Where do health insurers fit into the convergence in healthcare, if anywhere? All problems are also opportunities, even if it might be in disguise.
"Change is something happening outside of you," said Ben Jonash, a principal with Doblin, a part of Deloitte Consulting.
Consumer health technology like telemedicine, "everywhere care" like retail clinics, palliative care, personalization like concierge and direct primary care--all are evolving independent of health insurers, indeed some borne in a backlash to managed care and its discontents.
For health plans to find a place and add value amid this convergence, there are some questions to ask the company and industry, Jonash argued, at America's Health Insurance Plans Institute.
"How do you embrace that complexity?" "How do you dramatically simplify that?" "How do you remove the friction for providers?"
On the organizational level, "is there clarity about the level of ambition?" added Jeff Wordham, a principal with Deloitte's Doblin.
A mandate from executives to work on "innovation"--succeeding in selling more individual insurance, for instance, or improving the primary care experience for patients and physician practices--needs to have a focus that aligns the whole company. Multiple business units should be working towards the same goals, rather than various departments each pursuing different agendas that may not add up in the whole, Wordham suggested.
There are of course limits and anxiety with pursuing all things change. One AHIP attendee, working in the Medicaid business of health plan, said that the company's clinical quality analysts have raised concerns about retail clinics offering mediocre services and leading to a kind of two-tiered system.
The concerns may be reasonable and merit oversight of retail clinics, but given the demand from Americans more convenient care, including telemedicine, perhaps it's worth the risk.
"If you're not running a few experiments that are pushing the boundaries, others will figure out how to do it at better quality and lower cost," Wordham said.
Although other industries are not perfect examples for case studies, health insurers trying to evolve with new business models for new services should look to companies like Netflix, Whole Foods, Zara, Oxo, Nike, Zappos, Virgin and ZipCar, Wordham suggested.
ZipCar in particular in an interesting study in using technology and new business models to bring people a new service and experience that they didn't necessarily know they wanted.
Now a part of Avis, ZipCar was started in 1999 by data scientists in Cambridge, Massachusetts, who developed an algorithm to locate rental cars based transportation patterns in a city--and to offer an alternative the prevailing model of having all cars located in one place and an alternative to charging customers on a per-rental basis.
Today ZipCar is the world's largest car-sharing service, with a subscriber base that spans millennials, yuppies and urban boomers--people who pay for access to a car and the freedom it offers, without having to own one.
Wordham said it's worth thinking about that subscription model when it comes to health plan design. It's a kind of "collaborative consumption" that could be helpful when thinking about moving past the high deductible, narrow network plan.