The health insurance industry is in the midst of "cataclysmic change," and if health insurers aren't willing to adapt they won't be in business in 10 years, Medica's Vice President of Business Architecture & Strategy Kimberly Branson told FierceHealthPayer in an exclusive interview.
Looking to embrace change, Minnesota-based Medica has invested in innovative technology. But it's focusing on more than just technology tools--innovation related to the people and processes has helped it to create a new type of health plan inside its existing model.
"You need the new technology, but you also have to drastically transform processes and how you do things," Branson said.
To spur that kind of transformation, Branson often tells her team to find their inner 4-year-old and look at the health insurance industry in a different way. "You have to ask yourself why a hundred times--why do we do it that way, why do we have to do it that way, why have we always done it that way, why can't we do it this way?"
Answering those whys led to a new health plan model with more flexibility and automation, enabling Medica to do processes with fewer resources, improve autoajudication transactions and provide better service to members.
Thanks to new technology tools, Medica has been able to experiment with how the insurer interacts with providers. It also has focused on using technology to better interact with its members and create an "outside in" culture that puts members first. For example, recognizing that people only call insurers at a vulnerable time in their lives, the insurer armed its call center operators with all the data and information they need in one place.
"Being able to have all the information at the fingertips of a human being answering the phone is critical to a member feeling cared about and feeling assured that we're there to help and assist them," Branson said.