Health plans are driven to innovate in response to the growing consumer market. Service and product personalization and responsiveness are key expectations of the post-reform health care consumer. Much of the innovation discussion within the health plan market in past years has focused on new product execution and delivery generally related to consumer health information exchange strategies, and/or technology related to improving consumer multi-channel interactions. Yet, to date, the healthcare market continues to suffer from relatively poor overall consumer satisfaction, ranking in the bottom third repeatedly in industry surveys. Clearly, successful innovation that translates into improved consumer engagement, stickiness and satisfaction is a work in progress.
This theme was explored during the recent “Ready, Set, Innovate” Panel at Pega’s recent Collaborative Healthcare Summit on October 27-28. The panel featured Bill Shea, Vice President, Cognizant and Leon Sabarsky, Agile Practice Lead, BCBS of North Carolina and hosted by Don Schuerman, Pega’s CTO and VP of Product Marketing. It has long been suggested that health plans assess consumer innovation by reaching well beyond their industry to evaluate and study engagement success in other key consumer industries. Retail and financial services are most often highlighted as key industries from which much can be learned regarding consumer engagement strategies.
However, most frequently health plans are seeking to paste new products and services, and new web or digital capabilities on to legacy technologies, applications and processes. This ignores the need to execute consumer engagement strategies that are rearchitected not just at the user interface. Though an appealing UI is critical, it is only one attribute of the consumer engagement strategy. Consumer engagement is truly context changing - from marketing to interactions to health and clinical programs to operations and processing. Merely addressing the front-end interface may expose back-end program insufficiencies and inconsistencies. For example, many consumers enrolled in value-based benefit programs find themselves facing the kind of care management decision previously reserved for medical professionals: their doctor or health plan nurse case managers. In this instance, information about the consumer’s product and benefit requirements and features, personal employer-sponsor/PCP/PCMH/ACO-driven “network”, and provider quality information are all components of the consumer decision strategy architecture.
During the panel discussion, Don Schuerman posed the provocative question “What would Google do?,” noting that Google has achieved great success viewing its consumer strategy as an end-to-end initiative. Processes, programs, products and interfaces all must support holistic consumer needs and expectations for personalization, customization, efficiency, speed, accuracy, communications and outcomes – and in healthcare, privacy and security. Health plans competing in the new consumer market will be best served by emulating the holistic Google strategy – with focused holistic strategy and service, also seeking technology solutions that provide both consumer, integration, and program and process flexibility.