Medicare Differentiation
Medicare Differentiation was an innovation initiative I lead as a Healthcare Innovator at Highmark Health. The initiative focused on creating new experiences and products for people aging into Medicare in the next 5 - 10 years.
The Problem Statement
With over 60 million Americans enrolling in Medicare every year, Highmark’s healthcare offerings for seniors face strong competition in the market. To stay competitive, Highmark must create differentiated experiences, services, and solutions for people aging into Medicare in the next 5 - 10 years.
Project Goals
Understanding the Age-In Population
The Needs and Behaviors of People Aging into Medicare
Based on the field research and internal stakeholder perspective, my team and I developed a set of foundational insights on the age-in population that focused on 4 areas of their lives:
Market Research
The design team leveraged market research on age-ins from the Blue Cross Blue Shield Association to test and support our qualitative research findings.
From Insights to Concepts
The design team then moved into the define phase, where we brainstormed several potential concepts and opportunities to meet the needs and expectations of age-ins, based on our primary and secondary research, and the personas developed from BCBSA’s market research.
Concept Testing
The team tested the concepts in the field with 21 age-ins who were recruited based on their identification with one of the 4 key personas defined by market research. The following breakdown shows the top concepts as ranked by each persona type:
Concept Prioritization and Refinement
After testing the concepts with age-ins, the team then worked with our project stakeholders in Senior Markets to prioritize concepts to develop further. Through discussions that examined how each persona might leverage the prioritized concepts in their daily life, unpacking business needs, and discussing potential impact, value, and feasibility, the team narrowed the number of concepts down to 3 finalists, with the á la Carte Health Plan taking the lead.
Refining the Concept
The design team refined the concept into a data and AI-driven tool that would prompt age-ins with questions about their health, lifestyle, and financial needs — and then deliver them an á la Carte plan package that would include Medicare coverage that would suit their particular needs and add wellness programs, plan perks, ands add-ons that matched their individual needs. The team then tested this idea as a storyboard and paper prototype with 22 participants.
Design Iteration and Re-Testing
The concept was well-received in the first round of testing — however participant feedback surfaced a critical insight that guided the next round. Our participants felt the most important aspect of the experience was the personalized information on Medicare that it provided, not the á la carte plan perks. Age-ins wanted the tool to serve up Medicare plans and services that met their needs based on how they answered the questionnaire, not all “the extra perks that are in those plan packages.”
Finalizing the Concept
Based on our learnings from testing, we finalized the design concept: a “smart” questionnaire which leverages a patient’s existing EMR and insurance data in conjunction with their quiz responses to deliver a personalized report outlining the best Medicare plans, services, and perks for that person. I finalized the quiz content and designs with the support of our Senior Markets plan experts, which you can see below:
Launching the Pilot and Beyond
After delivering the finalized concept to our partners in Senior Markets, Highmark’s digital team built and launched a pilot of the tool with our guidance. Member feedback on the tool has been largely positive, increasing pre-Medicare member engagement rates by 15% after pilot launch. The digital team refined the tool and released it as a Highmark product in Q3 2021.
