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My year of living wired (for health)
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My year of living wired (for health)

 My Quantified Self

2013 was a big year for me. I resigned as Chief Innovation Officer of a major insurance plan at the end of 2012 to pursue what I consider to be the culmination of things I have been working on for well over a decade. I call this Health Model Innovation. My technical definition for it is to develop profitable and sustainable business models by creating and realigning the activity systems that improve member experience, boost provider performance, and enable payer cost control. Simply put, my goal is drive start-up businesses and new product lines that create disruptive change in the healthcare space.

This alone will be a big challenge for me in 2013. But I also need to save some time focusing on my personal health. That’s why in 2013 I am publicly challenging myself to exercise regularly and validating my journey through verifiable data. That means I’m recording the exercise that I do so that I have the data about my progress. Based on Wired magazine’s Thomas Goetz and his work on the “quantified self”, I will be using several tools to reach health goals and track my progress.

The Power of Habit: Why We Do What We Do in Life and BusinessSo you all know, I am fully aware that no one besides myself and my wife and child care about this endeavor – but my hope is that my fear of public shaming for not sticking to my guns pushes past my desire to take a nap or procrastinate. Moreover, I want this to be a sustained effort. I am a big believer in the power of habit, so I am trying to re-establish a good habit of daily exercise through the combination of incentives and dis-incentives – and a little bit of fun along the way.

Getting the Data

Nike+ FuelBand

To get the data I want, I need to start with a pedometer. Better yet, an accelerometer. You might be asking, “Kevin, what is the difference between an accelerometer and a pedometer?” Well, from a mechanical standpoint, accelerometers measure vertical acceleration, while pedometers are much simpler and only respond to vertical acceleration. Another difference is around $100 price point.

Nike Fuel BandSo, my accelerometer of choice is the Nike+ FuelBand. Keep in mind, I tested most of the major brands: the FitBit Classic, the BodyMedia FIT LINK, and the Striiv Smart Pedometer. First, I wanted something that was simple. Second, I wanted something that was unobtrusive. Third, I wanted something I would remember to carry with me at all times. For these reasons I settled on the Nike+ FuelBand – however, I am not sure the Nike+ FuelBand is as accurate as the FitBit, as it seems to count movement that I do not consider exercise – like typing up a new BLOG.

In any case, this is what I will be wearing to collect data on my exercise whether I’m doing P90X, running or sweating it out at boot camp in the morning.

Xbox Kinect

Another means to acquire data is using my Xbox Kinect. By now if you are unaware of what these nifty little devices do, you really must get out more. The Xbox Kinect is a motion sensing “camera” that inputs data into the Microsoft Xbox 360 video game console. At its launch in 2010, it set the Guinness World Record for being the “fastest selling consumer electronics device” with 8 million units sold in its first 60 days.

Along with the device though you need a game. I bought the new Nike+ Kinect Training. This game “creates a personalized, dynamic workout program based on your body, performance, fitness goals, schedule, and level of commitment.” You can check it out here. So far I like it.

 

The Workout

I was an athlete in college, and I am far from that now. I sustained a pretty severe back injury and my flexibility is something I am constantly fighting with. Moreover, I am pretty busy with work and being a father and husband. Finally, I can get bored doing the same thing too long.

So knowing all this – I have opted for a mix of the workouts provided in P90X (although not all of them), the Nike+ Kinect Training Game, riding my bike 1X per week, running 2X per week, and trying to do Yoga 2-3X per week.

Staying Motivated

For me, staying motivated is a mix of incentives and dis-incentives. The dis-incentive part is my public commitment to track and publish the data of my workouts and write about my progress on occasion. Fortunately, my Nike FuelBand publishes the data “auto-magically” for me, as does the Kinect game. I also need to mark things in the – old fashion way – and send a tweet now and again. So if you do not see a tweet now and again about my workouts – send me a not-so-gentle reminder. Finally, I am using some wellness apps to help me set goals, record progress, and win prizes.

RunKeeper

RunKeeper1

RunKeeper is a mobile app and website that helps keep track of running, walking, biking activities. Since running and riding my mountain bike are part of my regimen, I might as well track them and compare them against my friends. I also gave myself a goal inside of Run Keeper – to run in a 5K race by Feb 23, 2013. I think I may need to push that out a month or so.

There are several useful and cool features that RunKeeper provides. First, I can look for a local 5K to run in. I wanted to select the GATE River Run on March 9th (yes, I know that is past the 23rd) and then I remembered I will be at SXSW in Austin, TX at that time. I will need to keep looking for something that fits my goals and my schedule.

RunKeeper3

The second useful feature is a training plan. I signed up for the Beginner 5K plan that Mike Deibler M.S., C.S.C.S put together. Sweet!

RunKeeper2

Finally, I downloaded the iTunes App and uploaded it to my iPhone and iPod Touch that I will carry with me when I run.

Everymove

I also joined Everymove. This is part of the incentive portion of my program. My reasoning is if I am going to exercise anyway, I might as well get some rewards for it. I looked at several of these reward programs – CoolLeaf, ShapeUp, Trim Challenge, and a few more. The idea behind these companies is connecting health and wellness related vendors with consumers in a manner that drives access to discounts through activity. In some cases, they get employer and insurance companies to sponsor and even subsidize “points” that their employees and members earn for healthy behavior. It works well with airlines and hotels, why not health?

Everymove Logo 1

Nike Missions

Finally and just for fun, I am going to try out the Nike Fuel Missions. Nike has once again taken things to the next level by integrating their activity tracking products with a game that is powered by the user’s activity. This is something much bigger than Microsoft Kinect. Take a look.

