Ever since the first mobile app was created in 1997 by Nokia (the popular arcade game snake) and popularized by Steve Jobs, phones have been increasingly using apps. However, some studies have shown that the number of available apps has begun to overwhelm users. A recent survey from Gartner found that 41% of mobile users have not downloaded a new app in the last six months and that mobile users spend 85% of their time on their phones using only five apps. This trend affects Managed Care Organizations (MCOs) and contributes to the growing problem of why engagement rates among members for mobile apps are down. With more than 1.96 million apps available on the app store, this ever-increasing trend is called app fatigue.

Rewards serve as the primary tool for Managed Care Organizations (MCOs) to incentivize healthy behaviors by their members. However, despite the investment some health plans put into these programs, they don’t always reach their intended goals. Rewards are used to promote healthy behavior to drive completion rates, but results are sometimes disappointing. If this has happened to your organization, don’t drop the idea of using rewards just yet. Instead, here are three ways you can create a rewards program that drive the results you want.

Getting ready for payer-to-payer data exchange as part of the CMS Interoperability mandate? If so, your priority as a payer is to address the need to aggregate your members' data from various former payers. While this mandate focuses on empowering members, it also makes payers rethink how member data needs to be aggregated and distributed. 

How can you get members to do what you need them to do? This is the number one challenge facing many Medicaid Health Organizations (MCOs). Member engagement is crucial for encouraging healthy activities that can improve outcomes and drive down costs for your organization. Plus, it’s the best way to make a positive impact in the lives of your members.

API Management is a critical component of the payer’s FHIR infrastructure. It helps in fulfilling the security requirements of the CMS mandate and business services integration requirements to orchestrate with enterprise systems and services. Further, effective management helps you comply with the security requirements for monitoring, reporting, and managing access to the FHIR resources by external stakeholders, including third-party apps and health plans. We will briefly touch upon how this API management functionality is implemented within Sagitec’s HealFHIR in this blog.

For Medicaid plans, there has been a shift in the way members communicate. With a clear preference for texting over calls, it’s important to align with this preference. Further, SMS is an efficient channel of communication and can help your organization serve more members while improving quality. Whether it’s being used to send informational messages and reminders to the members, the benefits are numerous.

CMS Interoperability compliance is a long-term journey for Payers. IT systems and processes not only have to be realigned to meet the requirements of the new mandate but also must be nimble enough to adapt quickly to changing business models as patient adoption increases. To best meet these demands, payers should focus on putting together an FHIR infrastructure that complies with the mandate and provision it to extend and scale as the mandate as patient adoption evolves.

The COVID-19 pandemic has driven more businesses online than ever before. With health care plans growing their number of older members, this may not be welcome news. Even though remote mobile service is a growing industry trend, a study from the Pew Research Center found only 26% of internet users aged 65 and over were “very confident” when using smartphones. Optimizing your plan’s mobile design to accommodate their needs should be a key focus heading into 2021.

In an effort to provide members with access to their health data, government sponsored health plans are required under the new CMS mandate to better support interoperability and access to patient data. With the mandate coming into effect in only a few months, payers need to act quickly on ensuring their organization's compliance. One of the key steps in ensuring ongoing compliance is to evaluate and choose the right type of cloud deployment model for the FHIR server. The choice comes down between two options: cloud-hosted open-source system (OSS) FHIR server and managed FHIR server offered as Platform as a Service (PaaS).

As we plan for the new normal, it’s time for Medicaid plans to evaluate the change in member expectations and behavior. People are now performing jobs successfully at home in record number, and a recent Gartner poll shows that 48% of employees will continue to work remotely in the future. In short, remote work and service are trends set to control the remainder of 2020 and 2021.