The Pulse from UnitedHealthcare: What’s driving health care innovation?
Jean-François Beaulé, FSA, shares his perspective on 3 emerging trends he sees shaping the future of health care benefits — and how they may impact employers and employees.
From analyzing risk and uncertainty to leading design innovation for our large employer commercial segment at UnitedHealthcare, staying on top of emerging health care trends and forecasting their impact is one of my more exciting day-to-day responsibilities.
People often think of innovation in revolutionary terms like rockets launching into space or energy breakthroughs. In health benefits, innovation often needs to be grounded in the realities of the moment while also keeping an eye on the horizon. At UnitedHealthcare, we approach innovation in terms of addressing health care quality, affordability and predictability, reducing abrasions to accessing care and ensuring the best possible outcomes.
With that ultimate goal in mind, I see 3 areas of focus as we enter 2025:
1. Meeting the demand for more human-centric care
Simple. Predictable. Timely. This is what consumers have grown to expect from most retail and financial experiences. Checking the status of a prescription, prior authorization or claim payment should be as simple as tracking the delivery of a package. Conducting a provider search, scheduling an appointment and viewing the cost of care should be as simple as buying a product online.
At UnitedHealthcare, we believe members should get a similar experience from their health care interactions, especially in areas of search, access, tracking and paying. In growing areas of health care, this is being achieved, but, as an industry, we need to be relentless about not just reaching that bar but challenging ourselves to raise it. We need to make sure processes and tools are developed with proper personalization and seamlessness, so that interactions are immediately relevant and helpful.
So where do we start? We first need to take a look at today’s health care processes and its various agents with “the whole system” in mind, helping us understand where we can drive better value while avoiding unnecessary disruption as well as removing what no longer belongs.
For instance, the use of electronic medical records (EMR) has become mainstream for medical groups and providers. In fact, nearly 80% of U.S. office-based providers and 96% of hospitals use electronic medical records to capture patient data and recommend treatments.2 But the next challenge is to find a way to achieve greater alignment between carriers and providers by better integrating members’ plan information and data into those EMRs to improve processes like prior authorizations; enable more timely and accurate payments; and provide a holistic patient view with claims data so providers can have more information to make their care decisions.
2. Taking a thoughtful and practical approach to new technologies
With one of the largest health care datasets in the nation, UnitedHealthcare is constantly seeking opportunities to better connect that data to deliver a simpler, less cluttered experience. Layering on advanced technologies that are powered by that data can help us do that at greater speed, with greater accuracy, while providing value in the moment.
With that said, we must proceed with caution and attention to detail, while ensuring that the human hand is always the guide at the top. Storing, securing and manipulating data, along with deploying advanced analytics, can carry multiple risks and requires the highest standard of stewardship. At UnitedHealthcare, this means ensuring our data security standards, as well as those of the vendors we work with, are at the highest level before any data is shared.
It’s exciting to see how artificial intelligence (AI), machine learning (ML) and advanced technologies are already improving operational efficiencies in areas that provide benefit to patients, doctors and other stakeholders as a whole, by removing waste and improving usability and satisfaction.
For instance, our Advocacy programs use AI algorithms to intelligently identify members’ unique needs and serve them with clinical offerings or specialized support such as the Special Needs Initiative (SNI). Since launch in 2017, SNI has supported 248K+ families with 1:1 Care Advisor support helping to simplify the health care experience and increase connections to clinical, behavioral and community-based programs and resources.
Combine these tech advancements with incentives aligned to the goals of value-based, and we could accelerate sustainable progress for a more sustainable and accessible health care system.
3. Delivering simplicity and greater value for employers and employees
One of the top concerns for employers is health care affordability — for them and their employees — and appealing to the broad demands of a multigenerational workforce. They are looking for new and innovative solutions that offer employees and their families quality and cost-effective care, delivered within competitive solutions to attract and retain talent.
Part of the challenge in designing these offerings is that people often prioritize choice above all else, even if that means going out of network or seeing a provider that may have demonstrated the desired outcomes for a given condition or diagnosis. At UnitedHealthcare, we design plans that help employees make informed choices by including options that address convenience, cost, quality and personal preferences. For instance, Smart Choice, a care matching experience rolling out in 2025, will help guide members to personalized, quality care options to meet their needs and preferences.
Additionally, Surest® is copay-only health plan designed to make it easier for consumers to compare treatment options and costs before making an appointment or filling a prescription. Because of this transparency, members can better understand the connection between lower prices (copays) and providers that deliver higher value care.
Today’s employers are increasingly challenged with solving the cost and coverage equation: How to provide more access, more options and more personalization that employees are demanding, while at the same time controlling costs. Our industry needs to help find the right balance between adopting new technologies while advancing quality with innovative solutions, services and engaging (simple) experiences.
Like all of us, I want to feel in control of my health care choices. I want a health plan that provides options that I can understand and that I can engage in with confidence. I want clarity and transparency into costs, and let me be rewarded for making the better choices. That’s the perspective I and all my colleagues bring to UnitedHealthcare each and every day.
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