MEMBER ENGAGEMENT AND THE NEW HEALTHCARE CONSUMER. Joe Van De Graaff Research Director, KLAS April 2016
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1 MEMBER ENGAGEMENT AND THE NEW HEALTHCARE CONSUMER Joe Van De Graaff Research Director, KLAS April 2016 Copyright KLAS
2 A LITTLE BIT ABOUT ME 2
3 KLAS MISSION Improve the delivery of healthcare technology & services by amplifying the client s voice. 3
4 ABOUT US The data KLAS collects/publishes on vendor performance helps healthcare providers & payers make informed decisions and acts as a catalyst for vendors to improve their products/services. 4
5 5
6 only The thing that I wouldn t want to be in healthcare right now is a patient. HIT Vendor Executive, June 2015 KLAS Confidential 2014 KLAS Enterprises, LLC. All 6 Rights Reserved
7 In today s world, what would you say the new healthcare consumer looks like? KLAS Confidential 2014 KLAS Enterprises, LLC. All 7 Rights Reserved
8 WHERE YESTERDAY S CONSUMER COMES FROM Insurance is too expensive Always difficult to enroll; too many choices & not sure which ones relate to me or are best for me Why do they keep changing my coverage and why can t I keep my same provider? Some who don t want it are pushed/required to get insurance (ACA) Patients are used to (grudgingly) filling out repetitive paperwork & insurance forms Doctors offices see insurance as problem to be dealt with and pass on that perception 8
9 TODAY S HEALTHCARE CONSUMER Market forces changing healthcare consumer thinking/behavior High deductible health plans (now ~25% of workers) Expectation of something different/better (i.e. 20K medical apps in ios, 8K apps in Android) Incentives from employers/payers to be healthy (or get healthy) Reality of modern consumer expectations/preferences bleeds bleed over into healthcare Loyalty to product/service or just to convenience (i.e. think emerging market of retail healthcare) Anticipation of personalization product/services (i.e. think 3D printing) Prefer to remain a consumer and not have to be a patient 9
10 TWO RESEARCH CALLS IN THE LAST TWO WEEKS Executive at Healthcare Provider Assuming we ve got a fixed budget and are paid X amount per year to keep people healthy, what would we need to do to change our entire business model to make that happen? That is radically different than the way we operate now. We are trying to tell consumers that we want them to pick us as their healthcare provider for life, and we re just as concerned about keeping them healthy as we are taking care of them when they re sick. It s an awesome opportunity for us to address the big global issues that are affecting healthcare and people s ability to even afford it. Executive at MCO & Health Plan We have done some pilots with wearable technology trying to help patients be more healthy. The consumer engagement part is challenging. You can give patients pedometers, but after a while, the charm wears off, and they just run the pedometer through the washing machine. We have some senior centers with clinics attached to them. This year we are doing all kinds of new things, like line dancing. It has been amazingly popular, and it s not like having to do 800 sit-ups. It s fun. It has the benefit of keeping elderly folks moving and active. That helps us keep them healthy. 10
11 How is member engagement different in healthcare than other industries? KLAS Confidential 2014 KLAS Enterprises, LLC. All 11 Rights Reserved
12 THE UNENGAGED PATIENT 12
13 THE UNENGAGED EMPLOYEE 13
14 HEALTH PLAN CEO PERSPECTIVE Our top goal with the provider side and the health plan side is to see the member and the patient as the same person. -CEO, Payvider Organization 14
15 PAYER & PROVIDER RELATED IT STRATEGIES Providers Risk stratification/pop health solutions CRM Patient Portals Telemedecine platforms Patient bill estimation solutions Secure messaging solutions Health Information Exchange (HIE) solutions Payers Care Management solutions CRM Member portals Telehealth services Price transparency solutions Integration platforms - wearables/m-health data Health Insurance Exchange (HIX Solutions) 15
16 OTHER PAYER STRATEGIES Clinical/nurse call line & services Employee/member wellness assessments & coaching Consulting/services engagements on network strategy, population health Social/sentiment data analytics technology & services engagements 16
17 The average loyalty (i.e. duration) of a health plan member on the exchange is KLAS Confidential 2014 KLAS Enterprises, LLC. 17 All Rights Reserved
18 18
19 MEMBER ENGAGEMENT LIKE TRAINING? 19
20 NOTABLE SHIFTS IN HEALTHCARE STRATEGY Information Technology: from products to solutions From installation/implementation to adoption From applications/products to SaaS, hosting, and technology enabled services Consumer Engagement: from B2B to B2C Providers: from hospital service lines to patient satisfaction, patient engagement Payers: from managing risk to member engagement, wellness Business: from operations to outcomes Model and operations changing from FFS to P4P From providing patient treatment to creating consumer demand 20
21 What should we learn from Exchange the market about how to prepare for the future? KLAS Confidential 2014 KLAS Enterprises, LLC. 21 All Rights Reserved
22 LESSONS LEARNED / PILOTS YOU VE DONE 22
23 QUESTIONS Copyright KLAS 2015
24 Healthcare Providers & Payers: Share with KLAS Your Voice and Experience Joe Van De Graaff KLAS Confidential 2014 KLAS Enterprises, LLC. 24 All Rights Reserved
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