HealthSeptember 07, 2023

Healthcare payers can help improve health outcomes through member education

Health plan members and patients need health information from clinicians, yet often have more questions than can be answered in a typical encounter with a provider.

Eight out of 10 Americans still have questions after healthcare visits and would appreciate access to relevant educational materials, according to a recent survey of adult consumers conducted by CITE Research.1 Addressing the education gap and tapping into the benefits of patient education is an opportunity to improve health outcomes.

Equal partners in health promotion

Improving health outcomes through education is best achieved by targeting educational materials for member needs and addressing patient questions after healthcare visits. Payers can become a trusted partner by providing inclusive healthcare education that meets members where they are.

Today’s consumer has high expectations on responsiveness to communications, and this extends to healthcare. However, providers simply do not always have the bandwidth among multiple commitments to provide instant responses to every patient. Payers can become a resource to both member and provider by stepping in to offer real-time access to health education.

Relying on member-focused solutions such as UpToDate® Member Engagement solutions (formerly Emmi®) can improve healthcare payer engagement, narrow the education gap cost-effectively, and improve improve outcomes and satisfaction. Education, outreach, and engagement efforts, however, must be consistent and targeted for optimal impact. People over 56 years old (53%) and rural residents (39%), for example, are less likely to receive educational materials, despite the growing prevalence of chronic diseases such as diabetes and hypertension among these populations. More alarming, a different study found that typical engagement rates for a health insurer’s disease management programs averaged only 13%.2

The healthcare payer role in patient education—delivering relatable educational content

Payer-sponsored education initiatives that focus on patient-centered education deliver results. Educational content needs to be credible, empowering, inclusive, and provided in formats that resonate with patients. UpToDate engagement solutions are designed to meet these criteria as well as others. The solutions connect with patients by delivering:

Trusted, actionable content

Health content is developed and reviewed by medical experts, aligns to current standards of care, and is delivered in a way that encourages positive action by patients. The interactive voice-response campaigns in UpToDate Outreach, for example, include expert voice design and conversational questions and prompts.

Empowering and inclusive examples

To be compelling, educational materials must be diverse, equitable, and inclusive. UpToDate engagement solutions are available in a variety of languages, and reflect patients’ diverse life experiences and backgrounds, so patients see people like themselves in videos, pamphlets, and illustrations. Inclusive materials can serve as a short bridge to knowledge and save care managers’ time.

Digital formats

Our survey found that patients and members preferred online, digital resources, in part so they could review them whenever was convenient and return to them often. Almost half of 18- to 34-year-olds surveyed (42%) prefer online resources on health-related websites, while adults 35 to 55 years old look to their medical providers and online equally.

A key benefit of health education is improved member satisfaction

Getting the right healthcare education into the right member’s hands at the right time can be a challenge. Payers can improve the patient experience and reduce patient confusion by identifying members for outreach and engagement and then delivering targeted education. The pay-off can be significant: Two-thirds of patients surveyed (63%) who received educational materials during medical encounters had more confidence and positive feelings about their healthcare encounters.

But clearly there is room to improve the healthcare payer role in patient education. The disconnect between what patients want and what is delivered creates an opportunity for payers to satisfy patients’ expectations and move the needle on cost of care and outcomes. Organizations using UpToDate engagement solutions (named Emmi at the time) reported tangible improvements:

  • An accountable care organization had 47% greater improvements in Proportion of Days covered than those that did not use engagement programs.3
  • A multi-hospital system posted an aggregate overall improvement of 2.8% across all ED CAHDS scores, which correlates to improved discharged outcomes.4
  • A public healthcare system serving Medicare patients that used the solutions had a 12.4% readmission rate vs. 20.4% for a similar system that did not.5

As medicine continues to evolve, so must the provision of educational health information. Payers can lead by investing in member educational resources that improve both member satisfaction and their care management operations.

The takeaway: The right patient education resources make a difference—to patients and to payer care managers and medical management efficiency.

Download our new whitepaper to learn more about the survey, and how payers can close the medical education gap.

Download the Whitepaper

  1. CITE Research. Online survey conducted for Wolters Kluwer. N=1,034 on file.
  2. Methods and Outcomes of Care Management Programs. Content last reviewed December 2016. Agency for Healthcare Research and Quality, Rockville, MD.
  3. Wolters Kluwer. Case Study. Cone Health: Triad Healthcare Network. September 2021. Data on file.
  4. Wolters Kluwer. Case Study. Midwest Health System Press Ganey ED CAHPS. September 2022. Data on file.
  5. Wolters Kluwer. Case Study. MetroHealth. March 2022. Data on file.

UpToDate Member Engagement

Partner with members to better outcomes

Engage and educate members with interactive programs wherever they are, featuring inclusive, conversational language and images, helping amplify the reach of care management teams.

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