Essentially, health insurance companies could be extremely exciting marketing organizations. There are hardly any companies in other industries that, based on the number of over 15,000 ICDs, generally have a similar number of product options. However, you first have to take the perspective of supply management in order to even recognize these opportunities. The possibility and necessity of this are demonstrated by the HRM HealthCare relationship management approach with its differentiation in cost and customer excellence as well as empirical studies on the health insurance of the future. In order to realize these opportunities, communication plays a central role. The example of bonus programs shows how the world of supply management and communication policy can be meaningfully linked. Even innovative technological solutions can be ideally combined with supply management and a “marketing mindset” - in fact, they only make sense because they, such as mobile appointment booking applications, only provide real benefit in this way.

>> January 1, 2009 marked a paradigm shift in statutory health insurance (GKV), because with the implementation of the Competition Strengthening Act, the age of competition began under a uniform contribution rate and the new financing conditions of the morbidity-oriented risk structure equalization (mRSA). The consequence was an enormous wave of mergers, including across all types of health insurance companies. But even mergers that initially place high integration demands on everyone involved do not solve the fundamental strategic problem of how a fund should position itself under the new competitive conditions.
Customer and cost excellence:
Central challenges of the GKV
It already seems to be foreseeable that a second wave can be expected that will bring marketing or, better yet, marketing-oriented corporate management to the fore. The reason for this second wave is simple: in order for a fund to operate successfully under the changed competitive and financing conditions, it must simultaneously overcome the challenges of customer and cost excellence. This means that a health insurance company can no longer concentrate its customer relationship management (customer excellence) only on the previously “worthwhile” target group of healthy people. In addition, it must also establish relationship management with the acutely and chronically ill, as these can be very attractive due to the allocations from the mRSA. The logic of the contribution margin requires all funds to compete against the average costs in providing services and increasingly forces the funds to develop supply management. The solution to this dilemma is an overarching approach or a leadership and management concept that has been developed in recent years: HealthCare Relationship Management (HRM).
As Figure 1 makes clear, the challenges of statutory health insurance must be viewed holistically. Requirements for the classic marketing mix (product / price / placement / promotion) are derived directly from this. But where exactly are innovations in the two areas of customer and cost excellence taking place against the background of the three core target groups (healthy, acutely and chronically ill people)?
Supply management:
Fund of new products
The result of a representative study carried out in the summer of 2009 by the consulting firm Terra Consulting Partners GmbH (TCP) reveals that modern treatment programs coupled with medical expertise to stay healthy and in the event of illness decisively determine the future profile of a statutory health insurance from the customer's perspective.
According to Figure 2, even 54% of the insured are open to premium offers that may cost more. These findings indicate that health insurance companies should also see their service and supply area - from a marketing perspective - as a research and development unit or as a production area for health products. This opens up a completely new understanding of where and how a cash register can get ideas for products and their marketing from their own field of expertise.
The topics mentioned in Figure 3 are technically known to the health insurance companies. However, the marketing potential is often not even recognized and is often even dismissed with the argument that “we don’t want to become a health insurance fund for hypertensives, etc.” Analogous to the required development of specialization and high case numbers in hospital care, it can make sense for health insurance companies to build up specialized expertise in the form of care products. This applies in particular to health insurance funds that see their opportunities in access to (former) sponsoring companies and important regional employers. In this respect, there is a high potential for innovation in this understanding of care alone.
Communication: The underestimated component
When implementing supply management, proven communication policy instruments (promotion) can be used - albeit on a much broader scale than before. Bonus programs are a good example of this, as they illustrate the close connection between promotion and product, as well as between supply management and customer relationship management. In addition, according to the Bertelsmann Foundation's population monitor, bonus programs have by far the highest acceptance rates from the perspective of insured persons and therefore hold enormous potential that is still largely unused.
This unused potential is due, among other things, to the fact that, from a functional point of view, the majority of instruments cannot be referred to as bonus programs, but only as discount stamp programs. Bonus programs require that all participants are known to the respective fund. Figure 4 makes it clear that the GKVn currently mainly use the historical predecessors (88.1%, rather small GKVn), ie the classic stamp and discount stamp programs, while only 11.9% (larger health insurance funds) use real bonus programs. The former is particularly the case when communication processes are limited to sending bonus magazines and the program can therefore be assigned to the pricing policy in the marketing mix because of the discount function. Such stamp and discount stamp programs that only provide price
send signals do not have a lasting effect on supply management. Real bonus programs, on the other hand, can have a positive impact on compliance and thus the quality of care.