Final Words

So as I get ready to embark on this journey, I ask that you all feel free to keep me honest and motivated. Here is to a healthy and happy new year for all of us.

 

To your health,

The Team at imagine.GO

Does Healthcare Need a Chief Experience Officer (CXO)?
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Does Healthcare Need a Chief Experience Officer (CXO)?

Do Healthcare Companies need a Chief Exp. Officer?

What do I mean by Experience? Great customer-focused companies have built their business around the voice and perspectives of their customers. Healthcare companies, more specifically health insurance companies, are typically not primarily viewed as consumer-centric entities. The Affordable Care Act is a major impetus in changing healthcare from an almost industrialized, business-to-business modality to a retail one. This change is also driving healthcare companies to adopt the best practices of big box retailers and banks. One of those practices, albeit still somewhat new, is to have a C-level position dedicated to bringing emphasis on the customer to the forefront, as well as to govern the traditional business in how they “go retail.”

I advocate that all healthcare companies follow suit – provider, payers, and everyone in between – and create a Chief Experience Officer or Chief Customer Experience Officer.

Forrester has done some great research (April 2011 “Customer Experience Index, 2011: Health Insurance Plans”) on how customers feel about various industries. In 2009 health insurance ranked near the bottom at 51% – in 2011, it remained relatively unchanged – at 53%. What makes it worse is that other forms of insurance, like auto and life, rank much higher at 72%, so there should be no excuse for the healthcare companies to be satisfied with status quo. To also be perceived as lower than the cable companies is shocking, as it is nearly impossible in my experience to find someone who thinks they create great customer experiences.

Source Forrester Research
Source Forrester Research

Too many companies equate customer experience with customer service (or support). Service is a part of what makes a great overall customer experience. Experience is a lot more than just service and is certainly more than just a measure of your “first call resolution.” If you are more worried about solving the problems you create, as opposed to ceasing to cause problems altogether, you have missed the boat. Furthermore, if you consider “first call resolution” to technically be a good experience when the customer stays on the same phone call but talks with 3 or 4 “support specialists” and managers then you have again missed the boat.

WIKI defines “customer experience” as: “the sum of all experiences a customer has with a supplier of goods or services, over the duration of their relationship with that supplier. From awareness, discovery, attraction, interaction, purchase, use, cultivation and advocacy.”

This works for me. What is to be understood from this is that many single experiences accumulated together provide an overall customer experience, which in turn drives the attitudes and behaviors of a customer towards a company. Let’s take a look at what this might look like for an average healthcare consumer.

A Consumer’s Healthcare Vignette

Sam is employed and has his benefits through his employer. His company has sponsored an annual worksite wellness event where Sam gets his blood glucose and cholesterol checked. Sam also plans to get a full diagnostic screening using ultrasound technology sometime this year from his in-network primary care provider.   He also scheduled an annual physical that includes a full blood lipid panel workup. Additionally, Sam has access to a kiosk located in his worksite clinic to check and report on his glucose levels. He also has a WebMD account through his employer but chooses not to use it because he perceives it as too complex. Sam’s wife gets a mailer from their insurance company inviting them to come in at the newly opened insurance retail center. If they do so – they get a free screening.

None of these experiences communicate to each other electronically, and none of them automatically or conveniently store Sam’s data in his Microsoft Health Vault account.

Because his previous annual physical showed a high glucose score, Sam was identified as pre-diabetic. He has received messages and calls about pre-diabetes care options from a “consultant” at his insurance provider. He wonders if this nurse works for his doctor and if not, does his doctor know she is calling and what she is saying. He wonders if his doctor would agree?

This only gets more confusing the more we go on. Consumer oriented or consumer focused companies understand and plan for an intentional customer experience. To drive a consistent customer experience (a branded experience) across all of your channels, you need someone in control who has both the purview and the spine to get things done. This example is where a Chief Experience/Customer Experience Officer comes in.

What is a Chief Experience Officer?

Chief Customer Officer: Getting Past Lip Service to Passionate ActionThis C-level position is most commonly referred to as the Chief Customer Officer (CXO), though other titles are used: Chief Client Officer (at OptumHealth), Chief Experience Officer (at Cigna), or Executive Vice President, Member Experience (at USAA). What is important to note is that these individuals are empowered to design, orchestrate, and improve customer experiences across every customer interaction.

In The Rise Of The Chief Customer Officer, a report by Forrester Research, they looked closely at this growing corporate trend. In summary, the report found that the role is far beyond just fixing the problems of unhappy customers. It is ultimately responsible for determining how to accelerate the practice of customer-centricity throughout an organization by teaching the techniques and building the capabilities that are needed to serve a consumer. This report, like many reports that deal with change management, also echoes the need for change to stem from the executive management team, which brings the impetus for change to the company and the customer’s voice into the boardroom.

In Chief Customer Officer – Getting Past Lip Service to Passionate Action, the role of the CXO is defined as:

  • Influence agreement on what and how to deliver the greatest value to customers
  • Establish metrics for defining relationships and value creation with customers
  • Drive accountability through the organization for those data and metrics
  • Clarify a common approach and process for driving the work across the organization

The Key Takeaways

So what should you get if your take the leap and create your own CXO role?

Better Design

You cannot have a good experience without good design. The CXO must be a believer in the principles of User Centered Design and invest in bringing those techniques into their company. In this role, creativity – not productivity is the key to business success. In my opinion, the incumbent should serve as the chief design officer as well. It does not mean that the CXO has to be a great designer, but they must appreciate the need for great design, recognize when they do not have it, and push to ensure they get it across all touch-points. This consistency can also be served by having a strong partnership with the brand team and brand officer.

