Healthcare Innovations: How to Drive Revenue and Reduce Care Gaps While Improving Health Outcomes

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The healthcare industry has been upended by the COVID-19 pandemic. While it wasn’t a foreseen or necessarily welcomed change, it has served as a reminder that digital transformation is at the core of improving outcomes for consumers.

Whether in telemedicine, IoT medical devices, mobile apps and/or increased use of digital channels for communications, the way that healthcare organizations engage with consumers is going through a structural change. Moving forward, it’s critical that payers and providers rethink how they acquire, retain, and serve each healthcare consumer at a lower cost.

Value-Added Healthcare Opportunities

There are several ways for healthcare professionals – including payers and providers – to achieve their revenue goals while also leading to better outcomes and lower costs, including:

• Real-time data and telemedicine: Telemedicine, or the distribution of health services and information electronically and with telecommunication technologies, can effectively minimize hospital re-admittance rates and prevent disease progression. A key part of this is gathering real-time data, such as vital signs, from connected devices to monitor health and recommended care. This data can then determine the next step in a patient’s care pathway – such as a call from a nurse, a motivational message, a visit from an ambulance, or scheduling a new treatment plan – all of which are dependent on real-time signals from a connected device.

• Acquisition of Medicare and Affordable Care Act (ACA) healthcare consumers: Acquiring Medicare and ACA healthcare consumers are important segments not only for revenue growth for both payers and providers, but also because preventive care measures directed to those consumers achieve the greatest health outcomes. Revenue opportunities include financial incentives to reduce gaps in care as well as take on more risk for value-based care arrangements.

• Reduce gaps in care for clinical and preventative services: This is another big opportunity to personalize communications for education and appointment-setting purposes. For example, the Centers for Disease Control and Prevention (CDC) say that colorectal cancer screenings beginning at age 50 are the most effective way to reduce a person’s risk of getting the disease. However, only 25% of adults age 50 to 64 in the U.S. – and fewer than 40% for those over 65 – are up-to-date on this screening. This might be because some consumers are simply unaware that there are now noninvasive screening options widely available. In addition to age-related screenings, other focus areas should include prescription adherence, chronic condition management, telemedicine innovations, and IoT connected devices. Using personalized communications, we have seen providers increase appointments for these purposes by over 50%.

What these examples of value-added opportunities share is a single point of control over healthcare consumer data, decisions, and interactions to drive down costs and produce better outcomes.

A Single Point of Control Over Data & Messages

Moving forward, healthcare organizations should focus on addressing inefficiencies or gaps in care that it can tackle using data from a population under care that it already possesses. Using this data, executives can test out specific use cases and determine the ROI potential.

This is where a single view of each patient – and knowing the context and cadence for engagement – is key. Many consumers engage with healthcare content outside of their portal access, and this engagement data is typically lost today. Having all data enhances test and learn capabilities, making it the basis for determining a next-best action for each individual healthcare consumer.

A holistic view also allows organizations to understand channel preferences for each consumer and optimize communications accordingly. When enhanced by automated machine learning capabilities that can analyze real-time data, this becomes even more actionable and drives deeper relationships with consumers.

Personalizing the Last Mile to the Consumer

By testing various approaches – whether it’s a focus on personalization, frequency of contact, or channels – healthcare organizations can determine which approach most positively impacts individual behavior. Those communications may be consistently delivered and coordinated through any touchpoint – email, website, telemedicine, mobile apps, IoT devices or points of care. This is a practical way to move from managing broad segments to a segment-of-one.

With a model in place that continuously collects and analyzes this data, organizations can make further refinements and gradually increase the relevancy of each communication. As more data is collected and analyzed, organizations can refine this even further.

By communicating with individual healthcare consumers on this highly personalized level, and in the context and cadence that resonates best with each consumer, organizations will gradually drive up revenue while driving down costs and improving outcomes.

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