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Today’s customers are no longer just looking at a company’s offerings when making purchasing decisions, as explored in PwC’s Transformation talks series. Rather, customers are increasingly looking toward the experience delivered and the values a company demonstrates. To effectively attract and retain customers, this means companies must leverage assets and capabilities in a way that demonstrates their values while delivering differentiated experiences to both serve and empower customers.
What values do customers want from payers and providers?
Today, the imperative for payers and providers is clear: help patients and members proactively manage their total cost of care through seamless experiences tailored to them. In 2021, a nationwide survey was conducted to better understand customers’ top concerns when interacting with the healthcare system. More than half of survey respondents noted that healthcare costs have led to sacrifices in their healthcare. At the same time, customers are willing to pay approximately $400 a year out of pocket for services like personalized recommendations for treatments, medication and integrated care management offerings.1 This suggests that while cost is front and center when considering the healthcare customer experience, customers also value a tailored and meaningful experience. If businesses are unable to deliver on these demands, customers will choose to go elsewhere. In fact, one in four customers have indicated that they will stop using or buying from an organization if they have a bad experience. To attract and retain customers, delivering tailored, affordable care should be core strategic initiatives for payers and providers.
Organizations should start by defining their customer attraction strategy and articulating their core values. Acting as a north star, these core values then inform the capability investment decisions that follow. In today’s market, PwC sees three primary values that payers and providers are championing:
- Convenience: Connecting customers seamlessly and quickly to knowledgeable, helpful, friendly service and the right information.
- Personalization: Creating a personalized experience that leverages data and insights to provide tailored guidance and increase patient connection to their healthcare.
- Advocacy: Supporting and servicing the customer proactively by understanding their needs and the solutions necessary to address them.
Each value drives a unique approach to how an organization responds to the imperative and appears in the marketplace, spawning new payer and provider behaviors. As payers and providers respond, we can see new ecosystems emerging. Three models within these ecosystems — that of Platform and Solution Players, Orchestrators and Integrators — enable payers and providers to best align their values to capabilities and position themselves for success in key customer segments.
Convenience
Organizations primarily positioned as Platform Solutions Players excel at leveraging digital front doors and advanced analytics to create seamless and accessible solutions for their customers. These organizations stitch together health and non-health assets to create more convenient, digital-first solutions.
For example, Teladoc Health attracts users by offering convenient and accessible care solutions across multiple channels (e.g., phone, video, digital). They also support a variety of health needs across the care journey to ensure a customer’s care journey needs can be met, whether they are in need of primary care or chronic condition management. Teladoc Health is continuing to invest in simplification through their recently announced partnership with Healthjoy (2022). By integrating Teladoc’s virtual care services with Healthjoy's care navigation platform, they can simplify benefits navigation and make it easier for customers to access care.
Personalization
Organizations primarily positioned as Orchestrators focus on generating tailored experiences to encourage engagement and proactively help customers manage their plan and care. These organizations use advanced analytics and artificial intelligence to customize touchpoints to a member or patient’s history as well as their stated and implied needs. They excel at gathering, securely storing and distilling insights from robust data sets (including the customer’s interaction history, any social or behavioral determinants of health, and their lifestyle preferences) to anticipate the content a customer needs, when they need it and through what channel. In proactively cutting out the noise, they provide customers with clear insight, direction and support that builds trust.
Consider Sharecare, which attracts customers by offering a single platform through which customers can manage their care. Sharecare leverages advanced analytics to generate personalized care plan recommendations and connects customers to their network of digital care plan applications to create a convenient and tailored experience.
Sharecare is continuing to invest in their network of digital applications that make managing care convenient and seamless for their customers. Earlier this year they announced their preferred musculoskeletal therapeutics partner, Sword Health. This partnership not only increases access to convenient care solutions, it also helps eliminate vendor fatigue for customers by providing clear direction on how best to manage their care needs.
Advocacy
Organizations primarily positioned as Integrators advocate for customers by managing risk, reducing waste and managing the health of their population. Doing so helps prevent costly hospitalizations and treatment. Similar to orchestrators, Integrators use advanced analytics first to evaluate the customer’s care plan needs, then advocate for the optimal course of treatment and provide referrals to their robust network. What differentiates Integrators are their strong networks of clinical and non-clinical services that enable them to directly provide high-quality, lower-cost care to their customers. By creating and owning the optimal network of care services for their populations, they can better align incentives and risk and more efficiently surface insights across the care team to make care more affordable care and more effective.
Take Kaiser Permanente as an example. Not only are they focused on establishing an expansive network of providers to help drive value-based care initiatives and align risk incentives, they are also invested in leveraging integrated platforms to help drive information sharing and transparency across their care teams.
Most recently, Kaiser announced its new value-based care expansion initiative, Risant Health. Geisinger is poised to be the first acquisition to join the initiative, allowing Kaiser to share its vast experience, network and integrated tools to accelerate value-based care adoption. This alliance creates yet another avenue for customers to access high-quality, affordable care solutions, and they can feel comfortable that their providers will have their best interests at heart.
What investments enable convenience, personalization and advocacy?
Organizations should consider the capabilities they need to attract and retain customers through convenience, personalization and advocacy, evaluating their current maturity and the options to close any identified capability gaps. These core capabilities include the following:
- New care delivery models meet seamlessly with their care journey while keeping administrative costs low (e.g., telehealth and home health).
- Digital front doors create a convenient integrated platform for members and patients to access care solutions and resolve basic account management and payment tasks, while point solutions help organizations expand their portfolio of care programs by offering convenient products that support specific health needs (e.g., behavioral health assessments, social determinants of health interventions and wellness incentive programs).
- Advanced analytics (including artificial intelligence (AI) and generative AI) aggregate customer insights, understand their preferred engagement channels, anticipate their needs and share tailored notifications for suggested care actions at their preferred time.
- Integrated service and clinical platforms surface shared data and insights to payers and providers across the key touchpoints in a member or patient’s health care journey to ensure their entire care team is working collaboratively to create a unified experience that ultimately reduces costs — meaning that savings can be passed onto members.
Whether your organization decides to mature existing capabilities or to invest in net new ones, selecting the right portfolio of capability investments is critical to capturing and retaining your customer base.
1 PwC ‘Designing for the new health consumer’ 2021 survey.
How PwC can help
PwC can help payers and providers develop optimal customer attraction and retention strategies. Together, we can align on the prioritized customer-facing values to inform the capability investment strategy. Even mature organizations can benefit from a reassessment of core values tied to capability investments. No matter the stage, PwC is ready to help you deliver value.
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