Providers must compete at two points of sale

Insight 2 from the 2014 CEO Special Sessions

Success in the retail market starts with securing enrolled lives. To stay competitive, insurance plans and employers need to assemble the most attractive and affordable networks possible—so they’re taking stock of your total cost, your geographic reach, and your clinical scope, not to mention clinical and service quality standards.

If your organization doesn’t meet the bar, you’ll find yourself on the outside looking in.

Of course, securing enrolled lives isn’t just about being in-network. Individual insurance shoppers on the retail market have to choose the network. You’ll need to do everything you can to keep premiums low and quality high.

Once in-network—even for narrow networks—you’ll still need to secure volumes at the point of care. As more patients choose high-deductible plans and have greater visibility into cost and quality differences, they’ll become more discerning shoppers for individual services. You’ll have to offer a combination of low price and convenient access to be sure you’re winning at this second point of sale.