How digital technology is helping insurers create personalized experiences

Colette Balaam: For starters, could you tell me a little about your background, your current role and your top-line objectives for Healthfirst?

STEVE BLACK: I have more than 25 years of experience in healthcare and managed care operations for health insurers. In my current role I have broad-based responsibilities for operations, IT, program management, strategy, as well as enterprise initiatives to optimize the healthcare experience for our members. As New York’s largest not-for-profit health insurer (by revenue), our core mission is to provide access to affordable, high-quality care in a way that both sustains the company and aligns responsibly with member needs and with the communities we serve.

CB: Taking into account your current service delivery capabilities and where you want to be in the future, what will the digital experience look like for Healthfirst members five years from now? Where do you see the biggest changes?

SB: As a non-profit, Healthfirst is in a unique position. We serve some of New York’s most under-served residents — many of whom would not otherwise have access to healthcare. That can be life-changing for many of our members. So, it’s important that we are not only sensitive to their situation but also, that we respond in a personal way suited to their unique challenges and needs. Like many health insurers, one of our biggest challenges is helping members understand their service options so that they can take full advantage of everything that is available to them — while at the same time safeguarding confidential data and meeting strict regulatory requirements.

We currently engage with members across two primary channels―through our call centers and through more than 900 field agents who respond to inquiries and interact with members through our community-based offices. Our ability to personally engage with members is an important differentiator for Healthfirst. Everything we do points back to our roots in the communities where we make an impact. It’s all about empowering our members and it starts with building trusting, personal relationships.

Right now we’re looking to strengthen our digital capabilities around mobile applications. Our goal is to create services that exceed member expectations―personalized touches like reminding them to take their medications or to get their flu shots. These personalized experiences are vital for us―whether it’s through a phone call, a digital interaction, or a face-to-face encounter because our goal is to embrace our members and enhance their lives within the communities where they live.

CB: With all the new technology that is emerging, particularly in the healthcare sector, how do you cut through the noise and determine where to place your digital technology investments to suit both your member’s needs and long-term transformation goals?

SB: Our focus is squarely on enhancing the member experience. One of the ways we try to distinguish ourselves is through trust and sensitivity to each member’s unique situation. If someone is worried about food or shelter or has a pressing medical concern, getting a reminder about the importance of getting a flu shot is not high on their list. Because we realise that better health is a journey and not a destination, we continue to find ways to make it easier for our members to understand their healthcare plans, gain access to the right services based on their personal profile, optimize what’s available to them and ultimately deliver an outstanding member experience.

Our success depends on our ability to overcome challenges better and faster than our competitors. To that end, the smart use of digital technology will certainly be a key enabler of our strategy going forward. Our healthcare plans allow members to receive care from some of the best physicians at many of the best hospitals in New York City, which is quite remarkable, really.

“Our success depends on our ability to overcome challenges better and faster than our competitors. To that end, the smart use of digital technology will certainly be a key enabler of our strategy going forward.”

Connecting the right service to people who are in real need in a personalized, professional way is core to our mission. Our unique advantage is rooted in our mission of putting members first by aligning our goals with the health care providers who deliver care. This value-based care model has been a catalyst for sustained growth over the course of our 25 year history, in one of the most dynamic markets in the country.

CB: With all the new technology that is emerging, particularly in the healthcare sector, how do you cut through the noise and determine where to place your digital technology investments to suit both your member’s needs and long-term transformation goals?

SB: Our focus is squarely on enhancing the member experience. One of the ways we try to distinguish ourselves is through trust and sensitivity to each member’s unique situation. If someone is worried about food or shelter or has a pressing medical concern, getting a reminder about the importance of getting a flu shot is not high on their list. Because we realise that better health is a journey and not a destination, we continue to find ways to make it easier for our members to understand their healthcare plans, gain access to the right services based on their personal profile, optimize what’s available to them and ultimately deliver an outstanding member experience.

Our success depends on our ability to overcome challenges better and faster than our competitors. To that end, the smart use of digital technology will certainly be a key enabler of our strategy going forward. Our healthcare plans allow members to receive care from some of the best physicians at many of the best hospitals in New York City, which is quite remarkable, really.

