Healthcare client: Human-centered health insurance plan design.

For a category that supports an individual's most personal characteristics, health insurance is often completely void of leveraging human insights when it comes to plan design. Underwriters and actuaries use past performance data and analytics to inform plan design, which is akin to driving using the rearview mirror. And while they will seek input from others in the organization, the most important source of information, the consumer, is not consulted.

This was the situation when Barkley worked to help one of our health insurance clients* create the plan design for an upcoming advanced primary care entrance into the provider space. The overarching offering was based on human-centered insights, why would the health insurance plan that accompanied the offering fail to do so?

* Specific healthcare clients ask we not use their business name, logo, or any other branded imagery in published case studies due to proprietary information and organizational policies.

Challenge

With the imminent rollout of a new advanced primary care model, how do we align the health insurance plan design to enhance the overall consumer experience, as well as drive down the total cost of care, and improve consumer satisfaction and lifetime value?

Modern Consumer Insight

Through extensive qualitative research, including in-home ethnographies, we came to understand how consumers thought about the challenges of healthcare and health insurance. We asked consumers to describe what they were getting from their current healthcare experience and what they wanted from their healthcare experience. Mapping that to a 2x2 quadrant analysis (See chart below) began to show us the white space for product design.

We learned consumers wanted their healthcare to be simplified: No copays, no deductibles, free lab work, no charge for common prescriptions, a behavioral health professional aligned with their PCP, and to be able to spend as much time with their doctor as they need to. These insights drove our ongoing product development.

Solution

Based on the qualitative insights, we launched a national adaptive conjoint quantitative study to gain an understanding of the importance of 18 different aspects of the consumer’s healthcare experience. From this data, we were able to simulate a host of product adoption scenarios. In the end, with the plan design that fit the advanced primary care business model best, we projected one in five of the group employees who were offered this plan design would enroll in it.

The attributes we tested included:

Monthly premium
No cost prescriptions
Behavioral health therapy at no additional cost
Copays
Deductibles
No EOBs
No cost for x-rays
Unlimited time with the physician
Care Guide Navigators

Results

The plan design enhanced the customer experience, delivered a significantly lower monthly premium, and lowered the total cost of care while delivering a higher margin for the health insurer.