a fresh start. Payers can use their market power to establish new, innovative trends throughout the industry that enable quality of care and drive down costs.

Listed below are three main areas to focus on, along with details about what some payers already have in the works.

Convenient care at low costs

As the trend of consumerization heats up, payers should focus on what's convenient for their members. Case in point: Last year, New York Attorney General Eric Schneiderman urged 15 insurers in New York to let certain members buy specialty drugs at retail pharmacies instead of through mail-order services, FierceHealthPayer previously reported. If payers can locate convenient pharmacy stores, it can help members avoid hefty out-of-pocket fees.

Blue Cross Blue Shield of North Carolina has banked on urgent care clinics to help it defray the cost of hospital ER visits. If just 5 percent of non-emergency patients in the BCBSNC network sought treatment at urgent care centers instead of emergency rooms, medical spending could drop by $8 million a year, FierceHealthPayer previously reported.

Encourage wellness initiatives

By covering wellness programs, payers can encourage their members to take better care of themselves. For example, New York-based Oscar Health has given each member a free MisFit Flash device to monitor activity.

Oscar intends to prevent its members from getting sick in the first place. If the program works, Oscar wins financially as well, since healthier members cost less than non-healthy ones.

Be the middleman between tools and consumers

2014 was the year of technology trends in the industry--everything from wearable devices to mobile apps. Over the next three years, insurers are expected to invest $47 million on average into digital transformation. By embracing data and tools, payers can enable the shift to a more consumer-centric industry.

Cigna is harnessing data to better understand members. Its data now includes consumer preferences, purchasing habits, demographic information and retail purchasing choices, Joan Kennedy, Cigna's vice president of consumer health engagement, told FierceHealthPayer in a previous interview.

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