For health plans, their digital front door is crucial to connecting members to efficient, high-quality care. But in reality, it has become an unmonitored driver of unnecessary utilization and rising medical costs.Inaccurate directories, generic search results, and one-size-fits-all matching send members to inappropriate, higher-cost providers, and for specialty care, no provider at all. Members may delay care until it becomes more acute. All these problems result in measurable financial leakage that payers absorb.With margins tightening and pressure mounting on medical loss ratios, this represents a missed opportunity to address one of healthcare’s most persistent cost drivers: the $400 billion in annual waste tied to low-value and unnecessary care.Mike Gordon, Head of Product at Pager Health, joins Julie Scherer, Chief Solutions Officer at Motive Medical Intelligence, to explore how health plans can turn their digital front door investment into an active lever for cost control and quality improvement. Mike and Julie will share how connecting the digital front door to the back-end capabilities of tiered benefit design and high-quality networks enables seamless member navigation to the appropriate care, delivering 20-40X ROI. Attendees will learn:How to drive better optimization of high-value network providersWays to reduce the “hassle map” for members trying to get care, especially specialty careHow care navigation and provider performance data drives smarter navigation and ROI How to deploy agentic AI capabilities with clinician-level performance insights within your existing digital front door technologies to help ensure members get the right care from the right clinician at the right time
The Digital Front Door Problem Costing Millions and How to Take Control
For health plans, their digital front door is crucial to connecting members to efficient, high-quality care. But in reality, it has become an unmonitored driver of unnecessary utilization and rising medical costs.Inaccurate directories, generic search results, and one-size-fits-all matching send members to inappropriate, higher-cost providers, and for specialty care, no provider at all. Members may delay care until it becomes more acute. All these problems result in measurable financial leakage that payers absorb. | See how payers can turn the digital front door into a cost-control engine using AI-powered navigation, provider intelligence, and high-value networks to drive better outcomes and 20–40X ROI.
440 words~2 min read
