Interview with Aetna CMO, David Edelman, on Healthcare Journeys – Part 2

Part 2 of the interview with David Edelman, Chief Marketing Officer at Aetna, to discuss how Journey Sciences is helping Aetna partner with their customers to manage their care. 

Tim: Having data connected across all of these different organizational silos is paramount to understanding whole journeys, of course. It’s exciting to see companies like yourselves, and other clients of ours, organizing Journey Science teams with journey owners, and journey scrum teams, to investigate and prioritize journey improvement opportunities. How are you aligning your organization around journeys?

David: There are three kinds of journeys that we’re aligning.

One set is what we call “process journeys”. These are things everybody goes through, but are different and fine-tuned for each individual. Onboarding, for example (like getting an ID card), is a process in which there are many different segment variations, and we have a team that’s focused on that process.

The second set, are “condition or ambition journeys”. This is where somebody has a more longitudinal thing that they want to address, such as a condition (like diabetes) or a health goal (like weight loss). There’s an ongoing journey here that will be tied to that ambition or need.

The third set is situational journeys”, where something suddenly happens. For example, somebody might be in a car accident, or be diagnosed with cancer, and they have to quickly deal with it. These sudden things have an intensity to them where, in a short period of time, you want to pack lot of things into a very effective journey.

We're organizing around these three types of journeys. There’s different people and organizations that associate themselves with different types of journeys, so we're doing analysis and setting goals along those lines.

Tim: We typically see that companies have approximately 15-20 core journeys customers experience with their brand, then there might be 75 to 100 sub processes to those journeys. By industry, there’s a codex, if you will, of what journeys should be focused on first. Do you feel that the same applies to what you're experiencing in healthcare, or is there more to it?

David: We haven’t documented every single journey yet. We’re working down from a set of priorities, from what we call moments that matter, then prioritizing by segment and journey type. There is certainly a pretty wide range. On the process side, there are about 6 core journeys, where on the condition side there could be any number. We'll probably end up with around 20 priority journeys that we’re managing that will keep us busy for a couple of years. 

Tim: With what you called the condition journeys, we know that you're doing some pretty exciting stuff assessing the behavior before and after medical events to create better evidence-based treatments for your customers. With all of the patient, device, and medical data available, it’s really exciting to think about the data that can be connected and analyzed and journeys that can be improved. Is there one thing that you're most excited about or that you'd love to tackle that you just haven’t gotten to yet?

David: I think some of the most exciting stuff happens at the intersection of what has traditionally been very different lines of business. (Things that employers tended to buy separately, for example). If you look at core medical benefits, plus behavioral or mental health benefits, plus pharmacy benefits, an employer might buy all of this separately, thinking they’re buying best of breed. The reality is that putting those under one provider, such as ourselves, there are things we can do to manage a member better by putting more investment in one area in order to get better outcomes on another. For example, we might decide that a particular medication, even though not in our discounted formulary, is worth it for a patient to use very specifically, and maybe more aggressively, in order to cut medical costs. We're willing to spend a lot more on pharmacy in order to keep somebody out of the hospital. It could also be that some people may benefit from having more psychotherapy counseling to get them to behave differently. That’s worth investing in for better medical outcomes.

Traditionally, insurers manage each of these lines of business as separate silos of decisions and cost management. But people are whole humans, and we have to look at this holistically. The excitement in the journey is when we actually see how this all comes together and to be able to manage the whole person towards a better end. That’s what we’re looking to uncover in the data.

Tim: The way the Customer Journey Analytics market has evolved is very marketing focused around customer acquisition and purchasing. Where ClickFox has always specialized in is the holistic journey across organizations and operations. It does seem like there’s a shift where CMO's, CXO’s, CDO’s etc. are looking holistically across the company. How do you see some of the focus shifting toward better understanding customer journeys across organizations as opposed to just focusing on that initial acquisition and purchase journey?

David: A big part of what we’re trying to get from journeys is to help people manage their care and it even integrates to when we bring people on-board. If people choose us, or we provide their insurance through their employer, they can pick from different plans. We also want to help people understand, by optimizing the journey, how to get on the right plan for what they need. When people are first picking their health plan, we want to educate them upfront, based on who they are, what would be the best choice for them. In doing so, we are already setting their expectations that we are going to help them manage care in a certain way so they will be receptive to the tools and support that we provide. They will have also made a smarter financial decision, given who they are, so they won't feel like they made a bad choice. They'll question their financials a lot less if they are on the right product to start.

In order to minimize calls into the call center downstream, we've got to make sure we get people on the right plan upfront. There’s an end-to-end aspect in so much of what we do. You want to make sure people get on the right plan and are made aware of the right services for themselves. Then we can help them take advantage of that to be healthier. 

Tim: You're really understanding, holistically, each customer for their entire journey, as opposed to just getting them in the door and then focusing your efforts on new acquisition.

David: That’s right, it’s just a question of the best way to acquire people. For us, we always have to make sure we are acquiring people into the right offering for them personally. Because we’re a service business, it’s absolutely critical.

Read Part 1 of the Interview:

Click Here to Read this Blog

Written by Tim Friebel

Tim Friebel is the Vice President of Marketing. He oversees all marketing activities and contributes to the overall product strategy. Tim joined ClickFox more than 10 years ago with 10 years of experience in contact center operations and systems management and development at MCI/Verizon. While at ClickFox, Tim has overseen the PMO and Product Management. In doing that, he’s been very closely involved with the largest Journey platform implementations in the world, while helping to shape some of the concepts that would eventually become product vision.

Subscribe to the ClickFox Blog

  • Be the first to know about what's trending in Journey Science
  • Stay up to date with our latest Journey Analytics Products
  • Be a part of the Journey Science movement!