Friday, January 30, 2015

Physicians spend 20% of their time on non-clinical paperwork, according to a recent report.

Source: "2014 Survey of America's Physicians: Practice Patterns and Perspectives," The Physicians Foundation/Merritt Hawkins, September 2014,

According to a recent survey of members of the American Academy of Pediatrics:

  • 79% of pediatricians used electronic health records (EHRs) in 2012, up from 58% in 2009
  • 31% used an EHR considered to have basic functionality
  • 14% used a fully functional EHR.

Source: "Use of Electronic Health Record Systems by Office-Based Pediatricians," Pediatrics, December 19, 2014,

According to a recent CDC report on healthcare-associated infections, on a national level there has been:

  • central line-associated bloodstream infections (CLABSI) decreased 46% between 2008 and 2013
  • surgical site infections (SSI) related to 10 select procedures decreased 19% between 2008 and 2013
  • catheter-associated urinary tract infections (CAUTI) increased 6% since 2009
  • MRSA bloodstream infections decreased 8% between 2011 and 2013

Source: "Progress Being Made in Infection Control in U.S. Hospitals; Continued Improvements Needed," Centers for Disease Control and Prevention Press Release, January 14, 2015,

Wednesday, January 28, 2015

Better, Smarter, Healthier: In historic announcement, HHS sets clear goals and timeline for shifting Medicare reimbursements from volume to value

News Release


U.S. Department of Health & Human Services

News Division                                   



            Twitter @HHSMedia


Monday, January 26, 2015


Better, Smarter, Healthier: In historic announcement, HHS sets clear goals and timeline for shifting Medicare reimbursements from volume to value

 In a meeting with nearly two dozen leaders representing consumers, insurers, providers, and business leaders, Health and Human Services Secretary Sylvia M. Burwell today announced measurable goals and a timeline to move the Medicare program, and the health care system at large, toward paying providers based on the quality, rather than the quantity of care they give patients.

HHS has set a goal of tying 30 percent of traditional, or fee-for-service, Medicare payments to quality or value through alternative payment models, such as Accountable Care Organizations (ACOs) or bundled payment arrangements by the end of 2016, and tying 50 percent of payments to these models by the end of 2018. HHS also set a goal of tying 85 percent of all traditional Medicare payments to quality or value by 2016 and 90 percent by 2018 through programs such as the Hospital Value Based Purchasing and the Hospital Readmissions Reduction Programs. This is the first time in the history of the Medicare program that HHS has set explicit goals for alternative payment models and value-based payments.

To make these goals scalable beyond Medicare, Secretary Burwell also announced the creation of a Health Care Payment Learning and Action Network. Through the Learning and Action Network, HHS will work with private payers, employers, consumers, providers, states and state Medicaid programs, and other partners to expand alternative payment models into their programs. HHS will intensify its work with states and private payers to support adoption of alternative payments models through their own aligned work, sometimes even exceeding the goals set for Medicare. The Network will hold its first meeting in March 2015, and more details will be announced in the near future.

“Whether you are a patient, a provider, a business, a health plan, or a taxpayer, it is in our common interest to build a health care system that delivers better care, spends health care dollars more wisely and results in healthier people. Today’s announcement is about improving the quality of care we receive when we are sick, while at the same time spending our health care dollars more wisely,” Secretary Burwell said. “We believe these goals can drive transformative change, help us manage and track progress, and create accountability for measurable improvement.”  

"We're all partners in this effort focused on a shared goal. Ultimately, this is about improving the health of each person by making the best use of our resources for patient good. We're on board, and we're committed to changing how we pay for and deliver care to achieve better health," Douglas E. Henley, M.D., executive vice president and chief executive officer of the American Academy of Family Physicians said.  

“Advancing a patient-centered health system requires a fundamental transformation in how we pay for and deliver care. Today’s announcement by Secretary Burwell is a major step forward in achieving that goal,” AHIP President and CEO Karen Ignagni said. “Health plans have been on the forefront of implementing payment reforms in Medicare Advantage, Medicaid Managed Care, and in the commercial marketplace. We are excited to bring these experiences and innovations to this new collaboration.” 

“Employers are increasingly taking steps to support the transition from payment based on volume to models of delivery and payment that promote value,” said Janet Marchibroda, Health Innovation Director and Executive Director of the CEO Council on Health and Innovation at the Bipartisan Policy Center. “There is considerable bipartisan support for moving away from fee for service toward alternative payment models that reward value, improve outcomes, and reduce costs. This transition requires action not only by the private sector, but also the public sector, which is why today’s announcement is significant.”  

