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A positive member experience is vital for payers looking to increase their market share. It will enhance new member acquisition and increase current member retention by creating a flywheel of positive feedback. It will also translate to higher Centers for Medicare and Medicaid Services (CMS) star ratings if you have a Medicare Advantage offering.
The best way to influence the experience is during routine visits. Members who have a positive experience during a routine visit like an annual physical are more likely to seek care on an ongoing basis and invest in their overall health. They’re also more likely to return to providers who take the time to develop and nurture relationships with them.
Before we can understand how to create this type of experience, we first must examine the current state of member care.
Ten years ago, improving the member experience was not a high priority. Care was expensive and the number of options available to members were limited to closed networks.
Things have improved in the last decade, but the member experience remains disjointed. While care is more accessible than it was, there is much more work to be done. And, if a member puts off care until it’s an absolute emergency, they find themselves navigating a frustrating maze of expensive specialist visits, without anyone to guide them along the right path.
There’s one guarantee in this process: stress.
Digital innovation has increased the disruption in the healthcare space. Every day, payers and their competition have more options. New channels of care, from telehealth to direct to consumer, are becoming more readily available. All the while, members are searching for an integrated experience on a holistic level, and they have more options.
In order to avoid becoming a commodity, payers must determine the right levers to pull to fulfill each member’s desire for holistic care without making that care more complicated. We believe the right lever is primary care.
Members want what Vera’s advanced primary care model provides. They want options. They are looking for accessible care. And, they want someone who cares enough to actually spend time with them. Someone who has the patience to really listen — not just write an Rx, ship them to a specialist, or send them off to get a lab test. They want someone to show empathy and help them live healthier.
Insurers and payers who are able to deliver this type of experience to their members will empower them to take ownership of their health. They will also increase satisfaction and health outcomes, giving them a strategic advantage as they seek to outpace their competition and increase their market share.
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