The COVID-19 (SARS-CoV-2) pandemic has dramatically accelerated digital transformation in healthcare, taking the topic from conceptual to table stakes in a matter of months. Telemedicine has been lauded for its promise—and for good reason. When millions of Americans were compelled to stay at home, maintain social distancing and avoid in-person appointments, telehealth offered an accessible option to help individuals maintain their health and well-being.

Despite its potential and wide-spread adoption, telehealth’s shortcomings mirror those of traditional healthcare in the U.S: it is still episodic and fragmented. These virtual visits alone can’t address the broader healthcare needs of individuals who require long-term, more frequent support between provider visits to become empowered self-advocates for their own health.

Additionally, consumers have been conditioned to expect Amazon-like experiences—digital, on-demand, and personalized—in every other aspect of their lives, whether it’s shopping online, traveling or reading the news. This has led to growing frustration as healthcare continues to lag behind these consumer experiences. Now, the mandate for more convenient, accessible health support has never been more urgent.

Wellframe, the market leader in digital health management solutions, commissioned a survey to deliver insights to help health insurance plans provide members with more unified and coordinated experiences, as well as connect the dots between in-person and virtual care in this new era of healthcare. The survey was conducted through a third-party provider and included 1,103 individuals in the United States who have either public or private health insurance coverage. The survey revealed widespread consumer preferences for the following:

The survey took place in October 2020, against the backdrop of a continuing pandemic, the Nov. 3 presidential election, and open enrollment season, when individuals make choices about benefits and learn about insurance cost changes for 2021.

Addressing gaps between clinical visits, while catering to consumers’ preferences for convenience and personalization, should be a priority for the entire healthcare system, from health plans to providers.

Addressing gaps between clinical visits, while catering to consumers’ preferences for convenience and personalization, should be a priority for the entire healthcare system, from health plans to providers.

When people don’t understand their health insurance, they are more likely to avoid care, which can lead to poorer health outcomes. A 2018 study published in JAMA, a peer-reviewed medical journal, found that nearly 30 percent of adults surveyed have forgone or delayed care because of cost, and that lower health insurance literacy is associated with greater avoidance of both preventative and non-preventative services.

44 percent of respondents said they understand their health plan benefits and coverage “somewhat well” or “not well,” compared to 56 percent who said “extremely well” or “very well.”

Understanding what their health plan covers and what it doesn’t enables members to take proactive control managing their care and benefits. This keeps them more engaged and more likely to stay on a healthy path.

Given that the population surveyed was insured individuals, including people with chronic conditions and those without, improperly coordinated care is potentially leading to worse health outcomes for a broad segment of the population.

But people with certain chronic conditions were more likely to experience some of the above challenges. For example, survey participants who have cancer were more likely to miss a prescription dose (53 percent) or miss a provider appointment (44 percent) than the overall population (42 percent and 34 percent, respectively). 65 percent of those who experience certain mood disorders, such as depression or bipolar disorder, and 57 percent of those people with diabetes, said they had forgotten to take a prescription dose.

The financial consequences are also severe – the New England Journal of Medicine pegged the cost of lack of adherence to prescribed medication at between $100 billion and $290 billion annually in the United States.

The survey responses show significant challenges among the overall population in attaining or advocating for appropriate care for themselves. Thirty-eight percent of respondents said they proactively manage their health “somewhat well” or “not well” between doctor’s visits, compared to 61 percent who said they do so “extremely well” and “very well.” A sizable portion of the population realizes they can and want to do better to reach their health goals.

How can health plans rise to the occasion and do their part to alleviate some of their members’ confusion and uncertainty across their healthcare journey?

There is a broad consensus from respondents in this survey that health plans have an important role to play in becoming a trusted advocate for all of members’ healthcare needs.

There is also widespread interest in accessing virtual support from a care management team – a group of healthcare professionals including nurses, dieticians, social workers and others – accessed through a mobile device. Just under 75 percent of respondents said having increased access to a virtual care team would help them keep to their doctor’s recommendations during the COVID-19 pandemic. There was essentially no difference in opinion between people who have a chronic condition and those who don’t.

Nearly the same portion of respondents (72 percent) said they would use a virtual care management team to manage a health condition. Additionally, 46 percent of respondents said they wish there was more support from doctors and health plans for their personal healthcare journey, while 53 percent said they felt “well supported” by the healthcare system.

Health plans can play an important role in augmenting the support members receive between clinical encounters, as well as partnering and coordinating with providers to ensure that people with chronic conditions receive the support they need. An ideal whole-person care team includes a staff member, often referred to as a Health Advocate, who can help coordinate health support and resources, serving as a single point of contact for members. For people with lower health risks, this point of contact can address questions about expenses, benefits or coverage if needed, as well as direct members to relevant resources and providers based on their needs. This enables members to get personalized support that improves their satisfaction with their health insurance plan.

Interacting with healthcare providers in-person remains the preferred method of care consumption for consumers, but the survey showed significant support (49 percent) for interacting with providers using virtual tools.

When asked which of the following ways interacting with a healthcare professional would most likely inspire them to take action on their health and well-being, respondents answered as follows:

Some of the preferences for virtual methods of interacting with providers may be partly driven by the need for social distancing. But consumers are broadly becoming more comfortable consuming information and engaging with healthcare professionals on their device.

It hardly bears repeating that the COVID-19 pandemic has heightened anxieties over the future. About 38 percent of respondents in this survey said they had sought support from their health plan for mental health concerns, such as stress and anxiety. And many recognized the vital importance of the 2020 presidential election for accessing the care they need, with about 90 percent of those surveyed saying they thought improving healthcare access was important in making their decision about which presidential candidate to vote for.

Millions of Americans, whether they have coverage through Medicare, Medicaid, or a private insurance plan, will be making key decisions about their health benefits for 2021. The time for health plans to help the healthcare industry face this challenge head-on is now. Health plans have a unique role to play in interacting with members in more continuous and personalized ways to keep them more engaged. By leveraging digital health management, health plans are ideally equipped to close the current gaps in episodic care, and help their members live healthier, happier lives.

Wellframe worked with a third-party provider to collect responses from 1,103 U.S. adults. The only requirement to participate was that they currently subscribe to health insurance, either public or private. The sample included a roughly equal number of responses between genders (53 percent female and 47 percent male) and age groups (22 percent ages 18-29, 22 percent ages 30-44, 34 percent ages 45-60, and 21 percent over age 60).

Wellframe strategically partners with health plans nationwide to reimagine the relationship between plans and members. Our digital health management solutions for care management and advocacy enable a level of care and support that empowers people and organizations to achieve their best. By combining innovative solutions, strategic partnership and passionate conviction, Wellframe creates measurable impact on lives, at scale.

For more information on Wellframe, visit www.wellframe.com.