Paving the way to healthcare consumerism: how TPAs can lead clients to success

July 22, 2021
Josie Rasberry

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One of the top, if not the top, healthcare trends for 2021 is healthcare consumerism. Healthcare consumerism is all about empowering patients to have more control over their healthcare decisions. It includes price transparency and digital shopping tools so patients can actually be consumers. It also includes patient education so they're better equipped to make healthy decisions.

Why healthcare consumerism is beneficial to you and your clients.

So how is this beneficial to you, a third-party administrator, and the clients you serve? For one thing, healthcare consumerism is all about the individual. Consumer-centric care can lead to higher member satisfaction and better retention. For example, 60% of employees with employer-sponsored health insurance report that they are looking for more ways to save on their healthcare benefits. Fulfilling the needs of that 60% can greatly improve your self-insured employer clients’ satisfaction ratings, retention rates, and growth. For clients of all types, bringing in healthcare consumerism could result in greater revenue. One study found that a 20% increase in member satisfaction can result in as much as a 15% increase in revenue. Healthcare consumerism is also beneficial to:

- Health cost sharing groups.

- Self-insured employers.

- High deductible health plans.

Since members in these plans usually pay for a higher part of their care, it’s crucial they go to an affordable provider. This keeps their own out-of-pocket costs low, as well as claims costs. Plus, being able to find affordable healthcare lowers the possibility of unexpectedly high medical bills. Expensive, surprise medical bills are a sure-fire way for your clients to get an angry phone call or email from a member. Healthcare consumerism also educates these members on how to make healthier decisions. Healthy members are especially beneficial to health cost sharing groups since a physically healthy community is a financially healthy community.

There’s a clear benefit to healthcare consumerism, so how do you introduce this strategy to your clients?

Customize your proposal and get a third-party partner.

Buyer personas and customer journeys are great for finding the best way to introduce healthcare consumerism to your clients. Look at who your client serves to find the best form of healthcare consumerism for them and your client. Let’s look at self-insured employers and their employees as an example. One study found that 41% of self-insured employees want:

- Tools to compare costs and care options.

- Online appointment scheduling.

- And personal support to help them find their ideal care.

Your self-insured employers are too busy to put all this in place on their own. So the ideal solution would be a third-party company that can take care of these needs. There are a few you could go with, but we’ll make your search shorter by giving you a place to start: us! Our Smart Healthcare Platform combines:

- A shop-and-compare healthcare app.

- Personalized healthcare navigation.

- And expert bill negotiation services.

The Smart Healthcare Platform can help you lower costs, improve retention, and grow membership for clients of all types, not just self-insured employers! Other clients that benefit from having extra hands to offer personalized healthcare navigation services that lead to higher member satisfaction and lower overall costs are:

- Large health insurers.

- Health cost sharing groups.

- Discount medical plans.

- Limited benefits medical plans.

Final thoughts.

Healthcare consumerism in your clients’ plan offering ultimately means fulfilling the wants and needs of members. Members are increasingly demanding that healthcare fit the consumer-centric experiences they’ve come to expect in every other industry. They’re also sick of healthcare being confusing and expensive. Your clients are tired of high churn, falling revenue, and little growth. As a TPA, when you offer healthcare consumerism solutions (such as our  Smart Healthcare Platform) to clients, you'll:

- Lead clients to success.

- Bring healthcare consumerism into the mainstream.

- Stand out from your competition.

Download How to Leverage Ambulatory Surgical Centers for Lower Costs and Higher Satisfaction

Discover how TPAs, health cost sharing groups, and limited benefit medical plans can benefit from the use of ASCs.

Is Your Health Plan a Tech Whiz or a Dinosaur?

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Download the Patient Advocacy 2.0 White Paper

Discover what health plan members had to say about the value of patient advocacy in our survey.

Download the Complete Guide to Retaining Health Plan Members.

Learn the best strategies and tips for retaining your members while keeping costs low.

Download the Complete Guide to Growing Your Health Plan Membership

Learn the best strategies and tips for growing your members while keeping costs low.

Download the Complete Guide to Lowering Member Costs

Discover what health plan members had to say about the value of patient advocacy in our survey.

Download Healthcare Consumerism 101: A Playbook for Health Plans

Learn the best strategies and tips for retaining your members while keeping costs low.

Download Your Guide to the Transparency in Coverage Rule

Discover how the the new rule will affect TPAs and health plans and how you can start your journey to compliance.

Download Your Guide to Unique Benefit Offerings that Don't Break the Bank

Discover how to add value to your health offerings that delight clients and members but don’t cost a fortune.

Download the Complete Sedera Case Study

Discover what health plan members had to say about the value of patient advocacy in our survey.

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