Survey reveals great divide between patients, payers, providers

Patient engagement is central to improving health outcomes and reducing the cost of care. This is a well-known fact. Yet, there continues to be a huge disconnect between patients, payers, and physicians.

A recent survey of 761 U.S. adults who are healthcare decision makers for their households and 204 healthcare payers and providers found that 95% of payers and providers believe patients are delaying treatment due to cost concerns, but only 42% of consumers said this is true.

Additionally, the survey, which was commissioned by Xerox, found that 90% of healthcare professionals say patients need encouragement from their doctor to lead a healthy lifestyle, but only 55% of consumers say they need such encouragement.

This points to a critical disconnect between patients and providers, and lack of an understanding among patients of the resources and value providers offer them.

The future of healthcare will be proactive, not reactive

During open enrollment this fall, patients will decide whether to switch or stick with their health plan-and if they shop for health insurance on a state or federal healthcare exchange, they may also be deciding whether to stick with their current health insurance provider.

This is an opportunity for payers to start a dialogue with their members to enhance the payer/member relationship and ensure patients recognize how regular primary care is accessible and beneficial to them.

This conversation may include questions like:  

• How satisfied were you with your plan last year?

• How satisfied were you with your customer service last year?

• How can we help you with your health and health-related expenses?

• How can we help you understand your benefits better and make an educated decision for 2017?

During the conversation, payers may find that the member did not have an annual appointment with their primary care physician (PCP)-perhaps they didn’t have time or didn’t know it was completely covered by insurance. Or, they might learn that the member wasn’t satisfied with the plan or that they had trouble understanding their healthcare benefits.

The service representative, in either of these cases, should help the member coordinate with their PCP and set up the appointment, or explain their family plan benefits and options-to ensure that the desired outcome is achieved.

The service rep should then follow up to ensure that the member is satisfied with their service experience and that their immediate care needs are met-or coordinate follow up if necessary.

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