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Building health insurance concepts that deliver maximum member value

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The challenge

A top insurer needed to differentiate itself in a competitive health insurance market where many supplemental benefits had become table stakes. While the organization had opportunities to introduce new value-added programs beyond core coverage, it lacked clear insight into which concepts would resonate most with members and deliver real impact.
We knew this challenge required more than simply testing ideas; it demanded a structured, member-led approach and strong stakeholder input that reduced uncertainty and drove confident decisions.   

 

The method

We mimicked real office visits to move beyond self-reported data and reveal the subconscious biases and ingrained drivers guiding treatment decisions. We carefully crafted each element to mirror the pressures and complexities of a real clinical interaction, involving:
 
  • Simulated consultations: We hired a trained patient actor to engage with physicians. This allowed us to extend beyond stated intentions and contextualize the tangible gaps in what’s communicated to patients.
  • Realistic scenarios: We primed the actor to present with different, nuanced hesitations about starting T2D treatments, particularly injectables. We intentionally included variation to analyze the full range of counseling.
  • In-the-moment observation: We witnessed how physicians react to patient concerns. Real-time observation allowed us to focus on what language they used and how their underlying beliefs shaped the conversation and treatment recommendation.

The impact

We set out to identify which value-added benefit concepts could truly differentiate the insurer, while accounting for feasibility and the broader member experience.
 
  • Collaborative ideation and qualitative co-creation: We worked with stakeholders and members to generate and refine concepts, capturing clear feedback on what resonated, what needed improvement, and what felt most valuable.
  • Cross-functional feasibility input: Operational, legal, and financial perspectives were incorporated early to ensure concepts could realistically move forward.
  • Nationwide quantitative validation using MaxDiff and TURF: We quantified the impact of each concept and identified the optimal bundle of benefits to maximize appeal and reach across key audiences.

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