“Our success depends on our ability to overcome challenges better and faster than our competitors. To that end, the smart use of digital technology will certainly be a key enabler of our strategy going forward.”

Connecting the right service to people who are in real need in a personalized, professional way is core to our mission. Our unique advantage is rooted in our mission of putting members first by aligning our goals with the health care providers who deliver care. This value-based care model has been a catalyst for sustained growth over the course of our 25 year history, in one of the most dynamic markets in the country.

CB: Clearly any type of organizational transformation requires some tough decisions and clear measurements. How do you get everyone culturally onboard and in sync with this type of major shift?

SB: Like many health insurers, we’ve been going through a multi-year business transformation―assessing our core capabilities and evaluating areas for improvement. We’re using our marketing team to conduct research and identify ways to elevate and optimise the member experience. A key differentiator for us, however, is that our business model as a non-profit provider, allows us to be more member-centric and place a large amount of our focus on improving member benefits and service delivery. Ultimately the savings we achieve through better execution and better care management of our members is returned to the provider delivery system, and then the cycle repeats. So, while value-based care may be a new area of focus for many organizations, it has always been our core focus.

">“From a leadership perspective, we can’t afford to be timid in our technology approach. It requires clarity, boldness and a precise picture of the type of capabilities and the specific ROI we need to elevate us to the next level.”

Delivering high-value service is essential but we still need to prioritize our digital plans and initiatives to ensure a strong return on investment. If we don’t get a solid return, we can’t reinvest in our capabilities to improve our services and deliver even more benefits to members. One expression we like to use is: “Innovators are the ones whose dreams are clearer than the reality that tells them they are crazy.” The reality is the world is going digital and those who are not on the cutting edge will be left behind.

From a leadership perspective, we can’t afford to be timid in our technology approach. It requires clarity, boldness and a precise picture of the type of capabilities and the specific ROI we need to elevate us to the next level.

CB: With this massive trend towards everything digital, what technologies do you see having the greatest impact on health care in the next three years?

I believe digital technology will continue to enhance our member experience allowing us to deliver more useful and personalized information in more consumable and efficient ways. I believe analytics, for example, will continue to play a major role in improving the customer experience in health care and across all industry sectors.

Certainly creating, delivering and sustaining a successful healthcare plan is a complicated endeavor. The good news is we operate in a data-rich environment and the ability to use and analyze information in a highly dynamic way can provide important operational and strategic advantages. We intend to capitalize on that information by investing in new data warehouse capabilities that allow us to work from “a single version of the truth” across all our operating applications. Our ability to be more efficient will hit a limit at some point―you can only be so efficient in answering the phones and paying claims. Where we can really distinguish ourselves is in the area of decision making about care delivery and meeting the personal healthcare needs of each and every one of our members.

CB: When you talk about some of the cultural changes companies today are going through as they transform their operations, what are some of the impacts you are seeing at Healthfirst?

SB: One impact of our customer-centric culture is that our employees truly care about our mission―our success at accomplishing that mission is highly motivating. We operate in a highly competitive, regulatory-intensive environment. Throughout this constant pressure, we continue to meet our operational and financial performance goals. Success spurs a motivation cycle where we are able to share our profits with our hospital sponsors who invest more in our product, giving our members a better healthcare and insurance experience. It’s a challenge but it’s motivating because people crave success and want more. That is a big sustaining factor for us.

CB: How would you define your personal mission or goal through this journey of improving the healthcare experience?

SB: I would say that we are certainly a community-centric health insurance provider. We are mission-driven and it is a cultural norm for us to be nimble. This operational agility allows us to do things more rapidly. We are not perfect and we don’t have infinite funds but we have the opportunity to impact our market in two substantial ways.

The first is simply providing efficient access to high-quality care. We have the best healthcare in the world but oftentimes connecting people to the right care at the right time at the right cost can be a major challenge, particularly for the disadvantaged in society. I believe we are having a major impact on that. Second, because of our community engagement capabilities, we can influence our members in ways that would be difficult for providers who are not “hyper-local.” We help people live a better life by providing access to services that take care of what is urgent and by coordinating resources so they can focus on their health. That’s an important and inspiring mission to fulfill.

Follow Steve on LinkedIn.