Podcast: 2016 Wellness Trends with Mark McConnell
In this episode of the Well-Being Experts podcast, we’re discussing 2016 trends, including how health plans are changing and where they’re going next. We sat down with Mark McConnell, Vice President of Health and Wellness Solutions at Onlife Health, to talk about the driving trends around fully insured, self-funded, and exchange health plans. He also shared what’s new in the marketplace as it relates to the blending of technology and the human connection.
“Every single time we have the ability to effect change, we need to try to effect change.”
Want to dive deeper into this Well-Being Experts podcast? Here's the full transcript from our discussion with Mark McConnell, Vice President of Health and Wellness Solutions at Onlife Health.
Mark: One of the things that we understand as an organization is the role and the power that technology can play, but we also know that, often, it is the human connection aspect of what we do that is more meaningful for many of our participant/members.
Host: This is the Well-Being Experts podcast and you just heard from Mark McConnell, Vice President of Health and Wellness Solutions at Onlife Health. We talked about the driving trends around fully insured, self-funded, and exchange health plans. He also shared what’s new in the marketplace as it relates to the blending of technology and the human connection.
Mark: What we know we’ve got to do is: every single time we have the ability to effect change, we need to try to effect change, and if that’s daily, that would be optimal.
Host: On our fourth episode of the Well-Being Experts podcast, brought to you by Onlife Health, we’re discussing how health plans are changing and where they’re going next. Here’s a quick snapshot of Mark’s background.
Mark: I’ve been in this total population health management space for over 20 years and I’ve had the unique opportunity to see that from a few different perspectives. I worked for a very large auto manufacturer who was very aggressive and proactive in the health management space as a private purchaser of healthcare. I’ve also worked for a health plan in a variety of different roles, and I’ve also worked here in this vendor-management space where we’ve been a part of helping health plans to develop total population health management strategies and solutions for quite some period of time.
Host: Previously, we’ve heard discussions around behavior change, data, user experiences and much more. This episode is going to take a closer look at some of those especially as it relates to today’s pain points in health plans.
For more content like this, go to onlifehealth.com/resources. Enjoy the conversation!
Host: I’m going to begin with just the types of questions that you’re hearing, routinely, from health plans today.
Mark: Yeah. Thanks. I think it falls into a couple of different categories, and often it depends on the geography of the health plan, it depends on the demographics or the region of the country in which they operate, and it also depends quite a bit on the line of business that they’re trying to affect. Many of the questions that we would get from a health plan who has historically been B2B and is now going to a B2C are around, “How do you translate some of the successes that you’ve had communicating a wellness program to an employer or a broader total population health management program to an employer, out into a consumer marketplace?” in a scenario where many of those health plans do not have deep experience. And they’re looking for assistance in that. We may be asked, “How do you create a unique member experience using wellness as well as other assets the health plan has at their disposal to create this menu of items that on the exchange market might appeal to a consumer who’s looking to select a partner?” That’s a very, very popular question that we get pretty frequently in the last year or so.
In addition, there are health plans who have very deep and progressive employer partners and may, in fact, also have a very active business group in their marketplace, and their questions are aligned more around, “How do I take this wellness capability or this lifestyle management capability that you guys have and create a way that, coupled again or partnered with our solution set, can engage some of our employer customers who are asking for an impact on their total claims cost, an impact on their productivity with their employee workforce, and the ability to attract and retain great employees?” And that’s a whole different value proposition that we may have been asked on the exchange side.
And then of course, most health plans also have a fully insured block of business, and there, they’re looking for, “How do I use wellness as an additional lever or tool in order to affect some of the claims cost that we’re incurring as an overall health plan?” Depending on where we’re at in an organization, where we are in the country, who within the executive leadership is the sponsor of this conversation with us, those questions are all on the table for us and have been over the course of the last couple of years.
Host: Now, we’re going to dig a little bit deeper into all three of those main areas – the fully insured, the self-funded and the exchange. Before we get to that, are there general metrics and trends? Keeping at the top of your mind, we’re in a new year now and we’re looking into the future, what do you think are the most important metrics to be thinking about right now? What do you think is influencing this business right now?
Mark: I’ll go back to the line of business conversation and it is very line-of-business dependent. In other words, on the fully insured side of the house where they are trying to affect medical claims cost, there may be specific metrics around reductions of risk factors, and some of those reductions and risk factors, they can directly attribute to cost savings over the course of a year. That could be a very viable metric that we build into some of those conversations. On the self-funded side, they’re often looking for additional revenue and creating a value proposition with their employer groups that drives throughput in all their ancillary programs like EAP, price transparency, case management, disease management, and so it could be a conversation about how do we bundle that and how do we create the metrics that drive penetration into that employer book of business. And then on the exchange side, as I mentioned earlier, I think there’s definitely a conversation about how do we use wellness to create some differentiation in the marketplace, and there’s part of a broader component that we would use in order to allow the consumers to look between different options and why would they choose the option that includes what we’ve put together with this health plan.
