Suspicious minds: Prepping your team for high-performing health plans

In our first article, we discussed our belief that despite a lot of bluster about next gen benefits techniques and cost controls to lower health care costs, many advisors are not actually implementing what they are talking about. If they were employing and executing these strategies, rather than just talking about them to make a sale, the questions they'd ask and the resources they'd be seeking would address the challenges that arise from implementing high-performing health plans. But these questions aren't being asked, and as this industry changes and non-traditional competitors enter the health care space, this talk-only approach will no longer work. We're worried about this phenomenon and how it will affect our profession, which brings us to these questions:

Does your team dread the day you return from industry conferences with countless ideas and excitement levels at an all-time high? Do you change gears each year, making plans to implement dozens of ideas that ultimately confuse and overwhelm your team?

In order to succeed your firm needs a clear, consistent direction and a plan for how to get there. The path shouldn't zigzag like a pinball every time you're inspired by speakers at events and conversations with colleagues.

So after some careful and thoughtful analysis, you're ready to transform your business model and offer independent, high-performing health plans to your clients. But first it will take some preparation, especially to get your staff to embrace the changes with you.

If you have tried and failed to implement big changes in the past, you need to deliver a clear and strong message that this is not a flavor of the week or something you are going to dabble in. Show everyone you are committed to this new direction and explain in clear concise terms how you will get there together.

What holds teams back

There are several obstacles you are likely to encounter as you start to implement your new strategy of building independent, high-performing health plans. Look out for these possible roadblocks:

Your team doesn't believe it will work.
Your team isn't familiar with the vendors you need to get it done.
Your team believes the changes will leave them with a service nightmare. (Look for the non-verbal clues on this one)

You may not see these as roadblocks, but you're the one on the front line attending the conferences, meeting the vendors, etc. To resolve some of these concerns, your support team and account managers need to be included upfront, so that they know how to manage these programs.

Understanding the problem

Does your team fully understand why your firm and your clients should take on a major shift toward independent, high-performing health plans? After all, traditional markets have produced well-documented plan performance results. For some clients, these markets are their only alternative. For others, these results are acceptable as they scramble year over year looking for a "less bad renewal."

But still other clients who desire stability and predictability need a different option. They want more control and better benefits at a lower cost. The traditional models aren't working for them, and they'll keep getting the same lackluster results year after year unless they switch to a different model.

Traditional markets are like buying a car. If you want leather seats, you have to get the rear-seat DVD player and the sunroof as part of the upgrade package, whether you want them or not. All we want for our clients is the network and the access to the contracts with the providers, but carriers also make us buy the pharmacy benefit management, the medical management, administrative services, etc.

To create an independent, high-performing health plan, you need a level of customization that's required in order to truly control costs. An independent plan has a traditional structure, but non-traditional packaging. All of the parts are the same, but the pieces are built independently. They need to be packaged together to work as part of one system.

Building consensus and buy-In

Some members of your staff probably will dislike the changes because they don't believe that the cost controls you're proposing can affect claims. They may be hearing from outside "experts" who don't support it and you will need to be prepared to combat the noise. These techniques work. If someone doesn't believe from the start, you'll never get the buy-in you need to move forward. Do not skip this step. If they don't buy in, they will always find a reason not to recommend or implement these strategies for your clients.

Find a champion

Who on your staff will be a champion of this transition? Who will be resistant? Past experience can give you some clues, and you may ask certain managers or supervisors to help you recognize where the resistance will be strongest. You should also consider assigning an internal champion or champions to assist you in transitioning this message from the conference circuit to your firm and your clients.

Your team doesn't want to wind up carrying a heavy burden in the form of vendor problems. An independent plan is a custom program, and your account managers may assume customization means more work for them.

Find ways to include your team in professional learning, networking and conferences that will help them understand and accept your firm's new direction. After all, a lack of knowledge and a track record of searching for the "next quick fix" will leave teams skeptical and hesitant to commit. But if they're included, they will also provide valuable feedback about which strategies and ideas are achievable and which ones are conference bluster that will fall flat when implemented.

Do you have the right intellectual capital to train your team, or do you need to outsource this training through events, professional organizations, etc.? As agency principal, do not assume that you have the time and patience to conduct this training yourself. Consider delegating it to an internal champion who is knowledgeable and on board with the changes.

It's a mistake to sell a big dream and leave someone else to service a nightmare situation. When it's done correctly, your team will understand that, compared to traditional insurance, the new direction does not mean more challenges, just different challenges.

Preparing for implementation

How do you find the right vendors? Colleagues, networking groups, and conferences are all possible sources. Encourage your staff to provide feedback and take part in the decision-making process. That way, they'll be more likely to be on board with the overall transition when you move forward.

You should pick your partners carefully, but if you spend 10 months interviewing 12 third-party administrators, that's not moving your firm in a new direction. Be decisive in your selection. Once you do, begin integrating your teams or at least the person you have designated as your champion. Do not get stuck here. Many agency owners or management teams get bogged down because they are the nonbelievers themselves and look for reasons not to use new vendors.

If you create an environment that allows your account managers to build stronger relationships with vendors, it will pay dividends moving forward. They are used to the carriers your firm has used in the past, so creating direct connections to the new partners will build the same rapport and comfort for your team. Loop the champion in on communications about how and why the vendor was selected. Hearing that confirmation from a fellow team member is important.

To support a smooth transition, we have found that the need for a clear strategic direction and a roadmap to execute it is imperative. It's not the type of change you can do in a loose, informal way. Take small, strategic steps to build credibility with your staff and they believe and adopt the transition.

The next four articles in this series will take you step-by-step through the process and examine the challenges, so you will be ready to tackle them head-on. The articles will focus on:

Transitioning your firm: Converting from commissions to fees, performance-based compensation, etc.
Now that you are ready: Transitioning your clients
Now that you and your clients are ready: Managing your carrier relationships
Conclusions and looking ahead

Mick Rodgers is the managing partner at Axial Benefits Group, which is based in Boston. Mick has been called a pioneer, a disrupter and has always had a focus on disintermediation.

Bob Gearhart Jr. is the third generation to lead DCW Group and is responsible for helping clients manage the healthcare supply chain to improve benefits and increase their earnings.

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