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The eCommerce Opportunity in Health Care - Best Practices for Insurers

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The online consumer presents both an opportunity and threat for the typical health insurer. This document highlights the changing landscape in terms of consumer, B2B and technology trends. It ...

The online consumer presents both an opportunity and threat for the typical health insurer. This document highlights the changing landscape in terms of consumer, B2B and technology trends. It discusses how health payors with a progressive e-commerce program can make the most of the emerging opportunity.

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    The eCommerce Opportunity in Health Care - Best Practices for Insurers The eCommerce Opportunity in Health Care - Best Practices for Insurers Presentation Transcript

    • THE E-HEALTH IMPERATIVE ONLINE OPPORTUNITIES FOR INSURERS ©Sanjay Chatterjee, January 2010
    • Payors - today’s realities
      • Pressure on revenue drivers
        • A zero-sum market for new members
        • Member churn – poor economy, changing demographics
        • Price sensitivity in all market segments
      • With limited relief on costs
        • Cost of health care growing faster than economy
        • New mandates and regulations to implement
        • Silo systems, costly integrations, manual processes
      © Sanjay Chatterjee, 2010
    • Online consumer trends
      • Seek
        • 140 million+ US online health information searchers and surfers
      • Buy
        • Online comparison shoppers
      • Transact and Engage
        • Adoption of online service channels
        • Health and wellness content consumption
        • Deeper provider-consumer relationships
        • Preventative net-initiatives
      • Mediate: emerging net intermediaries
        • Online brokers
        • Content portals and communities
        • Marketing, advertising and technology service provisers
      © Sanjay Chatterjee, 2010
    • Online business-business trends
      • Use of web and voice e-channels for cost savings
        • B2B self-serve gateways
        • Inter-plan transactions
        • Call avoidance
        • Workflow automation
        • Auto-adjudication
        • Cost and security management
        • Pharmacy authorization
      • Employer portals essential to closing and doing business
      • PHR initiatives
    • Online technology trends (opportunity)
      • Highly scalable and flexible web services
      • B2B trading gateways
      • Personal health records
      • Voice recognition technology
      • Mobility
      • eCRM and contact management
      • Heterogeneous data management
      • Cheaper, scalable infrastructure and development
      • Robust and flexible user security management
    • Online-trends - opportunity or threat?
      • An opportunity for first movers and a threat for laggards
        • The health care sector is going online, but not as fast as the consumer is
        • Net-savvy customers will gain share of voice in driving health care trends
        • Net-savvy payors and intermediaries will gain share of mind and wallet by listening to customers and the market
        • A sound, yet dynamic, e-business strategy and roadmap must be part of every payor’s corporate goals
        • At 15% of GDP going to 25%, investment in the online channel isn’t a luxury, it’s a necessity to compete and grow
      Confidential: Sanjay Chatterje
    • Best practices for payors
      • Common online channels
        • Unified approach to branding and services
      • Cross constituent support
        • Prospects, members, providers, brokers, employer-administrators
        • Requirements grounded in constituent research and feedback
      • Online solution capabilities
        • Basics – shopping tools, enrollment, accounts, claims, eligibility, billing and payments, etc.
        • Advanced - e-Prescribing, care management, clinical information, cost management tools, configurable products, etc.
        • Content and community – original, syndicated or partnered
        • Site optimization: experience, traffic, conversion
      Confidential: Sanjay Chatterje
    • Best practices for payors
      • Governance
        • Executive buy in and ongoing engagement with e-business initiatives
        • Grounded in business case framework in partnership with finance
        • Strong business sponsorship, possibly co-owned by IT and Business
        • Early adopter customer forum for feedback and validation
      • Technology architecture
        • Scalable design, infrastructure and cost management
        • Tiered architecture to separate channel and business transaction layers
        • Open web services, trending towards services oriented architectures
        • Common user management, security and data layers
    • THANK YOU ©Sanjay Chatterjee, January 2010 http://www.linkedin.com/in/chatterjeesanjay [email_address]