Host: Looking closer now at each of those three, the pain points that fully insured, self-funded, and exchange, as we look closer, what are other types of questions? What are the specific types of pain points, if you had to choose these two or three?
Mark: I think, on the self insured on the employer side of the house, the health plans are looking predominantly for a way to continue to stay relevant and to stay engaged with those employer groups and so they provide – I think they’re in a unique position right now, they really are – to pull together some data from disparate sources like claims information, pharmacy information, eligibility files, EAP programs, provider networks. I think they’re in a unique position right now to leverage all those assets with some additional capabilities that a company like Onlife will provide in order to attract and retain large employer customers in a way in which they’re seeing that health insurance or health plan, as not just a claims payer and a provider network, but somebody who’s partnered with them to drive institutional change in all those different metrics that we’re trying to effect.
I think we have the ability, not alone, but in partnership, and it’s that important distinction that we make. We private label our solution underneath the health plan. It’s the health plan’s program at the end of the day that creates these solutions to their employer groups. We are merely an asset that they would use and hopefully a very strategic partner that would be used in both the value creation and product bundling capabilities that we would create on the front end to create a solution set that we could offer to those employers as well as a trusted partner that would be alongside them during the sale and then during the delivery of the solution in order to continue to create value for them that they could then transpose to their client.
Well-Being Experts is sponsored by Onlife Health. Onlife Health is a comprehensive wellness provider serving health plans and large employers nationwide. With 20 years of industry experience and over 10 million members, Onlife takes a high-touch, high-tech approach to wellness that creates real results for your population. Find out more on onlifehealth.com.
Host: I’m curious to hear how the role of technology either changes, or adapts, or grows as it relates to the desire to have more personalization.
Mark: One of the things we have found is that there is no cookie cutter approach to wellness. We spend a lot of time on the front end of any opportunity to talk to a potential partner that involves trying to discover as much around the types of value creation they’re trying to create, the way in which they’re trying to create it, the way they’ll measure the outcomes, and the type of population that they’re going to serve. In many cases, at the end of the day, technology can play a very vital role in helping us to achieve those goals. Technology can both allow us to collect data on a real time basis, and definitely at a higher frequency rate than we would with just a health assessment or just biometric screening on an annual or even semi-annual basis. Technology also allows us to take disparate data sources and try to create personas that help us tailor the interventions and unique member experience in a way in which a member might be more receptive to the type of data that that information would bring.
The other thing that data does is it helps to allow the member some ability to control both the mode in which they receive the information and the frequency at which they receive it. There is still a tremendous benefit that we get off of the human connection of our programs. That human connection can be via telephone, where a member would speak to a health coach and that health coach would work on the specific challenges and goals that they had around their unique health needs. It could also be on-site at an employer group, where there is a group of employees that want to gather together and speak specifically about a topic area that’s of interest. Or they have an on-site clinic and they’re looking for a way in which biometric screening could be put on at that on-site clinic and drive additional participation in some of the services that they would offer on-site.
All those things are very necessary and will never be supplanted 100% by technology, but we know that technology can advantage all those human connections, help us do it at scale, help us leverage some of the efficiencies of those human connections so that we aren’t needing to hire 3,000 of those very passionate health coaches, but how do we use them more effectively to create the types of unique member experiences that we know drive the value creation and savings that we want to achieve for our partners.
Host: One thing I was curious to ask, and this might be a detour we don’t want to go down, but I’m curious, as we’re thinking about trends, we’re thinking about what we’re seeing new in the marketplace now as relates to all the devices that are creating data, and all the different opportunities to take that data and make meaningful information out of it. I was just curious to see if you wanted to talk any more about the importance of being able to understand all this information so it can, at the end of the day, help someone’s life be better and be healthier.
Mark: I think that health plans are in a very unique situation. They have lots of data and information that can be utilized in order to create a persona. All that persona really does is allow us to craft the types of information, the frequency of that information, the mode in which that information is received, and the types of intervention that we might deliver in order to ultimately provide the end user with a unique and meaningful member experience. To the extent that we are creating that data on a very regular basis, it means that we have the ability to have that member interface with our solution on a very regular basis.
