Jay Sheehy, senior vice president of product innovation at EmblemHealth, explained that being able to tailor your message to specific patient populations will help to better engage consumers, which will prove to be more successful for healthcare companies in the long term.
Jay Sheehy, senior vice president of product innovation at EmblemHealth, explained that being able to tailor your message to specific patient populations will help to better engage consumers, which will prove to be more successful for healthcare companies in the long term.
Transcript (slightly modified)
Do you differentiate between consumers who are in the marketplace versus consumers with employer insurance?
We do, and we need to. The difference is: are you directly engaging with the consumer, which is where you’re going in the marketplace, or are you working through the employer or their advocate, being a broker or a consultant. Are they a part of that process? So you need to tailor your message.
Also you often find there are different ways to really get to the consumer, meaning that when you’re dealing with an employer, it can be an amalgamation of a lot of different backgrounds, so you may have to change your message. You may have to adjust your message to what the employers strategy is as well, as opposed to gong direct to the consumer.
However my view, and based upon all of my research over the last several years, is we are really moving to a consumer marketplace. By 2020, I feel over 60% of the healthcare in the United States through 1 means where another will be direct to the consumer with public exchanges, with Medicare, with Medicaid and with private exchanges. So again, refining and really understanding the consumer in the marketplace is going to be really critical for all of us to be successful longer term.
You expect more people on the exchanges and that more employer coverage may diminish in the future?
I think similar to 25 or 30 years ago when we moved from defined benefit pension plans to 401k, I think we’re clearly reaching a tipping point in the United States where we’re moving from defined benefits sponsored by employers to more defined contribution programs with vehicles like the public and private exchanges are very fast growing, rapid areas for the employer groups where they’re looking for help to really give the good housekeeping seal of approval on different arrays of choices but giving their employees more choice but actually moving towards that defined contribution program.
Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
Listen
Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
Listen
The Pivotal Role of Payers in Improving Health Equity, Maternal Health Care in the US
March 26th 2024A presentation at the Greater Philadelphia Business Coalition on Health's 2024 Women’s Health Summit discussed how payers, including employers and public entities, can strategically influence health care purchasing to prioritize maternal health and equity.
Read More
What We’re Reading: HHS' Funding Flat; Mifepristone Safety; Insulin Shortage
March 25th 2024Flat funding for Health and Human Services (HHS) leaves critical health initiatives stagnant; Supreme Court weighs tightening regulations on abortion pill; manufacturing delay sparks access concerns for insulin medication.
Read More