Combining Technology and Human Connection to Improve Member Health
July 26, 2024 · Becky Kolinski
In a recent episode of the Quality Matters podcast, NCQA’s Andy Reynolds spoke with Tam Ward, Senior Vice President of Insurance Business Operations at Oscar Health, a health care technology company. The interview was the first in a two-part series: “In Data We Trust.”
Oscar Health provides health insurance to 1.4 million members in 20 states. Its mission is to make a healthier life accessible and affordable for everyone.
Ward talked about Oscar Health’s efforts to drive health equity through improved provider data collection, and about the importance of empathy and human connection.
Focusing on the Members’ Needs
“We are a member-first organization,” said Ward. “The things we decide to do as a company are focused on doing what’s best for the member. And we believe that effort is going to yield the right results.”
That has been Oscar Health’s philosophy from the outset. Using technology to influence behavior and drive positive health outcomes for members allows Oscar Health to make their products more cost effective. And that allows them to deliver health insurance to more people.
“We leverage our technology platform to drive cost savings that we can reinvest in creating a better experience for the member,” said Ward.
As a result, Oscar Health has built loyalty and trust with members, as reflected in its high member retention rates and net promoter score of 66.
Understanding Community Needs
While many health insurance companies focus on large metropolitan areas, Oscar Health provides insurance to underserved and rural areas. That means tackling the challenges of working in communities where not everyone is engaged with technology.
Oscar Health has made strategic investments in community-based organizations that provide outreach and education to members.
“In markets where there isn’t broadband access, we have concierge teams to help members,” said Ward. “We’ve built strategic partnerships with providers to reach out to those members and connect with them in a meaningful way.”
In 2021, Oscar Health created a culturally competent care program that includes grants to community-based organizations to use technology, engagement and empathy to address systemic barriers in the health care system that make quality health care inaccessible for many communities.
“We’ve learned a lot from our grantees about what’s required to influence members based on their unique and diverse needs,” said Ward. “You need to have health care professionals from that specific community servicing the membership, because that is how you build trust.”
The Power of Pilot Programs
Another way that Oscar Health seeks to understand the needs of its diverse membership is through pilot programs. Many of its existing programs—such as its diabetes management and COPD programs—started as pilots.
Pilot programs help Oscar Health ensure that programs are designed to meet the needs of the populations it serves and better define the types of community outreach required for those populations.
“We’ve had quite a few pilots. We start small, we learn and we reiterate. When we are ready to move from a pilot to a program, we make additional investments to ensure that the program is comprehensive.”
Listen to the full episode of the Quality Matters podcast with Tam Ward to learn how Oscar Health collects and reports provider race and ethnicity to improve the member experience.
