Challenges, Opportunities of Digital Health in Health Insurance
A couple of barriers may block digital health progress in health insurance, but some payers have taken steps to circumvent these obstacles.
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- Technology-centered solutions, lack of payer alignment, and competition over data are barriers to digital health advancement in health insurance.
Peter Long, executive vice president of strategy and health solutions at Blue Shield of California and co-author of an article on digital health published through the National Academy of Medicine, shared his perspective on digital healthcare.
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“The key to thinking about the digital transformation of healthcare and realizing its potential is to anchor it in the human. So, it's an interest in taking the science of information and technology but making sure that it's anchored in an actual person's experience,” Long told Healthcare Strategies.
This has been a fundamental barrier to expanding and leveraging digital health solutions in healthcare, Long said. The healthcare system’s approach has been to build the technology solution and assume that consumers will gravitate toward the tools, without offering patients explanations regarding what these tools can mean for them or aligning the financial incentives with their utilization.
Another barrier is the lack of multi-payer alignment around digital health efforts. This would require interoperability and consistent quality measures. Instead of aligning around digital health, health payers are competing over digital health data.
The third barrier that Long mentioned was the idea that a health insurer owns the patient’s data.
“We have created a sense that we need to curate that data, we need to hold it safe for patients or from patients—we can debate which preposition you want to use, but the result is the same. So, I do think that fundamental mind-shift in the industry of ‘once we get the data, we collect it and we're going to do great things with it,’ not that it's actually the member's data and our job is to help them interpret it and help them take action—that's a big shift, even probably bigger than how we compete,” Long said.
One of Blue Shield of California’s solutions to these challenges has been to introduce an integrated health record.
The integrated health record compiles prescriptions, medical services, medication use, diagnostics, and laboratory results and tracks these over a three-year timeframe. The records are member-accessible and nearly real-time. The health insurer is working toward standardizing this solution across its members.
Healthcare leaders should prioritize translating digital outcomes to actual outcomes by using data appropriately and improving population health and targeting solutions in alignment with population health discoveries, Long said.
Experts have emphasized that it is critical to approach digital health with a whole person care perspective, particularly when applying digital health solutions in underserved communities.
The virtual-first health plan was one of the major trends in digital healthcare in the health insurance space in 2022. These plans offer digital solutions as the first step in patients’ engagement with healthcare through e-triage, telebehavioral healthcare visits, e-prescribing, and other methods.
Experts have recommended assessing member demand and driving consumer adoption of digital health tools as key steps in cultivating consumer-oriented solutions.