We know sustained behavior change is tough. There is no silver bullet in that engagement, and so what we know we’ve got to do is, every single time we have the ability to effect change, we need to try to effect change. And if that’s daily, that would be optimal, but we know that, in the short term, may not be likely, and so, again, the frequency to the extent we can improve the frequency of that intervention or that information, we can only do that if the information is relevant and valuable to the end user. We believe that gathering additional data about the member and helping to personalize that to the member will allow us to create that type of engagement that drives them back. It makes them want to go back to our solution, not just the portal but the ability to see some of that information on their mobile phone, to track their progress on a fitness device, to talk to their coach and get reinforcement via telephone, and maybe even to get some of that information via text.
We know different demographic groups want to receive that information at different frequencies and through different modalities. It’s easy to bucket people into Gen X or baby boomer, but the reality is, even within those groups, there are different levels and frequency of engagement that people wish to receive, and so to the extent possible, we want to allow them some control over that because we know, at the end of the day, that will help to improve the engagement.
Host: I think that fits really well into this next question. I wanted to ask you a little about how the personalization needs and those desires have been impacting and shaping the marketplace.
Mark: At a basic level, one of the things that’s changed over the course of the last couple of years is the influence of the mobile phone on the way in which we push content, interact with the member, and how they want to interface with a program like total population health, lifestyle management, and wellness. We didn’t create a mobile solution because we thought it was the most effective way to interface with a client or an end user. The end user told us they access information using their mobile phone, and if you want to stay relevant with me, you need to create the types of tools, solutions, and interfaces that would make me want to do that on a more regular basis. We clearly saw that as a reason to continue to develop a very strong mobile presence.
An additional area of opportunity is the “Bring Your Own Device”. We know a lot of people are using fitness devices of all sorts, from Fitbits to Garmins, Jawbone, Apple Watches, and the list of those is increasing everyday. We didn’t want to forget about that as an opportunity to both gather data on a very regular basis, but also a way to tailor the program to that individual based on some of the attributes that we would see from the frequency of the use, the amount of steps, or the types of programs that they used in order to do things like exercise. All that data and information, if collected, would allow us to tailor a program, an intervention, and even push information and content that is more relevant to that person as an individual and not just as a member of either a health plan, an employer group or a line of business.
Host: The more you have all this integrated, does it reveal more opportunities to help people meet their goals?
Mark: Yeah. I think there’s a couple of things in that point. One is, we know that health plans often have very detailed information on claims, whether that be medical claims or pharmacy claims, and they may have other programs that interface with a member on a regular basis. If they do, that’s great. If they don’t and there is a way to use things like health assessments, health coaching calls, and biometric screenings as additional ways to identify some of the subcategories of an employee population, we find that to be an area where providing that information allows us to stratify members to put them into certain categories and assist in a health plan’s efforts to create the right tailored, unique member experience for that individual.
Host: I’m curious to hear how the role of technology either changes, or adapts, or grows as it relates to the desire to have more personalization.
Mark: One of the things that we understand as an organization is the role and the power that technology can play, but we also know that, often, it is the human connection aspect of what we do that is more meaningful for many of our participant/members. And so, one of the things that we’ve developed is the whole technology-enabled services part of the way we describe our business, and that means that technology is not a means unto itself, but really a way that we allow our organization to help scale and supercharge the types of interventions that we drive everyday with our very impassioned coaches in our call center, the way our on-site coaches, who may be on the ground, either in a fitness center or an on-site clinic at an employer group. All technology does is allow them to gather more information and scale that interaction that they do on an everyday basis, that is that meaningful one-on-one human connection that we know, at the end of the day, for many people is what drives sustainable, unique experiences for the member.
Host: So the human connection, I’m hearing it loud and clear – there’s nothing that can replace that and the goal is to create more authentic human interactions because that, at the end of the day, is what’s going to help make a difference in the lives of the members and help them be healthier.
Mark: It’s definitely one of the things that we want to have in the arsenal, and the reality is that even an individual member does not have one standard way to receive that information over their lifetime. That will change as they get older or it’ll change if there’s a specific life event that happens for them where they’re diagnosed with a chronic disease, or they have an accident, or that they got a reading back for high blood pressure or high cholesterol levels, and they’re now in a different situation and maybe more receptive to some of the information that they’ve heard over the course over the last couple of years. Now they’ve got a meaningful reason for them to interface with a program like ours or a program that we have implemented through our health plan, that they didn’t a year ago. And so we want to be there at the point at which they’re ready. At the end of the day, if they’re not ready, behavior change is really tough to have happen.
Today’s podcast and additional perspective from Well-Being Experts can be found at onlifehealth.com/resources. We welcome any comments, questions, feedback, anything, at firstname.lastname@example.org. Thanks.