13 takeaways from 2016
Dennis Bolin, Health Plan Alliance
12/12/2016
Over the last year, the Health Plan Alliance team had the pleasure of working alongside nearly 50 provider-sponsored and independent health plans across the nation, sharing in their biggest challenges and developing opportunities for them to collaborate with others to solve them. While we had many conversations with thousands of health plan professionals over the course of the year, the following is a list of our top 13 takeaways from 2016:
1. Health Plan Alliance member plans are committed to succeeding in the market created by the ACA.
2. If we can’t be everything to everybody, where do we focus our time? How we answer this question will be key to our future success.
3. “We will struggle to create a superior customer experience until we begin to treat the health plan member and hospital patient as though they are the same person.”
4. Health systems with health plans (the model for the majority of the Health Plan Alliance members) have shifted in their thinking about the insurance component of the organization. Having a health plan has given health systems a leverage point for partnerships and joint ventures.
5. The movement to value-based reimbursement strengthens the reasons for a health care system to include a health plan. The integrated model that we work with needs the delivery system and the health plan to work together in many different ways for both to be successful. The intersection points of governance, care management, analytics, risk adjustment and information technology require commitment and collaboration within the independent delivery system.
6. The meaning of the word “disruption”. While we all are probably tired of hearing this industry buzzword, we learned from Clayton Christensen’s book, “The Innovator’s Prescription,” that health care disruption has three sources: employers, corporate orchestrators and integrated fixed-fee providers.
7. The eight key intersection points where health systems and their provider-sponsored health plans need to work in tandem to be successful: governance, customer experience, contracting strategy, risk adjustment, quality metrics, clinical integration, informatics and analytics, and technology assessment and IT infrastructure.
8. Self-funded health plans make up the largest percentage of the market…by a lot!
9. “Never judge yourself by a bad example and feel good about it.”
10. John P. Kotter’s eight steps which are essential to achieving change in an organization.
11. When you enjoy what you do, it can be very rewarding.
12. You can’t trust election polls. We were all surprised; and industry experts had a lot to say about how a Trump administration might impact the future health care policy.
13. “If we’re serious about building our brand to be about the very best customer service and customer experience; then customer service shouldn’t just be a department – it should be the entire company.” - Tony Hsieh, CEO, Zappos
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