A major insurer considering entering the integrated health management (IHM) market wanted to understand what competitors were offering in the space. Fuld + Company, bringing extensive experience in the health insurance industry, analyzed the strengths and weaknesses of those competitors, their positioning, their strengths and weaknesses, and their messaging.

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CASE STUDY
The Challenges of
Facing Integrated
Health Management
for a Leading Insurer

2. THE CHALLENGES OF FACING INTEGRATED HEALTH MANAGEMENT FOR A LEADING INSURER WWW.FULD.COM
One Door Closes and Another Opens
A major insurer considering entering the
integrated health management (IHM) market
wanted to understand what competitors were
offering in the space. Fuld + Company, bringing
extensive experience in the health insurance
industry, analyzed the strengths and weaknesses
of those competitors, their positioning, their
strengths and weaknesses, and their messaging.
Finding a highly fragmented market with few best
practices and formidable obstacles in the way of
payer-led IHM, Fuld was able to offer an
alternative strategy, closely related to IHM, along
with recommendations about how the company
could leverage its strengths in executing that
strategy.
Case Overview

3. THE CHALLENGES OF FACING INTEGRATED HEALTH MANAGEMENT FOR A LEADING INSURER WWW.FULD.COM
The Promise of IHM
Key Business Challenges
IHM proactively integrates health promotion and health protection of
individuals to comprehensively reduce their risks over their lifetimes and
help lower health care costs. Emphasizing prevention, health maintenance,
and early intervention, IHM offers an alternative to the disease-driven
approach to care that is largely reactive, impersonal, and highly expensive.

4. THE CHALLENGES OF FACING INTEGRATED HEALTH MANAGEMENT FOR A LEADING INSURER WWW.FULD.COM
An Obstacle Course for Payers
Key Business Challenges
As our extensive research
demonstrated, payer-led IHM, in
which the insurer manages the
health of an insured population,
faces some difficult hurdles,
including a hard-to-prove value
proposition, a long payback
period, and the complexities that
arise from health care providers
using multiple payers. The
emergence of public and private
healthcare coverage exchanges
may also be hampering adoption
of IHM by diverting employers to
other cost-reduction solutions.

5. THE CHALLENGES OF FACING INTEGRATED HEALTH MANAGEMENT FOR A LEADING INSURER WWW.FULD.COM
Finding a Way Over the Hurdles
The Fuld Approach
While we found some trends – like the movement towards health status
trends and quality outcomes – that might give IHM some traction in the
large group market, no insurer has effectively differentiated itself or
demonstrably overcome the obstacles to payer-led IHM. We provided the
client with detailed analyses of competitors and recommended an
alternative strategy that, although much like IHM, overcomes some of its
hurdles for insurers by aligning the interests of payers and providers.

6. THE CHALLENGES OF FACING INTEGRATED HEALTH MANAGEMENT FOR A LEADING INSURER WWW.FULD.COM
Ready to Create a Path through Uncertainty
Key Business Impact
The client is now positioned to make a more
informed strategic decision about the IHM
market. In addition, our analysis of
competitors and our recommendations
about how to leverage the client’s strengths
and shore up its weaknesses provide
guidance in a murky and uncertain market.

7. THE CHALLENGES OF FACING INTEGRATED HEALTH MANAGEMENT FOR A LEADING INSURER WWW.FULD.COM
Delivering on our Commitment to Candor
The Fuld Review
As this project unfolded and it
became clear that the IHM market
was problematical, with few best
practices and little differentiation
among competitors who were testing
the space, the focus shifted. Drawing
on our commitment to complete
candor with all of our clients, we
directed the client’s attention to what
we believed was a more promising
course of action. Although the client
had neither previously considered
that strategy nor sought information
about it, they have now have options
that can help them crack the code of
a very challenging market.

8. THE CHALLENGES OF FACING INTEGRATED HEALTH MANAGEMENT FOR A LEADING INSURER WWW.FULD.COM
Think a similar solution could
work for your organization?
CONTACT US
fuld.com/solutions

9. THE CHALLENGES OF FACING INTEGRATED HEALTH MANAGEMENT FOR A LEADING INSURER WWW.FULD.COM
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About Fuld + Company
WHO WE ARE
Since 1979 Fuld + Company have pioneered competitive
intelligence, and today we work with leading companies
worldwide to deliver the competitive and market insights they
need to make better business decisions. We don’t rest on our
history and past successes. This means working hard to
deliver uncompromising analysis that generates sound advice
and earns us enduring partnerships with our clients.
WHY CHOOSE US
We are driven to expose our clients to insights about their
industry, their competition and a changing market; designed
to help avoid surprises and industry shocks. Through deep
research, penetrating analysis and strategic gaming + advisory
expertise, our team of professionals help you identify and
solve tactical and strategic challenges. We help reduce the
risks associated with business-critical decision making.
COMPETITIVE + MARKET INTELLIGENCE
Competitive + Brand Insights
War Games / Competitive Simulations
Market Analysis, Share + Sizing
Supply Chain Mapping
GO-TO-MARKET STRATEGY
Brand + Product Positioning / Launch Support
Product Portfolio Roadmap
New Market Entry / Segmentation
Value Chain Analysis
Life Cycle Management
Win / Loss Bid Support
CORPORATE STRATEGIC PLANNING
Early Warning + Scenario Planning
Sales Force Effectiveness
Merger/Acquisition + Licensing
Innovation Strategy
Business Model / Industry Convergence