2020 pushed the health care cost conundrum to the back burner.
As we roar into 2021, Americans are getting access to the COVID-19 vaccine and—with confidence returning—deferred care is coming back to the front burner. With this renewed interest in healthcare by more and more consumers, the challenges facing our health care institutions will continue to compound.
Given the significant new regulatory requirements and the continued need to help improve consumer health literacy and care decision making, health plans are at a critical juncture and I truly believe Sapphire can be an extremely valuable partner in both.
When I think about the opportunity ahead, there are many facets for health plans and their members, providers and their patients, and employers and their employees. But what is universal to all of them is that the consumer will begin to drive our healthcare system and—as they do—cost will be on that front burner.
For today’s health consumer, a few age old challenges still exist.
- Health literacy among consumers remains low
- Nearly 36 percent of adults in the U.S. have low health literacy, with disproportionate rates found among lower-income Americans eligible for Medicaid. Individuals with low health literacy experience greater health care use and costs compared to those with proficient health literacy. Through all its impacts — medical errors, increased illness and disability, loss of wages, and compromised public health — low health literacy is estimated to cost the U.S. economy up to $236 billion every year.
- Member compliance or non-compliance drives health care costs—and the factors that impact a consumers decisions are multi-faceted
- The advent and importance of customer satisfaction as a driver of growth and retention (via Net Promoter Score (NPS), click stream analytics, CSAT, and other measures) has finally reached health care over the past few years. As these tools are deployed, they are revealing that customer satisfaction is often tied to faster, easier answers with fewer decision points before getting needed care. They are also helping show that recognizing the individual as unique is not inherent in health care.
So, you may ask – what does this have to do with me joining Sapphire?
As a member of the executive leadership team, I am excited to bring vision, solutions, and strategies to health plans as part of the leading platform for cost transparency, healthcare shopping, and incentivized care navigation.
As an industry, we must quickly recognize and make plans to address these problems head on. They can’t be addressed by point solutions alone. They will require a platform that can orchestrate these high value point solutions in a coordinated customer journey.
In the mind of the consumer selecting health care services is similar to how they select services in other parts of their lives. They shop, they consider, they decide and they access. This shopping journey typically involves understanding the cost of the procedure or the care path as a critical input to making the decision.
I’m thrilled to partner with health plan leaders to build answers and deploy solutions centered on the understanding that at the end of every health care cost is a person trying to make the best (and often complex) decision. At Sapphire, we believe that consumers deserve to learn, understand, and be rewarded for making better decisions based on cost but more importantly quality. Through our CareSelect and Smart Shopper solutions, Sapphire delivers a comprehensive solution to health plans that helps reduce or eliminate consumer healthcare confusion through a digital-first shopping platform available to over 100M members nationwide. Centered on the consumer experience, these solutions help deliver better healthcare with a reward at the end of their journey. But most importantly, Sapphire works in harmony within a health plans’ ecosystem to simultaneously deliver on the federal requirements while solving the consumer transparency challenge.
To learn more about our solutions or to have a discussion, request a demo or meeting and I’ll follow up to schedule a time.