A health plan’s success depends on its ability to evolve and modernize to meet new expectations. This begins with the adoption of a member-centric, omnichannel business model.

By: Chris Althoff, Stuart Siegel, and Greg Poffenroth

It’s no secret that the business model for health plans is rapidly evolving. In the past, plans were in the business of administration—maintaining provider networks and processing claims and reimbursements.

These days, they are expected to deliver a holistic experience for healthcare consumers, making use of their unique position as one of the few points in the healthcare ecosystem that has a 360-degree view of each member. This means taking on relationship advisor and care coordinator roles, helping members stay healthy, and paving the way for access to better care—roles that have historically fallen on providers or, frankly, the members themselves.

In the new order, a health plan’s success depends on its ability to evolve and modernize to meet these new expectations. In particular, delivering personalized, information-rich services and embracing the potential presented by new, digital technologies to engage members in a consistent, coordinated fashion across the communication platforms they prefer.

In other words, it means adopting a member-centric, omnichannel ethos—a sizeable change for most health plans as they operate today. This white paper summarizes the challenges that health plans face in this regard and describes steps they can take to overcome them.

In this paper, you will learn:

  • How to identify the cultural norms and structures that inhibit a health plan from thinking and acting with a member-centric ethos
  • How to jumpstart a member-focused approach by using proven methods such as defining a North Star and journey mapping
  • Steps to improve the member experience while by eliminating organizational silos and leveraging technology to reduce costs