New reality: Consumer-driven healthcare

In a changing health insurance market, payers used to marketing to employers are finding consumer engagement is the new name of the game. Prior success with marketing to groups doesn't predict insurers' ability to win over customers. And with 50 million new customers expected to enter the post-reform individual market, insurers face a massive adaptation test.

Specifically, payers have five key challenges in the consumer-driven market, according to a new white paper from Infosys Public Services. They include:

  • Acquiring and retaining new members through multiple channels;
  • Changing business models from employer-centered (B2B) to consumer-oriented (B2C);
  • Competing on value and consumer-focused offerings;
  • Differentiating with unified customer experience across the lifecycle; and
  • Engaging customers to reduce costs and improve health outcomes.

To meet these challenges, payers must show customers the value of their products, equip them to make informed insurance decisions and secure their commitments to personal health, said Infosys, a business consulting and technology solutions firm. That may be a tall order given low levels of health insurance literacy.

Nevertheless, insurers are boosting customer outreach through multi-channel commerce, mobility and social media, according to a blog post from technology and management consulting firm Perficient. And payers increasingly are working to connect members with their electronic health information.

Other evidence of the consumer market trend comes from a survey of 120 health insurance executives last summer in which insurers acknowledged they must become more "retail oriented" to improve consumer experience, Perficient noted. But obstacles remain on the path to consumer-driven healthcare, as insurers still get roughly 80 percent of their revenues from group business, for example. And surveys have consistently shown customers dislike insurance companies and don't want to deal with them, according to Perficient.

Nevertheless, a fall 2013 assessment of U.S. health plans found 10 major insurers scored high marks for engaging and empowering customers. Cigna and Kaiser Permanente led the list for using social media, mobile apps and websites to connect with customers, FierceHealthPayer previously reported.

For more:
- see the Perficient blog post
- here's the Infosys white paper (.pdf)

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