by Holly Fletcher | The Tennessean | Apr 06, 2015
The health care industry’s transition to a business-to-consumer model after decades of being a business-to-business industry requires that insurance companies connect with providers and customers in individual, trusting ways, said Joseph Swedish, CEO of health insurer Anthem in Nashville on Thursday.

Swedish, speaking with Sen. Bill Frist at a Nashville Health Care Council event, said that government and consumer-driven demands are challenging health care companies to be nimble and forward-thinking in unprecedented ways. Swedish talked about the need to “pivot” in response to consumer demands throughout the conversation.

“We believe we are moving into a retail world so that our customers … are having to make choices, … and so we have to be responsive,” Swedish said. “We need to build loyalty on a brand they respect. That is retail behavior, not a traditional environment in a (business-to-business) world.”

Anthem – mostly recently in the headlines for a data breach that impacted about 80 million people – will be focusing on the total cost of care management, building collaborative relationships with providers and consumer focus in rolling out and fine-tuning products and services, he said.

Sen. Bill Frist, left, talks with Joseph Swedish, president and CEO of health insurer Anthem, about how health insurers and providers can respond to consumer and government-driven changes to health care during a Nashville Health Care Council event at the Renaissance Hotel in Nashville on Thursday. (Photo: Paul Wharton)

Consumers are for the first time making decisions about health care – whether it’s about what plan to buy on an insurance exchange or choices about how to spend money in a high deductible plan – so the insurance and provider sectors need to make sure choices are transparent, Swedish said.

“Patients today are increasingly savvy and are looking for price transparency and value more than ever before,” Frist said. “Payers and providers will need to get in the business of facilitating access to and helping patients use this information, or they will see themselves passed over for providers and payers who will.”

Swedish expects accountable care will be on the uptick, whether via accountable care organizations or other structures. The one-on-one relationship between providers and patients will help corral costs associated with chronic disease. He pointed out that 5 percent of health care consumers account for 50 percent of costs, which is emblematic of the challenges that physicians face with transitioning to a population health model.

But the emphasis on value, and outcomes, is not fading. The U.S. Department of Health and Human Services anticipates that by 2018 more than 50 percent of payment will be value-based, Swedish said.

Swedish touched on the importance of harnessing big data to better understand the relationships between patients and doctors, as well as how people think about and interact with health care outside of the exam room.

The recent data breach was not mentioned during the conversation, but Swedish said afterward that the company expects to finish the notification process “very soon.”

“We’ve got the protections built into the system that would not allow what happened to happen again,” he said.

http://www.tennessean.com/story/money/industries/health-care/2015/04/02/anthems-swedish-insurers-must-pivot-win-loyalty/70856962/