How can health insurers become more innovative and flexible in a heavily regulated market? You must develop an organizational culture that prioritizes innovation and ties it to the organization’s strategic direction.

1. Creating a Culture of Innovation
for Health Plans
AHIP Executive Leadership Programs
Tuesday March 12, 2:30 – 3:45 PM

2. Synopsis
Creating a Culture of Innovation for Health Plans
This session will focus on how both leading health plans
and other businesses stimulate innovation to stay ahead of
the curve.
What You will Learn:
• How can health insurers become more innovative and
flexible in a heavily regulated market?
• What are best practices for innovation in health care?
• How do you create an organizational culture that
prioritizes innovation and ties it to your organization’s
strategic direction?

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 Health Model Innovation?
Producing value though profitable and sustainable
business models made by creating and/or realigning the
activity systems that improve member experience, boost
provider performance, and enable payer cost control.

5. Purpose
What is the purpose of innovation at a health plan:
• to foster and imaginative culture?
• to incubate and advance innovative ideas?
• to accelerate consumer-focus?
• to change patient/member behavior?
• to test new payment models?
• to design new products/models?
• to diversify the revenue stream?

6. Intent
New Value
Transform your core Disrupt your core
Model Model
Models
New New-New
Maximize your core Transform your core
Marketplace Marketplace
Existing New
Markets

7. Framework
Application of disruptive principles within a conservative industry
requires the tools, techniques, and infrastructure needed to
support an innovative workforce. You need a framework.
An innovation framework is both practice and platform aimed at:
• Systemically seeking opportunities aligned with your strategy
• Receiving/responding to idea challenges from within/without
• Utilizing a defined process to evaluate, nurture and prioritize
• Navigating qualified ideas from concept through launch

8. Resources
Dedicated
Stakeholders Team
Members
Leadership
Emissaries
Governance

9. Process
Innovation requires a systematic approach
to produce intentional results.
Employ an innovation process (they are all the same)
supported by an innovation system (they are not the same).
test
think market

10. Measurement

11. Practical Examples of Enterprise Innovation
• Good: Simulcast TEDMED across the company
• Better: Simulcast TEDMED across external stakeholders
• Good: Launch an idea management system
• Better: Open it up to your customers
• Good: Build an innovation center on campus
• Better: Build an Innovation Center off campus
• Good: Launch a living laboratory with internal departments
• Better: Launch a start-up accelerator

12. The Important Stuff
• Develop your internal innovation talent
• Partner with department leaders to expand innovation
presence across the company
• Cultivate and advance business emissary relationships
• Foster business process excellence through all innovation
processes
• Bring design thinking techniques to the organization
• Implement employee metrics for measuring innovation

13. Questions
Kevin Riley & Associates
Business Model Innovation for Healthcare
kevin@healthmodelinnovation.com
www.healthmodelinnovation.com