NSider • Posted on October 2, 2024
Our Journey: MembersEdge & BeneFACT+
In today's rapidly evolving healthcare landscape, payers face mounting pressures to meet the needs of customers, across markets, to apply a holistic lens and multi-generational understanding. Employers combat soaring healthcare costs combined with increasingly personalized expectations to the employee benefits they offer. Health plans must design products that stand out in their markets based on the ability to support the whole person, where benefits are both accessible and affordable.
Over the last 6 months we’ve made strides in our product portfolio to improve MembersEdge and evolve BeneFACT offerings to deliver on market and customer needs. The process began back in May with extensive customer and market research, putting our ears to the “Voice of the Customer,” which highlighted a need to redefine the Sales-to-Care Healthcare Journey for the Blues. We built persona profiles, developed journey maps, explored pain points and validated our hypothesis around these products with wireframes and initial prototypes.
Our customer’s needs were apparent for something more comprehensive to solve their challenges from NASCO.
Shortly after, we identified an opportunity to extend the capability suite on BeneFACT to better streamline benefits for Horizon and we began BeneFACT accelerator work focused on specific workflow activities to enhance capabilities and technology, including A
We are building upon our strong foundation in the portfolio – MembersEdge and BeneFACT – that today enable downstream capabilities of managing benefits through to account activation and enrollment and ultimately the administration – and leverage a bolder business domain understanding to unlock incremental and new value across the board.
From this, we created a value proposition for Horizon that focuses on how a total Benefits and Membership solution unlocks new growth potential and provides overall portfolio value across other NASCO solutions like Claims and Servicing. Although confidential at this point, NASCO was able to respond to a Horizon RFP with full Benefits and Membership offering showcasing some of these innovative capabilities build on MembersEdge and BeneFACT.
Healthcare has evolved, therefor product design and mindsets must too to empower the future healthcare ecosystem successfully.
MembersEdge and BeneFACT will bring new and innovative solutions to market through a multi-faceted approach.
MARKET POSITION & REVENUE POTENTIAL
Challenge: Niche vendors are entering the market, offering employer groups solutions to reduce care costs while enhancing employee experiences.
Solution: Our platform empowers customers to unlock existing potential, streamline packaging, pricing, administration, and performance tracking. This positions them competitively against national players like UnitedHealth, who are undercutting prices through operational efficiencies.
BENEFIT INNOVATION
Challenge: Traditional health benefits are no longer sufficient. There is a need for comprehensive programs that include personalized components of care programs, accessibility simplification, engagement, and affordability controls. As these are designed and made available vis ancillary services and buy-ups, health plans must be able to bundle and customize offerings to employers in a cost-effective manner.
Solution: Our solution allows for the set-up and integration of a diverse library of products and benefits, enabling clients to offer a holistic product suite. This includes the ability to administer, track, and adjust offerings to ensure optimal performance and customer satisfaction.
IMPROVED PROFITABILITY
Challenge: Reducing operational costs while maintaining high-quality service and experience is critical.
Solution: The ability to streamline product packaging and selling of market competitive offerings, our platform reduces manual interventions and streamlines data processes, thereby reducing the cost to sell and administer benefits and allow increased focus on experience excellence.
UNIQUE SELLING POINTS
Our solutions are not just about technical integration but focus on real-world business scenarios.
We offer a provocative packaging of services that resonate with market needs, ensuring our clients stay ahead of the competition.
With these enhanced product offerings, we have a finer ability to help our customers analyze data, leverage connectors to streamline processes, monitor performance, and manage documents.
The Customer Value Proposition
If you have attended the Innovation Station NASCO Now sessions for BeneFACT and ASO Billing – you got a glimpse into the vision for the core components of value – What we will be sharing next is how that comes together for the Blues POWERED BY NASCO.
Key takeaways:
We’ve been on a long journey, hit some curves along the way, but yielded a lot of evolution and innovation around this Market challenge
We listened to our customers and we’re at the point of sharing the solution to our customers
The solution is made up of robust capability models across both MembersEdge and BeneFACT and extends upon them to solve the bigger strategic problems our customers face
Potential opportunity with Horizon in play (confidential)
What we’ve accomplished so far:
Began with a Market back approach to problem discovery
Understood the problem and looked for leverage of NASCO’s portfolio on which to solve the problem
Strategized on how empowering the healthcare ecosystem vs. singular product offerings = portfolio effect
Building strong messaging and story that demonstrates why MembersEdge and BeneFACT are better together and solves today’s Benefit Innovation needs
Our innovative solutions are poised to transform how healthcare payers manage costs and engage with members. By focusing on market position, benefit innovation, and profitability, we provide a robust framework for success in a competitive landscape. As we continue to develop and refine our offerings, we invite stakeholders to explore the full potential of our platform and join us in shaping the future of healthcare management.
Market Position
Provides an ability for the set-up and integration of a diverse library of products and benefits, enabling clients to offer a holistic product suite. This includes the ability to track and adjust offerings to ensure optimal performance value and customer satisfaction.
IMPROVE PROFITABILITY
Streamline product packaging linkage through administration where our solution reduces manual interventions and streamlines data processes, reducing operational cost and allow increased focus on experience excellence.
Benefit innovation
Empowers customers to unlock existing potential, streamline, packaging, pricing, set-up & administration, and performance tracking. This positions them competitively with enhanced benefit options and fen off price cutting plays
We really need a holistic and efficient platform with fully integrated capabilities, including Salesforce, market product modeling, calculation flexibility, enroll and billing set up, benefit set up, data access and reporting, and open access for all stakeholders and users.”
"It would be a great revenue opportunity for us to be able to sell some of our programs across carriers. Today, due to the limitations of our platforms, we leave business on the table.
I was shocked when I got to this Plan and found out that the benefits we sell have no sku.. I have no way to know who bought what, how it’s being utilized, nor it’s financially performing.”