SAN FRANCISCO - From personal computers to trendy salad greens, California has a reputation as a market innovator. With its Access+ health plan, another company from the Sunshine State - Blue Shield of California - has made recent innovations in the realm of healthcare provision.
Introduced in September 1996, Access+ reflects how extensive research and a new consumer perception assisted the company in designing and marketing a successful new HMO.
"All businesses must add value in order to survive," said Blue Shield product manager Bob Wadsworth, addressing attendees at the Alliance For Healthcare Strategy and Marketing conference held here a few weeks ago.
"Blue Shield is intent on becoming a product innovator in the California marketplace." To ensure the effectiveness of his company's research and the success of Access+, Wadsworth said, understanding customers' needs proved central.
Starting in 1995, the company conducted statewide surveys that revealed consumers' 20%-30% rate of dissatisfaction with a variety of healthcare aspects - specialist access, appointment and waiting times, patient education, and high costs. Overall, Blue Shield found that California consumers resented a perceived loss of control over healthcare decisions.
Many Californians saw HMOs as entities to whom they must 'Hand Money Over.' "Consumers understood [the HMO's] gatekeeper role," said Wadsworth, "but few were satisfied with the access to care that they were getting."
Where some businesses might have perceived a hostile marketplace, Blue Shield saw opportunity, mapping out key leverage points with which to develop their new health plan. These included increases in access to specialty care, satisfaction with office visits, and online availability of health information. As long as Blue Shield maintained continuity and convenience of care and kept their costs competitive, the market seemed ripe for a new plan.
Jessica Rothberg, senior manager at Applied Decision Analysis, Inc. (ADA), the firm that provided Blue Shield their additional marketing research, concurred. "The market for healthcare services and HMOs is evolving rapidly," she said. "In order for providers to remain competitive, they must add value to their services and products."
Access+ focused on three key features: it allowed members a self-referral option instead of finding specialists through their PCP; it guaranteed service in physicians' office visits as a way to address service issues - and offered a rebate if the customer wasn't satisfied; and it supplied members networked information, providing them a greater sense of empowerment when diagnosing their own symptoms.
Before Blue Shield could accurately predict Access+'s success, however, the company had to study the plan's communication and tracking - the loop, Wadsworth explained, that many companies fail to close. "A lot of activity ends after assessing consumer needs and testing the value propositions," he said. "Execution is often left up to others to figure out. We came to understand that as part of implementation planning, we had to focus on communication with all stakeholders, to make sure they were comfortable with the program's concept."
These steps required more market research, and ADA Inc. targeted eight broad focus groups statewide.
"The results were promising," said Rothberg. "What we learned was that Access+'s features addressed key concerns consumers had with their current HMOs. Consumers reinforced what Blue Shield was proposing."
In launching the plan, Blue Shield coordinated an "army" of nine teams who sold it to brokers, employers, and physicians, bringing Access+ onto the market in less than six months.
The results so far have been enviable: 40,000 members have signed on, and access complaints are down 28%. More than 90% of IPAs and medical groups have joined the program, and - most rewarding - competitors are beginning to mimic the plan.
Access+'s advertising slogans - one reads "Your body is a personal road map; you should be the guide" - reflect research proving Blue Shield's belief that a subscriber's informed independence marks the next wave in HMOs.
"One of our major features was that of empowering the member," Wadsworth explained. "That's what a lot of HMOs are going to need to do to survive in the future. The individual member must feel comfortable making his own healthcare decisions. We've taken that understanding and designed a new HMO product around it."
As if to remind Californians of their home state's reputation for trend-setting, Blue Shield's latest ad for Access+ appeared on TV the night before Wadsworth's presentation at the conference. It ran among the numerous commercials shuffled between another of California's innovations: the Academy Awards. (Blue Shield of Calif., 415/445-5000)