Better Consistency

Consistently clear messages and appealing design only come when a company has a common design language and consistent design principles. If your company does not integrate the communications and consumer experience efforts, you will send mixed and probably confusing signals to your customers – without even trying. Brand is brand, and should stay that way. But ensuring the promise of the brand is delivered in a consistent and clear way, across channels, synchronized for maximum effectiveness, requires a CXO, in partnership with business operations and the brand team, to bring it to action.

Better Transparency

Consumers’ standards for clarity have changed. Regardless of what industry you are in, the best-in-class retailers are setting your customers’ expectations for a clear understanding of your products, their price, and what you are going to do when something goes wrong. But it is complex to deliver a good customer experience. Forrester analyst Liz Boehm says it best when she states the goal “it is not simply to provide what the consumer wants but provide it in a way that gives them information about something they might not want to understand.” Your customers expect you to have access to the same information about them as Amazon does, and the same winning attitude as Zappos does. Chances are that you are probably not there on either count right now. The role of the CXO is to bridge the communication gap and close the consumer’s disconnect between expectations and reality.

Can it work at a legacy Healthcare company?

How do we make it (customer experience focus) work?  This question is a far better question for healthcare companies to ask then- can it work? For any healthcare company that is preparing to conduct business in an environment impacted by reform, the voice of the customer is, and should be, a priority. I advocate here to create the role and office of a CXO to drive, help lead, and manage your company’s journey towards ensuring that the customer’s perspective is always brought to the forefront, storefront, and boardroom for consideration in all business decisions.

It bears repeating that the CXO role is not a senior support role. A company should not, as Forrester’s research indicates, rush to appoint a CXO in the attempt to solve poor customer satisfaction ratings. As Hagan suggests in his HBR article, creating a CXO requires three preconditions for success:

  • a mandate to differentiate based on customer experience, preferably from the CEO,
  • a portfolio of successful projects that create buy-in across the organization, and
  • a uniform understanding on the leadership team for what the position can accomplish.

While all retail companies must place emphasis on their customers’ perspective, a brand new C-level position may not always be necessary. As Manning states, the work of the CXO function is vital to achieving customer-centricity, but may be able to be fulfilled by an existing executive dedicated to overseeing and linking different functional groups, with the ultimate objective of maximizing customer and corporate value. Whether you appoint a CXO or not, it is clear that healthcare companies will benefit from a single executive, sitting on the executive management team, focused exclusively on the customer experience.

Some quick tips to get started

I plan to write more on these later but should you decide to create a CXO role here is a basic

6-step plan to get you started.

  1. Announce the Role and its Premise
  2. Design the Framework in which the role it will Exist and Operate
  3. Define the Resources internal and external to the Department
  4. Explain the Process, Tools, and Techniques that will support the framework
  5. Outline the Governance model for the strategy and work
  6. Publish the Metrics for Measurement

 

Here are some other good sources on Customer Experience.

 

To your health,

The Team at imagine.G

 

Disrupting the Disrupters in Health Insurance
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Disrupting the Disrupters in Health Insurance

A Quick History of Retail Health

In the mid-2000s, I was part of a disruptive movement in healthcare to build nurse practitioner run clinics within grocery store settings. These clinics, called convenient care clinics (CCCs), in essence, are limited in scope (acute care, minor illnesses, and preventative healthcare services) and located in retail stores, supermarkets, and pharmacies. The idea was that the market needed to expand distribution of these types of services to meet demand and that by building them in locations close to where people live and work, and not require an appointment for  medical care. This movement was dubbed Retail Health at the time and led by Minute Clinic, Take Care Health, and others. I helped three of these CCCs – two were quite successful, one not so much.

Retail Health disrupted again when insurance companies started building retail stores to attract consumers and sell their insurance products. To my knowledge, the first of these was done with the largest insurer in Florida. I was at Florida during the expansion of these stores and saw them grow in both usage and size. They started out in the 800sq. feet range and now are free standing 5000 sq. feet buildings. The idea here is that a company that is facing a shift to a retail market as a means to establish positive brand awareness directly with consumers by creating a retail location where customers can buy and receive service for their insurance products.

Source: Minute Clinic
Source: Minute Clinic

Selling Insurance to the Consumer Market

Since the first store was created, many have followed suit, albeit with differing store footprints and models. Some of these are UnitedHealthcare, WellPoint (Anthem), Highmark, many of the blue plans, and Humana. Humana actually started with a partnership with Max-Wellness stores and opted to try a different approach.

Could this be the equivalent of the beginning of the “burger wars”? What is also telling is the number of large and regional insurers that are in a “wait and see” approach – not yet ready to commit the resources to a direct retail footprint. I would expect to see others follow suit in the coming years, but with a mix of smaller and kiosk-related storefronts. GuideWell has also innovated even more by creating one of its retail centers as a member clinic under the blue umbrella. Early signs look like this idea is getting a good reception by members.

These retail “centers” are designed to sell to individual consumers. Companies that are pursuing this channel as a key element of their consumer strategy feel this model provides three competitive differentiators:

Reduce Sales Cycle

1. It shortens the sales cycle – Buying insurance is confusing, and even frightening to many. It is an expensive product with little consumer understanding, and poor “user documentation.” Having a high-touch sales rep there to explain all of the options and implications will create a better sales experience for the consumer and in all likelihood shorten the sales cycle.

