Podcast: Replacing the Incumbent with Mark McConnell

In this episode of the Well-Being Experts podcast, we’re discussing what happens when the wellness incumbent is replaced. We sat down with Mark McConnell, Vice President of Health and Wellness Solutions at Onlife Health, who offers his advice on what to look out for during implementations.

“I look at a vendor as somebody who is given the opportunity to provide a very discreet solution or service. I look at a partnership opportunity as somebody who is looking for a joint innovation that you create together.”

 

 

 

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 McConnell: I look at a vendor as somebody who is given the opportunity to provide a very discreet solution or service. I look at a partnership opportunity as somebody who is looking for a joint innovation that you create together.

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 had the chance to sit down to discuss what happens when the wellness incumbent is replaced, including advice on what to look out for during implementations.

Mark: Where I've seen implementations in other organizations not go well is when they underestimated the expectations of the client. If it's not understood on the front end, it has absolutely no chance of being successful as you go through implementation and into execution.

Host: For more content like this, head on over to onlifehealth.com/resources. Enjoy the conversation.

Mark: Hello. I am Mark McConnell and I am the Vice President of Health and Wellness Solutions here at Onlife Health. I've been in the marketplace for over 25 years, primarily serving as the business development lead in a number of different population health management companies. My passion in my career has been around helping, specifically health plans and employers generate the types of results that I know can come from programs and solutions like we offer here at Onlife Health. I'm committed to making sure that we lead Onlife Health into being the premier Blue's health and wellness vendor for every Blue plan in this country.

Host: A few of the things that we're going to talk about today, it's all surrounding around replacing the incumbent. The first question I want to lead off here with is just what your opinion is as to why contracts with wellness vendors typically don't exceed two to three years. Do you have any thoughts around that?

Mark: I do and I would first want to draw the distinction between a vendor and a partner. At Onlife, we certainly would love the opportunity to be a partner with our health plans, and, as a result, partnerships tend to – by their nature – generate longer term arrangements or agreements. But sometimes, that's not possible. And, if it isn't possible and we're in more of a vendor relationship where we are providing a solution to a specific area of the health plan, three-year contracts are typical for a number of reasons. I would say, first, the landscape is changing and is ever evolving. Often, the health plans are not willing to commit a longer period of time to any one vendor.

I think the second is often those proposals have a built-in price increase associated with them and the market is often fluctuating to the point where if we tie in the pricing to a CPI or Consumer Price Index, that neither side wants to get too far ahead and lock in pricing for too long a period of time. I think the other rationale is that often, the programs are designed to create outcomes over a year or two period of time. By year three, the health plan will be able to tell based on what they were looking to produce as an outcome from the vendor, whether or not that vendor will be successful with their various populations.

Maybe the final reason is that often, the smaller vendors in our space go through acquisitions or many roll out of business. Often, it's that volatility in some of our competitors in those smaller organizations that lead a larger organization to be wary about a longer term relationship with a smaller vendor partner.

Host: I'm really curious to hear more of your thoughts about the difference or true difference between a vendor versus a partnership.

Mark: I think people might have different definitions of those. I'll tell you what mine is. I look at a vendor as somebody who is given the opportunity to provide a very discreet solution or service. That could be something as basic as, "I need a portal that looks like X, Y, and Z and I want you to offer it for a term not to exceed three years." I look at a partnership opportunity as somebody who is looking for a broader set of solutions from you, but more importantly, is engaging you in the types of conversation that would lead to joint innovation that you create together, owned of course by the health plan and managed and controlled by the health plan.

But often, we're seen in a partnership relationship as an extension of various parts of their organization. It could be an IT extension where they have great ideas, they have exceptional innovation, don't necessarily have the bandwidth in their organization to execute on that, so would engage an organization like Onlife to go out and, on behalf of them, help them to joint innovate or create these opportunities that are then extended out into the marketplace. That partnership could occur in other areas beyond IT. It could exist in reporting or marketing where we are trying innovative new pilots to try to generate additional engagement and participation within certain lines of business. How can we try new things to try to crack the code of various entities within their organization, either by line of business, by demographic? What are the types of personas that we are trying to crack that allow us to get deeper into the populations that they are trying to penetrate?

Host: As we're talking a little about that lifespan – two to three years – is there a typical industry turnover rate that comes to mind? Or when you think about turnover rate, what comes to your mind?

Mark: It's interesting. I would say that in the health plan market, the tendency to stick with a longer term vendor relationship or partner tends to be more prevalent than it is in the employer market. I know for us at Onlife, our customers have been around for many, many, many years. Often, that comes about not just because we have solutions that we provide to various lines of business that they offer, but also because of the outstanding service that we provide and the ability for us to innovate along with them to produce the kinds of new solution development they need for, perhaps new markets that they want to either enter into or offer our services in.