“Today’s announcement will be remembered as a pivotal and transformative moment in making our health care system more patient- and family-centered,” said Debra L. Ness, president of the National Partnership for Women & Families. “This kind of payment reform will drive fundamental changes in how care is delivered, making the health care system more responsive to those it serves and improving care coordination and communication among patients, families and providers. It will give patients and families the information, tools and supports they need to make better decisions, use their health care dollars wisely, and improve health outcomes.”  

The Affordable Care Act created a number of new payment models that move the needle even further toward rewarding quality. These models include ACOs, primary care medical homes, and new models of bundling payments for episodes of care. In these alternative payment models, health care providers are accountable for the quality and cost of the care they deliver to patients. Providers have a financial incentive to coordinate care for their patients – who are therefore less likely to have duplicative or unnecessary x-rays, screenings and tests. An ACO, for example, is a group of doctors, hospitals and health care providers that work together to provide higher-quality coordinated care to their patients, while helping to slow health care cost growth. In addition, through the widespread use of health information technology, the health care data needed to track these efforts is now available.  

Many health care providers today receive a payment for each individual service, such as a physician visit, surgery, or blood test, and it does not matter whether these services help – or harm – the patient. In other words, providers are paid based on the volume of care, rather than the value of care provided to patients. Today’s announcement would continue the shift toward paying providers for what works – whether it is something as complex as preventing or treating disease, or something as straightforward as making sure a patient has time to ask questions. 

In 2011, Medicare made almost no payments to providers through alternative payment models, but today such payments represent approximately 20 percent of Medicare payments. The goals announced today represent a 50 percent increase by 2016. To put this in perspective, in 2014, Medicare fee-for-service payments were $362 billion.  

HHS has already seen promising results on cost savings with alternative payment models, with combined total program savings of $417 million to Medicare due to existing ACO programs – HHS expects these models to continue the unprecedented slowdown in health care spending. Moreover, initiatives like the Partnership for Patients, ACOs, Quality Improvement Organizations, and others have helped reduce hospital readmissions in Medicare by nearly eight percent– translating into 150,000 fewer readmissions between January 2012 and December 2013 – and quality improvements have resulted in saving 50,000 lives and $12 billion in health spending from 2010 to 2013, according to preliminary estimates.  

To read a new Perspectives piece in the New England Journal of Medicine from Secretary Burwell: 

To read a fact sheet about the goals and Learning and Action Network: 

To learn more about Better Care, Smarter Spending, and Healthier People: 

A blog from Secretary Burwell is here:

 Participants in today’s meeting include:  

  • Kevin Cammarata, Executive Director, Benefits, Verizon
  • Christine Cassel, President and Chief Executive Officer, National Quality Forum
  • Tony Clapsis, Vice President, Caesars Entertainment Corporation
  • Jack Cochran, Executive Director, The Permanente Federation
  • Justine Handelman, Vice President Legislative and Regulatory Policy, Blue Cross Blue Shield Association
  • Pamela French, Vice President, Compensation and Benefits, The Boeing Company
  • Richard J. Gilfillan, President and CEO, Trinity Health
  • Douglas E. Henley, Executive Vice President and Chief Executive Officer, American Academy of Family Physicians
  • Karen Ignagni, President and Chief Executive Officer, America’s Health Insurance Plans
  • Jo Ann Jenkins, Chief Executive Officer, AARP
  • Mary Langowski, Executive Vice President for Strategy, Policy, & Market Development, CVS Health
  • Stephen J. LeBlanc, Executive Vice President, Strategy and Network Relations, Dartmouth-Hitchcock
  • Janet M. Marchibroda, Executive Director, CEO Council on Health and Innovation, Bipartisan Policy Center
  • Patricia A. Maryland, President, Healthcare Operations and Chief Operating Officer, Ascension Health
  • Richard Migliori, Executive Vice President, Medical Affairs and Chief Medical Officer, UnitedHealth Group
  • Elizabeth Mitchell, President and Chief Executive Officer, Network for Regional Healthcare Improvement
  • Debra L. Ness, President, National Partnership for Women & Families
  • Samuel R. Nussbaum, Executive Vice President, Clinical Health Policy and Chief Medical Officer, Anthem, Inc.
  • Stephen Ondra, Senior Vice President and Chief Medical Officer, Health Care Service Corporation  
  • Andrew D. Racine, Senior Vice President and Chief Medical Officer, Montefiore Medical Center
  • Jaewon Ryu, Segment Vice President and President of Integrated Care Delivery, Humana Inc.
  • Fran S. Soistman, Executive Vice President, Government Services, Aetna Inc.
  • Maureen Swick, Representative, American Hospital Association
  • Robert M. Wah, President, American Medical Association

