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In order to create and sustain a successful health plan – health system collaboration model, it’s time to get the consumer on the dance floor.
In this final installment of a three-part series, HealthScape explores how to build on the health plan – health system collaboration process already being tested in many communities. This briefing presents four key consumer-centric points of engagement designed to enable engagement and drive long-term planning and success. As consumer engagement takes center stage, organizations must have new choreography ready in order to enhance overall performance while maintaining a strong commitment to collaboration.

The two related briefings in this series outlined a conceptual framework for greater collaboration and mutually beneficial partnerships between health plans and health systems. They began to establish what we believe are the core building blocks of a successful collaboration model, including:

  1. Three-way engagement of health plans, health systems and consumers
  2. Commitment to an explicit collaboration model as a strategic, short-term objective of the health plan and health system
  3. Understanding and engaging the consumer on multiple levels

Say farewell to the status quo where consumers take a back seat to other priorities that drive the bottom line; traditionally, health plans focus on employers and buyers, while health systems focus on referrals and negotiating power. Now, health plans and health systems must re-orient their priorities to be more consumer-focused in order to enhance the foundation of successful collaboration models.

Collaboration will be optimized through a unified view of the Four Points of Consumer Engagement:

  1. Point of Health Status Segmentation – Analyze and categorize consumers based on their health needs and preferences to inform engagement continuum
  2. Point of Product Design – Design a product portfolio that aligns consumers with the economics of the collaboration and incentivizes consumer behavior
  3. Point of Consumer Navigation – Determine whether the health plan or the health system has primary responsibility for care navigation to align with consumer segmentation
  4. Point of Care – Engage consumers based on their health needs and preferences, whether healthy or with significant healthcare needs

To protect the future, health plans must now build the infrastructure of collaboration-based partnerships and incorporate consumers into every operational analysis and market-based strategy deployed in the short term. In the long-term, become adept at anticipating and accounting for what might evolve into the next generation of consumer-based requirements. Read more to understand how HealthScape can help.


Stop, collaborate, and listen – it’s time for consumer engagement to take center stage. Contact HealthScape for more information about the new choreography enabling successful health plan-health system collaboration models.