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09:16 AM
Michael Battaglia, Chief Consumer Officer, Humana
Michael Battaglia, Chief Consumer Officer, Humana
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Beginning At the End

For private health insurance to survive, the industry must rebuild its operating model, starting with the consumer, says Michael Battaglia, Chief Consumer Officer, Humana.

Executive Intelligence Series If we want a system of private health insurance to survive, we need to figure out how to create products and services that actually advantage the consumer - informed services that help them make better choices about their benefits. We must give consumers the control they want over their decisions and support them with technology.

At Humana, we start with a set of core principals that underlie all of our products and services. First, choice. People want choice - they feel and act differently about what they actively choose than they do about something they've been forced to accept. Second, transparency. We can't give people more choice without giving them the information they need to manage their choices. Third, independence. People don't want health plans interfering with decisions about their healthcare.

From Rhetoric to Reality

Making good on the promise of consumerism will mean adopting a whole new operating model. It will mean flipping the lens through which the business is run from "what we manage" - information platforms, business segments, markets - to "what consumers require to be successful," across a detailed spectrum of consumer touch points, processes, preferences and needs.

Making good on the promise of consumerism means building disciplined R&D systems for recruiting consumer intelligence into the ways products and services are designed and managed; it means innovating from the outside-in to create true value for the consumer; and it means developing effective feedback mechanisms that use a multi-faceted view of consumer experiences as a source of performance improvement and ongoing insight into how to create consumer advantage.

A Boost from Technology

Underlying it all must be a sophisticated infrastructure of information and decision support technology that makes the shift in control over health financing manageable and enables consumers to maximize the value of their benefits. Here are a few ways that technology can help consumers take advantage of the increased choice and responsibility of consumerism.

- Wizards. Based on consumer research, Humana has developed a plan "wizard" that guides consumers through configuring a plan based on their personal preferences along basic dimensions of benefit design. Along the way, it educates consumers about how their benefits are built and creates a significantly higher degree of transparency into the value the benefits deliver. Innovative benefit designs are accompanied by tools that help consumers calculate their best deal. These can be enhanced with clinical information about consumer healthcare needs based on age, sex, stage of life and known health history to help them plan their care and manage its financing.

- Online information and decision support. We deliver tools that democratize medical knowledge, making it available to anyone, on demand, and that helps individuals weigh the costs and benefits of alternate treatment paths or select where to get their care.

- Predictive modeling and high-touch/high-tech guidance. Advanced analytics enable Humana to identify individuals most likely to be helped by clinical programs and services. The technology creates a platform for delivery of a distinctly humanized Personal Nurse service that helps people take action that will improve their health and manage their care.

The End Is Our Beginning

A strong, persistent focus on the consumer is central to performance improvement and has been shown, across virtually every industry, to increase profitability, competitiveness, brand identity and long-term customer loyalty.

Granted, redesigning our businesses to drive real value to consumers is no small undertaking. But we don't have a choice. Only with a heightened strategic focus on data accuracy and management, as well as the highly personalized provisioning of information to consumers, will we be able to create real value for end-users - and in so doing manage to scratch ourselves off the endangered species list.

Louisville-based Humana ($4.7 billion in assets) offers health insurance coverage and related services to employer groups, government-sponsored plans and individuals.

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