• Increasingly health plan executives think of growth as a health plan via two primary avenues: line of business growth and asset diversification.  

• Plans are rapidly chasing member growth in their insurance lines of business with Medicare Advantage receiving outsized attention given profitability and growth trajectory.

• Many health plans are expanding their offerings to include diversified health care service divisions. 

• To grow, health plans must excel against strong existing competitors and established, yet evolving, market dynamics. 

• Provider relations is an imprecise term used to describe the relationship between health plans and providers — most notably physicians. 

• Collaborative providers are essential to advancing health plan strategic goals such as value-based care, behavioral health integration, and efficient specialty referrals.

• The path forward seems clear: successful plans will relentlessly focus on physician-led, data-driven provider enablement. 

• The function of a health plan is to enable and equip beneficiaries to access the best care possible, which often means access to transformative, innovative models or treatments.  

• Health plans must support pioneering approaches that strengthen the patient experience, improve patient outcomes, and reduce cost of care.

• This requires health plans to closely monitor and evaluate innovation in the care delivery environment on a variety of vectors such as pharmacy, virtual-care, and behavioral health. 

Member engagement is the process of building, nurturing, and managing relationships with members to drive behavior change.

• To build and manage relationships, health plans must deliver a good experience — both live and digital.
• Resulting behavior change enables health plans to increase revenues or manage medical spending.
• Access our member engagement resource library, which includes tools, case studies, cheat sheets, infographics, and more.