BLOG: Why health plans should think more like Netflix

Kristin Rodriguez, Health Plan Alliance



Reed Hastings, the founder of Netflix, said their success didn't come from one dramatic market play, but instead is based on a thousand little choices made by their leadership as they reacted to new opportunities and a changing landscape.

10 years ago, my husband and I browsed the shelves of our neighborhood Blockbuster with my son toddling around the store, looking for a video to bring home.  Today, our family movie night is still alive and well, but the neighborhood Blockbuster is now an empty store front, and our family can binge on Netflix or select the evening’s rental instantaneously with Amazon Prime.  These streaming services have become central to our entertainment budget because, while family movie night has remained firmly in place for the last decade, I crave an experience that is convenient, rich in choices, and allows me to get to the desired outcome faster.  In less than 15 minutes, my family can clean up after dinner, get into our PJs, pop the popcorn, and be snuggled with blankets and pillows for a double feature of The Neverending Story.

Netflix’s ability to make a thousand little choices that ultimately transformed my Friday nights—and created an entirely new marketplace—is powered by two things: 

  1. Their deep understanding of their consumer

  2. Their ability to make decisions powered by that understanding  


Opportunities abound

Many health care companies are talking about consumerism and improving the member experience, but by and large, the improvements are more conversational than proactive.  As an industry we need to transition from talking about change and start moving towards making the thousand little decisions that will ultimately result in a health care experience our consumer values as much as family movie night.


Are we willing to pivot?  

Alliance member health plans have more data available than ever before, eager prospective partners in their employer audience, and for those operating in government-sponsored programs, state and federal policies that encourage new models. This all leads to a much broader definition of “health care” requiring collaborative approaches.  So, what is preventing us from making those little shifts that will keep us moving with the needs of our customers?

Resisting the urge to assume a successful past guarantees a successful future

Blockbuster, at one time, was the market leader.  Their stores carried a solid section of videos.  They had acceptable customer service.  I could even grab snacks and treats at the register to enjoy at home with our new release.  But that was not enough to carry them through to the next evolution of home entertainment.  Blockbuster failed because it was unable to leverage the brick and mortar stores to get me where I wanted to be even faster: on my couch, with my kids, watching Rick Moranis explain precisely how the kids got lost in the backyard.

And Netflix succeeded not because they went head-to-head with Blockbuster, but because they brilliantly constructed and deconstructed their delivery system to not only elevate family movie night, but also to delight me with experiences I hadn’t even thought possible (Why yes, I would like to download Working Moms to my phone and watch a few episodes on my next flight!).

They pivoted—and customers joyfully followed.

It's not enough to provide just what is expected.  The market shifts to companies who deliver an elevated experience that exceeds what currently exists.  


Moving forward, or even sideways, is better than standing still

With market disruptions coming at us from all angles, traditional health care delivery systems will need to re-imagine their ability to provide the best experience, the best care, the best outcomes, all at a reasonable price, with no surprise bills, so that we can keep our relationship with health care consumers strong.  

We can evolve our models to exceed expectations and delight our members and patients.  Let's work together to start making those collective choices that will lead to the next generation of delivery – in ways we might not have even been able to imagine just a few years ago. 




Kristin Rodriguez

Kristin Rodriguez is the chief knowledge officer at Health Plan Alliance. Leveraging a decade of experience in managed care education and consulting, she supports provider-sponsored and regional health plans across the country with educational programming and consulting related to government-sponsored health care, compliance, risk adjustment, risk management, cybersecurity and information technology, as well as informatics. 

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Collaborate with us

Join Kristin Rodriguez at ILN Pivot!

Hear pivot stories, gain insight and connect with ILN members who didn’t let a change of direction get in their way.

Collaborate with your Alliance peers at the Elevating the Member Experience Value Visit

Dive deep into the some of the moments that define a member who is happy, loyal and engaged—and one who is not.

VBID 2.0 Fly-in: New perks available for payers that enroll in the latest CMS model

A workshop that will bring both the "vision" of VBID and the "real world experience" into a single conversation, arming Medicare Advantage and Special Needs Plans with the insight they need to better evaluate the opportunities VBID 2.0 present for their health plan.

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