by Susan Yeazel

Originally featured in Healthcare Innovation

Health plan leadership, organizational momentum, and staying true to your values

The year ahead is creating the perfect storm of uncertainty: an ongoing global pandemic, an incoming White House administration with a vastly different approach to healthcare policy, and a pending U.S. Supreme Court ruling on the future of the Affordable Care Act (ACA). 

Despite the unknowns, health insurance organizations can accelerate growth and retention by moving quickly in the right direction. This means building competencies that support an adaptive strategy and planning process—one grounded in mission, vision and values and focused on both foundational capabilities and high-priority initiatives. 

Optimize Your Business Model 

With the acceleration of consumer-centric healthcare, health plans must continually review, clarify and execute on key initiatives while minimizing disruption to daily operations and sustaining an engaged workforce.  

While multi-year planning is critical, day-to-day uncertainty demands an adaptive approach to strategy and planning that builds on strategic goals and value drivers. It may be time to re-evaluate your key value drivers based on consumer behavior, available data, technology, and socioeconomic and regulatory changes. By identifying your value drivers, you help ensure a through line to desired results in a market battered by economic volatility, fast-changing population health, and sky-high consumer concerns about safety. 

Once your value drivers are clear, use scenario planning and financial modeling to determine inputs, assign risk, and evaluate options. Planning and modeling equip you to make more informed decisions in prioritizing, what might otherwise seem, an overwhelming number of organizational imperatives.  

Communication is key. When decision-making is quickly followed by clear communications to all functional areas, you build understanding and adoption of the priorities and performance levers essential to achieve agreed-upon goals.  

Instead of reacting to disruption, you can begin driving it in your favor by using a business model innovation framework that provides a disciplined method to rapidly evaluate new business concepts. This framework can help focus leaders on promising new concepts and position your organization to grow in even the most uncertain of times. 

Focus Your Culture on Your Customer  

When individuals, families, employers and government agencies invest in your products, they expect value: access to care, prescription medication, and the information to confidently make decisions that affect health and financial well-being. 

Every interaction with your customers affects your value to them, and their value to you. Organizational culture has a profound impact on these interactions. As such, it has a primary influence on business outcomes. An organization dominated by employees who are fiercely focused on creating and delivering the best possible experience for members, employers, providers, and other key stakeholders creates sustainable momentum to realize your most critical objectives. 

A customer-focused culture favorably influences key revenue drivers, including positive word-of-mouth and brand perception—winning customer loyalty throughout life stages and economic turbulence. Companies with an inherent workforce focus on the customer experience can positively impact the bottom line by reducing negative cost levers such as escalated inquires, re-work and, ultimately, renewal losses. Greater customer satisfaction also lowers unwanted attrition and the costs of recruiting and training new hires 

A company’s culture is typically influenced by five main drivers: 

  • Strategy driven by cultural values and core tenets 
  • Structure, including governance, organizational design, and the flow of value 
  • Information and decision-making transparency, including an organization’s ability to learn from data and experience and to adapt accordingly 
  • People, including talent strategy 
  • Rewards, including incentives and accountability mechanisms aligned to support culture. 

Not sure where your company culture stands? You’re not alone. During this time of rapid change and disruption, you may want to apply a maturity model to assess your culture’s current state and define the conditions needed to realize the desired future state.   

Focus on Sustainable Cost Reduction 

Cost reduction is not “one and done.” Sizing up cost-saving opportunities (via data and analytics) and executing meaningful cost reductions (via operational optimization) should be a continuous effort. It can be enhanced by tailored insights that are actionable and, in some cases, transformational. To create sustainable value, choose the right opportunities, build a realistic and detailed roadmap, embrace a change management plan to move through the process in a healthy way, and rely on insights that enable the organization to lock in savings by adapting the people, process and technology for each opportunity. 

To generate immediate cash-flow savings, use agile practices and nimble project governance to identify and drive quick-win sprints. Quick wins build confidence and momentum as longer-term savings opportunities are identified and prioritized. Longer-term savings efforts must take into account the drivers that influence expense: employee and partner labor, data architecture, underlying processes, technology architecture, and even physical space.  

A successful cost-reduction initiative should result in more than simply increased savings. You should expect:  

  • Sustainable resource capacity that’s freed up to focus on innovative solutions  
  • Organizational learnings that enable a repeatable and scalable approach to future cost-reduction efforts 
  • Improved employee experience due to increased efficiency, simplification and standardization.  

Most importantly, don’t compromise the features, services and experiences that your customers value.  Cost-reduction efforts must be balanced with increasing value to your key stakeholders. As with all initiatives during times of disruption, cost reductions must be true to who you are and what you stand for. 

The Bottom Line 

Times of uncertainty can result in a slow-down of activity or, worse, an entrenchment in ways of working that are familiar but no longer effective.  By moving from a defensive position into actions that honor their customers and their culture, payer organizations can create opportunities to engage their workforces and unite stakeholders in common purpose. This is not an easy time, but it can be a rewarding time—when leaders purposefully build trust by setting a course of action and making sure that any necessary deviations along the way are firmly grounded in mission, vision and values.