Consumerism and Disruption: Lessons from Florida Blue, Part 3

Editor’s note: In a three-part series, Morrison explores the consumerist-led disruption of conventional health care. The first part defined consumerism and showed how health plans are becoming more consumer friendly. The second part focused on the case of Florida Blue, a plan that helps consumers understand their insurance and make informed choices. This final part offers lessons from that case for health care strategy.

The case for Florida Blue provides insights on the rapidly changing field of consumerism in health. It also spurred me to think about where we are headed with consumerism in health. My takeaways: 

Meet people in their lives. Florida Blue is meeting people in their lives, in retail environments and on-line, with services and support, and with navigation tools that enhance the overall health care consumer experience.

Make the complex simple. Health care is complex; it needs to be made more simple. And even if we have simpler designs, we need to build better support tools for consumers that may involve more retail handholding and decision support. Health insurance is a complex product, and even tech-savvy Millennials struggle with it. Indeed, a recent Aon Consumer Survey found 41 percent of Millennials say: “I have stopped trying to figure out what I should pay for medical services and just pay the bill when it comes.”

Believe that scale and local market penetration matter. Insurers with significant market share in local markets, such as regional Blues plans, can have significant influence on provider systems and population health in their geography. Powerful local plans have an opportunity to set the standards and change the rules of engagement for the entire local health system.

 Use multiple channels. Consumers, even Millennials, are not all digital all the time. Sometimes we need a little real help, face to face.

Expect that technology and policy will expand consumer-facing digital services. Recent policy and technology changes such as Fast Healthcare Interoperability Resource (FHIR) standards, open Application Programming Interfaces (APIs) and Blockchain tools are all likely to promote interoperability and create a rich and rapidly evolving environment of consumer-facing digital offerings. This new frontier is not without challenges, such as cybersecurity, data privacy and the potential for fraud and abuse; but overall, we will see an acceleration in the number, range and hopefully the quality of digitally enabled, consumer-facing solutions. Expect continued competition and disruption in this space. 

Admit that navigation tools need work. In the early 2000s we asked a series of questions in Harris Interactive Surveys about consumers’ use of report cards on health plans, hospitals and doctors. We asked: Are you aware of them, do you ever use the report card, and did you actually make a change on the basis of the report card? We did the surveys every year for 10 years, and the square root of zero humans ever changed a decision based on the report card (actually 1 percent). I am sure it’s better now (we’ll check this year). Consumers do want information to make comparisons on cost and quality of plans, providers and treatment options; but we need to get better in consumer decision support. 

Make more offerings free. Great consumer service brands such as Google and Facebook are popular partly because they are free. (Actually not really free, since we users are getting bombarded with commercial messages as we surf, post and like.) In health insurance, there are actually some free or close to free offerings, such as Medicaid, zero premium Medicare Advantage and highly subsidized exchange offerings. But generally, health insurance carries a consumer cost that is more visible and economically painful every year. We may not all get to free, but the ultimate goal is to get health insurance and health care affordable for all concerned. Let’s work on that.

Ian Morrison is an author, consultant and futurist based in Menlo Park, Calif. He is also a regular contributor to AHA Today. The opinions expressed by the author do not necessarily reflect the policy of the American Hospital Association.