Anthem CEO Calls for Value-based Insurance Models to Gain Customer Loyalty

by James M. Loy | Loyalty360 | Apr 07, 2015

As healthcare costs continue to soar with virtually no end in sight, insurance providers and health care organizations are feeling the pressure to find ways to reduce, or at least control, costs. Better patient care management, augmented data driven solutions for improved one-to-one doctor-patient customer experiences, and a refocused shift towards preventative care have all been heralded as important answers to this growing problem.

Many brands are even starting to eye tremendous customer engagement opportunities on this front as well. Rite Aid and Walgreens are two prime examples. Both retailers have introduced innovative loyalty programs that attempt to change unhealthy behaviors, improve fitness, and reduce future healthcare costs.

Considered to be an empowering form of customer engagement, Rite Aid’s wellness+ provides the tools to unlock a wide range of discounts and benefits for customers that participate in wellness related programs. Similarly, Walgreens’ Balance® Rewards is a loyalty program that rewards customers for making healthy choices and tracking daily activities such as walking, weight, and blood pressure.

Major healthcare providers are also beginning to dramatically alter their perceptions on this matter. And some, such as Anthem, are even taking important steps into this new reality by attempting to build more trusting, individualized, and “value-based” relationships with their customers.

During the recent Health Care Council event in Nashville, Anthem CEO Joseph Swedish discussed this topic at length with former Republican U.S. Sen. Bill Frist of Tennessee. Having served in leadership roles at both health-care payer and provider-based organizations, Swedish offered unique viewpoints on this subject. Throughout his talk, he stressed the need for an evolved health care system, a refocused emphasis on value-based care, and the cooperative need for industry players to work together.

“We believe that through collaboration, we can drive better quality care at more affordable prices,” Swedish said. “At Anthem, we are engaging in partnerships across the country in an effort to move boldly forward with these key initiatives.”

According to Swedish, new demands from both the government and consumers are forcing many health insurance providers to rethink traditional practices. Business models that were once almost exclusively business-to-business are moving towards a new business-to-consumer centric approach. Swedish stated that these transformations were crucial factors for insurance providers hoping to gain customer loyalty.

Customers want insurance providers that they can respect and trust, and many experts view “value-based” models as a way to innovate the way healthcare is paid for and delivered. Through collaboration, accountability, and a payment structure based on successful outcomes, this new model seeks to improve treatment results, lower costs, and increase access to healthcare.

In short, it stresses a shift from the volume of care to the value of care.

While addressing the decline of the traditional “fee for service” model, Frist also concurred with the significance of a value-based system.

“Patients today are increasingly savvy and are looking for price transparency and value more than ever before,” Frist said. “Payers and providers will need to get in the business of facilitating access to and helping patients use this information or they will see themselves passed over for providers and payers who will.”

Now, more than ever, consumers are continuing to wield unparalleled amounts of power in the service provider sphere. Instant access to more information and the breath of choices at their disposal mean that consumers are no longer beholden to any one brand. Unsatisfactory customer experiences can dissolve loyalty in an instant and many brands, insurance providers included, are finding themselves racing to catch up with the changing demands of consumers.

It’s now clear that many insurance providers are also hoping to figure out how to improve customer experiences and win loyalty. More than 300 executives gathered at the Nashville Health Care Council to hear Swedish and Frist discus Anthem’s rigorous attempts to bring value-based customer care to almost 100 million individuals.

“This Council program is another timely opportunity for our members to hear from one of the nation’s chief health care leaders on issues that are top of mind,” said Council President Caroline Young. “Today’s conversation was an exclusive opportunity to hear about Anthem’s commitment to finding real-world solutions that simplify processes and improve care.”

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