Healthcare costs are skyrocketing, making it more important than ever for health plans to find ways to engage their members and promote healthy behaviors. One way to achieve this is by using supplemental benefits, such as gym memberships and funds for healthy foods. Still, these benefits often go underused or unused due to low awareness and confusion over access.
The study “The Digital Platform Promise: What Baby Boomers and Seniors Want From Digital Healthcare Platforms,” a PYMNTS and Lynx collaboration, revealed that only about 4 in 10 consumers are very familiar with their health insurance benefits. This lack of awareness can result in missed opportunities for members to take advantage of benefits that could improve their health outcomes, which has a downstream impact on cost.
In an interview with PYMNTS, Joe Firnstahl, head of product at Lynx, discussed how health plans can leverage member engagement with supplemental benefits to improve member health and experience. He explained that the utilization of supplemental benefits depends on how much the plan emphasizes them as part of their engagement with their members.
“If they see them as a true value-add in addressing things like the individual members’ social determinants of health, or the value that they drive in overall engagement, they will invest more, ultimately, in trying to highlight those supplemental benefits to their end consumers. And in those cases, they can see great utilization,” he said.
Noting how at the beginning of the plan year, welcome kits arrive telling members to create a portal account or download the health plan’s app, he compared that to receiving a new debit card, for example, saying people are more likely to go online and activate a card than they are to activate their health plan portal. It’s a matter of ease and perceived value.
When a more streamlined digital experience is offered, giving clear information about and access to supplemental benefits, he called it “a great touchpoint to drive me into the app again, where, as we know, any engagement that we can get with that member can be so valuable for identifying activities and encouraging them to take different health activities.”
It’s not just about highlighting the benefits, though. Firnstahl also mentioned that for plans working with dedicated digital platforms, embedding key functionality for the utilization of benefits becomes essential, eliminating the need for multiple health portals and apps.
Consumers are seeking ways to simplify their lives, and this is particularly true with healthcare. With the burden of downloading multiple apps and remembering multiple logins for different provider portals, it can be challenging for consumers to keep track of their health journey.
Supplemental benefits being embedded in unified platforms are changing this.
Firnstahl believes that embedding supplemental benefits into a single platform is essential for engaging consumers and making it easier for them to access those benefits.
On top of healthy food and OTC benefits, he said, “We’re starting to see that expand into additional offerings that might address specific individual needs, like potentially paying for things like transportation to a doctor’s visit, or for gym access. Some of the tools that need to be provided to a user to understand how they can unlock these benefits and make it easy are different than what we might see in the commercial space.”
That includes everything from understanding who’s in-network to specific retailers where members can purchase covered items or the types of healthy foods that are eligible.
Much will depend on the member demographics, as baby boomers and seniors will be accessing these benefits through Medicare in most cases, while others using employer-provided health plans have a different assortment of benefits.
As part of this, allowing individuals to purchase products directly through a digital interface simplifies things even more. “You might have many individuals who might not have the ability or the want to get out into the actual physical retail location,” he said.
“Providing them with the ease of shopping online, having the item delivered to them quickly and in an easy, streamlined process becomes important. Those are some of the things when you think about the digital experience for these MA supplemental benefits that need to be taken into consideration.”
Digital engagement with supplemental benefits is becoming increasingly important for the Medicare population. With the breadth of products that can be purchased using supplemental benefit offerings expanding, the possibilities for improving health outcomes are considerable.
Real-time data from the use of supplemental benefits can be used to identify opportunities for intervention, coaching, and training. Firnstahl explained that the data collected from the use of supplemental benefits helps create micro-benefits for individuals and additional funding.
The goal is to tailor the benefits to an individual’s needs and challenges.
“Health plans have a plethora of data at their fingertips,” he said, “but one piece with these supplemental benefits that starts to extend that is how individuals are shopping. What does their day-to-day activity with shopping at the grocery store, going to purchase things at the pharmacy, going to a fitness location, what does some of that activity look like and how can that help paint a clear picture of a population?”
This opens use cases for those on low sodium diets, for example, and access to real-time data can show if a member is making healthy choices from their grocery bills. “We can start to understand if there is a need for additional intervention, coaching, or training for this individual,” he said.
Going further, that data loop informs plans as to how a population interacts in the community, when they are shopping, where they are shopping, the places they’re frequently going, and more granular insights.
“We can start to get a better sense of how we can create localized care community for populations and use those as touchpoints to engage with them,” he said. “The thing that also gets me excited about that is how you start to think about the supplemental benefits as being kind of part of that ongoing life cycle with an individual.”
This scales into an ecosystem where providers can understand that members are shopping at certain stores and buying specific items, which can be turned into additional recommendations.
He explained it like this: “Joe is shopping at Kroger, and it looks like he is purchasing a higher quantity of sodium-packed items than he should be. Let’s provide him with an additional benefit where he can work with one of our tele-nutritionists and start understanding what is going to be a healthy diet for him and start providing him with funds” to buy those healthier items.
We’re always on the lookout for opportunities to partner with innovators and disruptors.
Learn More