Gartner Research

Five Industry Trends Create Opportunity for a Revolution in Care Management Engagement

Published: 30 November 2012

ID: G00245324

Analyst(s): Jeff Cribbs

Summary

Healthcare market forces are creating an opportunity for dramatically increased care management engagement. CIOs and business and IT leaders in payer organizations must develop technology to respond to these trends and capitalize on them.

Table Of Contents
  • Impacts

Analysis

Impacts and Recommendations

  • New provisions of the ACA will cause payers and employers to increasingly use member compliance with objective, modifiable clinical measures (such as biometrics) to determine member cost sharing. Members will look to care management programs for assistance in achieving compliance and saving money.
  • The migration of financial risk to providers in ACO and PCMH models will increase providers' stakes in collaborative or provider-led care management. Members will be much more likely to engage in a program initiated or endorsed by their provider.
  • The payer shift in focus from a B2B to a B2C business model will force payers to develop expertise in healthcare consumer analytics, and can be leveraged for more effective care management outreach
  • Development of social, mobile and gamification technology will enable payers to use persuasive behavioral economics techniques at the individual member level
  • Care management engagement will rely less on the telephone and more on online, mobile and social modes of communication, spurred by new vendor functionality, customer expectations and efficiency demands

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