New paths for consumers to find you…if you tell them.

By Cliff Frank

Experts in health care. That’s what all our instincts tell us that we want to be. To our patients, to our community, to our regulators, to each other. But when was the last time we were perceived as experts in health care finance and insurance? Last time I checked, we had ceded that territory to insurers. Well, sometimes we get lucky and get a do-over.

The individually-purchased health insurance market is going to likely expand a hundred-fold or more on 10/1/13 as health insurance exchanges for small employers come to life. Whether it is a state-sponsored exchange, or one that is federalized in your state, individuals in your market working in employers with less than 50 employees will have options they do not have today. Industry observers expect upwards of 50% of small employers to simply turn the health insurance purchasing decisions over to individual employees by giving them a voucher to spend on the health insurance exchange for a product that best meets their family’s needs.

This is going to be a big decision, affecting employees, dependents and health care providers. You can expect a full array of products will be offered on the exchange including low-priced narrow network products that may, or may not, include your facility and affiliated medical staff. The product mix and complexity will be staggering for a knowledgeable participant. Think how difficult navigating the process will be for those individual employees who are new to the health insurance purchasing process. Most of these people are unfamiliar with insurance terminology, evaluating benefit designs, network accessibility and quality, and other key product features. Yet, many thousands in your market will be going through this process simultaneously this next October-November.

Who is going to tell your story to all these consumers who may become your patients, if they pick the right plan that puts your medical staff and facility in the right benefit tier in a manner which is understandable to consumers? Do you really believe the insurance industry is going to manage this process in a way that protects your interests? Have they ever done so in the past?
Then why would you rely on some other entity to tell your story than you? Do you have experience with most or all of the insurers in the market? Likely, yes. Are there differences in their levels of administrative and medical management performance? Likely, yes. Can you help educate these new insurance purchasers on the pluses and minuses of particular insurers, types of benefit designs, network options, and what combination provides the best consumer value? Probably not today.

Who would consumers and your future patients call to get this information in your organization today? The billing office? They might know some of it, probably more with some insurers, less with others, and they have all this time to chat with your potential consumers, right? How about your discharge planners – they might have a handle on some of the clinical questions, but would likely be stumped by the business questions, and they don’t have time to talk either. How about your marketing department? Not likely. What about your physician referral service? They might be able to tell the consumer which doctors participate in which plan, but teaching consumers how to differentiate between plans and how to make a great choice for their individual circumstances is not likely their core focus.

This health insurance exchange is going to be your biggest channel for new patients that you have seen in decades. This exchange will help individuals in your neighborhood reverse the incentives they have had to have their care provided elsewhere by a not-so-friendly insurer. Now is your time to begin building this outreach to a whole new set of insurance purchasers. If you wait until next October, your messaging will be buried by insurers competing for these consumers. Your brand is based on trust. Build on it. Make yours a brand based on love, and show it. Help consumers love you by letting them tell you what they need, and give them what they want – confident, competent answers.

© 2018-2019 Cliff Frank, Healthcare Management Solutions, Inc.