Payers: Meet member expectations

Build member and provider trust with personalized, guided experiences

Health insurance companies must balance both member and provider relationships. An integrated system allows payers to unify data and operations to build better end-to-end experiences, reduce provider friction, scale collaboration between distributed care teams, and identify cost savings.

Disconnected systems tend to slow down the processes that make these experiences possible, which is why prioritizing connected tools and technologies is so important. An integrated system allows payers to unify data and operations to build better end-to-end experiences, improve affordability, reduce provider friction, and scale collaboration between distributed care teams.

When members and providers feel seen, heard, and engaged, it lays the foundation for a more trusting and loyal relationship. In fact, members who trust their payers are more satisfied with their overall experience.

 

78% of consumers with a trusted relationship believe their health insurer genuinely cares about their health as compared to 3% of consumers who do not trust their insurer

Source: "Connected Health Consumer," Salesforce Industry Research, 2021.

Technology helps providers solve common pain points by:

PAIN POINT

Difficult and time-consuming tools and systems mean that the majority of member interactions are reactionary rather than proactive.

ANTIDOTE

Integrating all relevant member data — from benefits and claims, to clinical events and wellness programs — into a single console allows payers to gain insights and prioritize actions that will lead to the best outcomes. This boosts member satisfaction, and makes plan renewal more likely.

PAIN POINT

Customer service can be manual and cumbersome, leading to poor member experiences that impact trust and loyalty.

ANTIDOTE

An integrated healthcare platform digitizes customer service, giving call center agents a 360-degree view of each member. Agent productivity is improved with best practice tools like caller validation, member relationship mapping, and interaction tracking. This helps payer call centers resolve cases in a faster, smarter, and more compliant manner.

PAIN POINT

Participating providers may encounter a clunky experience with their health insurance partners and find it difficult to collaborate or connect with new, qualified patients.

ANTIDOTE

An integrated healthcare platform uses a single, connected system to quickly grow and manage a network of providers. Payers can engage new and existing providers with targeted campaigns. And, during onboarding, providers can easily see the status of their application and manage their profiles.

PAIN POINT

It’s difficult for payers to identify and manage high-risk members and to target those who have been flagged as “not engaged” in wellness or disease management plans.

ANTIDOTE

An integrated healthcare platform can help payers leverage cohort data so they can more easily create personalized, post-acute care plans and long-term engagement. It also makes it easier to monitor outreach results and quantify action, enabling payers to refine intervention strategies in the future.
 
Discover how to engage members more easily throughout the care journey with our technology playbook for payers.
 

Select your industry

 
Overview
Introduction to healthcare platforms
Providers
Improve the patient experience
Pharmaceuticals
Streamline the product life cycle
MedTech
Drive commercial excellence
 

More resources

 
 

Get timely updates and fresh ideas delivered to your inbox.