The shift to consumer-centric healthcare is forcing healthcare payers and providers to rethink how they engage their members. Retailers, creative partnerships between payers and providers like accountable care organizations (ACOs), and other non-traditional entities have further cut into the traditional market share of healthcare payers and providers, which has made healthcare a more competitive industry.
Yesterday at AHIP Institute & Expo 2018, I spoke alongside Melissa Cellucci, vice president of business development at GuideWell Connect, a leading provider of consumer sales, marketing, and engagement solutions to health plans. We discussed these changes in the marketplace, and provided advice to healthcare payers looking to adapt. It is crucial that healthcare payers adapt now, especially given the scale of the coming disruption. Recent research found that there is a more than $500 billion opportunity for a disruptor like Amazon to deliver a superior customer experience and create a new “front door” to healthcare, changing the first point of contact from a doctor’s office to a local drug store or the consumer’s living room.
Healthcare disruption will come in many forms, including value-based care as a replacement for the fee-for-service model and increased risk-sharing between payers and providers. Pair this with rising customer expectations and empowerment, as well as innovations in engagement channels and delivery models, and it is clear healthcare payers need to make substantial changes. The best way to weather the coming disruption is through personalizing the member experience, which requires taking action in five key areas.
To provide a personalized member experience, healthcare payers need to understand that marketing to individual consumers is far different from marketing to broad groups. Each consumer has their own communication preferences, with specific behaviors and attitudes that are relevant to them. This requires altering internal processes to reach each consumer as a segment of one, which can be achieved by pursuing five key business imperatives:
Achieving each of these imperatives puts healthcare payers on the road toward long-term growth. This is especially important because recent research found that personalization will push a revenue shift of some $800 billion over the next five years in retail, healthcare, and financial services to the top 15 percent of organizations who deliver the best experiences. Only healthcare payers that personalize the member experience effectively will capture a portion of this revenue.
Most healthcare payers right now have substantial fragmentation across their technology infrastructures and internal processes. The disconnected technology stacks of groups like marketing and telesales, which evolved based on department-specific needs, have caused duplicated processes and disconnected member experiences. The same Medicare member, for example, may engage with different departments depending on their needs. That member then receives a disconnected experience that ultimately causes confusion and frustration.
Solving the problem of disconnected experiences through innovative technology and process adaptation can drive substantial benefits. One of GuideWell’s customers who undertook a personalization initiative, for example, enjoyed a 20 percent increase in effectiveness of member engagement and 20 percent lower costs. Healthcare payers who personalize the member experience also enjoy five times higher retention rates, extending the value of personalization far beyond the immediate financial impact. This can be transformative for any healthcare payer’s longevity.
Consumers increasingly expect their experience with healthcare organizations to be personalized, allowing them to access the information they need when they need it. This ultimately needs to take the shape of a closed-loop virtuous cycle where members engage with payers, who in turn use those engagements to further personalize the member experience. Healthcare payers who evolve their operations now, before disruption shakes up more of the industry, will be well-positioned to weather the transformation happening in the industry now and in the future.