In terms of population size, Hispanics have always attracted payers’ attention – certainly more so in this exchange market as consumers wield ever-growing insurance buying-power. Yet many established health plans don’t appeal to prospective Hispanic members because they limit their offers to products, networks and service experiences designed for a homogeneous market. Attempting to retrofit those things assumes that the Hispanic consumers’ needs, wants and even approach to health care mirror the traditional market. Here lies the source of the problem. Viable plan growth depends on satisfying diverse needs and placing the consumer at its core (Hispanic or otherwise). This reality is what motivated us to build something new from the ground up for the Hispanic health care consumer.
Before GuideWell could execute on a new health solution, we took a hard look at the local Florida Hispanic population, recognizing our strengths and our gaps with this segment. We realized:
The Hispanic market is highly subsidized, impacting product and network design. Affordability has to be redefined by and for these consumers.
Florida’s Hispanic population is increasingly comprised of South American natives, with varying degrees of acculturation, and many distinctions from Florida’s established Cuban population. Any solution requires extensive understanding of this diverse group.
The most robust solution combines our payer expertise with a partner’s Hispanic care delivery expertise. The payer-product-provider experience should be seamless.
These factors led to our joint venture with Organizacion Sanitas International (OSI), the leading health provider of choice in South America, to create GuideWell Sanitas. This new entity is truly a synthesis of both OSI’s and GuideWell’s strengths and is the first partnership of its kind in the United States.
Don’t Retrofit, Innovate
Most exciting about this venture is how it solves for three critical gaps left from a retrofitting strategy:
We are creating a new product that will meet the needs of the Hispanic consumer, accounting for the benefits they’ll desire at the price point they seek.
Care delivery will feel familiar and welcoming, since our network includes CliniSanitas, the health care clinic component of the venture modeled after OSI’s clinics in South America. And there is no administrative friction between product and network.
Our infrastructure optimizes the entire member experience, from sales through service encounters, with our “Hispanic-first” and culturally relevant approach and care.
This short interview with Dr. Fernando Fonseca, the CEO of both GuideWell Sanitas and CliniSanitas, provides more details on the CliniSanitas model and the three clinics that will open in August and September, 2015:
Collaboration is Key
With stakes as high as they are in this exchange market, we know pivoting towards collaboration with a high-value partner is the right thing to do.
I’ll be writing more on the CliniSanitas solution with a focus on three areas:
removing barriers to an optimal patient experience,
Prakash Patel, M.D., is Chief Operating Officer of GuideWell Group and the President of GuideWell Health. A former CEO of Access MediQuip, Prakash’s accountabilities include providing leadership across the GuideWell enterprise to ensure exceptional experiences for our customers and providers. Under his purview, GuideWell Health will also further innovate care delivery. Prakash is a graduate of the University of Michigan and Cornell University Medical School. A die-hard Wolverines fan, he now resides in the Jacksonville, Florida area with his family. Follow him on Twitter @Prakashpatel_MD.