Consumers are coming: 3 steps to prepare for them


The consumers are coming! The consumers are coming! That might as well have been the bottom line message of each interview I have conducted related to the AHIP Institute 2013 in Las Vegas.

Although I was unable to attend the event this year, I reported from the sidelines, checking in with several insurers and consultants who all provided the same message about the AHIP conference. You guessed it–the consumers are coming. The entire industry has its collective eye on October's open enrollment period for the health insurance exchanges and the accompanying influx of millions of new consumers.

"The payers that will win will be the ones that quickly can understand their consumers' needs, the value they can bring and then segment their consumers to get the consumer that best fits with their value proposition to delivery superior value," Steven Auerbach, president of Optum-owned Connextions, a healthcare solutions provider powering insurers' direct-to-consumer channels, told FierceHealthPayer.

That's no easy task, though. So what's a payer to do if it wants to remain competitive within the exchanges and the overall shift to a consumer-oriented marketplace? Auerbach says there's a three-step process for payers as they prepare to handle the influx of new consumers–prepare for your volume, customize and segment, and create the new experience that you want to represent your brand using multi-modal capabilities. 

"First, it's all about understanding the volume of new consumers that will be entering your ecosystem," many of whom differ from the consumers that payers are currently used to dealing with, so they'll have a "flood of new shoppers in the marketplace with a lower level of education," Auerbach said. Those new consumers will then impact payers' handle time, call arrival patterns and call volume, for example.

The next thing that's really important is segmenting all the new consumers. "Not all consumers are created equal," Auerbach said, adding that different consumer groups have different needs and values. "The ability for payers to get a simplified, consolidated view on prospects and members by wrapping around a consumer database, collecting all the information about the consumer … is going to be mission critical," he said.

By segmenting consumers, payers can provide a customized experience that includes tailoring products to the consumer, modifying products with value-added features that help consumers in unique situations, like addressing diabetics' specific medical and support needs. The problem with payers today, however, is they deliver services with "a peanut butter spread," Auerbach said, meaning that "everybody gets the same service experience; everybody gets the same interactions."

That's why it's critical to package in value-added services to help consumers obtain the right coverage specifically for their needs, he added.

The third step payers should take involves using multi-modal capabilities and world-class consumer engagement practices. "To really be able to respond to the volume of calls that are coming in and drive the consumer experience and brand experience, it's all about integrating the multi-modal approach," Auerbach said. That could include, for example, an intelligent website that collects consumer information and personalizes the consumer experience that is then integrated into the call center and any retail outlets and all forms of communication in between.

Another component to creating brand loyalty is switching from reactive service to proactive service. "Consumers are going through a period of increased confusion and anxiety with increased accountability and responsibility for making their own healthcare decisions," Auerbach said. So they're looking for someone to help guide and coach them through the healthcare decision, whether that's buying the right plan, selecting the right doctor, or understanding the right location to have a certain procedure, for example.

"Progressive plans are actually starting to do a much more proactive service modal all around total lifetime value and results, helping consumers spend their dollars more efficiently and improve their health, which then increases their peace of mind and loyalty," he said.

When Americans bellowed their warning that the British were coming, they knew a war was imminent. I'd like to hope that the exact opposite will be true in the next few months between consumers and insurance companies.

Perhaps by implementing these three steps, payers can effectively extend a warm hand to consumers, welcoming them to the industry and paving the way for a positive experience and robust coverage. Let there be no war here. - Dina (@HealthPayer)