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2013-01 Retail Healthcare and Its Implications for the Future of Health Insurance

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Consumer-directed healthcare empowers consumers by providing them with information about price and treatment options so that they can pursue cost-saving opportunities. As a result, a growing number of managed care organizations are adding retail health.

Published in: Health & Medicine
  • Retail health— from convenient care clinics in drugstores to the emerging insurance exchanges mandated by healthcare reform—has the potential to reshape the provider and payer markets. Health plans are taking a position by investing in technology, assisting members with price and quality transparency, and developing innovative care networks that broaden member access.

    This webinar in brief is about how consumer-directed healthcare empowers “shoppers” by providing them with information about price and treatment options so that they can pursue cost-saving opportunities. As a result, a growing number of managed care organizations are adding retail health stores and clinics within their networks. Consumers want convenience in their health care options, which is right in line with retail channels offer.
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2013-01 Retail Healthcare and Its Implications for the Future of Health Insurance

  1. 1. Webinar: Retail Healthcare and its Implications for the Future of Health Insurance a presentation by Kevin Riley for Corporate Research Group January 8, 2013This content is property of Kevin Riley & Associates – All Rights Reserved.
  2. 2. Synopsis Session: Retail Healthcare & its Implications for the Future of Health Insurance Consumer-directed healthcare empowers consumers by providing them with information about price and treatment options so that they can pursue cost- saving opportunities. As a result, a growing number of managed care organizations are adding retail health clinics in stores within their networks and are realizing substantial cost savings. Consumers want convenience in their health care options which is right in line with theses clinics offerings. Attend this webinar to: • Explore the origins and evolution of retail healthcare with an eye toward emerging trends that will impact your business. • Understand how retail healthcare coupled with consumerism can impact member behaviors—improving quality and cost. • Formulate a retail healthcare strategy that encompasses market-based initiatives coupled with reform-driven mandates. • Assess the impact of retail clinics on member access, costs and quality.
  3. 3. Who am I? Principal at Kevin Riley & Associates | Health Model Innovation • former chief innovation officer of Florida Blue (Blue Cross Blue Shield of Florida) and founder and former president/CEO of GuideWell • entrepreneur, health care executive, business model innovator, and pursuer of experiences that drive behavior, and ultimately action Kevin started Kevin Riley & Associates | Health Model Innovation consultancy in 2006 to help companies with the convergence of health care and the consumer. He founded and was CEO of a national health care retail company, played leadership roles for several national retail health start-ups, and served as the first Chief Innovation Officer of a major insurance plan. Kevin holds a Masters of Business in entrepreneurship and marketing from Rice University. follow me on @kevineriley, linkedin, slideshare
  4. 4. What is Health Model Innovation? Developing profitable and sustainable business models by creating and/or realigning the activity systems that improve member experience, boost provider performance, and enable payer cost control.
  5. 5. What is retail health? “Retail health is where consumers find quality care in a variety of convenient forms and at competitive prices. Consumers are able to plan for the health care needs they can anticipate and make informed decisions based on readily available information. They can then “shop” competitively for products and services using a variety of channels, formats and business models. And for those that need help, they can turn to “navigators” who work with them to design the most suitable health care solutions for themselves and their families.” Source:* Booz & Companys Health Care’s Retail Solution Retail health should serve as a means to EDUCATE | NAVIGATE | PLAN | MOTIVATE to enable consumers to choose from suitable solutions for health care needs, anticipated and otherwise.
  6. 6. The evolution of retail health One Day Events Retail Clinics Online Stores Screening and flu shots Primary care provided Online health stores at big box retailers, in convenient where you can spend usually on one or two locations with your FSA and health days extended hours rewards dollars Mobile Health Insurance Stores Mobile Stores Health screenings in a Retail centers that sell Crowdsourcing, mobile unit at your work and service insurance Groupon for health, and neighborhood plans spot pricing, care enablementThis content is property of Kevin Riley & Associates – All Rights Reserved.
  7. 7. Does retail health = consumerism? Retail health is a business model that Consumerism is a focus on the needs creates direct-to-consumer channels to and wants of a specific consumer set and sell health related products and services. their purchase decision behaviors.This content is property of Kevin Riley & Associates – All Rights Reserved.
  8. 8. The science of behavioral economics To understand how retail health coupled with consumerism can impact member behaviors, you have to go back to the first principle thinking of behavioral economics.This content is property of Kevin Riley & Associates – All Rights Reserved.
  9. 9. Outcomes thru incentives The secret sauce to delivering reform-driven mandates is to serve them up as rewards and awards.This content is property of Kevin Riley & Associates – All Rights Reserved.
  10. 10. Develop a channel threading strategyThis content is property of Kevin Riley & Associates – All Rights Reserved.
  11. 11. A retail health case study – Retail Stores
  12. 12. A retail health case study – Retail Store
  13. 13. A retail health case study – Retail Store
  14. 14. A retail health case study – Retail Store 2.0
  15. 15. A retail health case study – Retail Store 3.0
  16. 16. A retail health case study – Retail Clinic 4.0
  17. 17. Kevin Riley & Associates | Health Model Innovationkevin@healthmodelinnovation.comwww.healthmodelinnovation.comQuestions?

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