The Shift to Digital Transformation Has Begun


During a recent webinar, health plans shared how they're identifying and implementing digital innovations for today's world and the future.

Oliver Wyman Health

Editor’s Note: The following article captures key takeaways from a December 9, 2020 webinar organized by World Congress and supported by Wellframe – Health Plan Digital Transformation, moderated by Tom Robinson, a Partner in Oliver Wyman’s Health and Life Sciences practice. Here are some memorable moments from Oliver Wyman’s coverage of this event, and the full webinar replay.

Digital health’s transformation has boomed over the last year because of COVID-19. In the meantime, healthcare providers and patients alike are using new technologies to improve care delivery access, cost, and health outcomes.

Earlier this month, three health plan leaders – Marc Willard, Senior Vice President, Digital Health and Analytics Products and Experience, Humana, Rick Abbott, Vice President, Product and Market Solutions, Premera Blue Cross, and Jacob Sattelmair, DSc, MSc, Co-founder and Chief Executive Officer, Wellframe – convened online for World Congress’ webinar on digital transformation, moderated by Tom Robinson, Health and Life Sciences Partner at Oliver Wyman. They discussed what digital innovation strategies health plans might consider adopting to thrive amidst uncertainty and an evolving consumer landscape. Here are more key takeaways from this webinar:

Watch the Full Webinar 

Consumer-Focused Care is the Center of a Digital-Enabled Shift 

With the many struggles people are facing amidst COVID-19 – such as economic and health inequity challenges – virtual care, said Tom, is one of the bright spots that can help people access care on a more equal basis. However while 30 percent of CMS beneficiary’s visits in urban areas were telehealth, only 22 percent were telehealth in rural areas, pointing to continuing challenges. Overall though, he said, telehealth visits tracked by CMS were up from 13,000 per week last year to 1.7 million per week at their peak this year. Oliver Wyman analysis, for example, predicts convenience and timeliness of access will become two major drivers as telehealth goes mainstream over the next few years. The bottom line, he said, is that it’s extremely hard for a member to receive any kind of physical urgent care in less than a 90-minute window of time.

Said Marc, his company, Humana, is working to address barriers like these. For instance, they are creating an ecosystem that will allow members to choose their care delivery options according to factors like how much care costs and what the experience of receiving that care is like.

COVID-19, added Marc, will accelerate the pace of new innovations and the pace of the greater market. Although managing people’s day-to-day care is complex, health plans are now in a unique position to help consumers proactively find the right digital resources, he added.

Said Jacob, telemedicine has changed how consumers perceive care delivery. It has taught a lot of people, for example, that they can get care virtually and digitally. Telemedicine has also pointed more people over to remote options like their phones to get medical assistance and have their questions answered. Health plans therefore need to double down on their remote offerings, he stressed.

Certain Kinds of Offerings Have Potential to Improve Health Outcomes

The panel next pinpointed what kind of products and analytics capabilities show promise in mitigating health barriers and stigmas tied to areas like social determinants of health, behavioral health, and chronic condition management.

Behavioral health is a critical issue that demands being addressed through virtual means. Regarding some stats, for example, one in three people, noted Marc, struggle with anxiety and depression. Depression, he specified, is actually the leading global cause of disability. And nine in ten people who need access to substance disorder treatment never seek help.

Digital transformation massively improves access for behavioral health, Tom responded, noting that half of all US counties don’t have a single licensed behavioral health specialist.

Said Tom, there was a critical shortage of behavioral health services pre-COVID-19. And this shortage has only been exacerbated. The panel therefore talked about what kinds of digital approaches are helping address this gap.

Said Tom to attendees, there has been a big surge recently in behavioral health needs. For example, downloads of the top 20 US apps were up 33 percent from January to April. Although this number perhaps may not sound like a lot at first glance, Tom urged health plans to compare this to the same period in 2019, when these numbers dropped due to seasonality by 30 percent.

Digital health, noted Jacob, has a key advantage to address challenges such as these: more touchpoints across more people means people feel more connected and more empowered to take charge of their health. This means, for example, that people who are lonely and use text messaging communications with their health plans are perhaps more likely to know they’re supported and someone is there to help look out for them during hard times.

Said Tom, a key benefit of texting applications like these that health plans should also consider is that tools like these allow people to take better control over their mental health. There’s something unnatural, he said, about having to show up at 4PM on a Thursday for an appointment. But, on the other hand, with something like a free texting session, suddenly, a consumer can talk to a provider whenever stress arises, rather than according to when their next appointment happens to be.

One tool that’s working well in this way, especially in areas of mental health, are avatars. Marc added that he’s noticed members engage very well with an app-based-bot, for instance. Thinking about member and provider access to these kinds of tools remains a priority for health plans. The panelists agreed that someone struggling with mental health issues, for example, may feel more comfortable discussing their situation and experiences with a robot versus a human who is perhaps more likely to impose judgement versus a non-biased, more neutral robot’s more matter-of-fact, information-intake, information-outtake kind of reaction to a patient.

Emphasized Rick, another digital health benefit is the bridging of disparity gaps. Health plans need to find ways to make access to care as low-cost to possible, so more people can access it, he said. This way, health plans can reach more communities that have especially been decimated by the pandemic.

Said Marc, communication during tough times is key to help address these kinds of challenges. For example, reaching out to those patients worried about whether or not their elective surgeries will be canceled due to changing health guidelines has been a big priority for his company. It’s really important, he said, to take a personalized approach to care delivery. For example, meet members where they are and consider what their care delivery journey is like and how to best engage with different kinds of people along their care paths.

Helping People Be More Engaged with Tools They Can Leverage

Third, they discussed what kinds of artificial intelligence-centered offerings are proving valuable for consumers to drive the future of digitally enhanced care delivery.

Said Jacob, Wellframe, for example, aspires to think about tech-enabled transformation as a collaborative effort where partnership drives impact.

Added Marc, the key to making tech-enabled transformation work is to make digital tools easy for people to use and understand. When encountering members who are technically adverse, for example, focus on making it easier for them to engage by taking the stress out of telehealth, he explained.

Questions remain that health plans must address. Said Rick, what his company, for example, is starting to wrestle with is how they will manage what they’ve been able to build, regarding their ability to adapt to digital transformation quickly during a pandemic.

The specific opportunity to support people on their digital health journeys is an exciting one, said Jacob. In the words of Rick, digital health can ultimately be a powerful tool for social justice.

Digital health can ultimately be a tool for social justice.

"We were thrilled to have Wellframe support this webinar and partner with us," Gina Glendening, Vice President, Product Development, World Congress and Validation Institute, told Oliver Wyman Health.

“World Congress is pleased to create complimentary content for our healthcare leaders,” Benny DiCecca, Chief Executive Officer of the World Congress and Validation Institute, said to Oliver Wyman Health. “We want to help them do their jobs even better, share innovations, and improve patient outcomes.”