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How to Develop Innovative Solutions That Drive Patient Behavior Change

Shahid N. Shah
March 06, 2017
150

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/

Shahid N. Shah

March 06, 2017
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Transcript

  1. Develop Innovative Solutions That Drive
    Behavior Change Through Multi-Stakeholder
    Engagement
    Shahid N. Shah
    Entrepreneur-in-Residence
    AHIP Innovation Lab

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  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

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  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/

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  4. www.netspective.com 5
    There will be no disruption
    of the healthcare “industry”.
    But small portions can be impacted.
    Positively.

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  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

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  6. “What's not going to change
    in the next 10 years?”
    Jeff Bezos

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  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

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  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?”

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  9. www.netspective.com 10
    http://www.stripes.com/va-nurse-practitioners-nationwide-no-longer-need-physician-supervision-1.445862

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  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. 

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  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)

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  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

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  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

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  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)

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  15. AHIP IL Marketing Solution Working Group
    (“SWG”) Case Study
    An innovator’s primary job is to define desired outcomes tied to inflection points

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  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

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  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

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  18. www.netspective.com 19
    Each member
    population requires
    different engagement
    techniques based on
    various facets.
    Treating members in a
    personalized approach
    increases engagement.

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  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?

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  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

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  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.

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  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.

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  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.

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  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.

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  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?

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  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

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  27. Visit
    http://www.netspective.com
    http://www.healthcareguy.com
    E-mail [email protected]
    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.

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