Reduce Post Sales Service

2. It cuts down on post-sales service – because consumers are in theory more informed about the product they have just purchased, post sales service should correspondingly be less. Ask any insurer and they will tell you – it is expensive to provide customer service for their products. The current model is equivalent to a doctor treating the symptoms as opposed to the source of a sickness. Regardless of industry, most service issues are a result of poor consumer information leading to lost expectations.

Increase Consumer Trust

3. It creates a high level of trust – Health insurance is not a high margin business, and new regulations are greatly restricting how much insurers can make and spend on non-medical related costs. For insurers to make the revenues they need to survive, they must sell additional, or “ancillary” products. Upselling directly correlates to consumer trust. No consumer will buy more from a vendor that has given him or her a poor product or poor experiences. If the high touch environment is better at informing the consumer about the product, which leads to better satisfaction and usage of the product, it stands to reason that trust will be increased as well. With more trust comes the opportunity to upsell. This is true in any retail market.

Useful for Small Employers

These retail stores also make a great outlet to serve small business. With the implementation of the Reform Act, it is highly anticipated that most small employers will send their employees to find insurance on the exchanges. In this environment, retail centers can be a real benefit to individuals who in many cases have never had the advantage of a fully dedicated HR manager or benefits advisor helping them with their healthcare decisions. The centers in effect can become an outsourced human resources department, wellness center, and benefits advisor all in one.

Florida Blue Center
Source: GuideWell

Disrupting the Disrupters

So where is this trend headed? I had the opportunity to give some market advice to an interesting retail health startup out of Tennessee called Bernard Health. The basic gist of their model is to sell insurance directly to consumers via retail outlets through salaried sales reps, not commissioned sales and service reps. They are concentrating on the Medicare Market.

These retail locations are similar to ones created by the insurance companies but different in two major factors. First, they are not selling their own product. Second, is their store footprint.

Source Bernard Health
Source Bernard Health

The Best Insurance Product for Each Customer

On point one, because they are selling the best product available for the customer they are working with, and not their best product, they, in theory, have a higher trust factor with the consumer. Couple this with the fact that their reps are salaried and not commissioned, and you have an interesting model. When last I spoke with Bernard Health, they were tracking 50 appointments per month, which was on par with traffic seen by benchmarking against similar retail settings, like a Jackson Hewitt store. It would be interesting to see the close ratio per appointment of their sales team versus a branded store by one of the big insurers. Do shoppers at the branded insurance stores purchase the product available because they like Trane, or do they go to get information and then comparatively shop it elsewhere?

Built to Be Profitable

The second difference is the store footprint. I know some of the blue retail stores in Florida are in the 5000 square foot range. They are quite nice. And their experience is a good one. Compare this against Bernard Health’s much smaller retail location. I am not certain you can even sell enough individual plans to pay for the large, or every medium sized store but perhaps they offer a better channel for customer service. Most insurance companies rate in the 70% satisfaction range for the call centers. These retail settings are much, much higher.

Are These a Good Idea?

Will they have any success? This profitability is yet to be seen. They do not have the marketing budgets that the majors have, but they have the “trust” advantage on their side. Insurance is one of the least trusted industries in the country. Having a non-biased advocate to help you make sense of the system may be just what the doctor ordered. I wish Bernard Health, and all of these retail health efforts the best of luck and a prosperous 2013.

 

To your health,

The Team at imagine.GO

Applying Personas to Healthcare
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Applying Personas to Healthcare

Do Healthcare Companies Need Customer Personas?

I just wrapped up giving a condensed version of my Workshop 1a – Claim your customer at the 4th Annual Medicare Advantage Strategic Business Symposium in San Juan, Puerto Rico. It was a fantastic group, and we all learned from each other. Participants ranged from major insurance plans to renowned hospitals, and everything in between.

We went through how to create personas specific for a Medicare market so that product developers at these companies will be able to create something that is meaningful for a specific audience. You can see my intro deck here.

 

According to John Pruitt, personas are “detailed descriptions of imaginary people constructed out of well-understood, highly specified data about real people”.

Every healthcare company should become familiar with and practice the discipline of persona development. This realization is a result of The Affordable Care Act changing the market from wholesale to retail. As I have said many times before – retail means a focus on the consumer’s wants, not your products. As consumers are offered a choice of competing products, healthcare companies need to create offerings that have a clear value proposition or risk losing share.  A standard method for persona development looks something like the following:

Healthcare-focused Consumer Personas

But person creation for healthcare, in my opinion, has some points to keep in mind, which I refer to as tenants.  I describe these in brief below, but I will focus on them in depth in future posts.

Tenant #1 – All of this Exists in an Ecosystem

All of this exists in an ecosystem, only some of which is in your control.  A good persona has detail about the user’s needs, attitudes, and behaviors, and a great one includes the most important and relevant influencers as well. Outside of the patients themselves (note: I did not say member or customer), healthcare influencers in my model are comprised of:

  • The provider – including all care providers and health information providers, such as doctors, family members, Oprah, Google, …
  • The payer – this is the insurance company and their intermediaries, such as brokers, employers, government, organizations, …
  • The purveyor – or those entities selling the products and tools we need to get and stay healthy, such as the pharmaceutical companies, Nike, gyms, trainers, …

Your personas must take into account the dynamic of this ecosystem and provide insight into how the person is influenced in a positive and negative way about their health and your product(s). This will help not only the product designers but also the product marketing team later down the road.

Tenant #2 – You are a Retailer Now

Dear healthcare company, you are a retailer now, get used to it and act like one. As I mentioned earlier, the healthcare market is being forced into a retail setting. This is not just for the payers but includes the care providers as well. Groups like The Cleveland Clinic and Mayo figured this out early on and established themselves as the Zappos of their trade.

