HEALTH PLAN IQ

AUTHORS


Florent_Moise_headshot_small
Florent Moise 
Principal,
ZS

Peter_Manoogian_headshot_small
Peter Manoogian
Principal,
ZS

Jeff_Traenkner_headshot_small
Jeff Traenkner 
Strategy Insights & Planning Manager,
ZS

Colin_Russi_headshot_small
Colin Russi 
Strategy Insights & Planning Manager,
ZS

Harbinder_Raina_headshot_small
Harbinder Raina 
Associate Principal,
ZS

Latest Posts

Everyone Wants Direct Access to Healthcare Customers, but When Will It Become Too Much?

Posted by Peter Manoogian on Thu, Aug 08, 2019

3615_HPIQDirectAccess_BlogAs broader debates about healthcare in America dominate headlines, a quieter revolution is already taking place in how it’s delivered to customers. Not a week goes by without news of a health plan, provider or digital health company promising to give consumers more options and greater access to healthcare services. These actions, taken together, have collective, transformational potential. For example, in recent weeks:

  • CVS Health announced that it’s partnering with software company Unite Us to launch a technology platform that gives Aetna’s most vulnerable Medicaid and Dual eligible members access to a network of social care providers who can connect them to transportation and housing services in their communities.
  • Anthem teamed up with digital health startup K Health to launch a co-branded app that allows Anthem’s 40 million members to text their doctors about their symptoms and test results.
  • NewYork-Presbyterian launched its new Hauser Institute for Health Innovation to expand its telehealth services, including remote patient monitoring, which helps reduce the length of patient hospital stays, and prevent rehospitalizations and teleparamedics.  

As I talk with executives at health plans, providers and health tech entrants, they all speak about having an obsessive focus on their customers—which is to say, on patients.

All of these efforts to connect with customers through multiple channels to address various aspects of their health may seem like a welcome development. But as startups, providers and life sciences companies jockey for direct relationships with their consumers, the amount of contact could become overwhelming. Will customers accustomed to interacting with the healthcare system in a traditional way—calling to make an appointment, sitting in a waiting room, getting referrals from a physician—embrace a complex system of patient portals, apps and texts?

As healthcare players try to own the relationship, it seems unlikely that customers will have the time, interest or bandwidth to maintain contact with so many different providers. Private health plans, which cover most Americans and have the broadest view of one customer’s health, seem to be best positioned to cut through the noise and become the primary point of contact. But to do so, they will need to understand their customers more deeply than they do today.

Consider the entertainment space, where Spotify does an amazing job of identifying musical preferences and suggesting new songs that listeners would not have discovered on their own. Spotify works so well because it has an algorithm that maps a musical genome based on listening patterns, not some manual rating system.

These days, being customer-centric requires having good tools on the back end to collect and analyze data and determine which approaches gain traction with which types of customers. Using these insights, health plans can personalize their offerings by scaling solutions for the customers who embrace those services while deploying different solutions for those who don’t.

For example, Anthem’s investment in the system for texting doctors will only take off if the customers who prefer texting learn about the service, know that it’s a covered benefit, and find it seamless to use. Even if the service is seamless, some customers will still want to talk to their doctors on the phone or in person. Health plans need to account for that, recognizing that these sorts of changes need to happen organically. They cannot be forced.

Health plans also need to be careful that customers don’t perceive that their efforts to steer them toward different offerings, such as cheaper MRI providers or remote monitoring, as purely motivated by cutting costs. Unless a service truly benefits a specific customer, health plans that unilaterally encourage certain offerings risk undermining their efforts to put their customers’ preferences first.  

Health plans that use what they know about their customers to create more convenience and less confusion will likely prevail in the end.


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Topics: customer centricity, health plans, healthcare, payers, Anthem, providers, digital health, patient centricity, healthcare marketplace, health benefits, health plan members, CVS Health, member centricity, health tech

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