January 5, 2023Finding the Consumer in Healthcare

To date, the entirety of the healthcare system in the United States has been constructed to work for people as patients, not as consumers. However, the industry is transforming as consumers become increasingly involved in their healthcare decisions.

This shift is in part due to the rise of high deductible health plans (HDHPs) and employer defined contribution plans, which employers are offering to better meet the individual needs of their staff members. With greater responsibility for their healthcare costs and spending, consumers need to be more intelligent and informed. And, in turn they’re becoming more discerning – behaving and expecting choices in the same way they shop online for other everyday items.

Consumers Expect Digital Experiences

With consumers spending more on their health care, they are expecting to get more in return for that spend, including experiences where they can access intelligence at scale in order to make decisions quickly and easily. Today, consumers have countless apps and websites that provide instant access to necessities such as food and drink, housing, finance, transportation and more. If they want to find a restaurant, apps like Yelp allow them to read reviews, identify availability and secure a reservation all in one place. If they need a ride to the restaurant, Uber enables them to schedule their ride and pay for the service without ever opening their wallet.

All consumers’ vital human needs can be addressed via connected technology platforms that bring together data from a variety of sources including user data, inventory data, geographic data, payment data, and countless other datasets. All through a seamless, intuitive consumer experience that makes it easy for people to make the best choices for themselves. It’s understandable that consumers will have the same expectations when it comes to their healthcare that they do in all other areas of their lives – and the technology must keep pace.

“Millennials and Gen Z have higher digital expectations and are more active consumers of information online — and now expect the same consumer-focused convenience from healthcare.” – “Three Forces Driving The Consumerization of Healthcare,” Forbes

Barriers to Creating Consumer-Driven Experiences in Healthcare

Payers are facing new and increasing regulatory, economic and market pressures to deliver seamless digital experiences to their members while directing them to the best care, at the best price. However, because the healthcare industry has not undergone the same digital transformation as other industries, many payers are mired in legacy and manual processes and technology, hindering their ability to overcome cost challenges and meet these market demands.

Confusing and opaque pricing have led to higher healthcare costs for payers, sponsors and ultimately members. Costs continue to skyrocket because payers lack the data and analytical capabilities necessary to design optimal healthcare purchasing solutions. Therefore, it’s impossible to understand the full landscape of your options in order to drive down costs for your members.

To further exacerbate this challenge, there are thousands of digital health vendors claiming they can help payers drive down costs and improve. However, vendor proliferation has caused greater confusion, as it’s challenging and time-consuming for payers to thoroughly evaluate their options, leading many to experience action fatigue and weary decision making.

As payers take on more point solutions, the ability to analyze and report on these solutions holistically becomes impossible. Not only that, but these disparate connections limit flexibility and the connectivity reusability needed to efficiently scale solutions and continually offer best-fit solutions for unique and evolving member populations.

True Transformation is Finally Possible

The legacy systems that the healthcare industry currently runs on will never be able to deliver the true transformation that’s required to provide consumer-driven experiences and address skyrocketing costs.

MacroHealth is bringing transformation to the industry. We make the buying and selling of healthcare simpler and more powerful, so you can ensure members have access to quality, cost efficient care and provide them with experiences that were once impossible. We offer a Intelligent Health Market-as-a-Service platform that creates Intelligent Health Markets for our clients.

Intelligent Health Markets enable payers to reduce healthcare costs, expand access to healthcare, and empower consumers to make more informed decisions. The MacroHealth Intelligent Exchange platform allows payers to do this through its three components:

Optimize provides a big picture view of your opportunity. It enables you to identify optimal provider networks and health solutions partners for your member population – and ultimately find solutions that measurably and dramatically reduce costs. Optimize makes it faster and easier to identify the right solutions.  Connect allows you to integrate to your entire healthcare ecosystem with an easy and efficient, single-point connection, right though the MacroHealth Intelligent Exchange platform. With Connect, you have the flexibility to integrate with best-in-class service providers, drive down the cost of integration and deliver it in a much faster timeline.Innovate enables you to continuously identify savings opportunities and then leverage these savings to reinvest in your business growth. As more data flows through platform, your bigger picture of healthcare becomes clearer and more insightful over time, bringing new opportunities for savings and re-investment into focus. Allowing you to innovate potential revenue channels, potential revenue models.

To deliver consumer-driven experiences in healthcare, transformation is imperative. As with all transformation, the first to address the need typically seize the biggest opportunities.

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