It is important for companies new to retail to understand that retail has its own rules – and the customer has the advantage. According to Willard N. Ander and Neil Z. Stern in their book Winning at Retail: Developing a Sustained Model for Retail Success, a successful retailer will only try and sell to one value position, and customers who prioritize that value position will shop at them. This means you can be Wal-Mart, or Target, but not K-mart.

One of the axioms of direct-to-consumer business is that you cannot be all things to all people. This means no more talking about your Medicare market as Over 65. The diversity of people over 65, in their health, and health knowledge, and how they shop is varied. Lumping them into one market with one set of products means you will be meaningless to all.  It is time to pick a horse and commit to the race.

Tenant #3 – Customers Behaviors Vary

Your customers attitudes (may) stay the same, but their needs and behaviors do not. People do not think of their health holistically. Instead, they break things down into jobs-to-be-done, as described by Clayton Christensen.  A single person, based on their changing health jobs-to-be-done and knowledge specific to them, can change their behavior and attitudes.  This means that the same person you lump into one segment can have very different behaviors associated with the different aspects of their health.

Smart healthcare companies have to realize this. Infinite customization of health products is a pipedream at this point. But matching a product to a like grouping, and being flexible enough to modify interactions based on a current job-to-be-done is crucial for creating lifetime customers, and the resulting value a company gets from that.

To Thine Own Self Be True

Healthcare companies, as all good retailers must know what they are capable of and should optimize their capabilities to 1) create meaningful value exchanges with customers around a specific value position, and 2) capture all of the data involved in a consumer making a purchase decision, not just the outcome of that decision.

You cannot just have a traditional “enROLLment” system.  Instead, you need a “ROLLing” system that moves with the customer through their health decisions, capturing all of the nuances along the way – and then uses that data, and some logical inferences, to create relevant and reasonable predictions for additional consumer needs.

More to come on all of this soon.

 

To your health,

The Team at imagine.GO

The World Needs Legacy Healthcare Companies and Start-Ups Working Together
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The World Needs Legacy Healthcare Companies and Start-Ups Working Together

A Model for Innovation in a Legacy Healthcare

Healthcare companies are trying to be innovative – but are their very natures preventing them from realizing success? My question is a simple one – how can you take the best of what is necessary and combine it with the best of what is available and form something both new and necessary?

The Premise

Can you make gold from lead? Actually, it turns out that you can. It really is possible and has been done at Yale University in the 1970s. However, it turns out that it takes significantly more energy (and cost) than it is worth in return. Juxtapose this with the question, “Can a legacy healthcare company be agile and innovative enough to change itself and its environment?” And even if they can turn themselves into “gold”, is it worth the cost? Start-Up

The Hypothesis

I believe we must combine the necessary with the available and pick the best source for each – and work very, very hard to ensure they grow, together. We know that healthcare is approaching a “cliff” – and the hands at the wheel are the same ones that helped create the current dysfunctional system. This includes the patient, as well the insurance plans, the care providers, and the purveyors of all things health-related (like pharmaceutical companies). We know that we must alter course. The Affordable Care Act has given the impetus to force a change. But to change course, we need to change the system. The system, like a living being, is interconnected and will resist change applied externally. Moreover, change to any one part of it without consideration to the impacts on the rest of the ecosystem is futile. As the laws of physics tell us, things at rest tend to stay at rest. Businesses are similar. Unless there is an external catalyst forcing movement, companies, like objects, will stay put (and stagnate). There is an alternative to innovation at gunpoint – it comes in the form of taking a proactive approach to change. However change from within is really, really hard to do. But it can be done. Why not combine the best parts (contributions) of a start-up company with the necessary (working) parts of a legacy company to form agile, yet comprehensive, solutions to the dilemma? I believe this can be done through 3 simple steps:

  • Place innovation front and center by embracing the successful attributes of start-ups,
  • Create ecosystems of stakeholders that include patient, provider, and plan, and
  • Simultaneously find the operational efficiencies needed to address rising costs.

I know this works because I have done it. But it takes a lot of effort to start the process for a breakthrough.  It takes even more energy and communication to keep it going.

 

To your health,

The Team at imagine.GO

Maximize Consumer Engagement via Technology
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Maximize Consumer Engagement via Technology

Maximizing Member Engagement Through Technology

In the spirit of the Christmas season, I will be (re)giving a talk entitled Maximizing Member Engagement through Technology. This will take place on December 19th at 2:00 pm ET.

This webinar will cover a variety of efforts to connect with consumers in the marketplace, and how to use technology properly as both a channel and an experience. I gave this same talk this summer and it was so well received I was asked if I would do it again.

The Internet has transformed the way healthcare is managed and delivered. It significantly reduces costs, builds strong relationships with customers, and allows for tailoring of message on a faster delivery channel. As such, the question is not who is searching for health info online, but rather “who isn’t”?

My basic premise of this talk is that technology should serve as a means to help educate, navigate, plan, motivate and choose from suitable solutions for health care needs, anticipated and otherwise. If this sounds informative to you, or perhaps helpful to your own work – please join me.

What You Will Learn

During this webinar you will explore how a leading health plan developed these best practices and learn:

  • Optimize member engagement through technology.
  • Maximize the potential of retail health.
  • Increase member engagement through direct consumer marketing.

The webinar availability is guaranteed only to the first 250 registrations so if you are interested please register by clicking here.

