This presentation introduces persona lifecycle modeling into the product design of Medicare Insurance products. It was coupled with my Workshop 1a – Claim Your Consumer.

1. Member Engagement:
A Journey to Consumerism for Medicare
Health Plans
a presentation by Kevin Riley
to the Opal Medicare Conference
December 2012

2. Learning objectives
Session:
Member Engagement:
A Journey to Consumerism for Medicare Health Plans
Agenda:
Part 1 – Defining insurance in a retail marketplace
• What is consumer health, really?
• Why bother with the consumer?
• What does Medicare look like in a retail market?
Part 2 – Workshop 1a - Claiming your customer
• Segmentation
• Categorization
• Personification

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. 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 & Company's 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.

5. The evolution of retail health
One Day Events Retail Clinics The Wired Self
Screening and flu shots Primary care provided Mobile devices and
at big box in convienent smartphones that track
retailers, usaually on locations with more than out steps, and
one or two days extended hours reward us
Mobile Health Insurance Stores Healthy Gaming
Health screenings in a Retail centers that sell Buy the shoes and the
mobile unit at your work and servioces game, work out and
and neighborhoods insurance policies show your doctor

6. 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 & Company's 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.

7. With so many choices …

8. What could be the problem?
It is for me? What do other people think?
Which expert is right? Can I afford it?
Can my family use it? What are others doing?
Will my insurance cover it?
Is it the best?
What works?
How can I fit it in?
What is new?
Where do I start?
Is it safe?
Who do I trust?

9. Too much of a good thing
~13,500 heart rate monitor entries on amazon
~23,000 articles on WebMD
>13,000 healthcare related apps in iTunes

10. Which one is yours?
A Shovel A Hole A Fruit Tree
By technicians for technicians – it is Better than shovel, in fact best They have utility and you forget
shinny and sturdy, but in of itself is created with shovels, holes have they are a tree because you are
of no use! usefulness only when applied focused on the sweetness of the
properly (filled with something) fruit and what it brings you

11. What is retail health?
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.

12. A better educator
VS.

13. A better navigator
VS.

14. A better planner
VS.

15. A better motivator
VS.

16. So how do you get there?

17. Tenant #1 – All of this exists in an ecosystem,
only some of which is in your control
Patient Payer Purveyor Provider

18. Tenant #2 – You are a retailer now, get used
to it and act like one
big- EST
quick- EST cheap- EST
easy- EST cool- EST

19. Tenant #3 – Your customers attitudes (may)
stay the same, but their needs and
behaviors do not

20. Kevin Riley & Associates | Health Model Innovation
kevin@healthmodelinnovation.com
www.healthmodelinnovation.com
Questions?