A more consumer-centric approach to healthcare has caused health plans to forgo the communications strategies of old. Consumer-directed
benefit products such as health-savings accounts (HSAs) have caused consumers to shoulder more responsibility in making healthcare
choices to make their dollars go farther and to weigh carefully the cost, quality and necessity of the care they purchase.
Households having screening tests in past two years
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It creates a market landscape where knowing who those consumers are and then addressing them in ways likely to influence positive
behavior can make the difference between success and failure—a lesson learned by the once-monolithic financial industry and
that the healthcare industry, particularly the care management realm, should also take to heart, says Tony Glebe, co-founder
of Factorial LLC, a healthcare consulting and data services organization based in Minneapolis, Minn.
"What they [the financial industry] have realized is that there is a great benefit in knowing who your customers and prospective
customers are," Glebe says. "They want to make sure that whatever message they're trying to deliver to you, whatever action
they're asking you to take, is as tailored as can be to the person you are—that it's going to have the highest likelihood
of having an impact on your behavior."
Instead of talking down to customers and using a one-size-fits-all mass market approach, intelligent member communication
can maximize the limited interactions between plans and consumers by seeking to provide the right message at the right time
via the right communications channel. A TAILORED APPROACH
For instance, although plans may spend tremendous amounts of money on programs such as disease management (DM) or care management,
the programs' communications tend to treat individuals in a population—such as diabetes patients—as one in the same in terms
of the message delivered and how it's delivered. This causes plans or DM programs to miss a chance to save costs and to encourage
patients to modify behavior, such as complying with their treatment regimens, according to Glebe. Care managers could take
a page from the best practices of the financial services industry, which targets certain customers who have particular interests
with credit cards that build toward rewards or services that would interest the customer, he says.
"They proved that knowing your customer along with designing a tailored approach, has the greatest impact on individual behavior,"
Glebe says.
Tailoring an intelligent member communication approach that addresses a diabetic population would include providing ways to
simplify the process for a busy single mother whose children take priority over her insulin treatments; for someone who is
going through financial difficulties, information about community resources that can assist with payments would be provided.
Other steps would be to point out information about generic products, mail-order or samples available and assist in the necessary
administrative tasks to fill a mail-order prescription, all focused toward the goal of decreasing program costs and heightening
return on investment.
"With an increasingly crowded marketplace, the ability to leverage consumer insights to tailor care management interactions
will be the critical factor is separating the companies that will succeed from those that will fail," Glebe says.
Effective data gathering—the basis for predictive modeling or the segmentation of populations into targeted behaviors such
as smoking—provides a foundation for putting a face on those consumers. However, using predictive modeling and segmenting
populations are minor steps toward a greater knowledge of the customer for the healthcare industry, Glebe says.
"Nearly all of the identification that happens today is based upon a very narrow view of the individual, comprised almost
entirely of healthcare claims data," he says.
LIFESTYLE INCLUDED
Health plans and care management companies have been incorporating some information about an individual's lifestyle, demographics
and attitude available to and used by other industries as a step toward a more meaningful, rounded view of that person, but
the expense involved and the general insights provided by the segmentation data provide little guidance in correlating interactions
with individuals, Glebe says.
