Here, five executives from Blue Cross and Blue Shield, Aetna, Texas Health Aetna, First Choice Health and NeuGen discuss overcoming challenges related to analytics, cost, member acquisition and provider relations:
1. Shahid Alam, senior vice president and chief analytics & information officer at Blue Cross and Blue Shield of Minnesota and its parent company, Stella, on using analytics: Unfortunately, it can be common in our industry to focus on vendors, tools and tactics before there's a plan to bring all of the work together under the same strategy. In my opinion, a successful analytics strategy starts with a solid understanding of where the organization wants to go and how they will get there. This means understanding customer needs; creating secure, scalable and innovative solutions; and focusing on deadlines and results along the way.
2. Firdaus Bhathena, chief digital officer at Aetna, on bending healthcare's cost curve: It's about moving healthcare to the kitchen table. In that vein, Aetna is transitioning to a health and wellness partner for our members. The only way we're going to bend cost curves is by partnering with consumers. That means not just being there when they break their leg. What we do for members on a day-to-day basis can keep them out of high-cost categories, like ER visits.
3. John Church, vice president and CIO of Wisconsin health insurance service company NeuGen, on acquiring and retaining members: Both the insurer and member have to have skin in the game. Insurers have to work with members through medical management programs. By aiding the member in living a healthy lifestyle, we can provide members with sustainable increases in premium.
4. Jaja Okigwe, president and CEO of First Choice Health, on expanding physician networks: Keeping provider data current for member navigation is critical. With a network of over 100,000 providers, managing the ongoing changes to physician practice locations, phone numbers and hospital affiliations, as well as maintaining a rigorous provider quality assessment program, are both significant undertakings.
5. Cory Scott, CEO of Texas Health Aetna, on negotiating with providers: There are so many factors that drive a financial negotiation; sometimes we just need to take a deep breath and think of our community and the individuals that live there, make decisions that help the outcomes and improve the health of the community. Misaligned goals can be detrimental. I will be honest — sometimes my wife and I don't agree, and I think we have pretty aligned goals. These types of relationships require continued work and ongoing refinement.