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3 ways payers can adapt to meet consumer expectations

Report from IDC Health Insights suggests health insurers take 'patient of one' approach

With consumerism now a game-changing reality in the healthcare industry, payers must align their business strategies to focus on their customers as both members and patients, according to a new report from IDC Health Insights.

In the report, titled "Business Strategy: An Architectural Strategy Driver for Payers -- Patient of One," IDC Health Insights Research Director of Payer IT Strategies Jeff Rivkin argues that the typical health insurer has become disconnected from its customers. But this cannot continue if insurers want to successfully adapt to evolving consumer expectations.

To do so, insurers must replace a fragmented approach with one that unifies what Rivkin identifies as the four main "islands" in a payer organization: loyalty or retention-based prospects, provider networks, administrative profile and subscription events, and patients' clinical profiles.

Here are some of Rivkin's suggestions:

  • When marketing plans tailor campaigns to draw in or win back customers as individually as possible, keeping in mind that consumers want their plan to fit their personal needs, rather than be categorized as a generic PPO or HMO.
  • Recognize that the traditional definition of a provider has changed to include entities such as personal trainers, naturopaths, retail clinics and virtual care, and drive consumer loyalty by showing the company values continence over network relationships.
  • Combine Triple Aim methodologies and illness burden scores--which segment patient populations for participation in care management--to form a view of the member population that offers actionable information to various consumer-engagement departments.

Insurers across the industry are striving to rethink their interactions with members to adapt to a more consumer-centric landscape. Michael Sturmer, senior director of consumer health engagement at Cigna, has previously said payers need to see members as consumers first and patients second, an approach that encourages them to get and stay healthy. Others say insurers should combine claims, lab and pharmacy data to apply risk stratification algorithms to their member populations, then use this information to engage members.

To learn more:
- check out the report (purchase required)

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