Health Plans: Using Innovation to Improve Outcomes

Health plans are the organizations that provide health insurance – if you have health insurance, you probably know if you go to the doctor or have a prescription that needs to be filled, you likely pay a small amount and your health plan takes care of the rest.  Because health plans cover most of the cost of medical care for their members, they are also known as payers – and they are incented to keep their members as healthy as possible, because complications or serious medical issues can be very expensive to treat.  Many health plans offer additional programs for members, such as smoking cessation programs or 24/7 nurse support for high risk pregnancies, with the aim of helping their members achieve the best possible outcomes.

In recent years, health plans have increasingly adopted new innovations as solutions for their members.  The digital health trend means that plans have more options than ever, including programs for telemedicine, healthy eating, diabetes and many more.  These programs are easy for members to use and can typically be accessed by computer or simply downloading an app to a smartphone.  Using these digital health solutions can provide a big benefit to both health plans and members, because members can take action more quickly – for example, with a telemedicine solution, a member can have a video chat with a doctor and avoid potential scheduling challenges of an in-office visit.   With Glooko, members use a mobile app to sync data from their diabetes devices and better understand their blood sugar trends, which can help them better manage their diabetes.  This more proactive and engaged approach can help members take better care of themselves and improve their outcomes.

So can you expect to see your health plan invite you to participate in one of these programs?  It’s likely!  Many health plans have spent the last couple of years piloting these programs and are now looking to expand them.  I recently got a letter from my plan letting me know I could schedule phone or video visits with a doctor.  Keep your eyes open – your invitation may be in the mail!