By Christine Tremblay

From the mobile apps patients use to schedule appointments to the online portal office professionals use to manage claims, there are few aspects of health care and specialty benefits that haven’t been influenced by technology. Healthcare executives, specifically, are turning to these technologies to solve very real problems they are experiencing at the back end—including rising health care costs, industry competition and consumer retention concerns.

Knowing that technology is being integrated like this across all aspects of health care means that every player within the specialty benefits landscape should be invested in not only what technology is being used but how it is being used.

Why each player should be equally as invested in technology
• Healthcare executive: One of the last areas of opportunities of significant growth for most specialty benefits plans, whether it be dental or vision, is catering benefits packages to the direct-to-consumer (DTC) market. COVID-19 may have been the impetus for the rise of things like telehealth but consumer response to and their embrace of digital technology is driving the future of DTC models, with benefits packages being designed now not just for growth but for retention purposes as well.

While benefits technology investments are largely driven by consumer preference, with nearly 1 in 4 consumers from SKYGEN’s 2023 Pulse Report indicating that digital solutions like web portals and mobile apps are important to their experience, healthcare executives face the dual challenge of meeting consumer needs and considering what will improve their bottom line. Investment in flexible digital platforms is one such strategy, designed for the customer but also serving the purpose of advancing operational efficiency through process improvements like speeding up and streamlining back-end tasks. In this way, healthcare executives can improve member engagement and retention, while promoting bottom line growth.

• Consumer: According to a recent report from SKYGEN, forty percent of adults living in rural areas have not visited a dentist in the past year, compared to 35% of urban and 30% of suburban residents. From this same report, consumers demand transparency, with 64% emphasizing the need for easier access to comprehensive information.

For the patient, transparency and access to care are closely intertwined with technology. For instance, when consumers have easier access to understand what their benefits are and what’s available to them, they can truly maximize its utilization. Through digital technologies like self-service mobile apps and direct-to-consumer web portals, consumers can not only better identify and select a plan down to the annual maximum they might spend to what’s covered under a plan, but through robust provider ratings and location-specific data, narrow down a provider that offers telehealth capabilities if they are in a more rural area. In this way, being invested in what technologies are at their disposal is just as much about convenience as it is about advancing their long-term care and engagement with their benefits.

• Provider: While patient clarity surrounding pricing is important in driving more proactive care overall, transparency through technology is also helpful on the provider side in instilling trust with a patient, which leads to overall higher retention and satisfaction.

According to the 2023 Pulse Report, cost is the top reason consumers lack dental/vision coverage. Simultaneously, 91 percent of participants from another survey said they would shop around for the “best quality of care at the lowest possible price” if they were able to see the prices of care upfront. Consumers are more willing to go with a service or a provider when pricing is transparent and, research shows, less likely to make the switch because of the convenience factor. Consumers are furthermore accustomed to Amazon-style shopping experiences where they can easily compare features and benefits; through digital individual enrollment portals, a user can easily compare benefit offerings. Once enrolled, the member’s mobile app can support finding providers not only by proximity but based on treatment quality, ensuring that the provider they do end up selecting is the one they really want that meets not just one but all their needs.

The current state of technological adoption is vast and complex, but at the core of this adoption is transparency. Consumers want transparency in how they understand what their benefits are and what’s available to them, providers want transparency in how they are represented to said consumers through accurate provider directories, while on the business side of things, more transparency establishes better rapport with consumers and in optimizing operations. By integrating technology into daily workflows, all players within the specialty benefits ecosystem can reap its benefits, including pricing transparency, encouraging benefits utilization and engagement and establishing trust upfront with care.

About the author: Christine Tremblay is the enterprise systems product management director for SKYGEN.