To your health,

The Team at imagine.GO

 

3 Ingredients for Health Innovation
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3 Ingredients for Health Innovation

Healthcare Innovation Require Three Things

For well over the past decade I have made innovative healthcare companies my home. In that time, I have developed a simple litmus test to determine if the company I am working with is ready, willing, and able to create breakthrough innovation. Let’s call it my “3-legged Stool of Innovation Readiness.”  Like any three- legged stool, it cannot stand on only one or two legs – it takes all three.

An externality creating an impetus (Ready)

I have heard that only wet babies like change. While I am sure the part about the babies is true, I am not convinced that most companies are truly resistant to change. The inherent desire is there, which we will talk about next, but without some external force applying pressure, most companies will forgo change to focus on the problems of the here and now. I think of this as needing equal parts carrot (desire) and stick (impetus). However, very few companies are disciplined enough to apply their own stick. Ingredient number one of the three-legged stool is that impetus.

Look at the healthcare industry as an example. With the exception of those services rendered to consumers for direct cash payment (such as Lasik and liposuction), we have seen little change in quality or cost. In fact, many trends seem to point in the opposite direction. Now this is obviously not the entire fault of the healthcare industry – I have always argued that consumers are equally culpable. However like those folks that would rather eat potato chips and sit on the couch instead of getting out and exercising, companies do not often seek out a change in lifestyle – even when, change is necessary.

So along comes some outside force to require that change – The Affordable Care Act. Say what you will about its inability to address the underlying cost issues; Reform has forced the hand of the healthcare industry to do something about the problems at hand. And now that we are past the point of no return, these companies must act or potentially cease to exist.

Without PPACA, I am convinced there would be little or no room for disruptive innovators like myself within the “healthcare industrial complex”. As it turns out, we are now in high demand.

But even with the requirement to change, some companies are not willing to change. Many say they are but are merely paying lip service to that fact. Let’s talk more about that notion.

A real desire to change (Willing)

So the second ingredient is a deep desire or a sincere willingness to embrace change.

I have heard that addicts will not change their lifestyle until they hit bottom and bounce. I am not sure it is that drastic for healthcare companies. But obviously, a company must be willing to make room for new thinking and new thinkers before it can change.

Let’s take a lesson from science here. Consider that adding any catalyst to a mixture creates some reaction. However, most catalysts get used up in the reaction. If you are being asked to both implement a new disruptive idea and create a culture of change readiness (where none exists) at the same time – be forewarned. What I have found is that you do not want to be the straw that breaks the camel’s proverbial back.

What I mean by this is that to realize large-scale sustained change within a large company, you need an established platform for change in place. Staring from a cold stop requires all of your energy to just get the ball rolling, and leaves you no time or resources to implement your new ideas. So, if you find yourself in this scenario, ask yourself if you are primarily a “change agent” or an “innovator.” A change agent is willing to focus on creating the infrastructure required to sustain change and introduce new ideas –which may or may not be their own. This is noble work and requires a full commitment to the long-term culture of the company that one is changing. An innovator, as described in this discussion, is about creating new value and getting new ideas to market fast.

So, if you are primarily an innovator and you are focused on getting your idea to market quickly, without having the luxury of a change platform in place – you will likely meet roadblock after roadblock. And you will become frustrated. And you will want to quit or be asked to as you gain the reputation for not being able to “get anything done.”

So this cautionary tale is for both you the employee and for you the employer. To the employer, I recommend investing time and energy in facilitating change readiness so that you can bring change agents in and they will have success. For you the employee – make sure you know who you are and which role you are being asked to play. This will ensure your happiness and their success.

A means to invest in the future (Able)

So the final ingredient is the hardest to come by – ability. Even with the previous two (assuming they are ready and willing) – a company must be able to change. They must be financially stable enough to commit resources in the form of capital and talent directly to unknown or uncertain outcomes. For a company struggling to stay afloat, or concerned with the cost of upgrading their core “plumbing”, this can be a frightening and unrealistic necessity.

So know the environment you are going into and the one that you are in. If your company is not willing to dedicate at least 1% of their capability budget to innovation/R&D, then you will forever be chasing ideas and never implementing them. Great leaders like AJ Lafley from Procter & Gamble understood the need to invest in radical ideas. Ask your leadership if they are willing to “put their money where their mouth is” – with no strings attached.

A quick note of caution in this respect – if you are promised a budget based on other conditions (like finding savings elsewhere) – you are most likely not going to get it. We all know that overruns and unforeseen circumstances or priorities are common occurrences, and if you budget is relying on the efficiency and generosity of another group – be prepared.

A Final Note

When you find all three of these ingredients in a company – jump on the opportunity. My coming to Florida Blue (the Blue Cross Blue Shield Plan of Florida) in January of 2010 to be their Chief Innovation Officer, was predicated on their alignment with these three requirements for “breakthrough innovation.” As such, we were able to accomplish some amazing things and be counted among leaders in the healthcare payer space in innovation.

And if you are lucky enough to find all three ingredients, it is your job as an innovator and/or change agent to respect and nurture them within the organization. Ensure that you continually and effectively lead the clarion call for the importance and progress of your work. Congratulate your peers and leadership for their commitment to innovation, and remind them of their professional responsibility to advocate for, and push change in your company. Most importantly share in the victories you have created with and because of their sacrifices.

To your health

The Team at imagine.GO

Workshop on Health Consumerism
imagine.GO

Workshop on Health Consumerism

The Journey to Consumerism for a Healthcare Company

I will be speaking at the 4th Annual Medicare Advantage Strategic Business Symposium in San Juan, Puerto Rico on December 4-5 at the Gran Melia Resort where I am conducting a pre-conference workshop entitled “Member Engagement: A Journey to Consumerism for Medicare Health Plans”.

