Tuesday, August 24, 2010

Revenue and Marketing Opportunities Due to the Affordable Care Act

With the implementation of the Affordable Care Act (aka healthcare reform) underway, do you think that there are any revenue and marketing opportunities?

A good questions since many, if not all of the current health insurance plans offered by employers either through a third party, or as self-insured are in grandfathered status. But that should not stop you from looking at the Affordable Care Act (ACA) innovatively and creatively to find and capture those revenue opportunities.

The basic reason is simple, employers do give a damn about grandfathered status, but will be unable over time to maintain it. In the business world, cost is king. Period. Employers will do anything they can to drive down that cost by making changes in co-pays, coverage and carriers. When these changes are made grandfathered status is lost. If you're not planning and getting ready to execute your revenue and marketing strategies now, you are already behind in the game.

Think Walgreens and CVS/Caremark are waiting around and not planning with their work-site and retail clinic programs?

Your first opportunistic date is September 23, 2010.

On September 23rd, the Preventive Services Covered under the Affordable Care Act become a reality.

The Opportunity

There are three primary areas: Covered Preventive Services for Adults; Covered Preventive Services for Women, Including Pregnant Women; and Covered Preventive Services for Children. I am not going to go into great detail here as there are a large number of covered services in each category, so if you follow this link to http://www.healthcare.gov/law/about/provisions/services/lists/html where
you will find all the information in great detail.

Important point to remember. These are services that must be covered without people having to pay a copayment or meet their deductible, when these services are delivered by a network provider. Be that network provider.

What you need to do is create a comprehensive preventive care product offering in these categories, price it accordingly and sell it to your exiting insurance companies and employers in your community. Screenings lead to diagnosis, and treatment. Revenue and volume. It's a straight line from one to the other if you are out in the market. Cost is king and if you are not cost competitive, you won't get the initial business and potential downstream revenue.

This play is B2B, B2B2C and B2C, requiring close communication and collaboration between business development, insurance contracting and marketing to pull it off. Create a strategy, develop the tactics and then execute. Remember, the view always looks the same if you're not the lead dog. Consider co-branding with the insurance plan and employer.

Don't stop there.

Marketing should be part of any discussion that's going on and it's not just make me some pretty materials. You need a strategy, clear brand messaging and tactical execution across a wide array of channels and communication vehicles. Your audiences are: insurance plans; employers; physicians; TPAs and consumers. Tactics include direct sales; video emails; direct mail to covered members; web; social media; media relations; community events and work-site programs. Deliver what you can on-site, in retail locations and create special fast-track registration and service delivery methods for preventive services. Keep your cost down and compete.

Be accountable. Be Measureable. Lead your markets. Healthcare is changing, don't get left behind.

Lots to do and little time to do it.

Michael Krivich is Fellow, American College of Healthcare Executives and a Professional Certified Marketer, American Marketing Association and can be reached at michael@themichaeljgroup.com or 815-293-1471 for consulting services in strategic marketing, media relations and interim marketing executive leadership assignments. Huthwaite SPIN selling trained and a Miller Heiman Strategic Selling alumni, both highly respected and successful international sales training organizations , I can lead your organization though the challenge of integrating sales and marketing.

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