By integrating capabilities and services, we can create health experiences that are more than the sum of their parts
Over the past few years, we have seen and heard a lot about the transformative changes taking place in healthcare, especially since the onset of the COVID-19 pandemic. The truth is that health and medicine are constantly evolving, whether through small advances or seismic shifts. Those of us working in healthcare must follow a similar evolution and become as nimble and flexible as possible to meet the needs of the communities we serve.
We recognize that we are all trying to find our place on shifting ground. Employers are pursuing strategies to maximize health benefits for their employees. Physicians are increasingly seeking partnerships with payers to collaborate in the transition to value-based care. Consumers are demanding greater transparency and personalized information to help them make proactive and informed health decisions.
As our industry focuses on improving health more proactively, we must ensure that employees, patients and consumers have access to services that will meet all of their health needs. , not just where they are right now, but throughout their healthcare journey. We must also recognize the unique challenges and barriers faced by a growing number of Americans with chronic and complex illnesses.
Managing chronic and complex illnesses can be challenging for some people, as it often requires navigating multiple points of contact in the healthcare system and understanding possible complicated treatment regimens. These challenges require the integration of health capabilities and services across the health system to deliver truly connected care that drives system-wide efficiencies, improves outcomes, and reduces costs. Here are three approaches to make this possible.
Leverage the power of digital platforms to create a better experience
A digital platform approach is key to providing consumers with the healthcare experience they deserve. It helps connect health data, systems and processes to make it easier for consumers to lead healthier lives.
The power of the platform model comes from leveraging data to derive insights that help businesses be more proactive. Understanding what consumers need and what providers have helps companies organize the customer experience and deliver the right services to the right people. In the context of healthcare, the platform enables a connected experience where consumers and providers can leverage the range of care options (digital, virtual, in-home and in-clinic) and access data organized and data-driven insights that allow them to make more informed decisions.
Driving real and lasting change in healthcare requires more than launching a consumer website or app. This requires digital transformation and equity where all consumers have access to quality care and support, when, where and how they need it.
Make people with chronic and complex conditions a priority
The percentage of American adults with multiple chronic diseases is on the rise. In 2018, nearly 52% had at least one chronic condition and 27% had multiple chronic conditions. Not only do people with chronic conditions face unique barriers to accessing care that meets their physical, behavioral and social needs, but they are also at risk of experiencing a more fragmented care journey as they use the health system more. than people without chronic diseases. For these patients, fragmented care can lead to gaps in care, unnecessary tests and procedures, and higher costs.
For example, many older Americans suffer from multiple chronic conditions that add layers of complexity to routine, acute, and long-term care. Today, a 75-year-old hip replacement candidate with hypertension and type II diabetes may need help understanding all aspects of the current surgical event and postoperative care. Even if they have the help of their family, a doctor’s office, a health insurance company or other groups to navigate some of these rooms, this person may still struggle with the many aspects overall health management. We envision a future of healthcare where the responsibility for care coordination is lifted from the shoulders of the patient and guided by healthcare organizations that can integrate and manage all aspects of care to improve the care journey and improve results.
We need to find ways to create better connected care experiences for these patients, as they are among our most vulnerable populations and often fall through the cracks. An improved healthcare pathway will contribute to better health outcomes for these people and possibly help reduce the significant cost of annual healthcare expenditures in this country – $4.1 trillion.
We know that intensive, highly personalized models of care that provide support throughout a person’s health experience can benefit these individuals. By deploying these models and engaging members where they are, through clinics, telehealth, text messaging and other channels, we can improve health outcomes and aim to reduce the cost of care by reducing admissions. in hospital and other expensive medical procedures.
Align your organization to best deliver integrated care
Making the health system more equitable, effective and efficient is not just a mission, it is a mandate for action. This mandate must be reflected in the way we conduct our business. We work with various payers and other healthcare organizations and bring together over 150 years of experience in the healthcare industry. By consolidating Carelon’s health services businesses, including pharmacy, behavioral health, complex and chronic care, and digital platforms, which are part of Elevance Health, under one roof, we aim to better provide consumers with truly integrated and connected care that improves outcomes and reduces costs.
Our mission is to make connected care possible by putting people at the center and providing the right balance of care, technology, data-driven insights and expertise to solve complex problems and help consumers lead a healthier life. As we actively work to realize our vision for the future of healthcare, we encourage other healthcare organizations, providers and caregivers to take equally bold steps to connect people to accessible, affordable and integrated care.
Pete Haytaian is president of Carelon Services. Rajeev Ronanki is president of Carelon Digital Platforms.
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