In the past year, several large insurers have hired executives from outside the industry, seeking to bring in new skills and perspectives to help improve the experience for customers increasingly demanding more price transparency and convenience.
Last October, Aetna hired former Wal-Mart healthcare solutions senior vice president Dijuana Lewis as an executive vice president to lead a new consumer products and enterprise marketing organization that will try to "align and energize the resources, technologies, products and people we need to truly personalize the healthcare experience," said Aetna President and CEO Mark Bertolini in a media release.
While Lewis spent 16 years at WellPoint, most recently as CEO of its comprehensive health solutions business unit, it is her experience at Wal-Mart – as the low-price retail giant expanded its footprint in the pharmacy drug business and started opening walk-in clinics – that may be most valuable to Aetna because it gave her a window into the thinking of new, potentially disruptive entrants and ideas for how established players should innovate.
Other insurers have followed Aetna's lead, hiring executives from retailers expanding into the healthcare market. For instance, Humana snagged Christopher Kay, a former senior leader from Target, whose healthcare offerings now include a $4 generic prescription drug program and walk-in clinics in Florida, Illinois, Maryland, Minnesota, North Carolina and Virginia.
Kay started working at Humana as chief innovation officer, tasked with focusing "on innovations in personalized health designed to simplify the healthcare experience."
Before a stint at Citi Ventures, Citigroup's investment arm, Kay spent 12 years in senior roles at Target, including overseeing its largest merchandise segment – healthcare. As Humana CEO Bruce Broussard said in a media release, Kay "brings experience in consumer-facing industries to a pivotal role."
Across healthcare, not just insurance, the idea of trying to offer a more retail experience has been gaining traction for a few years, and for good reason, argues Paul D'Alessandro, customer experience practice leader at PwC.
The average American consumer spends 50 minutes a year with their primary care provider and 50 minutes a day in a digital or physical retail shop, according to PwC research.
Along with price and convenience, health organizations are trying to manage complexity in choices – deductible and network options, test and treatment decisions – and retailers, from grocery stores to online marketplaces, have pretty successfully tackled the problem through "presentation of complex information," said D'Alessandro.
Retail experience can come in handy as both providers and insurers change their interactions with patients, from one based on transactions to one with ongoing relationships.
But retail isn't the only experience insurers find valuable these days. They are also turning to new hires from outside the industry who have had leadership roles in technology and strategy.
At WellPoint, the new chief information officer, Thomas Miller, spent three decades at Coca Cola, most recently as CIO.
While Miller is really a healthcare outsider, during the past two decades he did at Coca Cola what many healthcare organizations are doing now: integrating IT systems and standardizing business processes. After working on the IT side of Coca Cola's European expansion, Miller returned to the U.S. and helped deploy an Internet-based software-as-a-service platform across the company's bottling operations.
Now Miller will be overseeing the claims systems for Blue Cross-licensed plans in 14 states as well as IT initiatives like WellPoint's analytics collaboration with IBM using the Watson technology. Part of his task, WellPoint's Chief Administrative Officer Gloria McCarthy said in a media release, will be helping the company "harness the technologies that are available today, and plan for the groundbreaking technologies of the future."
New technologies and data systems are much needed – for easily sharing information with providers and offering dynamic websites that meet consumer expectations for digital convenience and price transparency, for instance, said Ashraf Shehata, KPMG's national health plans leader.
And leaders outside the insurance industry may bring what is needed to meet those expectations, as long as they are careful to avoid the hazards of "rip and replace."
"The ramifications of rip and replace are fresh in the minds of many, because it actually led to the downfall of a few organizations," said Shehata, an IT veteran who's worked in senior roles at Cisco, WellPoint and IBM.
Outsiders may have a lot to offer in other areas of insurer consumerization strategies, like branding and helping bring to mind ideas of wellness rather than prior authorizations, Shehata said. "As we move away from agents and brokers and HR entities to selling to individuals, the brand becomes more important. And health insurers need to have a brand that's associated with good experiences, and not bad ones."