7 Ways Healthcare Marketers Can Use Social Video to Improve Marketing

1.    Show Processes - Educate healthcare consumers, put them at ease and let them know what they can expect

2.    Highlight physician advocates - Turn ideas into reality and know how to replicate physician successes

3.    Promote awareness initiatives - There are an abundance of healthcare-themed days, weeks and months in our world

4.    Provide health tips - One in three people seek health advice through social media

5.    Showcase patient testimonials - Emotion cultivates brand loyalty

6.    Showcase products - It’s often difficult to effectively communicate the benefits of new and advanced technologies

7.    Promote an event - Move away from just an invite flyer and start developing a video that will promote the speakers, agenda and content of the event

Source: HART

10 Major Trends In Specialty Pharmacy

1.    The Cost of Specialty Drugs Is Skyrocketing

2.    The Specialty Marketplace Continues to Heat Up

3.    The “Marriage” of Specialty Pharmacy and ACOs Continues to Strengthen

4.    As Drug Costs Go Up, Adherence Goes Down

5.    New Patients Continue to Flood the Specialty Space Through Health Care Reform

6.    Growing Use of Technology Will Improve Patient Outcomes

7.    Health Care Is Evolving into a Patient-Centered Ecosystem

8.    Biosimilars Are Coming, Possibly Sooner than Expected

9.    Limited Distribution Networks Are Expanding for Greater Access to Specialty Drugs

10.  The Cost Will Be Weighed Against the Cure

Source: Pharmacy Times

When Stakeholders Estimate ACOs will Have a Material Impact in Their Marketplace

1.    Currently Do - 31.5%

2.    Sometime in 2015 - 20.4%

3.    2016 - 13.0%

4.    2017-2021 - 22.2%

5.    Never - 3.7%

6.    Unsure - 9.3%

Source: Accountable Care e-Poll, December 2014

Harris Poll: Where Consumers Want to Learn About Healthcare Services/Cost

A recent online survey conducted by Harris Poll on behalf of SCIO Health Analytics found that 38% of insured Americans do not have a good understanding of what healthcare services are covered under their current plan. According to the survey, here's where they want to learn about healthcare costs and services:

  • 62% want to use online research.
  • 41% would use a member helpline.
  • 37% would look to the insurance company.
  • 31% would use doctors as their source of information.
Source: Harris Poll, SCIO Health Analytics

96% of physicians interviewed in a recent study...

...use Smartphones as their primary device to support clinical communications.


Tuesday, January 27, 2015

CMS and Indiana Agree on Medicaid Expansion



FOR IMMEDIATE RELEASE                                          Contact: CMS Media Relations

January 27, 2015                                                                    (202) 690-6145 |



CMS and Indiana Agree on Medicaid Expansion


CMS Administrator Marilyn Tavenner and HHS Secretary Sylvia Burwell issued the following statement today after Indiana became the 28th state – plus the District of Columbia – to expand Medicaid under the Affordable Care Act. 


“With today’s agreement, Indiana will become the 28th state, plus the District of Columbia, to expand Medicaid under the Affordable Care Act. This agreement will bring much needed access to health care coverage to an estimated 350,000 uninsured low-income Hoosiers over the next three years,” said CMS Administrator Marilyn Tavenner. “HHS and CMS are committed to working with states to design programs uniquely their own, while maintaining essential health benefits guaranteed under the Affordable Care Act and other key consumer protections consistent with the law.”


“I continue to be encouraged by interest from governors from all across the country who want to bring health care coverage to low-income people in their states by expanding Medicaid. They understand both the economic benefits of Medicaid expansion and the health and financial security it brings to their residents,” said HHS Secretary Sylvia Burwell. “The Administration will continue to work with governors interested in expanding Medicaid to devise approaches that work for their states while keeping faith with the law’s goals and consumer protections.”


