From health plans to health services

The healthcare industry knows its goals: improving population health, enhancing the patient experience, and lowering per-capita costs. That's the Triple Aim. But even though the sector's moving in the right direction, the framework's objectives are still out of reach.

Changes are, however, happening. As the US healthcare system shifts from fee-based to value-based care, health plans are taking steps towards improving member outcomes and population health while also finding new sources of revenue. At the same time, employers want to cut costs and people want personalized experiences.

This is where social determinants of health (SDoH) – the conditions each of us grows up, lives, and works in – play a vital role.

In this Genpact study with HFS Research, 100 health plan senior executives from across the US share their views on SDoH and care management solutions.

Some of the study's key findings:

• Senior executives at health plans have a good understanding of SDoH and are embracing SDoH solutions to enhance their existing care management programs, drive competitive advantage, and positively impact the experience for members and employers
• There is a strong willingness to invest in SDoH solutions with goals to cut the cost of care and improve health outcomes. But when looking at how they measure the value of care management solutions, there is a disconnect. More than double the rate of respondents are measuring engagement – such as enrollment rate (54%) and program retention (54%) – than are directly tracking improvements in clinical or health outcomes (25%)
• Health-plan executives show that they either offer, plan to offer, or are considering offering a wide range of SDoH-related benefits, but two of the biggest challenges to embedding them are access to data and the complexity of managing multiple solutions

Read the report to explore the potential impact of SDoH on member health and companies' investment plans. See where plans are falling short and the challenges to overcome, including the healthcare data and technology hurdles.

To give companies a head start, we lay out the three building blocks that help health plans turn into health services by:

1. Orchestrating solutions
2. Understanding and integrating data
3. Embedding data analytics in healthcare