Roundtable discussion at the 10th annual McKinsey Healthcare Conference

1. CONFIDENTIAL AND PROPRIETARY
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Got Stakeholder Insights?
Best practices on using broker, consumer, employer and provider data to
drive decision-making and business performance

7. 8
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McKinsey lessons learned
Focus on
stakeholder actions
and behaviors
Stakeholders are often unable to
articulate or fully understand what drives
and motivates them (i.e., stated answers
to questions), so focus instead of
behaviors, attitudes, and experiences
2
Start with
business
outcomes
The business must clearly define
the objectives they are driving
towards and work with insights
leaders to determine how best to
gain the right insights
1
Differentiate
between correlations
and causation
Ensure that results aren’t only correlated,
but causal (i.e., what truly drives the
differences in behavior) to ensure actions
focus on what really matters
4
Understand at
a granular level,
tailored to the need
There is no "average" stakeholder, so
drawing conclusions from aggregated data
can lead to poor insight
Gain a clear understanding of segmentation
aligned to the business outcomes to gain
insight into those specific segments
3
Get the right
samples
Understand the difference between
directional insight to help inform early
hypotheses and thinking vs. deep insight
that is scalable
5

8. 9
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Potential business outcomes insights
Step 1
What is the business outcome
we want to drive?
Step 2
What are the insights that would
inform the business decision?
 What journeys or sub journeys are experienced by most
of our consumers?
 What journeys or sub-journeys are driving more
important to consumers?
 What journeys or sub-journeys are we over or
underperforming?
 Are brokers willing to consider narrow networks for their
employer clients?
 Are brokers willing to consider episodic payments for
their employer clients?
 Do physicians prefer accountable care organizations
(ACOs), physician hospital organization (PHOs) or
clinically integrated networks (CINs)?
 How does this differ by specialty?
 What factors make a physician refer to my facility?
 How do we increase consumer
loyalty/retention?
 What types of payor innovations will
attract new employer customers?
 What models will help me build
alignment with physicians?
Consumer
Employers
Providers
STAKEHOLDEREXAMPLE

9. 10
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Consumer example –
How do we increase consumer loyalty or retention?
15.012.512.09.5 13.511.0 14.09.08.57.0 11.5 14.58.07.56.56.05.0 5.54.5 13.010.54.0 10.0 15.5
90
60
85
16.0
70
65
55
80
75
45
30
35
50
40
16.5
Checking out
Paying bills
Selecting a provider
Follow up care
Receiving treatment
Purchasing or enrolling in insurance
Derived importance
% importance to overall CSAT
Checking in
Performance
% T2B
Managing my health Scheduling visits
Size indicates percentage of members that experience journey

10. 11
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Employer example - What types of payor innovations will
attract new employer customers?
11
Private exchanges were considered to be the
disrupter that would change the industry, but
interest has fizzled out
2013 -16 2016-17
29
43
19
2016132011
5%
22%
43%
6%
44%
23%
Employer and brokers are showing high interest in
new delivery and payment models
New delivery models
like narrow networks
New payment models
like episodic payments
Currently offered Employer survey Broker surveyEmployer survey
Only 13% of
employers had
high interest in
2016
How could payors and
providers respond?
 Embrace interest and
launch new
products/services to
drive share – even if
efficacy has not fully
been proven
 Continue to focus on
current
product/network
designs until new
delivery and payment
model show impact
 Use employer interest
in innovation to offer
alternative products
Medium to high interest
% of respondents, Employer survey
High interest
% of respondents, Employer and broker survey
SOURCE: McKinsey Employer Health Benefits Survey – 2016; McKinsey Broker Health Benefits Survey – 2017

11. 12
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42
27
18
10
100% =
None
601
PHO
Other 3
CIN
ACO
71
37
26
40
21
44
50
41
7
19
23
19
Other
ACO
CIN 86
145
203
PHO
14
No impact on referrals Some impact on referrals Major impact on referrals
1% of respondents preferring no alignment model by specialty: orthopedic
surgery – 52%, cardiology – 35%, primary care – 40%
Physician example - What models will help me build
alignment with physicians?
Physicians from
all specialties
surveyed
preferred no
alignment model1
over any
particular model
Physicians’ preferred alignment model
% of respondents
Impact of alignment model on referral patterns
% of respondents