The expansion is paid for with 100 percent federal funds through 2016. Federal funding rates gradually decline beginning in 2017, but never fall below 90 percent of costs.


Fast Facts on Healthy Indiana Plan:


Beneficiaries will begin to have access to quality, affordable coverage with the essential benefits guaranteed by law beginning on February 1, 2015 for eligible individuals.


Indiana’s plan establishes POWER Accounts, which beneficiaries will use to pay for some of beneficiaries’ health care expenses. These accounts will be funded, in part, through beneficiary contributions.


Beneficiaries will have access to all of the essential health benefits that are required under the law. The agreement allows two benefit packages (HIP Plus and HIP Basic), each covering all essential health benefits required by law and available to people based on their premium (POWER Account) contributions.


Individuals who are charged premiums (in the form of POWER account contributions) will enroll in HIP Plus and have no other cost sharing, expect for certain emergency room services. These individuals will also have the opportunity to reduce their premiums through incentives like receiving preventive care or through a rollover of their POWER account. For people with incomes at or under 100% of the federal poverty line (FPL) who elect to pay cost-sharing rather than premiums, cost sharing will comply with regular program limits and total cost sharing will not exceed 5 percent of the family income.


CMS did not approve a work requirement as part of this agreement. Indiana will seek to encourage employment through a state-funded incentive program that will be administered separate from the Medicaid program. Participation in this program will not impact coverage or costs for individuals. While states may promote employment through state programs operated outside of the demonstration, this is not permitted under the Medicaid program.


Co-payments for certain emergency room services to some individuals will be allowed in connection with a study testing whether copays encourage care in the most appropriate settings while not harming beneficiary health. Federal law allows waivers on cost sharing payments only based on meeting several criteria including the presence of a control group so that the impact can be carefully studied. Individuals who seek treatment at the emergency room will be charged copays ($8 for the first visit, $25 for the second visit). Those assigned to a “control” group will not be charged.


Individuals with incomes at or below 100% FPL are not subject to a lockout of essential benefits. A person who is not medically frail and has income above the poverty line who stops paying premiums can be locked out of coverage for six months – reduced from 12 months in the current Indiana plan – and subject to certain exceptions.The new demonstration shortens the lock out period from 12 months under HIP 1.0 to six months, limits the lock out to only people with incomes above 100% FPL who are not medically frail, and adds additional exceptions for some individuals. For instance, individuals with incomes at or below 100% FPL will also be given a 60-day grace period after non-payment of premiums before being automatically enrolled in HIP Basic.


Several features of HIP 1.0 were not continued as part of this new demonstration. These policies would not be authorized as part of a Medicaid expansion demonstration that, under the Affordable Care Act, triggers the enhanced federal matching funds. This agreement does not permit:

  • Capped enrollment;
  • Premium payments as a condition of eligibility for people with incomes below the federal poverty level; and
  • Premium payments in excess of 2 percent of income.

According to a recent study:

  • 6.8% of emergency department visits were followed by returns to the emergency department within 7 days
  • 5.7% of these returns were adverse events
  • 56.6% of the returns were preventable

Source: "Adverse events in patients with return emergency department visits," BMJ Quality & Safety, December 24, 2014,

Monday, January 19, 2015

Five Essential Cyber Risk Facts

By: Martin Frappolli | January 14, 2015


Martin J. Frappolli, CPCU, FIDM, AIC, is Senior Director of Knowledge Resources at The Institutes, and editor of the organization's new “Managing Cyber Risk” textbook. He can be reached at


As businesses struggle with embarrassing data breaches, this new normal is spurring better information protection. Costly intrusions have a long-lasting effect, from customer impact to insurance claims and lawsuit exposure.

Insurance professionals need pragmatic context to prepare insureds to handle a data breach — a roadmap to understanding and mitigating cyber risk exposures.

Start with these five facts:

1. Hackers attack for any reason or no reason.

Organizations fail to manage cyber risk because they believe their data simply isn’t worth stealing. Common vandalism is a frequent reason for a cyber attack. Hackers might penetrate a company’s digital defenses solely for a thrill or ego boost.

You don’t need to have lucrative information to be a target; the only prerequisite is having data in the first place.

2. Internal users can be the weakest link.

The Hollywood version of hacking is a computer whiz sitting in a dark room, furiously typing sophisticated codes. In reality, there’s a much easier way: Ask for the passwords.

