Blog : Consumerism

How to Get Started with CX at Your Healthcare Company

How to Get Started with CX at Your Healthcare Company

CX is all the rage these days. It seems that most of it is couched in theoretical theory and “potential” value creation. To be clear, we think it definitely has its purpose. In fact, it is core to our modelH approach. But, we are weary of anything that cannot be implemented in an Agile fashion.

In a McKinsey survey of senior executives, 90% said customer experience (CX) is one of the CEO’s top 3 priorities. This fact is due to increasing customer expectations in an evolving digital marketplace. Customers expect more, better and faster – and they expect you to know and fix your process problems. McKinsey research indicates that for every 10-point up in customer satisfaction, companies increase their revenues by 2 to 3%. Gains come from increasing wallet share (more product purchases) and lower churn rates (fewer customers leave). Satisfaction is correlated to operational or infrastructure-related factors. These include price, transparency, cycle times, product features, and use of digital channels.


We take for granted that the result of a great CX discipline produces customer action (behavior change), satisfaction (customer happiness), and attraction (brand loyalty).  As a result, your employees will be able to understand how their work impacts the member’s experience – and establish a baseline for all future CX endeavors.

Though this seems straightforward, implementing a customer experience discipline within a company is difficult. So how do you begin?

Well, even the longest journey begins with a single first step. Experience is something that can be designed, implemented and measured. In healthcare, favorable experiences can make a difference between healthy/profitable customers and unhealthy/expensive ones. A better experience comes from orchestrating a customer’s journey across channels. Experiential design starts with recognizing and prioritizing your (i.e. your customer’s) most important “touches” so you can optimize the operational factors that drive them. For health plans, the inventory of touches includes your member as well as your providers.

We recommend you start with defining (in a minimally viable way) how the discipline of Customer Experience (CX) will work at your company. Although CX eventually encompasses all of your company’s touchpoints and communications, synchronized across channels to achieve maximum customer activation and brand awareness – we are asking you to just spend a day outlining the basics and assigning responsibility for them. Just do enough to define your most important first CX project(s) and get someone assigned to the task. Then see where it goes from there – and keep it Agile.

As first projects go, we recommend you start with a journey map. A Customer Journey Map is a graphic representation of the journey your prospect/customer takes in relationship to your organization over time and across all touch points.  This tool emphasizes the intersections between your processes, your customer’s jobs-to-be-done, your measures, and your customer’s expectations. If you cannot define the touches, how can you truly prioritize which need fixing first? We recommend you first focus on the “experiences” that move the needle for customers and impact your cost/profit outlook. A few things stand out for prioritization. Digital journeys should be prioritized over manual ones as it easier to “fix” digital than physical. And, McKinsey research shows digital-first journeys produce higher customer-satisfaction scores than traditional journeys. Reducing journey time (the time it takes to complete an individual journey) should be prioritized over adding new features. Customer satisfaction has a higher correlation to “ease-of-use” than “feature rich”. However, keep in mind that there are diminishing payoffs for reducing journey time, so only take it as far as it produces returns.


imagine.GO specializes in helping companies thrive where consumerism and health care converge. We have helped organizations ranging from fortune-100 companies to startups, quickly define better business models and communicate them to stakeholders. We have implemented our “100 Days to Customer Experience” model for several large health insurance plans and other retail-focused healthcare companies.

Here is the link to the McKinsey article we are referencing (The four pillars of distinctive customer journeys).

To your health,

The Team at imagine.GO

Webinar: Finding and Closing Healthcare Customers through Digital Channels

Webinar: Finding and Closing Healthcare Customers through Digital Channels

Health care reform has created millions of new health care shoppers. Many of whom will be visiting your website for the first time. You’ve done the work to support the new health care consumer on your site, but are you converting visitors into shoppers, and shoppers into repeated customers? This webinar will focus on Conversion Optimization (CO) and Search Engine Optimization (SEO) to help you maximize traffic to your website and increase your conversion rate (CVR).

September 17, 2014
3:00 pm – 4:30 pm EST

*This webinar is part of the Consumer Experience Webinar Series.
Webinars will be held September 17, October 22, October 29 and December 10, all at 3:00 pm ET.

