What it means for payers to shift to a consumer-oriented market

One of the biggest changes facing the health insurance industry is the move to a business-to-consumer market, which requires payers operate within a more retail-oriented business. Given the enormity of that shift, Amercia's Health Insurance Plans (AHIP) has planned multiple sessions throughout its Institute 2012 to help payers learn the most effective strategies and determine what works best in their own organization.

Richard Popiel, President of Horizon Healthcare Innovations, a subsidiary of Horizon Blue Cross Blue Shield of New Jersey, will talk about how payers' efforts to better engage consumers has unintended consequences, including a shift in utilization of specialty services and an increase in claims. That's because consumers who are more engaged in their own healthcare will ask more questions, request care coordination more often and require additional health access points. Joining Popiel in this Thursday afternoon discussion are Andrea Gelzer, senior vice president at Amerihealth, and Amy Compton-Phillips, associate executive director of quality at the Permanente Federation. 

Cigna Vice President John Young will discuss how the company has helped its members successfully create sustainable change during another Thursday afternoon session, "Strategies for Helping Consumer Make Prudent Decisions." And Neal Sofian, director of member engagement at Premera Blue Cross, will take on the topic of establishing and sustaining consumers' engagement in their own health.

If you're interested in improving your consumer relationship, check out the Thursday afternoon session, "Building Brand Loyalty: Reinventing Your Consumer Approach," in which Lindsay Resnick, the chief marketing officer of KBM Group, will share his knowledge of consumers to help payers build brand loyalty and satisfaction, become highly engaged with socialized consumers and better address the whole consumer.

And then there's technology. Some payers are moving full-speed ahead down the technology path, using social media to reach out to members, digital gaming to motivate members' wellness and mobile platforms to expand members' access to information. During their Friday morning session, Bryce Williams, WellPoint's Wellvolution director, and Nancy Wongvipat Kalev, director of HealthNet's health education/cultural and linguistic services, will examine the technologies that have worked for them and discuss how other payers can implement similar strategies in their organizations.

Suggested Articles

Physician groups slammed a court ruling that overturns CMS' site-neutral payments rule for clinic visits.

Sixteen medical professionals, including six doctors and seven pharmacists, were among those charged in a Texas healthcare fraud and opioid takedown.

Blue Shield of California is piloting transportation benefits with some of its members in Sacramento.