Controlling costs and improving operational efficiency are the top challenges for health plan leaders today. Investigation Published on Tuesday.
The annual survey received responses from 312 insurance executives. It ran from April 26th to May 6th.
When asked what their biggest challenges are today, 46% said controlling costs and 41% said improving operational efficiency. Research has shown that the reasons may be an increase in claims due to the Covid-19 pandemic, an increase in costs due to delays in treating people, and the use of outdated systems.
“Operational efficiency has always been a challenge for health insurance, but as labor shortages continue to plague the market, health insurance leaders appear to be looking for new ways to do more with less.” “The ultimate goal is to build a solid digital foundation that will allow payers to eliminate repetitive manual processes and enable greater access to real-time data enabled by modern systems,” the report said. It will be.”
Many respondents also cite member satisfaction as a challenge, as consumers play a larger role in the health benefit decision-making process.
“Expectations continue to rise as the retail experience with companies such as Amazon and Google shapes the purchase drivers of healthy consumers,” said the study. “With improved access to real-time clinical and operational insights and tools that drive meaningful member engagement, care managers can reach more members, build stronger member relationships, and We are able to meet the expectations of today’s healthcare consumers.”
To combat rising administrative costs, 44% of respondents said they would improve interoperability, and 40% said improving billing accuracy would help.
When asked about billing accuracy, only 26% said more than 80% of bills were paid correctly the first time. If they are not paid correctly, the average cost per claim increases, the report says.
Respondents’ top goals are to improve quality, improve provider relationships, meet regulatory compliance requirements, and increase member satisfaction. To achieve this, 53% said they would invest in innovation, 53% said they would align their business and IT organizations toward common goals, 52% said they would improve their engagement strategy, and 51% said they would modernize technology. I said I will.
Most of these steps to reach our goals are the same as last year, but alignment between the business and IT organizations is a priority. Last year he was last in this step, but in this year’s survey he jumped to second out of six steps.
“This demonstrates a growing recognition of the critical role technology plays in the ability of healthcare plans to meet their business goals,” said the report.
Photo: Feodora Chiosea, Getty Images