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Answer THIS Question Before Launching Your Provider-Sponsored Health Plan

As provider-sponsored health plans (PSHPs) gain momentum across the country, the boundaries between providers and payors continues to blur.

Taking on full responsibility for a patient population presents an opportunity for providers to diversify their revenue and gain a footing in a changing healthcare landscape. It also requires a daunting set of responsibilities, ones that can be overwhelming for providers to wrap their arms around. There are expert resources available, and technology platforms to enable change and new capabilities, yet the first question must always be strategic.

In the haste to assemble all the pieces necessary to launch their plan, providers often overlook the importance of answering a foundational question that can help determine their success as they go to market: why establish a provider-sponsored health plan?

Providers who first launch PSHPs for their own employees as a test pilot before expanding more broadly could be overlooking this key question.

The importance of the why question is simple. Providers who enter the payor space are jumping into a crowded field, and they are doing it against competitors who have years of experience and existing market share. In addition, they risk aggravating the payors in their market when it comes time to renegotiate their contracts. Without a clear and compelling narrative that explains why a provider is launching its own PSHP, the plan risks becoming a “me too” product that’s no different than what’s already on the market.

Answering the why question is central to a PSHP’s purpose and identity, and the means to address the “why” is found in a brand strategy. A brand strategy is a guiding document that articulates how you want your organization, in this case serving as an insurance option, to be valued and differentiated in the market. A brand strategy should address your market positioning, brand promise, and brand attributes, and will serve as the core of a plan’s marketing strategy to create differentiation and communicate value to the prospective buyer.  From your plan’s name to ad copy, the answer to why must be infused into every element of the PSHP’s core message.

When developing a brand strategy for your PSHP, how do you go about answering the simple, yet confounding, question of “why?”  Consider these issues, and you will be on your way to finding out:
What do prospective customers want?

We often think we know everything there is to know about our customers and our market. Yet that’s not the case. Try asking prospective customers what they want through professional research, which can help uncover compelling market gaps that your PSHP can be positioned to address. Most provider organizations have a keen understanding of consumers as patients, but not necessarily consumers and employers as insurance purchasers.

What problem is your PSHP uniquely positioned to solve?

Whether it’s a prestigious service line, popular physicians, a convenient location or other factors, each provider organization has unique strengths that distinguish it in its local market. Consider yours, and think about how you can leverage those strengths to play a central and visible role in how you market your PSHP. How can your organization deliver coordinated care in a way that current health plans cannot?

Are there particular audiences whose needs align with your organization’s unique strengths?

Perhaps there are employers in your market with particular healthcare needs that your organization is well-positioned to address, or a large Medicare Advantage population that you already serve. Identifying your target launch audience should be one of your first considerations in establishing your PSHP. It should also play a key role in establishing your plan’s mission, as well as its brand positioning.

September 24, 2015
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