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healthcare literacy

Tech-driven health literacy tools for payers and providers improve outcomes

Susan Taylor,
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Healthcare organizations are redoubling their efforts for increasing the health literacy of the consumers they serve while seeking to attract a disproportionate share of the newly eligible Medicare population. Healthy People 2030 defines personal healthcare literacy as “the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.” It sets the very foundation for consumer engagement with healthcare organizations.

Often healthcare literacy programs focus on language and interactions to help individuals understand the information they receive and to help patients manage their care. While that is critical in the moment of a care interaction, more is needed. Employers, plan sponsors, and consumers are demanding improvements in literacy as a key component driving their goal to reduce the cost of care.

These demands put healthcare payers under significant pressure to operationalize and personalize health benefits and deliver on improvements in service, all while remaining profitable. Accuracy of benefit quoting in service, critical to improving health literacy and customer experience, is increasingly complex. As mandate changes accelerate changes in benefits, healthcare staff are in endless cycles of updates. But the impact of inaccurate information is clear: uncertainty and financial insecurities can arise and consumers are more likely to delay or forgo care, resulting in higher acuity care at greater cost (e.g., emergency department visits1,2,3). This is especially important with high inflation reducing available dollars for what is seemingly optional care.

Leading programs are looking deeper at proactive literacy to help consumers find and make decisions with information needed to be empowered to drive their own health journeys. They are achieving this goal by leveraging technology as a critical partner in engagement for their employees and their stakeholders (payers, providers, regulators, consumers, and their families).

Healthcare organizations are adopting solutions that provide:

  • Single source of truth to share benefit information with consumers and transaction processing engines, updated in real-time. These solutions generate personalized consumer-facing documentation, plan filings, sales catalogs, and information needed for
  • Real-time enterprise capabilities which dramatically improve the accuracy of information while substantially decreasing the time to market for updates and product and benefit introductions. For example, leveraging automation to decrease their annual product catalog update time from months to weeks and with error-free filings.
  • Responsive benefits which go beyond statis flex benefits to integrate personalization with real-time responsiveness to eliminate the need to generate benefit exceptions and enable consumer-based “whole person health” incentives that regularly deliver healthy rewards in real-time.
  • 1:1 engagement capability which continuously, and in real-time, seeks to optimize consumer interactions with payers providing every opportunity to close care gaps and improve health adherence and literacy.

    These solutions have delivered astounding results:

    • 100% Accuracy in plan filings
    • 85% Reduction in time to create annual plan filing updates
    • 70% reduction in plan and benefit errors
    • Real-time plan updates to remain compliant with new mandates
    • Personalized benefit offerings that respond in real-time to changes in consumer need.
    • Consistent and accurate information available across all interaction channels and for all stakeholders. That makes it easier for consumers to understand and leverage benefits they need to make critical benefit plan selections during open enrollment and payers to enjoy an engaged and growing member population.

    Healthcare literacy is important for both providers and consumers. Now is the time to utilize automation and real-time technology solutions to ensure that consumers are equipped and empowered to understand their health needs and nurture positive and trusting relationships with their providers.

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Industry: Sanità

Informazioni sull'autore

With more than two decades of experience driving outcomes and growth in the healthcare industry, Susan Taylor, Pega's Vice President of Healthcare and Life Sciences, helps healthcare organizations plan for and achieve digital transformation to improve operations and health outcomes.

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