Such stamp and discount stamp programs are neither contemporary nor able to achieve the desired long-term effects in the areas of customer loyalty or prevention. There is no doubt that bonuses have an important signaling effect from the point of view of price competition.
However, if such instruments are limited solely to pricing policy and are not seen as having potential in communication policy, a fund is giving away competitive advantages.
It is now well known (e.g. DIMDI report on increasing the participation rate in early detection measures) that it is not monetary incentives, but rather communication (e.g. reminders, telephone reminders) that ensures that people change their behavior. In this way, care-oriented goals (e.g. prevention) can be achieved with a simple marketing instrument. It follows that bonus programs become even more valuable if they both produce real health benefits and bind the insured emotionally to the fund through good service. It is always this personal connection (“not wanting to change”) that, compared to commitment (“not being able to change”), is based on psychological aspects (e.g. through personal contacts, trusting and credible customer relationships).
If a fund manages to properly design a bonus program with both pricing and communication policy elements, then it achieves a double effect. On the one hand in the area of customer relations - i.e. acquiring new customers and customer loyalty - as the income side is positively influenced and on the other hand on the expenditure side, as insured people stay longer in programs with controlled and effective health promotion and at the same time create preventive added value.
Marketing innovations from the field
of customer excellence
Basically, marketing thinking doesn’t care from which area product ideas for “building” products come from. As shown, it is innovative to include supply management in the marketing mix “p” product policy. This means that a fund can very well succeed in developing at least temporary unique selling propositions (so-called USP “unique selling propositions”) and converting them into competitive advantages, for example if it succeeds in building a network of service providers for effective osteoporosis treatment in a region. Supply management thus becomes the product policy of a cash register - but these products must be precisely communicated to customers. This brings us to the second area, customer excellence, with the “p” for promotion, ie communication policy. Are there already signs of innovation here in the market?
As the example of bonus programs has shown, communication policy is an important task. Communication can be seen as a key factor for a successful pricing and product policy, because the increasing information overload and the still unfamiliar variety of products offered by the health insurance companies sometimes lead to uncertainty or even rejection among the insured. Therefore, the main issue is that the health insurance companies have to manage to become the great “simplifier”. Complex material (social insurance law and medical) should be translated into an understandable language and communicated to the insured persons who are flooded with information in a sensibly dosed manner.
If - to deliberately exaggerate things - the communications department at IKEA, for example, manages to explain the structure of a wardrobe in an (almost) standardized way around the world, largely with pictures, then the communications experts in the GKV should also be able to deal with complex topics such as chronicler programs or to convey family doctor-centered care to the insured in a simple and correct form. (Fig 5.)
According to figure five, eleven instruments can be used - mobile services are certainly the very latest tools alongside social media. They enable interactions in areas of the insured's life that would otherwise not be possible. A targeted approach to customers via electronic media is considered a future form of communication policy in order to avoid wastage. 31 of 166 cash registers that were tested in the TCP-smartPhone study in June 2010 were already able to offer mobile services such as a portal, applications and messaging (Fig. 6).
This creates opportunities, particularly for young target groups, for a cash register to clearly distinguish itself among them. “High value added services” can be developed for certain customer target groups, e.g. insured people with an affinity for sport, which, for example, combine fitness and mobility. Those who don't like prevention, on the other hand, can be reminded of their next early detection measures or vaccination updates, which will also be rewarded. Or, mobile applications for booking and confirming appointments with service providers are of great benefit to many target groups among the insured, but also to doctors, for example, to reduce “no-shows”. They are based on the use of the latest technology in a very simple application environment.
Conclusion
Statutory health insurance offers a wide range of opportunities for innovations in marketing. However, the prerequisite for this is that supply management is viewed from the perspective of product policy in the marketing mix. This link alone is already innovative. In order for it to reach the “customer”, it must be closely linked to the second element in the marketing mix, ie the communication policy. Bonus programs that are correctly understood and professionally set up can provide central assistance in strengthening customer loyalty as well as sustainably securing cost advantages, for example in the area of prevention.<<

from: Dr. Michael Sander*
Viviane Scherenberg**