Health Insurers Need BPM and Governance Plans in a Hurry.

According to a recent article from Successful Workplace, “winning health plans will be those that can create and sustain brand loyalty equivalent to some of the best retail companies in the world.” Ironically, I did not come across this article in a healthcare, brand/customer experience or even a marketing setting. I came across the original article in a LinkedIn group focused on Business Process Management.

The transformation from B2B (wholesale to employers) organizations to B2C (direct to Consumers) as described in this article conjures up incredible visions of the challenge and the cost health insurance companies face in changing their document and communication paradigm in almost every aspect to address marketing to individuals. At the same time, they are facing legislative mandates forcing reporting of the percentage spent on administration vs. healthcare and true “administrative” cost reductions.

What is presented is a picture of a new health insurance world with new opportunities for a multi-media and multi-channel communication experience for the insured and companies providing the insurance.  The additional aspect of making this transformation while safe-guarding patient health information (PHI) privacy and meeting HIPPA requirements make this seem like a truly daunting task. While this article focused on Health Insurer’s need to use Social Media to reach their “individual plan” market – I was clearly not the only one who saw this as a process improvement opportunity on a wide scale.

Helping Insurance Providers to cope, manage and eventually optimize the transition from current communication model focused on primary sales to employer companies and post sales to consumers to a one to one sales effort directly to consumers will be exciting and a great opportunity. The kind of complexities in this scenario screams out for the discipline of Business Process Management (BPM). In any business, it is not possible to transform from being a wholesaler of services to a mass-retailer overnight without massively retooling processes.

If there is any doubt that this is the path that insurance companies are on, consider the announcement this week from Horizon Blue Cross Blue Shield of New Jersey regarding its plans for a retail center. When it opens this summer, visitors to the Moorestown, NJ retail center will be able to walk in and get the latest information on health and wellness and have health insurance questions answered by specially-trained staff.  Visitors will also be able to purchase health insurance products and services – just like a regular retail store.

As more insurers open retail branches ala Horizon, they will need to add the same level of process standardization and communication discipline encountered in the financial services arena. As products become more complex, insurers will need to be certain that “sales reps” are presenting the right products to the right individuals. The communications will need to be tailored to the product, the audience and the setting where the communications will be received (branch, email, mail, mobile, iPad) etc. With more variety and personalization comes more processes and a requirement for governance around those processes. With the push to have products ready to sell, it would be easy for insurers to put the support processes and governance on the back burner. Doing so would be a truly unhealthy decision.


About Richard Losch

Richard Losch specializes in driving operational efficiency through technology implementation and exchange, as well as strategic business process analysis. Things that don’t work well really get under his skin, so he enjoys fixing problems. Persnickety perhaps, but that’s what makes him so good at helping customers in the business communications industry to improve operating margins and quality and to integrate manufacturing, distribution, and service operations. Learn more at