Shift Shapers Podcast

15 Feb 2021

Ep #348: Is Your Plan a Bag of Parts or a Well-Oiled Machine? – With Ashok Subramanian

David Saltzman 0 Comments

This week’s episode features a conversation with Ashok Subramanian, Founder and CEO of Centivo. Plans succeed or fail based on the end-user experience they create. By optimizing the primary care-centered models and offering tailor-fit solutions regardless of the network construction, plans can remove the clunkiness of administrative tasks while ultimately providing the care and satisfaction that users are looking for.

What You’ll Learn From This Episode:

  • 02:16 User experience: Why traditional plans fall short of modern expectations
  • 06:06 Approaches with network construction
  • 10:47 Optimizing the tried-and-tested primary care-centered models
  • 16:14 Pharmacy affordability: A question of clinical efficacy vs economics
  • 19:14 Communicating with employees to drive engagement

Quotes:

03:57 “Folks are starting to get more sensitive to and starting to understand in much more detail that, as good as a thick network of doctors might feel at the time of enrollment, it’s kind of useless if you can’t actually get into that doctor.”

05:00 “A big part of user experience on the health plan side is increasingly becoming less about the payments of claims and the administrative processing, and far more the integration points around the usage of the healthcare system itself.”

07:13 “The most optimized plans are introducing tailored networks, narrow networks, using reference-based pricing, and other types of approaches to be able to get the efficiency and the value.”

15:04 “When you work more closely with partners by not trying to be all things to all people, you can deliver a better user experience by really optimizing on a simple set of things that matter to members.”

19:56 “For too long now, we’ve simply assumed that the buyer is the employer and employees are simply takers of what those employers decide for them.”

Listen to the Full Interview:

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