Design for the consumer is often overlooked as companies rush to build capabilities to fill mass-market needs for markets they do not understand. The push for a retail solution cannot bypass the need to understand who your customers are. The graveyard of poorly designed “consumer” health solutions reminds us of this fact.

The Workshop

The workshop will consist of a conceptual part and a practical part.

In the conceptual part of the workshop, we will be learning about the difference between Consumerism versus Retail, which I have written about before. And YES, there is is a difference. We will also look at what a retail market looks like for a Medicare health plan.

In the practical part of the workshop, we will be designing for a great Medicare insurance customer experience. To do this, we will be using the first part of my 3 part Collaborative Business Model Innovation Method For Healthcare. This visual language for healthcare system thinking, problem solving and solution design was designed to enable companies to quickly generate consumer focused business models and test them easily. The method is derived from years of healthcare experience delivering innovative solutions within both large legacy companies and entrepreneurial start-ups.

Healthcare-focused Consumer Personas

In our workshop, we will focus on defining your customer, creating a value proposition, and designing a customer experience.

We will then use some design thinking tools to help craft a value proposition for our exact customer.

And hopefully, if we have time, we will discuss how to then create an experience that will be meaningful for a consumer and result in a purchase decision.

We will start by defining which Medicare customer is the one we are focusing on – because they are definitely not all the same. This requires us to think in terms of their jobs to be done as well as our business needs.

I look forward to seeing you there. Contact me if you are interested in attending.

To your health,

The Team at imagine.GO

Sponsor Customer Teams Not Sports Teams
imagine.GO

Sponsor Customer Teams Not Sports Teams

The Current Marketing Model

Today I happened to notice the TV at the restaurant while eating brunch at with my family. The pre-game football fact was sponsored by Aetna and one of the football teams was sponsored by Florida Blue. It piqued my interest because at first it seemed novel, but as I thought more on it I wondered if it was a high-value use of marketing spend.

Recently, I have noticed the proliferation of health insurance companies sponsoring major sports franchises. As a marketer and capitalist, I get it – exposure to large audiences – but as a healthcare executive on the consumer side of the business, I hesitate. I pose this simple question, would it not be more sensible to invest advertising dollars in actual consumer sports leagues rather than professional sports? I believe that health insurance companies should sponsor sports, not sports teams.

Let me make clear, this is not a commentary on insurance companies – I recognize that as businesses they need to attract consumers and I feel they are a necessary part of the healthcare equation in America, and for the most part really do try to bring value to their customers. But with the affordable care act now in place, these traditional B2B companies are rushing headlong towards consumer markets. It is unfortunate that the advertising agencies they use have convinced them that their dollars are best spent associating their brands with Lebron James and Tiger Woods, as opposed to their actual constituents.

We did some research and found this interesting website that shows which companies sponsor what businesses. The graphic below from sponsorship.com is very telling – assuming it is accurate. Even without offering a total spend number, you can assume it is large as both professional sports and healthcare are big business.

Plan Sponsorship

 

Source: Sponsorship.com

Here are some examples of major insurance plans and their sports franchise sponsorships:

It even extends past the majors into college sports: Aetna sponsors the Taxslayer.com Gator Bowl in Jacksonville, Florida and Florida Blue sponsors the Florida Classic. Florida Blue also sponsors the Florida Sports Foundation which promotes Florida’s sports industry.

I am sure I missed more than a few, as this was just a basic search.

So, I asked myself, what is the motivation for an insurance plan to use professional sports as a brand booster? It must be two-fold, 1) the linkage with the sports as a model for healthy behavior and 2) brand differentiation via the association.

So, this is where the model breaks down for me. I can see Nike sponsoring pro sporting events as their constituents want to emulate the pro athletes that wear Nike gear. Seeing their favorite quarterback wearing branded wristbands results in a purchase decision for a young athlete. It also plays well for non-athlete fans that want to wear their favorite player’s jersey. A purchase decision ensures and the brand association works either way.

Now consider seeing a major insurer’s logo on a teams jersey, or up on the jumbotron. What effect does this have on influencing a consumer’s purchase decision? I would argue that the answer is resounding NONE. To be clear, I am arguing that a health insurer associating with a professional or college sports team has little or no bearing on a purchase decision by a consumer to buy or forgo an insurance product. Unlike the Nike example above, there is likely no transference of that brand association on a point of sale decision of one insurance product over another. One might argue that it actually has a negative effect in that with the perception of insurance premiums being so high – is that money better spent making insurance more affordable?

If this is actually not true – please someone show me, as I am very curious as to the true return on investment for this type of marketing spend.

A Better Way

There are some insurers that are actually focusing on sponsorship of sporting events that will likely result in healthy behaviors for their customers. This is a better model as it promotes the outcomes they most desire – healthy members. Remember, healthy people use health insurance products less than unhealthy ones do.  The result is a more profitable customer for the insurance plan.

  • Cigna has been involved heavily in the Walt Disney World Marathon Weekend.
  • Humana sponsors the National Senior Games Association, the governing organization for the largest multi-sport event in the world for adults over age 50; They also sponsor, thru their subsidiary HumanaVitality, many endurance sporting events (like the Kentucky Derby Festival Marathon and miniMarathon) to promote their wellness loyalty program.
  • Florida Blue sponsors a series of running events throughout its state. In fact, almost all health insurers sponsor local 5 and 10K in their hometowns.

