Deloitte: Health Plans to Transform Toward Hyper Personal Customer Wellness, Value and Efficiency

The health care industry is on the precipice of broad transformation, and for the health plan sector, organizations should transform business models if they hope to stay competitive among nontraditional market entrants, consumer-driven health demands and new data sources, according to new Deloitte research. The Deloitte Center for Health Solutions recently conducted crowdsourcing research to answer several important questions related to this transformation including: “How will traditional health plans transform, and what choices do leaders need to make now to survive the forthcoming disruption?”

The research revealed one particularly important vision: Business model transformation will speed up as health plans shift to a focus on improving wellness and care using multidimensional data. Tomorrow’s health plans will balance traditional population-level risk with being hyper personal and easy-to-understand, based on consumer need. The organizations will also engage and influence consumers toward better health through a high-touch experience with digital devices.

“Data and data interoperability will be the key to improving wellness and care for members,” said David Biel, principal, Deloitte Consulting LLP. “But consumers will own their data and will need to see and harvest the value in sharing it with health plans. Health plans will want to educate their members on the potential benefits of data sharing and alleviate concerns in order to build the level of comfort and trust required to access their data.”

Deloitte’s research found that companies will be focused on one or more of three fundamental roles that can drive value as the health care industry transforms:

Well-being and care delivery: Most respondents agree that to navigate the new role of being a steward to members’ well-being and care, health plans will need to be closely aligned with care delivery teams. This could open up new opportunities to manage health. Roles will evolve to focus on becoming a localized health hub and enabling consumer-centric care models delivered virtually, in the home or in the community.

Data and platform: According to the experts, health plans will move beyond using data to support compliance and reporting functions to become data conveners, science and insight engines, and data and platform infrastructure builders. Digital technologies that reduce cost of care, streamline processes, and achieve better outcomes will no longer be differentiators; they will be fundamental for any organization operating in the health care industry. This wealth of data will open new revenue streams based on consumer insights, monetization of data, population health initiatives and customized offerings.

Care enablement: As health plans shift toward enabling member well-being and care, they will take on the traditional role of “financer” as their business models shift to look beyond adjudicating and paying claims. This shift in mindset will result in a new line of products for consumers.
“The transformation to the health plan of tomorrow is just a steppingstone on the journey to the future of health — a future that health plans should begin to prepare for by making strategic decisions now,” said Biel.