- Source: HMS 2021
- Source: CMS 2023
- Source: KPMG Provider Research Study (2022)
Blog series: How healthcare payer sales models impact revenue growth
By Alex Tolmasoff, Director, KPMG Sales Transformation and HCLS Lead
In our three-part healthcare payer sales model series, we discuss the hurdles sales leaders face with finding and keeping members, how outdated sales models can impact revenue growth, and how updates to your sales model can impact results.
Prior to COVID-19, health insurance carriers faced a challenging market with new entrants, new products, and high patient and provider expectations. First, COVID-19 increased the pressure to maintain revenue growth and margins, while delivering new services that engage members virtually and digitally. At the same time, legacy sales model issues did not get easier – if anything they got more complex and challenging. Commercial leaders today need to re-examine their sales models to ensure they keep up with member expectations and gain access to new members.
Wrong. Not all members are created equal, and not all have the same desire or ability to consume high growth or high margin offerings. Without good customer intelligence and aligned sales enablement, such as analytics, revamped sales processes, new training and coaching, and updated incentives, leaders are likely to see:
1. With more government spending, sales models need to adapt their strategy and composition
2. Increasing payer and healthcare service consolidation puts pressure on sales leaders to act more nimbly and strategically
3. Rising acceptance of telehealth by providers and patients requires new digital sales motions and new expertise
4. Rise of behavioral health intervention apps (both home grown and stand-alone) require new business models and sales models to be successful
5. New market entrants with deep pockets will challenge legacy sales models
As a result of these “big rocks”, sales leaders must gain ground—and member access. Healthcare payers must shift to a new way of thinking and adopt a holistic sales approach.
See the next blog in our series on the issues that payer sales leaders will face if they continue to rely on traditional sales models.
As you focus on the challenges ahead, KPMG can help you improve the ROI on your sales investments by informing sales strategies, processes, and talent with connected insights. We’ll help you create winning customer interactions.