Expect collaboration to reshape the Medicare Advantage landscape in 2019-20. Strategic alliances, partnerships, and affiliations are becoming a key component of successful MA programs as they coalesce around three key areas: Product, Care Delivery, & Distribution.
Expect collaboration to reshape the Medicare Advantage landscape in 2019-20. Strategic alliances, partnerships, and affiliations are becoming a key component of successful MA programs as they coalesce around three key areas:
- Product: As MA plans struggle to achieve product differentiation, the race is on to include the “right” mix of new supplemental benefits–vision/hearing/dental benefits, medical transportation, over-the-counter (OTC) allowances, gym memberships, in-home services, telemedicine, or massage and acupuncture. Standing out from the pack often depends on selecting and managing the best partners to offer the most attractive array of benefits.
- Care delivery: As more MA plans place increased emphasis on the “community” nature of their customer relationships, expect provider partnerships, both health system and doctor groups, to take on increased importance. Health care is local…and it’s personal. The ability to leverage the connections between beneficiaries and their community of physicians, hospitals and health professionals can be a critical MA plan success factor.
- Distribution: In an environment where horizontal integration is sweeping across the health insurance landscape, MA plans must look to the value of strategic affiliation options that expand their marketplace sales reach. For example, one national big-box chain has insurance agents attached to more than half of their 5,500+ stores. The retailization of health care is here. Whether stand-alone MA pop-ups, big box retailers, pharmacy or supermarket chains, or mega-primary care networks, partnerships are headed for ‘table-stakes’ status in the MA marketplace.
What it takes
Collaboration among parties with different interests and business drivers isn’t easy. Meeting stakeholder expectations, balancing operational and financial goals, and servicing customer demands takes extraordinary internal discipline, let alone meeting the needs of multiple organizations. However, the recent blitz of horizontal integration is reshaping the business of health care. Collaboration is successful because parties involved are driven by common vision, mutual trust and transparency. Potential partners must assess cross-functional compatibility and remain disciplined around the value exchange collaboration offers.
As consolidated multi-hospital systems and national mega-insurers build dominant market positions, and retail behemoths storm the health care market, we’re also seeing alliances never before thought possible…some are competitors playing defense, others are seeking scalability, and still others simply want to take advantage of a perfect storm of an industry in transformation. As a result, we’re seeing retail giants acquire or partner with MA insurers, providers morphing into payers (hospital-based MA plans), pharmacies partnering with MA focused primary care clinics, and ride-sharing companies providing medical transport benefits (two years ago no one expected to see Uber and Lyft at an MA conference).
Everyone can win
MA will likely add 5 million beneficiaries over the next four years. Collaboration has become a cornerstone business practice in today's competitive Medicare sector. Successful collaboration must incorporate well-defined, disciplined controls—due diligence prior to selecting your business partners, dedicated resources to aggressively manage the ongoing relationship, and meaningful performance measures to evaluate the venture.
For those willing to invest in these relationship-driven strategies, collaboration can yield big rewards: open-up new markets, extend product offerings, increase customer access, expand sales capacity, and ultimately, reap collective financial gain. For MA beneficiaries, a collaborative approach for MA plans can broaden access to care, augment benefits, enhance customer experiences, improve patient outcomes, and bring efficiencies that lower overall cost.
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Lindsay Resnick is executive vice president at Wunderman Health, a creative, data and technology marketing agency built to inspire action and optimize customer experiences for healthcare brands. He can be reached at email@example.com.