2020 has been fraught with a devastating health crisis, which has in effect held a magnifying glass up to the U.S. healthcare industry to highlight both the heroism of frontline workers as well as the flaws within an industry that, at times, delivers poor customer experiences due to the complexities that burden it. As the healthcare industry continues to battle the pandemic, businesses and organizations are working to understand how this year’s events have changed consumer behaviors and identify long-term versus short-term transformational needs.

As Scott Galloway tweeted, “Healthcare is the industry most ripe to be disrupted.” Data flow, compliances, regulations and other aspects have long been a roadblock of digital transformation for many healthcare organizations, but this has quickly changed due to the pandemic.

The consumerization of healthcare

Pre-pandemic, there had been a path toward the consumerization and the self-managing of healthcare. Increased technology adoption has created greater visibility into heath records and improved accessibility to health information and education. COVID-19 and the following shutdown has reprioritized what classifies as an in-person healthcare need versus managing routine healthcare with digital options.
For most healthcare providers, COVID-19 has accelerated the changes that were already lurking on the horizon. For example, telemedicine adoption changed at breakneck speed, not only because patients cannot or are reluctant to visit doctors’ offices during the lockdown, but also due to regulatory barriers being knocked down quickly. This has presented many areas for healthcare organizations to focus on to create better customer experiences. However, the pandemic has also seriously impacted the financial health of many providers, 82% HCPs reported declines in patient volumes in a recent study. Revenue shortfalls from elective procedures and patient visits are creating resource shortages that may hinder growth.
Pharmaceutical companies, who play a vital role in healthcare, have invested resources to lighten the patient burden and find a COVID-19 solution. While many manufacturers experienced unexpected gains during the pandemic, the traditional sales rep model has experienced many challenges including access to HCPs.

A strong signal of what's to come: 2021 predictions 

Looking at 2021 and beyond, we see a series of trends that will be driving demand, including the anticipation of more consumers becoming unemployed, which in turns should create a larger percentage of consumers eligible for Medicaid and a higher need for short-term medical policies.

• Surge in ACA plans. The impact of the pandemic on the economy and employment has driven a significant increase in the number of consumers available to shop for an ACA plan, including a new surge of consumers now eligible for Medicaid and related subsidies. Although the ACA has weathered the storm of political controversy and the changes that were implemented beginning in 2017, enrollment is down. This may reflect consumers taking a “wait and see” approach to enrollment, perhaps anticipating a return to employment or considering lower-premium short-term plans to save money and bridge the economic gap.
• Steeper 2022 premiums. As social and economic restrictions have eased, payers are seeing rebounding claims that may be an indicator of future cost, but, like consumers, most took a “wait and see” approach to pricing plans currently being offered in Open Enrollment. During the pandemic, payers implemented waiving COVID-related copays, virtual mental health coverage and drug affordability programs through 2020, and many are highlighting similar new benefits for 2021 plans. With modest premium increases for 2021, payers will be monitoring population health closely. Depending on what 2021 brings, we may see steeper increases in 2022 premiums.
• Telehealth becomes a necessity. Healthcare businesses and organizations are responding with increased consumer empathy and taking a customer-first approach. Startups and new technologies are accelerating access to healthcare in remote areas and remote working has shone a spotlight on the importance, awareness and impact of mental health. Many businesses have developed wearables, apps and devices as new ways for consumers to self-manage health without ever setting foot in a provider’s office. Consumers were quick to take advantage of health monitoring wearables like Amazon Halo to keep an eye on their heath and have also become much more likely to embrace telehealth visits. These trends have accelerated in 2020 and we can expect many of these trends to continue post-pandemic.

The 2021 playbook for healthcare & pharma 

Pharmaceutical organizations can expect greater integration across digital ecosystems and representatives will likely have access to more digital tools and operate in a hybrid model, with in person meetings for some offices and virtual for others.

Players in the healthcare sector must prioritize digital transformation to be successful in a post-pandemic world. First, brands must understand customer identity data as well as build a healthcare organization identity graph for personalized interactions, build behavior-based micro-segmentation and place additional emphasis on data to predict future trends to make better business decisions.
Additionally, they need to execute personalization at scale - undergoing a rigorous Medical Legal Review process - and put a greater focus on trigger and Next Best Action initiatives. By building a platform of on-demand content and leveraging dynamic creative optimization, organizations can meet customers’ expectations of instant support and a variety of customer-centric options.
The playbook for payers, of course, looks a little different. As always, strive towards better UX by increasing the ease of use and personalization of online enrollment. Educate and engage with customers by hosting virtual seminars and investing in intelligent online chat platforms. Be sure to focus equally on existing customer engagement and retention as well as acquisitions. 

Contributors

• Puja Kartan, Strategy Director, Isobar
• Jane Portman, SVP, Health Vertical Practice Lead, Merkle