Breaking Down the 5 Stages of Health Insurance Product Development & Management

There are typically five stages a health insurance company goes through when developing new products, and then managing them once they’re live:

• Product innovation
• Product quoting
• Product onboarding
• Product servicing
• Product marketing

Each of the five stages in the health insurance product development and management lifecycle requires data to function, but this data is often spread out across multiple systems — some insurers even have a separate system for each stage of the lifecycle.

From an efficiency standpoint, these disparate and disjointed systems present a major problem. They prevent the employees responsible for each stage of the lifecycle from accessing valuable information from other stages — for example, they prevent product innovators from understanding which products are being quoted, sold, and serviced. In order to optimize health insurance product development and management, insurers need to consolidate their systems and respective data within a single catalog, ideally one with specialized capabilities for each lifecycle stage.

Rules engines and portals can also clean up and consolidate data and provide members, brokers, and employer groups with a single view, connected data, and perspective for each role.

Before we get too into that, though, let’s take a closer look at the five stages of health insurance product development and management, and why data is so important at each stage.

1. Product Innovation

Each year, during open enrollment, health insurance companies debut new products to existing health plan members. What members might not realize is that each open enrollment period is preceded by an innovation cycle, during which their insurer’s innovation team works to either build new products or reconfigure existing products according to member feedback, new products from competitors, and/or changes in regulation. In order to do this, health insurers need to collect massive quantities of data to be analyzed; but with disparate systems, the pool of data that an innovation team has to draw from is severely limited, making it difficult to get an accurate read on which products performed well, which ones didn’t, and so on.

By gaining a view into other stages of the insurance product development and management lifecycle, an innovation team can build new products and upgrade existing ones based on a wider range of factors, such as which products have been serviced, how easy they are to maintain, whether they’re relevant to members’ needs, member satisfaction, and more.

Additionally, by consolidating data and then introducing machine learning into the mix, health insurers can also enable their innovation teams apply sentiment analysis to incoming calls from members. Sentiment analysis provides insights to the innovation team on member feedback regarding benefits, limits, and coverage, which can be incorporated into future product releases. According to Forbes, sentiment analysis is “an automated process of understanding the emotional tone of a written opinion.”

Sentiment analysis data can come from any number of sources, including your company’s customer relationship management system or telephone system.

2. Product Quoting

During the second stage of the health insurance product development and management lifecycle, sales teams work to sell products crafted by the innovation team to new or existing members. Although this might seem straightforward enough, health insurance sales teams often lack the visibility they need into which products are actually available — another side effect of disparate systems — and run the risk of offering leads products that can’t be configured due to regulations.

An easy-to-use portal can provide rapid quote configuration. Quoting is easy and transparent because the data is integrated and easily accessible. User-friendly dashboards and access to even the most multifaceted plan configurations can provide brokers with the right data for the right customer in a timely manner.

A rules engine allows system customizers to create and manage condition-based rules in a software application via a user-friendly user interface. A rule defines some aspect of the customer relationship management behavior and is intended to help with (and influence) the behavior of users in a positive way.

By implementing a portal with a built-in rules engine, health insurers can clean up their current data estate and better guarantee that their sales team always offers the right product to the right customer at the right time.

For example, it’s important for the sales team to quote products that are available and applicable to the member (e.g. not quoting Medicare to someone who doesn’t quality). The rules engine helps determine the correct plans and filters out the ones that don’t match the correct criteria.

3. Product Onboarding

Once a sales representative has successfully quoted and closed on a deal, it enters the product onboarding stage. During this stage, a health insurer’s onboarding team will issue an ID card to the member in question so that they schedule a doctor’s appointment, file a claim, and so on. Traditionally a manual process, quote to card can take up to eight weeks and often involves a lot of back and forth between the onboarding team and new members.

By consolidating the entire quote to card process within a single workflow and automating it, health insurance companies can increase visibility across departments, improve the accuracy of health plans (they can be fined for inaccuracies), and reduce both the length of the process and the number of people involved.

A member portal can provide a personalized customer experience and easy access to plan information and claims details all in one place.

4. Product Servicing

When a health plan member is injured, they’ll file a claim and call in to find out where they should go for treatment, what coverage they have, how they can find a doctor, and so on. To handle these claims, call center agents typically have to pull up multiple systems across multiple screens — product data on one screen, member data on another, and cost share and product details on another still — in order to get a complete picture of the member and which products and benefits they currently have.

As one might assume, this approach is inefficient and more than a little confusing, which once again points to the need for data consolidation. Keeping all of this information within a single system enables call center agents to quickly get an idea of the issue at hand and how to resolve it, simplifying the product servicing stage of the health insurance product development and management lifecycle and increasing member satisfaction in the process.

One of the benefits of a member portal is the self-service option, which provides members with immediate access to critical information, such as benefits and claims statuses, all without having to make a phone call. This can improve customer loyalty and overall satisfaction due to a consistent, reliable user experience.

5. Product Marketing

In order to effectively market new or upgraded products, an insurer’s product marketing team needs to have access to data from the other four stages of the health insurance product development and management lifecycle.

With disparate systems, marketing teams have to manually collect and format this data, wasting valuable time and effort; with consolidated systems and automation, they can automatically gather this data by just clicking a button. A portal system, which is beneficial for members, employers, and groups, can provide a one-stop shop for the comprehensive data that’s needed; certain solutions will even generate a summary of benefits, renewal letters, and more. Health insurers have historically been behind the curve when it comes to marketing, so gaining this capability is major win and could be a competitive differentiator.

We’ve broken down the five stages of the health insurance product development and management lifecycle and the importance of data at each one — now, it’s time to talk technology.

From Engage for Health Plans to Microsoft Azure, Hitachi Solutions offers a full suite of products and services powered by Microsoft and brings to the table years of experience solving business challenges in the health insurance industry. Our specialists will work closely with you to clean up your data estate, consolidate systems, and streamline workflows so that the teams responsible for each stage of your company’s insurance product development and management lifecycle can work more efficiently and collaboratively.

The quote-to-card component of the Engage for Health Plans solutions includes a benefits library, benefit catalog, broker portal, and group and individual sales management tools.

By leveraging the Hitachi Solutions Business Rules Engine, system customizers can focus on business needs and not worry about how to code solutions. With a clean and easy to use interface, a user can configure the logic, write useful comments, evaluate the rules, and then easily deploy.

When you work with Hitachi Solutions, you aren’t just getting a solutions provider — you’re getting a dedicated partner.

Ready to transform your business solutions? Talk to one of our experts today.