 

This model makes great sense and should be continued. They might even consider getting some of the paid athletes to meet the insurance plan’s customers at the finish line as a reward. Something like “run a 5K and get a picture with your favorite sports hero” – this would be motivation for consumers indeed.

A Much Better Way

But I believe there is even a better way. Here is my idea. Health insurance companies should 100% subsidize both youth and adult sports leagues for the communities they serve.

This is good for the plan and consumer for a host of reasons:

  • First, Insurer X would actually be contributing to ensuring their customers are living healthy lives by investing in a healthy activity. They could then reward participants in the free league that are also their members – creating an incentive for those who are not to consider. Coupled with a well-designed channel-threading strategy plans could “gently” direct non-members to online, telephone, and in store sales reps to learn more.
  • Second, the publicity it will create for Insurer X. This would in effect be a perpetual positive PR generation machine.
  • Third, the experience it will create with mothers, who in fact are the key healthcare decision makers. Knowing they can afford to have their child participate in youth sports because of the investment of Insurer X would go a long way and yield fantastic word of mouth advertising.

 

Why not extend this sponsorship to adult sports leagues as well? All those twenty-somethings’ being influenced by the brand that cares which may translate to who they choose on the exchange.

What do you think?

To your health,

The Team at imagine.GO

Which of these Describes your Health App?
imagine.GO

Which of these Describes your Health App?

What is “Retail” Health Technology?

This post is specific to health technology, so let’s start by defining our context. I think this definition by Booz is the best I have seen. Take a moment to read and digest!

“Retail health is where consumers find quality care in a variety of convenient forms and at competitive prices. Consumers are able to plan for the health care needs they anticipate and make informed decisions based on readily available information. They can then “shop” competitively for products and services using a variety of channels, formats, and business models. And for those that need help, they can turn to “navigators” who work with them to design the most suitable health care solutions for themselves and their families.”

I love this definition. Particularly that it points out that consumers should be able to “shop” competitively for products and services using a variety of channels, formats, and business models.

So then, what is the right place for technology in retail health? For me technology should serve as a means to help educate, navigate, plan, motivate and choose from suitable solutions for health care needs, anticipated and otherwise.

How does technology power retail health?

Technology is transforming the way healthcare is understood by the patient, managed by the insurance plan, and delivered by the provider. One major benefit is that technology can greatly reduce costs by removing the need for the same care to be delivered through a much less expensive channel, which is available at the consumers demand. Another benefit is it allows for customer-intimacy over a faster (and less expensive) delivery channel. So, with those two benefits alone, and there are many others, it is worth the heavy investment that we see in the marketplace. But to add icing to the cake, technology enables consumer’s health data to be stored in one easy to access place, securely. This enables a consumer to access their health information over time to see if their health is trending one way or another. With increasingly sophisticated smart phones and collaboration software, there will soon come a day when health care is delivered seamlessly as part of a consumer’s accepted daily routine – such as appointments and care decision alerts via their calendar, email and text messaging.

Smart health care companies will find ways to overcome trust and regulatory issues, simplify – and make meaningful the fire hose of health information, and reach consumers with relevant and reasonable guidance to help them take charge of their own health.

As it stands today, there are (too) many companies offering solutions to help consumer with their health. Here are a few examples – there are many, many more.

So Many Health Vendors

With all this choice, what then could be the problem?

However, because technology has made choosing a cheap alternative, vendors have rushed to provide consumers with too much to choose from, and thereby exacerbating the problem by creating a fragmented path to solve their jobs-to-be-done. As such, consumers typically get help at “points in time” when making health related decisions, but not “over time” in a consistent and evidenced based manner.

Let’s take a look at what too much choice can be like.

Example # 1

Say you want to buy health products from Amazon. A simple search for heart rate monitors results in greater than 14,247 heart rate monitor entries. Try it yourself by clicking here.

Example # 2

Ok, so you and 1 billion others have a smart phone. Well now you need a health application. Yikes! There are over 13,000 healthcare related apps in iTunes. Try it yourself by clicking here.

Example # 3

Ok, let’s just play it safe and look up health information online. There are over 23,000 articles on WebMD that have to be searched through. Now WebMD does have search filters thank goodness, but that assumes I understand enough about the topic to know what filters to use. In most cases consumers do not. Just looking at the back pain page gives me a headache.

The moral of our story

Simply put, build technology that matters to the consumer by creating an experience in which they want to engage.

Ok, so what can you do to ensure that you are not adding to the problem? I offer up this simple test to see if you are helping or hindering the consumer in their pursuit of health.

Is your technology a shovel, a hole, or a fruit tree?

shovelA lot of our health technology is what I consider a “shovel”. It is by technicians for technicians – it is shinny and sturdy, but in and of itself is of no use! Well, this one is not shiny but it is sturdy, and you get the point.

Shovels offer no value exchange. They create no purchase reason.

 

holeOther health technologies are “holes”. They are there and can be used for whatever you want them for. Better than shovels (in fact best created with shovels) holes have usefulness if filled properly.

They can be good for growing a good idea into something bigger. They can also become mud puddles or sink holes.

 

FruitTreeFinally, we have Fruit Trees. The value is well understood by both growers (providers) and consumers. They have utility. You forget about the “tree” because you are focused on the sweetness of the fruit. This idea is what we have to aim for. You have to envision your consumer drinking a glass of your orange juice on a sunny morning before they go to work brimming with energy. Yes it took a hole to grow the tree, and yes it took a shovel to dig the hole, but the experience (that lip smacking satisfied customer) is what matters.

 

Envision the value being realized – now go create.

 

To your health,

The Team at imagine.GO