Health Reform’s New Customer Journey

By Lindsay Resnick, October 9, 2012

Health reform makes 2014 an important milestone for every health plan: market leaders protecting their turf and opportunists setting up for a land grab. At the same time, a value-based consumer experience has never been more important as the center of power shifts into the hands of the health insurance customer. The retailization of healthcare means consumers are in control and taking a new healthcare journey: budgeting for their health benefits, navigating care delivery, and recommending preferred health plans.

It’s time to anticipate and prepare for this new journey by putting a plan together built around a series of sequenced, deliberate action steps:

• Know existing and prospective customers better than any of your competitors.
• Build an actionable roadmap to secure a differentiated, believable market position.
• Establish an arsenal of B2C marketing tools to reach, motivate and bond with consumers.
• Integrate & optimize sales outlets (broker, worksite, telesales, online, mobile, retail).
• Design a high engagement customer experience to drive retention and loyalty

A health plan’s ability to anticipate market shifts and prepare for strategic and tactical execution has reached a new level of urgency. Informed decision-making will separate winners from losers as companies manage through uncertainty. It calls for laser focus on two strategic imperatives:

1. Protect and retain existing customers. With public and private health benefit exchanges now in hyper-speed development as a new distribution channel, plans need to deepen relationships with existing customers across product-lines, market segments and distribution channels. This means identifying and profiling a Plan’s most valuable and most vulnerable customers.
2. Leverage “big data” to target growth opportunities. Across the country, the Affordable Care Act is expected to bring access to 30 million new customers; 24 million entering a new customer journey (aka Exchange), and possibly 16 million new Medicaid enrollees. Having a deep understanding of these prospective customers through demographic, attitudinal and behavioral data-driven segmentation is the only way to build an actionable, first-to-market sales and marketing plan.

In a retail healthcare marketplace it’s the consumer’s responsibility to deal with intimidating, complex benefit and health care decisions. Whether driven by reform or natural marketplace competitive pressures, if the cry for “personal responsibility” means asking consumers to step-up and take control of their healthcare destiny, they need to be educated in order to make smart, individualized choices. The burden falls on health plans to guide customers with a roadmap of relevant decision support.

To read more about preparing for health reform get KBM Group: Health Services’ newest Solutions Brief - Healthcare 2014: Leverage Opportunity Buffer Risk - Click Here