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Putting Plan Members in the Driver’s Seat of their Health Care

Posted by Medavie Blue Cross on July 29, 2020

Editor’s Note: This blog is based on a presentation that Alaina MacKenzie and Pierre Marion gave (in English and French) as part of the national CPBI Virtual Forum 2020 in June.

Imagine a future where the plan member is firmly behind the wheel of their wellbeing— and their plan sponsor, their insurer and their health care providers are all co-navigators, guiding them along their journey to better health and wellness.

That future is closer than you might think— thanks in large part to COVID-19.

Before the global pandemic ushered in a new reality, health care was already in the midst of its own quiet revolution with three mega trends fuelling transformative change in the design and delivery of health care and health coverage: 1) maturing consumerism; 2) digitization; and 3) personalization.

COVID-19 Impact

COVID-19 has accelerated all three trends, namely by motivating consumers to go online, en masse, to consult a doctor, get treatment, receive counselling, fill a prescription, and so on.

In just a few short months, we have seen a seismic shift in consumer behaviour when it comes to accessing health care, a significant increase in their comfort level using online tools and, consequently, a major reset in expectations.

Embracing Virtual Care

This is verified by several consumer research surveys, including a mid-May poll conducted by the Canadian Medical Association, which found that Canadians would not only like to see virtual care options continued after COVID-19 subsides but improved and expanded in the future. The poll indicated that almost half of Canadians had accessed a physician using virtual care options while in quarantine and nearly all (91%) were satisfied with their experience.

Connecting to Caregivers

This in turn, has fast-tracked the adoption of online tools like virtual doctor visits and digital psychotherapy, and, in the process, has helped put patients in the driver’s seat of their health care. With a few simple clicks of the computer mouse or a couple of taps on their smartphone screen, they can connect with their family physician, health practitioner or therapist, at their convenience, from the comfort and privacy of their home.

As one industry analyst put it, we’ve gone from “the doctor will see you now” to “the patient will see you now”—six words that sum up where health care is headed.

Benefiting from Digital Health

Research shows that digital health can make a measurable difference in health outcomes, organizational efficiencies, and organizational performance. That’s because technology-enabled solutions:

  • Provide faster, easier access to expert health care
  • Reduce our reliance on costly and timely bricks and mortar care
  • Create that 24/7 on-demand, high-value experience that today’s consumers have come to expect from e-commerce and tech giants like Google, Apple, Facebook, and Amazon — also known as GAFA
  • Empower Canadians to take a direct and active role in their health and health care decisions.

Engaging in Participatory Health

Put another way, digital health is helping to take participatory health to a whole new level. By this we mean a fully integrated bottom-up model of health care that actively engages all stakeholders in the physical and mental wellbeing of Canadians.

It’s a model that takes a patient-centered perspective, harnesses the power of new technology, and forms strategic alliances to take novel approaches to health care. The result? “Beyond-the-pill” products and services, ranging from web-based health portals and on-demand tele-counselling to medication management and real-time adjudication features on our mobile apps.

Becoming E-patients

Ultimately, participatory health encourages plan members to become “e-patients”—a term coined by the late Thomas Ferguson, founder of the Society for Participatory Medicine, to describe individuals who are:

  • Equipped
  • Enabled
  • Engaged
  • And Empowered to become full and responsible partners in their health care

We all have a vested stake in helping plan members become e-patients with trends like the growing prevalence of chronic disease and declining mental health of Canadians, to name a few, placing us at a critical juncture in our history.

The Silver Tsunami

Consider that by 2031, about 23% of us will be seniors—a “silver tsunami” that will continue to raise the level of chronic disease in our workplace. Currently, 66% of baby boomers and 45% of Generation Xers have one or more chronic conditions (including heart, diabetes, lung disease, and gastrointestinal conditions), which are the top cost drivers of benefit spend across all generations.

Taking a Toll

Meanwhile, we see COVID-19 taking a huge toll on our mental health. The Conference Board of Canada’s “Pandemic Pulse Check”, taken in April, found that the mental health concerns of most respondents (84%) had worsened since the onset of COVID-19.

These trends alone point to the need, and the opportunity, to reframe our thinking when it comes to the design and delivery of health benefits—and help plan members take charge of their health care.

Boosting the Bottom Line

The returns on investment can include improvements in health literacy, greater self-care and adherence to treatment. Ultimately, this impacts the employers’ bottom line and leads to better organizational health with less presenteeism and absenteeism, fewer disability claims, and lower drug spends.

Looking to the future, there’s no doubt that health care will be smarter, more targeted and more personalized, spurred by driving forces for change like technological advances, product innovations, maturing consumerism and forces yet unknown.

Adapting to Change

As COVID-19 has taught us, there may be things on the health care horizon that we can’t fully anticipate. However, we can always adjust, adapt and innovate to keep pace with change—and better still, stay ahead of change.

Again, COVID-19 has been a strong reminder that with change comes with challenges but it also opens up new possibilities for health care—possibilities that speak to the ever-evolving needs and expectations of today’s plan members. In other words, building solutions that equip, enable, engage, and empower Canadians.

In doing so, we can help put plan members in the driver’s seat of their health care with their plan sponsor, their insurer and their health care providers as co-pilots on the road to improving the wellbeing of Canadians—the mission of Medavie.