For health insurance carriers, sick and costly patients have been one set of those important customers, and large employers have been a distinct set. The carriers haven't wanted to enroll sick patients, but once these people become subscribers the carriers have been highly incented to manage their costs. These patients have become a major focus of innovation efforts. On the other side of the business, the big employers who pay for insurance have been key customers to win, and carriers have sought to become closer to them.
The ACA may also lead employers to either push their staff to the public exchanges or to establish private exchanges in which staff can choose from a handful of plans vetted by the HR department. Either way, employers may become less important or lucrative customers than before.
With these pressures, carriers must innovate on three fronts -- to address the cost issues among sick patients, build the loyalty of employers to the health insurer, and attract the well. This will be hard. If carriers cannot accomplish the second and third imperatives, then they will be stuck focusing on the first -- an important but somewhat dispiriting mission. To go further, they will need to think in imaginative ways, going beyond traditional conceptions of their industry to build relevance and relationships that matter and that customers -- whether they are employers or consumers -- will wish to sustain.
For further analysis on this innovation challenge, see our recent piece for Forbes on the topic.
This post was written by Steve Wunker. Learn more about our healthcare practice.