A well-known method of data theft is impersonating someone within the company who needs confidential information.

Social engineering ploys can be deceptively simple, such as contacting an employee and claiming to be from IT, then soliciting a user’s account information. Or, call the help desk, claiming to be an executive, and exploit the representative’s good nature to gain system access.

Thieves attack the weakest link; sometimes that’s not the computer, but the person sitting at it.

3. Small businesses aren’t safe.

The public is aware of breaches at big companies like Sony and Target. While attacks on smaller businesses won’t generate headlines, they can potentially be more devastating, because smaller organizations are less able to recover.

It doesn’t take a multinational crime syndicate to steal data. It can be as simple as a disgruntled employee sharing access codes online or leaking sensitive emails.

For a small business, the reputational loss from betraying customer trust can be ruinous. While smaller businesses might not be the biggest targets, they are often the most vulnerable.

4. You don’t have a choice.

Legislators reacted to expanding cyber thefts with regulations requiring organizations to better protect customer data containing personal identifying information (PII). Congress, state legislatures, and agencies like the SEC have promulgated guidelines on how to protect PII.

Companies should not wait for the various bodies to agree on one standard — they should already be doing everything possible to manage information securely.

5. Cyber risk management is everything.

Cyber risk is not a computer issue only, or merely a customer data concern. Its impact must be evaluated from an enterprise risk management perspective. Like anything that threatens an organization’s long-term viability, cyber risk must be managed.

While a number of cyber risk policies are available, there are many non-transfer strategies for managing cyber threats.

While cyber risk is changing constantly, insurance professionals need a pragmatic perspective to cope effectively. Those who take the time to study this field will better protect their organizations and themselves while earning trust from their clients and managers.

Digital destiny: What your agency needs to do right now to become more competitive

If your agency isn't defining its marketing strategy and discussing upgrades to its digital management system, it's likely you’re behind the curve. Here's how to catch up.

Independent agencies boast a long history and culture of being highly effective at sales. However, that competency isn't always matched in their marketing efforts or the agency-technology decisions that are made.

To remain competitive, agencies must now do two things. One, they need to leverage the data they are already collecting via their agency management systems and turn them into new opportunities by using the right marketing software; and two, they need to take a hard look at the technology they’re using — including their agency portal, the hardware (and software) producers use, and the tools that streamline the agency's processes.

Is your agency website a few years old? If so, it's probably time for an upgrade. Do you have a mobile app? If so, what does it offer? And are you using e-signatures? What is your marketing strategy? These often-uncomfortable questions are among those that must be asked by agencies of varying size. The marketing-strategy question, in particular, is one that can no longer be ignored.

“For decades, we’ve relied o the inherent characteristics of the independent channel to add value to the customer experience. Customers are less convinced,” says Michael Jans, CEO of Agency Revolution, a Bend, Ore.-based firm that specializes in marketing platforms for insurance agencies. “Agents can't simply rely on the carrier segment to create value. They have to vigorously find ways to add value at the agency level.”

Advisors have one of the best jobs imaginable with the opportunity to create strength and unity within a retirement plan.

With the independent agent channel's struggles with market share and rivals entering the marketplace, a written marketing plan is vital, adds Jans: “This is urgent. There are serious competitors gunning for business. The complacency that the independent-agent channel enjoyed in the past is dangerous in this environment.”

In most agencies, he explains, marketing is haphazard and chaotic. In order for marketing to be effective, it must be systematic, “and the only way you can systematize communications that deliver the right message to the right people — thousands of customers and prospects — at the right time is through technology.”

“What I hear from our customers is that they like to be with an agent and an agency that is spending the money to be relevant to them,” says Stanley G. Logan Jr., an agency principal at Logan Lavelle Hunt Insurance Agency LLC in Louisville, Ky., and a member of the PIA National board of directors, representing PIA of Kentucky. Logan's firm is in an ongoing “aggressive growth phase”; he’ll tell you he doesn't know any other way to characterize his business. But he echoes a sentiment familiar to many an agent.

“When I talk to my insurance company partners, they are interested in sales. That's still the No. 1 game in town, and they want more and more from us,” he says. Having the right tools to do that job is the edge that forward-looking agencies can enjoy, if they’re willing to do the homework.

Keith Savino, a principal with the insurance agency Warwick Resource Group LLC in Warwick, N.Y., is another big believer in putting the right solutions in agency hands. “Our industry needs to embrace these tools to buoy itself in a changing market,” he says.