I would say that the turnover rate for a good vendor partner ought to be very low. I think also with partners like we have and other organizations have, when you're in a health plan and you're intertwined with other offerings that they have or other solutions that they provide and those assets become intermingled in a way that they're then represented as one seamless member experience out to their population, it becomes less likely that those products and solutions would be unwound from that organization. That tends to create longer term relationships with our health plan partners.

Host: Now, in some instances when there is a shorter lifespan, a shorter relationship – and I'm sure this is not easy to do – but how do you have talks with clients and how do you tactfully suggest that it may be time for them to consider changing vendors? How do you navigate that?

Mark: It's interesting. We often get the call as an inbound where they're very aware of some of the relationships that we have today and some of the results and solutions that we've been providing to multiple lines of business, and maybe they're not getting the types of results from their existing vendor as they would like. That could be anything from engagement and participation numbers. It could be from a user experience perspective. But often, it's something very basic like the vendor is not delivering on the promises.

It's one of the things that we at Onlife feel contributes to the long-standing partnerships that we have with our health plan customers, is the ability to deliver on those promises. But often, that's the reason why we are brought in and we've seen organizations where we've come in and taken a relationship away from a competitor or a vendor. In those relationships, we've come in and established new programs, new solutions, and generated some additional outcomes that they had been unable to see or achieve in the past. But more importantly, what they've said to us is, "You guys delivered on the promises that you gave us upfront." I think more than anything, that's ultimately what these guys are looking for.

Host: Do you find that surprising at all?

Mark: Well, I think one of the other areas that they find is that the partner that they have or the vendor that they have in place may be a great solution for one line of business. But when they look at the opportunity and it often happens with their large or strategic employer customers where the vendor is not able to flex or innovate or create the kind of value that this large strategic employer in their book of business might be looking for. Often, it's that large employer that creates the energy or the impetus within the health plan to consider other opportunities. What we often hear is, "The solution that we have today might work for our fully insured business where we offer only a very minimal program set and it's interwoven into other solutions that we offer as an organization." But where we're tripping and falling is in the ASO market, where the employer customers are not getting the sorts of flexibility or customization or modularization that they're looking for in order to achieve the outcomes that they are looking to the health plan to provide.

Host: As we're talking about some of these key decisions, a client is thinking about and that need to be made, where do you see risk come into play with – when I say the word risk, I'm really thinking about the risk of choosing the wrong vendor or doing the wrong thing – what is at stake?

Mark: I'll give a specific example that happened over the course of the last six months. We were talking to a plan who had implemented a vendor relationship and had made an assumption I believe around their experience in the ASO employer marketplace. Specifically, did not understand the nuances of that market in their particular geography. What we established on the front end was that, rather than a very traditional à la carte menu that they would train their sales folks on and roll out into the marketplace, we suggested they go to market strategy that was very specifically bundling products and solutions together. Some were ours, some were the health plans with very specific price points and value propositions associated with them, with a training plan for their sales team, and a go-to market plan that we are able to roll out and establish with them so that they could have a very clear understanding of the types of targets that they would have in their health plan, ASO market, and the way in which we would help them penetrate that market with products and solutions, both that they owned as well as what we owned.

Had we not done that front end assessment, we would not have understood both the ways in which they had not adequately gotten that product in service from their previous vendor nor would we have understood and been able to articulate the kinds of additional value we would provide with a bundled solution out into their ASO market. There are examples of that that I could offer in the exchange market as well. It is establishing exactly what outcome they're looking to achieve, what problem they're trying to solve, and us being able to step back and bring our 20 years of experience to try and provide advice and counsel around some of the successes that we've had in partnership with other organizations we've worked with over the years.

Host: But sometimes you might not know you don't know. You might be looking right at it, but if you don't know what you're looking for, you just don't even see it.

Mark: That's right. I think understanding, trying to articulate the value of having gone through trial and error for 20 years and being able to understand exactly the types of things that have worked and avoiding those things that we know we've tried and maybe haven't worked as we've expected over the years, allows us for – especially new clients – to learn off the 20 years that we've been doing this to make sure that we've maximized their opportunities to be successful.

Host: One of the triggers I'm hearing from you that has a big impact and needing to shift is just the promises not being delivered on. Are there any other triggers that might either occur at the same time or maybe before that that contribute to that decision to change?

Mark: Interestingly, this is a private labeled solution. It isn't as if the employer customer hears Onlife Health's name. What they see is that the Blue Cross Blue Shield plan that we've partnered with, a component of their solution is not working. We recognize how important it is for us to be delivering the components of the overall solution. They go out to the employer customers in a way that represents the true value of the brand name which often in the marketplace has been around for 50, even 100 or more years. We definitely understand the importance of supporting that private label solution that we are a part of out into the various lines of business that they may offer.

