Payers looking to take their operations to the next level should think of that work as a "journey," according to a new report from analysts at McKinsey & Company.
The report maps insurer operations onto 18 "journeys" that focus on one stakeholder and one value driver; for example, improving service for members. In this approach, insurers can embody certain archetypes based on which value drivers they're pushing toward the most.
Understanding which archetype best fits the company goals is key to determining which journeys are the most effective to achieving those goals, according to the report.
Addie Fleron, a consultant at McKinsey and one of the report's authors, told Fierce Healthcare that the acceleration of trends in healthcare, such as the growth of digital health, is driving changes in how payers view operations.
"These are going to have an impact on how payers think about not only their strategy going forward but also operations," she said. "There is a fundamental shift in how they think about the operational backbone of the company."
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The archetypes outlined in the story are:
- Ecosystem builders: These companies are especially focused on growing through strategic partnerships or acquisitions and diversifying their businesses.
- Value partners: Insurers in this archetype are prioritizing value-based partnerships with providers and other stakeholders.
- Administrators: Payers with this focus are looking for ways to achieve greater operational excellence.
Each archetype is built on the same three core values—managing members' health, assisting them in finding their plans and ensuring they use the right care—with varying degrees of emphasis. However, the strategy journeys vary.
For ecosystem builders, for example, focuses include working with the government to ensure members in public plans are cared for appropriately and finding the right partners to manage claims or build value-based arrangements.
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Using these journeys as a baseline for strategic planning assists in pointing to the most valuable areas for investment and identifying potential challenges and barriers, according to the report.
Fleron said there is room in this approach for insurers to switch gears and move between journeys and archetypes as their strategic priorities evolve and change.
"The most important thing is really understanding what you’re doing and picking something on purpose, and prioritizing the journeys between that," she said.