How to Develop Innovative Solutions That Drive Patient Behavior Change

Delivered at the World Congress 2017 Medicare Marketing Summit in Orlando, this briefing talks about how health insurance plans must develop multi-stakeholder engagement strategies to improve operational efficiencies and support a value-based consumer design. The key takeaways were how to:
* Leverage a multi-institution approach to understand the consumer’s needs, how they are utilizing care, and their preferences for engagement
* Discuss how to engage stakeholders across the health care industry to improve personalization and deliver the right messaging to members at the right time
* Develop strategic alliances that differentiate your brand and build trust through enhanced provider affinity
* Use AHIP’s Innovation Lab to solve innovation challenges: https://www.ahip.org/innovationlab/

Transcript

1. Develop Innovative Solutions That Drive Behavior Change Through Multi-Stakeholder Engagement Shahid N. Shah Entrepreneur-in-Residence AHIP Innovation Lab
2. www.netspective.com 3 @ShahidNShah HealthcareGuys.com Who is Shahid? • Technology Strategist and Entrepreneur in Residence (EiR) for AHIP’s Innovation Lab https://www.ahip.org/innovationlab/ • Chairman of the Board at Netspective Communications and Citus Health; Publisher at Netspective Media and serial entrepreneur. • Angel investor, board member, in several digital health and Internet startups. • 25 years of software engineering and multi-site healthcare system deployment experience in Fortune 50 and public sector (Fed 100 winner). • 15 years of healthcare IT and medical devices experience (blog at http://healthcareguy.com) • 15 years of technology management experience (government, non-profit, commercial) Engineer, strategist, entrepreneur, investor, author, and journalist
3. www.netspective.com 4 @ShahidNShah HealthcareGuys.com What’s this talk about? Background The health care consumer’s decision power is growing as individuals take more leadership in the care they receive. In order to meet the demands of today’s consumers, health plans need to transform to create member-centric approaches to health and wellness. But this cannot be accomplished by focusing on one entity (the consumer) alone. It requires a new way of thinking about innovation. Key takeaways Health plans must develop multi-stakeholder engagement strategies to improve operational efficiencies and support a value-based consumer design: • Leverage a multi-institution approach to understand the consumer’s needs, how they are utilizing care, and their preferences for engagement • Discuss how to engage stakeholders across the health care industry to improve personalization and deliver the right messaging to members at the right time • Develop strategic alliances that differentiate your brand and build trust through enhanced provider affinity Use AHIP’s Innovation Lab to solve your innovation challenges: https://www.ahip.org/innovationlab/
4. www.netspective.com 5 There will be no disruption of the healthcare “industry”. But small portions can be impacted. Positively.
5. www.netspective.com 6 @ShahidNShah HealthcareGuys.com Why is disruption in healthcare so hard? This is $1 Trillion and the Healthcare Market is three times this size This is $1 Billion
6. “What's not going to change in the next 10 years?” Jeff Bezos
7. What's not going to change in healthcare? Do no harm, safety first, and reliability effect on standard of care Statutory cruft & regulatory burdens increase over time Government as dominant purchaser Outcomes based payments intermediation & pricing pressure Eminence & consensus driven decisions as collaboration increases Increased use of alternate sites of care
8. www.netspective.com 9 @ShahidNShah HealthcareGuys.com Inflective vs. Reflexive Innovation “we need uberization of healthcare” “we need to disrupt healthcare” “how would elimination of co-pays increase utilization?” “how can improving provider affinity increase member satisfaction?” “we need to buy more digital health tools” “how can we pay non-clinicians to handle more patient-facing tasks?”
9. www.netspective.com 10 http://www.stripes.com/va-nurse-practitioners-nationwide-no-longer-need-physician-supervision-1.445862
10. www.netspective.com 11 There is an innovation crisis in the healthcare insurance industry because of reflexive innovation focus. The reasons why are complicated. 
11. www.netspective.com 12 Intermediation continues to grow Payers, employers, public sector not incentivized to change long term behaviors (new incoming administration indicates decentralization from Federal to State, potentially impacting incentives)
12. www.netspective.com 13 http://jamanetwork.com/journals/jama/fullarticle/2594716 No one funding entity or insurer has beneficiary long enough to be accountable for long-term care
13. www.netspective.com 14 Rahul Dubey AHIP SVP The AHIP Innovation Lab (“IL”) is a proven value-add/free service for AHIP Payers/IDN Members to help alleviate the innovation crisis, by discovering innovation inflection points. Explore multi-stakeholder multi- institution (MSMI) ecosystem challenges and “stated needs” one member at a time (or with their partners) Consumer | Payer | Provider | Pharma | etc. Individual Members Bring Their Unique “Stated Needs” First, IL is a “Think” Tank Then, IL is a “Do” Tank using “Solution Working Groups” (SWGs) Facilitate Implementation Document PTBSs & JTBDs Discover Inflection Points Document Innovation Strategy Assist with Business Cases IL Facilitates Innovation IL Connects Innovators Ecosystem Partners AHIP Member
14. www.netspective.com 15 @ShahidNShah HealthcareGuys.com Insurer defines desired outcomes, IL coordinates Understand management objectives based on desired outcomes Consider using Objectives and Key Results (OKRs) framework for defining outcomes Understand problems to be solved (PTBSs) For each PTBS, understand Jobs to be Done (JTBDs) and journey mapping (JM) Figure out how to model the PTBSs and JTBDs in simple spreadsheets or real simulations Eliminate as many JTBDs as possible through policy or process redesign For JTBDs remaining which cannot be removed (regulatory, statutory, business model, etc.) list remaining PTBSs Find or create solutions, based on remaining PTBSs, JTBDs, and JMs Test your hypotheses against the models and simulations and keep what’s evidence driven These are your “stated needs” (which you’ll use to influence demand)