 

Well-Being Experts are supported by Onlife Health. Onlife Health is a comprehensive wellness provider serving health plans and large employers nationwide. With over ten million members and 20 years of industry experience, Onlife takes a high touch, high tech approach to wellness that creates real results for your population. Find out more at onlifehealth.com.

 

Host: When you start thinking now, next about the decisions that a client will need to make before they're making this big change, so they know they need to do this, now they're thinking about what needs to go into this. What do you think those decision items need to be? What are the conversations that need to be taking place? What are your thoughts?

Mark: One of the areas that we spend a lot of time talking about – both in the front-end sales processes as well as the implementation and ongoing account management – is where wellness and healthcare services fall in the overall strategic vision of the plan. Often, that strategic vision could be different by line of business. For instance, there could be a very specific need that they have in their employer market if they've got a very robust strategic group of large employers who are driving that market and pushing innovation. They may have very specific needs in that market that we would want to make sure are addressed in the solution offering. They could also feel that wellness that we've seen this year is a very important component of an exchange offering.

To the extent, that they have an exchange product and they want to have the wellness component as a part of it, then we would have perhaps a very different conversation about the way in which that program would intertwine with their solution in that market. Same with Medicare advantage, same with a fully insured book. I think establishing the objectives that you're trying to achieve in partnership with your health plan is one of the very first things that we try to establish. That helps us – as a solution provider – better craft the way in which we would give information to them. It would also in turn help them understand our capabilities so that it fits into what they're doing today as well as what they may plan on doing down the road.

Host: It reminds me kind of what we talked about a moment ago about the partnership, the relationship, the conversation. It's funny what they need and then – none of this is cookie-cutter.

Mark: It's never cookie-cutter and that's part of the fun about what we do...

Host: Yeah, you have a big smile on your face when you say that too.

Mark: It is and as if you're walking in with a presentation and it is the same presentation and you're pitching a minor capabilities, it starts with being a solution provider. That means, to be a solution provider, you must first understand what problem it is they're trying to solve. Often, in a health plan that we are talking to, not only is that problem different by line of business, but it's also different within the departments that are represented in the room that we're presenting to IT, maybe has a very different need out of the program than marketing does or that the sales team does. As a result of that, we have to craft the expectation around our deliverables differently for those audiences, but in a way that it provides a cohesive solution out to the broader market.

Host: We talked about this just a moment ago as it relates to some of the triggers that will occur when a client starts to really think about making a vendor change. What are the things that happen when a client knows like it is for sure time to evaluate the current situation?

Mark: Sure. I can tell you from firsthand experience over the course of the last year having visited 15 of these plans in person, it can be as simple as we didn't get something that we had asked for. It could be very simple like that. It could also be that over a period of time, they had a lot of issues or problems related to service. Many times, it is that they aren't getting the attention that they deserve from this which is difficult for me to imagine, given the prominence of these organizations in the community.

But that is a common theme that we hear is that they aren't getting the sort of attention that they had expected from a vendor partner. Then often. it does come down to what kind of results are you achieving together. Those results as I mentioned earlier could vary quite a bit depending on line of business, but they often fall into buckets like engagement participation, outcomes of some sort, whether they be financial or in some programs more clinical metrics, patient satisfaction. It could also be in terms of the way in which the employers are receiving the offering out in the marketplace.

Host: What are some of the first things that you would tell someone who's in that role of, "All right, we're going to actually make a change, what's next?"

Mark: I don't think it should be ever painful. I think it should be absolutely something that we should not under-represent in terms of ease. It is a complex situation. However, I can tell you that having done this for over 20 years, one of the things that Onife help brings is a very rigorous process around implementation. We know exactly what we will expect to see as we go through this. But more importantly, we understand what we should represent to the health plan they should expect to see during this process, the resources that they should need to commit, if any, and where those resources need to come from.

It often depends on exactly how interwoven the program was in their existing solution offering. It also depends on the types of lines of business that they've been offered into. It often depends on their expectation around the way in which the integration will look going forward. But in all of those situations and having done this both in large health plans over even five-state coverage areas with multiple lines of business, covering millions of lives, down to employer direct offerings which can often be just as complex but smaller numbers of lives, we've been very successful in making those transitions so that the employer or the health plan realizes that we've come in, we've created a valuable solution, it's private labeled, it's tried to minimize the impact on the membership which is their most important concern. But more importantly, delivered a very robust solution offering for the future.

Host: When you talk a little bit about the implementation part, what kinds of thresholds – or if there are thresholds – that differentiates from the larger, more complex implementations? I know you're saying it shouldn't be overwhelming, it shouldn't be stressful, but are there things that wouldn't possibly make implementation more complex? Does that change anything here?

