In this column, we pose a question or share a perspective or prediction about some aspect of the health insurance/finance industry.
We invite industry leaders aka influencers to weigh in. If you would like to participate, reach out to email@example.com.
Prediction: There will be more and more customer segmentation
By Sachin H. Jain, CEO SCAN Health Plan, Forbes, Dec. 2022
While companies that focus on a single condition or subset of the population may struggle, all healthcare companies (big and small) are beginning to look at further segmenting their offerings to differentially serve and grow within diverse populations. Clever Care, a Medicare Advantage startup in Southern California, grew impressively in the Asian community through focused benefit offerings, a carefully curated network, and a grassroots model that engaged community members. Alignment Healthcare (NASDAQ: ALHC) began serving members through its “el Unico” option focused on the Hispanic population. And my company, SCAN Health Plan, partnered with Included Health to launch its Affirm product focused on the LGBTQ+ population. The products all provide differentiated service and benefits and also unlock growth that might not otherwise be attracted to the market or the company. Similar trends are present on the care delivery side where there are a growing number of startups focused on ethnic populations. Zocalo Health, for example, is a new clinical company founded by Amazon Care alumni Erik Cardenas and Mariza Hardin “by Latinos for Latinos.”
The idea that “all patients” should receive the same clinical model is being fundamentally questioned — and this is a very positive development. Whether these offerings will be viable in the long-run is an open question, but certainly worth watching as every company is looking to align with broader trends in diversity, equity, and inclusion and simultaneously drive results.
Tim Lieb, SVP of growth and marketing, Blue Shield of California
Do you agree or disagree on specific points about customer segmentation and why?
As far back as I can remember, we have known that a one-size-fits-all approach does not work in healthcare. Each individual comes to us with their unique health history and needs. Addressing the specific needs of groups, such as Latino people and LGBTQ+ people, is a key part of improving the health of all individuals.
Fortunately, we can use data to better understand health issues that may impact a community — whether that is defined geographically or by other demographics like race, ethnicity, age, gender identity, socio-economic status and more. From there, we are able to develop solutions or team up with an organization that has a deep understanding of how to support a specific population.
As a health payer with an expansive network, Blue Shield of California has an opportunity to bring this targeted support across the state — and we can partner with employers and brokers to ensure customers know what resources are available to them. For example, our Maternal Child Health Equity Initiative provides pregnancy and postpartum resources and support in underserved communities. This initiative specifically targets support for Black mothers due to the Black maternal health crisis driven by interpersonal and institutionalized racism, specifically in healthcare settings.
Are there other trends you want to comment on?
While it is critical to provide support that addresses what we know to be community- or population group-level needs, we also need to narrow it down even further and provide the support individuals are telling us they need. This is especially true as we work to meet the needs of our diverse population in California. This is why, at Blue Shield of California and across the industry, we see the impact of a member-centric approach in designing benefit offerings.
Moving forward, we’ll continue to see digital tools used to improve choice and accessibility as we address diverse health needs and close care gaps, especially targeted at the individual level. For example, our virtual-first benefit offering, Virtual Blue, allows members to select their primary care physician based on criteria that are important to each individual — including race, ethnicity, years of experience, language, experience with LGBTQ+ individuals and more.
Tim Lieb is senior vice president, growth and marketing, at Blue Shield of California, a nonprofit health plan with $22.9 billion in annual revenue serving 4.7 million members in the state’s commercial, individual, and government markets. He leads the company’s commercial markets, consumer markets including Promise Health Plan, and marketing departments. full bio.