Learning Objectives:

Discover how to implement a smart and consistent SEO strategy to ensure your company shows up where it matters.
Explore how you can launch and test ‘Calls to Action’ during key points in a person’s visit to your website so that you increase the rates at which visitors start the shopping process.
Examine how you can increase the rates at which shoppers complete the process to become customers.


Moderator: Kevin Riley, President, Kevin Riley & Associates

  • Andrew Bennett, Senior Director of Digital Marketing, Smartsheet
  • David Chase, Director of Digital Marketing, GuideWell
  • Bill Lan, Head of Industry, Insurance & Services, Google



To your health,

The Team at imagine.GO


How to Explain Healthcare Reform to Your Customer

How to Explain Healthcare Reform to Your Customer

This is a tale of two customer conversations about healthcare reform. The first is conducted by an insurer and the second by a large consumer financial services company.  Guess which one tells a better story. Here is a hint, not the health insurer. This article is not about picking on one or the other. It is about trying to uncover why healthcare companies have such a hard time communicating about their industry in a manner that is simple, clear, and effective. I set out to make a fair and honest comparison, and was actually disappointed in how bad the insurer got it.

H&R Block Reform Conversation Header

Why Communication is so important to Win Health Insurance Business

The battle for healthcare communication must be fought and won. As we head into the first enrollment period under the new Affordable Care Act (ACA), most small businesses do not have a clear or accurate understanding of what will be required of them to “play.”

This is a problem. I advocate that small businesses have the most change thrust upon them, and make up the market that is most competitive in the health insurance landscape.

I am not talking about the U.S. Small Business Administration’s (SBA) definition of a small business, which includes operations with up to $7 million in revenue or 500 employees. I am talking about the ACA definition of a small business – those with 50 employees and under, which includes most of the businesses in the country.  To put this in perspective, according to the to the most current U.S. census data, companies with 9 employees or less make up 95% of small businesses.

Provisions in the new law present difficult new decisions regarding healthcare benefits for companies of this size. Some employers must cover insurance for their staff or face a penalty. Some employers are exempt from having to buy insurance for their employees. Some can even be subsidized.  Here are some examples:

  • A small business with 50 full-time equivalent employees is required to provide coverage for employees who average 30+ hours a week, or a penalty will be applied.
  • A small business with less than 25 employees that pays average annual wages under $50,000 may qualify for a small business tax credit of up to 35% (up to 25% for non-profits) to offset the cost of insurance.
  • A small businesses may be eligible to use the new Small Business Health Option Program (SHOP) Exchanges to pick a plan they want their employees to enroll in. In 2014, the employer selects the plans, and employees choose from the selected options. In 2015, this changes to the employers selecting an actuarial value level and the employees selecting any plan in that range.


Infographic on Employer Understanding of Healthcare Reform

Source: Docstoc

So you would think Health Plans would be beating the streets to get the message out to all small employers.  It stands to reason that the Health Plan that does the best job of explaining healthcare reform and its implications on small businesses (thus taking a burden of information off of the small business owner) will probably be the plan that the employer selects for his employees in 2014. Assuming the Plan does a good job in 2014, there is a strong chance that the employees will keep that same Plan Carrier in 2015 and beyond. Yet, according to the infographic above, more than half of the exempt small businesses do not understand the basics of the equation. Who will win this business? The ones that does the best job explaining it!

2013 a critical year to compete for the small business health insurance.

But, healthcare reform affects more than just small businesses. It affects many individuals who are not on employer insurance roles as well.  To put this in perspective, according to the World Bank the total US workforce numbers a little more than 158 million.  By 2015 there will be 70 million independent 1099 contractors. That means that almost 50% of the US workforce will be an independent worker by 2015.  What are insurers plans to win this growth market?

2014 is critical year to compete for the under 65 consumer market.

What is Considered Good Communication?

H&R Block understands this cause and affect and has already started its communications to both groups. After filing my taxes this year, I was prompted to engage with the following interactive explanation of how the new healthcare reform law will affect me and my taxes. I made a quick video of what I thought were the highlights.

You can try it for yourself here:

Now juxtapose this to a more comprehensive and confusing explanation by a major insurer. I was not prompted in the course of another action as I was with H&R Block, so I did what we all do to learn – I started with a Google search. This page is what came back, so I clicked the top result.