Mark: The complexity of the implementation is typically tied to the integration with existing products and solutions within the health plan organization. If we are coming in and implementing an end-to-end solution that is all Onlife Health components, that is a little different implementation than if we're plugging in different components of the health plan into that offering for an integrated, seamless patient experience out to the member. We've done both, we've been successful with both, but one is a little bit more complicated and a little bit more complex for both organizations than the other.

Host: How are things from the user point of view, the member point of view? How do they normally handle this change and this shift? Is that a pain that they feel? How do they normally handle that?

Mark: They shouldn't feel pain. Because these are private label programs and they're often behind the branded solution that the health plan partner provides, they wouldn't necessarily see a change of name. What they would hopefully see is an enhanced user experience that allows them more either interoperability with the program, a more exciting engaging solution that they have as an offering, more tools for them in their toolkit. Those are the types of things that we hope happens from a new implementation. But from a look and feel perspective, we tailor all of that to the existing program that the plan has in place, so they should not see any disruption in the way the program looks to them.

Host: If you're successful in replacing an incumbent, are there pressures that arise from this with winning away the business? Are there things that you feel that either surprise you or...? What kind of pressures are there?

Mark: I think anytime a customer has experience that has led them to change vendors, they – as a result of that experience – have expectation that they are looking to fulfill. Oftentimes, you will see performance guarantees come into play that were based on a prior experience that you're then looking to fulfill. But I think what goes to the core of why Onlife Health has been around for so long and has the experience in these markets to back up a successful run is because we take pride in the way in which the solution looks to the member. We take pride in the way in which the client, or customer, or partner feels of us. We put it on ourselves to make sure that we want to blow out the expectation that they have of a health and wellness vendor and what a partnership experience can really look like versus a vendor relationship that they may have had in the past.

Host: In the partnership relationship, changing vendors, it shouldn't be painful. I definitely heard that loud and clear. When it is unfortunately painful in some other instances, what do you think some of those items that creates that friction?

Mark: What I have seen implementations in other organizations not go well is when they underestimated the expectations of the client and that they may have not done the amount of diligence necessary on the front-end to understand exactly the types of either value, or outcomes, or integration, or interruptibility between programs. That, if it's not understood on the front-end, has absolutely no chance of being successful as you go through implementation and into execution. We spend a lot of time on the front-end because we want to better understand and not just take or assume that we understand the value or the outcomes they're trying to achieve, but spend a lot of time on the front-end so that we in fact can map through that process, get an implementation and plan in place that meets the needs of the client, and we can roll it out successfully and have mutually successful solutions in place.

Host: We've talked about both sides all the way down to the member, the user's point of view. When you think about what the decision maker has on his or her mind, what are they usually thinking about? When they're trying to move the needle is – when they're thinking about trying to move the needle, when the switching of vendors occurs, what do you think is at the top of their mind?

Mark: Member experience has to be and often is at the top of their mind. They want to make sure that their members who are utilizing those programs and the members that they hope to entice to utilize those programs feel that this is not only a useful tool, but it is something that they look forward to using and being a part of. That experience has to drive the kinds of metrics that we are often measured on, which are participation and engagement metrics. Those are really proxies for, “how does a member experience look and feel, and why should somebody go in and utilize the combined offering that we've provided?”

Host: I like it. Again, I return to that focus on people, relationships and experience. That's what it comes down to. That's great. Well, do you have any final things or you'd want to share that are either on your heart or things that are on your mind about this?

Mark: One common theme that we weave through both the sales presentation as well as the way in which we manage programs on an ongoing basis is, this is not an Onlife health program. We cannot emphasize that enough as we go out and sell on the front end, implement and then manage on the back end is that we are an extension of our partners. This is their program. We are merely contributors to that program. We may offer a lot of the modules that are offered. We may offer a smaller number of modules. But at the end of the day, this is their program. The decision maker is often the owner of that program, and so has a very vested interest professionally and personally in its success and we have to do whatever is necessary to make sure that he or she is successful in their offering. That they are the ones who are seen as the successful program owner and that they are in fact on the stage at one of our industry conferences presenting the outcomes on behalf of this combined solution and not Onlife Health.

Host: Well, I know you have tremendous passion around this and I really appreciate you sharing with me a few minutes of your time and talking a little bit about replacing the incumbent and how... it might seem a little overwhelming at first, but actually it really doesn't have to be.

Mark: It shouldn't be. It was pleasure to talk to you as well. I hope I'm offered the opportunity to come back and talk to you again.

Host: Thank you to today's guest and a big thank you to you for listening along with us.

 

Well-Being Experts is brought to you by Onlife Health, a comprehensive wellness solutions company that has spent years working with health plans and large employers nationwide. Today's podcast and additional perspectives from the Well-Being Experts can be found at onlifehealth.com/resources. We welcome your comments, questions, feedback, all the above at engage@onlifehealth.com.