Health Plans Must Prep for Consumer-Oriented Business Model

Margaret Dick Tocknell, for HealthLeaders Media , November 9, 2011

Lapsley says a health plan’s successful transition to the retail world should involve these steps:

  • Adopt the consumer’s point of view. Demographics of your existing customers and target groups are certainly important, but the goal here is understand customers’ healthcare needs and attitudes, what they really want from their healthcare products, and what they value. Lapsley says analytics are key to identifying market segments and buying groups.
  • Exceed consumer expectations. Healthcare consumers have to be a resilient lot to deal with what the report refers to as the “extraordinary degree of inefficiency and inconvenience in accessing healthcare.” Lapsley believes these problems could be converted to an opportunity for a health plan to integrate its healthcare products with additional services. For example, in another Oliver Wyman survey, potential retail healthcare customers said they would be willing to pay extra for increased access to their providers.
  • Think long-term. Retailers look at the lifetime value of a customer. Health insurers should adopt that long view because “it will enable health plans to cross-sell and upsell products around a broader notion of health and wellness,” Lapsley says
  • Look for partners. Healthcare reform will attract new players, which may provide opportunities for health plans to partner on products or services with successful retail brands in consumer goods, over-the-counter health products, and pharmaceuticals. Humana and Walmart have already partnered on Medicare Part D drugs. Health plans also might want to look beyond the traditional partnerships and think about partnering with a company like Nike to bundle healthcare with a wellness and fitness program.

The transition to retail comes down to “creating stickiness” with the consumer, Lapsley says. The bottom line is that in the new world of healthcare, health plans need to think about all the ways they can engage their customers to expand the relationship beyond the simple transaction of buying health insurance.

Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.

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