CIGNA Explains Healthcare Reform

As I was trying to make sense of the overwhelming amount of information, unprompted CIGNA asked ME how to make THEIR website better.   This survey was unbelievable to me. They actually interrupted a bad experience to make it worse.

CIGNA Values My Opinion

And to boot, the dialog that I did not want and had to click to get rid of had errors on the page. Look n the upper left corner and notice the infamous “image not found” image. And to really go over the top, CIGNA gave me instructions on something I did not ask for and did not want, which put the burden on me. I was not here to help them with their website – I was hear to help myself learn about healthcare reform and somehow I am now roped into giving them my feedback. But even that was not easy. Take a look at the actual instructions they gave me – “When you click “Yes, I would”, another browser window will open for the survey. Please return to your open window, complete your visit, and then return to the survey window. All input you provide is strictly confidential.”

I had to go somewhere else, to do something I did not want to do, to help CIGNA, and then they had the brass to ask me to return to the page I was confused on in the first place to complete the business I was here for – absolutely unbelievable!!!

CIGNA H&R Block Reform Conversation

When will the insurance companies get it right? If H&R Block can do it, I expect them to be able to as well.

To your health,

The Team at imagine.GO


How to Send a Personalized Bill to Your Customer

How to Send a Personalized Bill to Your Customer

I just received a new bill from AT&T – and get this – it was a personalized video of my charges.  Yes, that is correct, a video.  It was my actual bill, with my actual charges explained.  And it was cool. I watched it three times and then recorded it and made a video to share. Here is the short video I made of my experience:

An Old Dog with Some Cool New Tricks

To be sure, I am not a raving fan of AT&T but I respect their product offering, and they seem to be getting much better at customer service. In truth, their coverage where I live at the beach in Florida is terrible. But, for the most part, they are pretty spectacular anywhere else I travel for work.  I pay around $130 to $150 every month for their services. I know and trust and rely on their product.  But, historically speaking I have had two issues with their product – at least from the arena of understanding my bill charges and getting someone one the phone to help me get answers.   I can sympathize as they have a lot of customers to deal with daily. However, I am still the customer, and I pay them close to $1500 per year. I have the right to expect better.  Such is life.

I have upgraded my phone and service several times in the life of my relationship with AT&T. Invariably, I am always confused at the one-off charges I see on the bill and in many cases, I have had the need to call and clarify what they were. I dread this scenario because I know it will be several trips through their telephone prompt system, then saying the same thing to at least three reps that have a somewhat less than mastery of English.  One month ago, I upgraded my iPhone to the new 5 (my relationship with Apple is a story in itself, and someday I may let you know about it).

So imagine my surprise when I received an email from AT&T with a link asking me to watch a video about my new bill. The call to action was clear and the broadcast email was well done, so I obliged. It took me to a page at the AT&T site where I saw a video that explained my most recent bill, in clear detail – even the one off charge. It was very well done, and it was tailored just for me.  I can still get access to the regular online or printed bill as well – but I feel no need to now.

AT&T Video Bill Email

How did they do it? I am not so naïve to think AT&T chose to invest resources in the AV department to create a video just for me – so I have to assume this was done by some smart new vendor that can tie into their systems and use list data to create custom videos. Whatever the reason, the result was that I understood the bill, and I did not feel a need to call AT&T – this saving them the transaction cost.  I have to assume the economics are for the mass/custom video versus the support line.  Furthermore, they saved me aggravation and got me talking in a positive light about AT&T. Nice work.

AT&T Video Bill

One other thing, because this is new technology and a new experience (I am sure they tested it quite a bit), AT&T was smart enough to ask me some survey questions at the end to see what I thought about it. Thus, validating their efforts. Again, nice work.

AT&T Video Bill with Questions

If My Phone Provider Can Do It, Why Can’t My Healthcare?

As I said, I spend approximately $130 with my phone provider each month. By contrast, I spend $400 with my health insurance provider.  As bad as my old phone bill was, by contrast, it is like a new Harry Potter novel (FYI I love Harry Potter books) compared to the bill I get from my insurance company. Or should I say, the “THIS IS NOT A BILL” I get from my health plan.  Take a look at a sample Explanation of Benefits (EOB) below.

