Payers are working hard to position themselves for success with health insurance exchanges. Competition for customers is fierce. Everyone wants a piece of the healthcare delivery business. And big data may help secure it.
Like a palooka that makes it to the heavyweight finals against improbable odds, the Patient Protection and Affordable Care Act narrowly became law, and ever since has fought off persistent attempts to bring it down.
Its biggest victory was almost a year ago in the Supreme Court (where it won by decision). Now it faces another bruiser: implementing health insurance exchanges next year.
So Las Vegas, a city where longshots are embraced, was a fitting backdrop for the annual conference of America's Health Insurance Plans (AHIP) last week. The focus of the gathering of health plan executives was the implementation of the PPACA and how it will affect the health insurance industry.
I am happy to report that since the Supreme Court's decision stakeholders and vendors have cast aside their doubts and worries (at least outwardly) and have been working to position themselves to thrive as healthcare reform is implemented.
AHIP 2013 featured several days of workshops, networking breakfasts, and appearances by the healthcare industry's equivalent of rock stars. Among them were George Halvorson, the outgoing CEO of Kaiser Foundation Health Plan, Toby Cosgrove, MD, the CEO of Cleveland Clinic, and Susan Dentzer, the former editor of Health Affairs and now senior policy advisor at the Robert Wood Johnson Foundation.
Some 30 sessions provided insight into the transformation of healthcare delivery, the new healthcare consumer, and the importance of big data.
These are the big ideas presented at AHIP 2013 that I came away with:
1.Wellness takes more than marketing.
If you still think of wellness as simply blood drives and cholesterol checks, then you are a few years behind the times. Wellness is emerging as a big business with a steady stream of vendors ready and able to help employers keep their troops in tip top working shape.
Employers are cautiously interested as they struggle to find tangible ways to correlate wellness programs to bottom-line benefits, but failure remains a very real option. While there is a growing body of research linking wellness to reduced healthcare costs, improved productivity, and higher morale, a recent RAND report finds that wellness programs don't pay off.
2.Everyone wants a piece of the healthcare delivery business (Part 1).
Competitors are everywhere. Target, Wal-Mart, and other retailers are looking for opportunities to cherry-pick healthcare delivery. Think you have the flu? Need a DVD to watch or book to read while you recuperate? Stop by one of 54 Target stores that include healthcare clinics. Big-box retailers have huge advantages when it comes to healthcare delivery: They are everywhere and they have been studying their customers' data, oops I mean guests, for years.
3.Everyone wants a piece of the healthcare delivery business (Part 2).
Each week, more than one million Weight Watcher members attend one of the company's weekly weigh-in meetings. Last year consumers spent $5 billion on Weight Watchers branded products and services. That's market power and CEO David P. Kirchhoff wants to bring that power to healthcare.
"We are effectively a provider network," Kirchhoff remarked during a session on the new entrants into healthcare who are driving change in the system. "We are actively looking for ways to work into the healthcare system." He sees Weight Watchers as part of the healthcare industry trend to partner to deliver care. Physicians and payers partner with community-based delivery systems (including Weight Watchers).
4.Big data is a big deal.
Each year at AHIP there is a buzz word or phrase. Last year it was "consumer engagement" and almost every vendor seemed to have a product to help healthcare providers and payers get closer to their customers. This year it was "big data."
The buzz on big data is that mountains of patient information from all types of medical databases have been aggregated and combined with big data algorithms to help create patient profiles and develop integrated and care options.
Vendors say big data will finally put healthcare industry on equal footing with the retail and banking industries, which have been gathering and aggregating their customer information for years.
5. It's all about the consumer.
At least seven sessions at the conference addressed the healthcare consumer. Developing trust, building long-term relationships, identifying the needs of the consumer, and nurturing the consumer all sound kind of New Age, but health plans are spending a boatload of money to better understand their members.
Health plans are taking a cradle–to-grave approach adding products that will build brand loyalty throughout a member's life.
If the PPACA is going to prevail over health insurance exchanges, it's going to need the payer side to be in its corner.
Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