15. AHIP IL Marketing Solution Working Group (“SWG”) Case Study An innovator’s primary job is to define desired outcomes tied to inflection points
16. www.netspective.com 17 Source: The Myers Group Plan marketers are focused on: • Consumer engagement • Member acquisition • Member retention • Network management • Value based care The marketing strategy needs to be: • Population specific not generic • Personalized to members • Done when member expects it, not when plans deem it necessary • Incorporate various constituents such as healthcare delivery organizations, healthcare professionals, patients, and their caregivers
17. www.netspective.com 18 @ShahidNShah HealthcareGuys.com Populations need different engagement styles • Obesity Management • Wellness Management • Assessment – HRA • Stratification • Dietary • Physical Activity • Physician Coordination • Social Network • Behavior Modification • Education • Health Promotions • Healthy Lifestyle Choices • Health Risk Assessment • Diabetes • COPD • CHF • Stratification & Enrollment • Disease Management • Care Coordination • MD Pay-for-Performance • Patient Coaching • Physicians Office • Hospital • Other sites • Pharmacology • Catastrophic Case Management • Utilization Management • Care Coordination • Co-morbidities Prevention Management 26 % of Population 4 % of Medical Costs 35 % of Population 22 % of Medical Costs 35 % of Population 37 % of Medical Costs 4% of Population 36 % of Medical Costs Source: Amir Jafri, PrescribeWell
18. www.netspective.com 19 Each member population requires different engagement techniques based on various facets. Treating members in a personalized approach increases engagement.
19. www.netspective.com 20 @ShahidNShah HealthcareGuys.com The Reflexive Plan Marketing Approach Insurer | Payer Product 1 Product 2 Product 3 Target: : Member Centricity Each member population requires different engagement techniques at various times. But is “Omnichannel” enough?
20. www.netspective.com 21 @ShahidNShah HealthcareGuys.com The Inflective Plan Marketing Approach (via SWG) Insurer | Payer Product 1 Product 2 Product 3 Target: : Influencer Marketing via Provider Affinity Each member population get personal care through their provider or other advocate, enabled by health insurer tools and support. Provider 2 Provider 1 Influencers Caregiver
21. www.netspective.com 22 @ShahidNShah HealthcareGuys.com How influencer marketing via provider affinity works Analyze high cost, high impact targets (not necessarily by looking at demographics) Design incentive plans for providers to participate as influencers Design incentive plans for members to work through influencers and advocates Create engagement tools for health institutions, caregivers, and clinicians Activate health institutions, caregivers, and clinicians Let influencers engage patients or caregivers by extending tools to them Let patients engage caregivers or vice-versa through their influencers and advocates Track outcomes and results of programs through active telemetry across the network 1 The AHIP Innovation Lab can work with you and your partners to develop specific programs and find solutions.
22. www.netspective.com 23 @ShahidNShah HealthcareGuys.com Advocate and Influencer Marketing discussion It’s the right thing to do… • Word-of-mouth recommendations are the primary factor behind 20- 50% of ALL purchasing decisions (McKinsey). • 73% of Millennials feel it’s their responsibility to help their friends and family makes smart purchase decisions – Fleischman-Hillard and Hearst Magazine via @caroberry. But… • Who are the influencers for the behavior you want to encourage – whether it’s buying a plan, picking a product, choosing a physician, or understanding a network – Are they physicians? – Are they nurses? – Are they care givers? – Who are they? • Old style personas based on demographics are not enough but what can you use to discover influencers? The AHIP Innovation Lab can work with you and your partners to explore emerging practices and get answers.
23. www.netspective.com 24 LINQIA “The State of Influencer Marketing 2017” Survey The AHIP Innovation Lab can work with you and your partners to explore emerging practices and overcome challenges.
24. www.netspective.com 25 LINQIA “The State of Influencer Marketing 2017” Survey The AHIP Innovation Lab can work with you and your partners to explore emerging practices and get answers.
25. www.netspective.com 26 Source: Optum “Member Centricity” vs. “Provider Affinity” for consumer engagement Which one is driving demand for innovation versus responding to existing supply? Each member population requires different engagement techniques at various times. But is engagement with plan more important than intermediated engagement with provider? Picking the wrong channel creates confusion and reduces engagement. But, how important is all this compared to provider affinity associated with choices members make?
26. @ShahidNShah www.netspective.com 27 HealthcareGuys.com Marketing opportunities in new care approaches General Wellness Specific Prevention Self Service Physiologics Self Service Monitoring Self Service Diagnostics Care Team Monitoring Care Team Diagnostics Healthcare Professional Monitoring Healthcare Professional Diagnostics Hospital Monitoring Hospital Diagnostics Work with us at the AHIP Innovation Lab to discover how to explore marketing innovations around new models of care
27. Visit http://www.netspective.com http://www.healthcareguy.com E-mail shahid.shah@netspective.com Follow @ShahidNShah Call 202-713-5409 Thank You! This deck is available at http://www.speakerdeck.com/shah Need help with your innovation? Tweet, call or write to me.