6 ways to refresh your payer sales model

Blog series: How healthcare payer sales models impact revenue growth

By Alex Tolmasoff, Director, KPMG Sales Transformation and HCLS Lead

In our first two blogs in this series, we discussed the hurdles healthcare payer sales leaders are facing with finding and keeping members and how outdated sales models can impact revenue growth.

Now it’s time to look at approaches for a commercial model refresh.

While some commercial or market leaders are taking a piecemeal approach to counter the challenges outlined in our previous blogs, strategic sales leaders are driving transformation across their models using some or all of these approaches:

1. Evolve from "sales ops" to customer operations 

  • Shift the mindset and charter from reactive to proactive, internal to external, narrow to broad
  • This means evolving from small “comp and tools” teams to full-fledged commercial operations teams that coordinate customer experience (CX) across marketing, sales, and customer success

2. Create omni-channel customer experience (CX) for patients and providers

  • Move away from siloed marketing, sales and service experiences, toward a common message across all customer-facing and member-facing roles
  • Take advantage of automation and digital CX measurement tools to enable seamless and data-driven experiences with full visibility and adaptability

3. Shake up customer segmentation and go-to customer models

  • Refresh segmentation models with new data and new cost to serve expectations based on digital-enabled sales teams
  • Create intentional customer journeys based on these new segments and then design new revenue motions (e.g., sales, marketing, service processes) that align to them
  • Rethink broker relationships and programs based on performance data, product compliance, share, employer trends, and competitiveness; invest and upgrade the insights and incentives provided to top performing partners
  • Given that many sellers became “inside sales” during COVID lockdowns, sales leaders can reinvent what “inside sales” means and rethink expectations, enablement, and talent profiles required

4. Create a career program that wins the competition for talent

  • Challenge existing talent with new career paths, value-focused coaching, and expanded digital / data literacy
  • Develop new talent profiles required to service new models, products and customer expectations with intentional recruiting, upgraded competency models, and refreshed career paths

5. Revamp incentives to grow the full suite – profitably

  • Say goodbye to the days when sellers could simply sell to the same customers or avoid ancillaries – the market has changed
  • Look for opportunities to stop using member-based metrics so you can balance growth strategies (e.g., base business + innovative products)
  • Add profitability metrics that focus sellers on good business, new products and value-based selling
  • Evolve incentives so sellers can’t hit all of their objectives without aligning to business strategy – and if they do, reward well

6. Make digital and virtual selling table stakes

  • Upgrade job designs and rules of engagement to align to hybrid, digital-enabled selling models that are now the new norm
  • Accelerate digital technology investments and data strategy that enable time-saving automation, just-in-time seller enablement, and rich customer insights
  • Invest in “seller experience” programs that combine mobile, CRM, and sales process innovation to give sellers more time and allow them to add more value

How can KPMG help?

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.

Contact us

Walt Becker

Walt Becker

Principal, Customer Advisory, Sales Transformation, KPMG US

+1 267-256-7000
Alex Tolmasoff

Alex Tolmasoff

Director Advisory, C&O Commercial, KPMG US

+1 415-963-5100