Firstly, I find it somewhat ironic that it is called an Explanation of Benefits – as it is neither a benefit nor a good explanation of what I owe. I am not picking on any one plan – I just happened to be able to find a sample EOB for them online. And not wanting to post my own, I had to have something to speak to, so they are the lucky winners. In truth, from what I know and what I have heard, all if not almost all insurance companies are this bad.

Here is what drives me crazy about this document. It gives me more than I need in a poorly laid out manner, so it guarantees my confusion. Thus, resulting in my need to call them. Thus, having to deal with the call center for the insurance company. Thus, ensuring I add anger to my confusion. This repeat cycle is a never-ending loop for million of customers across the country.

When will the health insurance companies get it right? If AT&T can do it, I now expect them can as well.

Explanation of Benefits with Notes

To your health,

The Team at imagine.GO


Power to the Patient

Power to the Patient

Retail health— from convenient care clinics in drugstores to the emerging insurance exchanges mandated by healthcare reform—has the potential to reshape the provider and payer markets. Health plans are taking a position by investing in technology, assisting members with price and quality transparency, and developing innovative care networks that broaden member access. This webinar in brief is about how consumer-directed healthcare empowers “shoppers” by providing them with information about price and treatment options so that they can pursue cost-saving opportunities. As a result, a growing number of managed care organizations are adding retail health stores and clinics within their networks. Consumers want convenience in their health care options, which is right in line with retail channels offer.

PANEL DISCUSSION: Power to the Patient: Technology and Networks that Support Consumerism

I will be giving a talk on Tuesday, February 26, 2013, at 1:30 – 2:45 in Arlington, VA at the 6th Annual Consumer-Directed Healthcare Forum.

Here we will discuss how consumer-directed healthcare (at its best) empowers consumer-providing information about price, quality and treatment options; offering network options and incentives, including access to low-cost self-care and retail healthcare; and providing tools, technology and interventions that help consumers make the best choices possible. I will provide insights on the evolution of retail healthcare and learn what’s coming next.

You can see an extended version of the talk I will be giving in the Slideshare below.

To your health,

The Team at imagine.GO


New Webinar on Retail Health

New Webinar on Retail Health

Retail Health and the Future of Health Insurance

I invite you to attend a webinar I will present this week on The Implications of Retail Health and The Future of Health Insurance on Tuesday, January 8, 2013, from 2:00 PM – 3:15 PM ET.

Retail health— from convenient care clinics in drugstores to the emerging insurance exchanges mandated by healthcare reform—has the potential to reshape the provider and payer markets. Health plans are taking a position by investing in technology, assisting members with price and quality transparency, and developing innovative care networks that broaden member access.

This webinar, in brief, is about how consumer-directed healthcare empowers “shoppers” by providing them with information about price and treatment options so that they can pursue cost-saving opportunities. As a result, a growing number of managed care organizations are adding retail health stores and clinics within their networks. Consumers want convenience in their health care options, which is right in line with retail channels.

The Evolution of Retail Health

What You Will Learn

This webinar will outline how you can best position your organization for success via retail health.

  • We will explore the origins and evolution of retail healthcare with an eye toward emerging trends that will impact your business.
  • I hope to show you how retail health coupled with consumerism can impact member behaviors—improving quality and cost.
  • We will also look at the impact of retail clinics on member access, costs, and quality.
  • Finally, we will examine how plans might formulate a retail health strategy to encompass market-based initiatives coupled with reform-driven mandates.

I hope to see you there.

To your health,

The Team at imagine.GO


Here is the deck on SlideShare.

What Can Health Plans Learn from Retail?

What Can Health Plans Learn from Retail?

Podcast on Retail Health and Its Future

Listen to a podcast I gave where I discussed why health plans have a lot to learn from retailers. In this discussion, we cover many topics related to retail health, its evolution and its trajectory. We also discuss some upcoming talks I am giving.

What You Will Learn

  • This drive towards consumerism is spanning all industries – how are health plans reacting?
  • How can plans continue to attract and retain members in a competitive marketplace?
  • What are some of the key takeaways that attendees can look forward to this March?

Sketch Video

To your health

The Team at imagine.GO


My year of living wired (for health)

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 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.


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!


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


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

Disrupting the Disrupters in Health Insurance

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

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