Payers start to leverage social networking media

Despite efforts of healthcare payers and providers, the vast majority of daily healthcare discussions have taken place outside of the industry. People talk to family and friends in varied settings - at home, parties, restaurants, health clubs, and religious and community institutions where the industry has no voice.

But the rise of new social networks, or social media, is bringing those conversations to new places where the industry can take part. In the emerging world of consumer retail healthcare, organizers of systems of care – healthcare payers - will increasingly begin to participate in social networks in 2008 to stay in step with the consumers they ultimately serve.

Social media is incredibly powerful and fast growing. MySpace has an estimated 300 million accounts, 139 million of which are in the United States. YouTube presently has 45 million viewers, and popular video clips quickly capture hundreds of thousands of views in a viral manner. Meanwhile, search engines interplay with various types of media and keyword searches can deliver uncanny results when an individual looks for straightforward information. For example, a search for a specific health plan (by name) on YouTube returns some disconcerting content, whereby a derogatory video appears that consists of an individual's rant against his health plan.

Most of the current emphasis in social networking is focused on a demographic known as Generation Y, consisting of online savvy 18-30 year olds who undertake a wide range of activities on the web. While the front-end of the baby boomers are still shredding their snail mail bills for privacy, Gen Y'ers are entering credit card information into their mobile phones to buy goods and services.

While our industry is still debating the hows and whys of establishing rating systems in healthcare, Gen Y has already created its own systems for rating college and high school teachers. Meanwhile, don't underestimate the likelihood of Generation X'ers and back-end Baby Boomers joining in, as they are the real consumers of healthcare.

In 2007, the healthcare industry, and payers in particular, were very badly represented in these media. Now in 2008, payers must scramble to take the high ground for several practical reasons. First, it must be clearly understood that most people seeking online information are not versed in "healthcare systems thinking," particularly as it pertains to the complex interrelationship of benefit plans, provider access and reimbursement, and care and wellness protocols. This, in turn, makes the prospect of navigating the healthcare system through non-associated data points and generic search a daunting challenge to even the most fearless Gen Y-er.

Adding to this concern is the notion that social media has already shown that people are quick to jump on populist bandwagons with high entertainment value, whether the information is accurate or false; or whether it is normative or a rare exception. If payers are to show that they provide any meaningful type of pricing, access or financial and health information management value for consumers, they must find ways to embed factual attributes of organized systems of care into the social media mainstream of how consumers are conducting affairs.

But can consumers who engage in social networking discriminate fact from fiction and will they make rational healthcare decisions? In its role as healthcare supply-chain coordinator, the payer industry has the opportunity to significantly strengthen its reputation by participating more in everyday dialogues about healthcare among consumers. In 2008, it is likely that several forward-thinking payers will assume leadership positions to fill this void.

How will payers get started in social networking media? The good news is that payers already possess most of the needed resources. While some will choose to partner with Silicon-Valley parade of social media and search companies, payers would do well to remember that they have an asset that is more valuable than search algorithms or anecdotally connected media.

Payers have integrated information about consumer demographics and preferences, consumer health status and health histories, provider and pharmacy network access, and pricing contracts. Increasingly, payers have the ability to bring focused and relevant care and wellness information to consumers at the right place, at the right time and in the right context.

Payers may ask members who have dealt with specific health conditions to be guest participants in appropriate forums and groups on MySpace or FaceBook. Members may even be encouraged and technically supported to start their own forums in these networks, to become accessible resources for others seeking help.

Some payers may develop their own content, recruiting authentic, but positive consumers and providers to place video testimonials on sites like YouTube, while actively managing the search and linkage criteria as would any sophisticated online advertiser. We may see some high-trust social networking develop between practicing physicians and consumers and nurses and consumers under the financial sponsorship of payers.

These are just a handful of many innovative ways that payers may leverage these new social networking media in 2008. These sites are one of the direct manifestations of consumer retail healthcare, and may be the best channel to influence not only the next generation of customers, but also those in the mainstream of healthcare spending today. Payers have a unique opportunity to extend that leadership into these new social media.

Jeff Margoli is chairman and CEO, The TriZetto Group