Preventive Care: 3 Years of Pulse Report Insights, One Clear Opportunity for Payers

For the past three years, insights from the SKYGEN Pulse Reports have distilled a clear theme across the healthcare landscape: preventive dental and vision care is essential. Consumers appreciate its value, providers depend on it to drive better outcomes, and brokers champion it for their clients. Still, despite this widespread consensus, actual access and usage lag behind the ideal. For payers, this persistent gap isn't just a hurdle—it’s a powerful opportunity to step forward and make a difference. 

The Pulse Reports capture distinct but complementary perspectives from consumers, providers, and payers highlighting where preventive care is working and where it isn’t:

Consumers: The Gap Between Value and Utilization
The consumer perspective centers on two things: affordability and transparency. Even when benefits are available, many individuals put off or forgo preventive care due to fears about out-of-pocket costs, complicated benefit structures, or uncertainty about what benefits are covered. This all-too-common scenario leads to fewer preventive visits now, and ultimately greater healthcare costs down the road as manageable conditions develop into more serious—and costly—problems.

Providers: Advocating for Expanded Preventive Coverage
Providers witness the ripple effects daily with patient conditions that may have been prevented or lessened. Providers repeatedly highlight the need for innovative diagnostic technology that can detect issues early and support robust preventive screenings, particularly for high-risk concerns like oral cancer and diabetic retinopathy. Access to these advancements not only boosts clinical results but also emphasizes the critical role of preventive appointments as the foundation of ongoing health.

Brokers: Telehealth Can Improve Access
From the brokers’ vantage point, the missing ingredient is access. Advancements in telehealth and virtual care present significant promise for breaking down barriers to preventive services, especially for those who face challenges related to location, scheduling, or provider availability. Increased access can help improve utilization.

Implications for Payer Strategy
The key takeaway from this robust research is unmistakable: Preventive care falls short when benefits are confusing, costs seem overwhelming, or access remains limited. Both providers and brokers agree that embracing technology-driven preventive and diagnostic solutions is critical to reversing these patterns. This positions payers perfectly to lead a transformation.

SKYGEN empowers payers to convert preventive care aspirations into tangible, measurable results. With the SKYGEN Enterprise System, payers can design custom preventive benefits and wellness programs, enhanced by condition-specific reminders, incentives, and focused educational outreach that boost member engagement. Virtual Visit Technology eliminates traditional obstacles to preventive consultations, while Enhanced Benefits Management guides   benefit designs that put prevention first without losing sight of cost-effectiveness. The Provider Select Suite delivers rewards for excellence in preventive care, driving a focus on long-term outcomes.

For brokers and employers, the SKYGEN Broker Portal and digital education resources streamline benefit communication, making it easier for members to understand and utilize their preventive coverage. Underpinning it all, the SKYGEN Data Warehouse offers robust tracking of utilization trends, highlights gaps, and ensures compliance with CMS regulations, including timely benefit notifications.

Partnering with SKYGEN enables payers to move preventive care from intention to impact—supporting healthier members, stronger provider relationships, and sustainable outcomes for the future. With the right benefit design, technology, and data-driven insight, payers can lead the way.

Want more integrated insights like these from the SKYGEN Pulse Reports? Download our 2026 Pulse Perspectives infographic today.