Savino's agency received the 2014 Excellence in Social Media Award from the National Association of Professional Insurance Agents. He sits on numerous industry boards engaged in technology, such as ACORD and NetVU, and has long been ahead of the curve when it comes to experimenting with new solutions. Warwick is on its third customer portal in the last 13 years, with a new one slated to roll out in a few months.

“I have to provide for someone the experience they’re used to in retail or professional services,” says Savino. “I want to make sure that what we can do in a brick-and-mortar world we can extend to other forms of media.” That includes providing e-signature capability on all documents (a huge time saver, he notes); an agency portal through which customers can, among other things, sign in and view all of their policies across multiple carriers; a mobile-enabled site and/or app for smartphone and tablet users; advanced CRM systems for client nurturing; and videophone VoIP technology for use by its staffers at locations in New York, New Jersey, Connecticut and its West Coast offices.

Yet, for Savino, the word “tech” is almost anathema. He draws parallels to the “ice box generation” of his grandparents, who once saw the refrigerator as a technological advancement; today, it's an appliance to which no one gives any thought. “These are just communications tools. I don't see them as ‘technology,’” he explains. “Some people don't even view smartphones as ‘tech’ anymore. I see it as a required part of business; I don't think of it as an advantage as much as a requirement. I challenge people to think differently about that.” Think it's too late to change? Think again. This philosophy is from a firm celebrating 150 years.

“The big challenge is communicating your value to your clients,” he continues. “The minute you stop offering a service because you will not implement new business tools, you’re intentionally putting up a roadblock to a good customer experience.”

However, no agency can simply build a new system and then assume the game is won. “If you don't continue to invest money on your infrastructure every day, it's going to get outdated really quickly,” Savino adds. “If you never did any maintenance on your house for 30 years, never reset the pavers, never cleaned out the gutters, what do you think is going to happen? Technology wears out much faster than your roof.”

Those using old agency management systems definitely need to upgrade, says Brian S. Cohen, an operating partner with Altamont Capital Partners in Palo Alto, Calif., and the former head of sales and distribution and chief marketing officer at Farmers Insurance Group. The “if it works don't fix it” strategy, he says, fails in today's insurance-distribution market.

“There are many cloud-based systems that allow agencies to do more with less — and most importantly, serve their customers the way they expect to be served in the digital age,” says Cohen. “Agencies that have made the transition need to start aligning with insurance carriers that will fully support a modern agency-management system.” If a carrier still requires faxes or other paper-based processing, he adds, agents should demand they upgrade — or look for other markets.

Portal potential 

The one essential conversation that needs to be had at an agency is the status of its web portal. How effective is it in serving customers, and how can it be used to reduce the number of hours spent on serving client requests that, if empowered by the site, they can easily handle themselves?

“Almost all agency web portals today are predominantly marketing sites that don't allow people to interact with the agency. They are one-dimensional,” says Cohen. “They don't give an existing client or a potential customer a reason to stay on or navigate through the site.”

The most important elements of functionality, he says, must be tools that provide value to visitors. For existing clients, Cohen explains, functionality should exist to enable self-service such as policy changes, claims assistance, or obtaining certificates of insurance. “Done right, the web portal acts as the 24/7 agency CSR and today people want to be able to interact with a business whenever and wherever.”

For potential customers, the web portal must provide resources that will enable people to discover the agency when they are faced with an insurance issue. These include things like weather alerts and a checklist of “what to do” to protect your property before a storm. “In other words, agencies need to adopt a strategy that attracts or ‘pulls’ people to their website,” says Cohen.

Jans notes that a constant stream of fresh and relevant content is critical for search engine optimization — the process by which the owner of a website improves its ranking on search sites like Google. Ideally, an agency should add new content weekly: “That means that the power to upload new content must be under the control of the agency,” he adds. “You can't afford to put ‘change requests’ into a webmaster's queue and wait weeks for those changes to happen. You should be able to click in, make changes, and click out and have them saved.

“If you have multiple niches, you must have pages that speak directly to each niche,” says Jans. “That way, prospects are more likely to find you on Google. Then, when they discover you, they’ll trust you.”

For any audience, the key element for a web portal today is mobile capability. Today, it's all about the smartphone, and every site needs to be able to provide a mobile experience.

“More and more people are using smartphones than computers or even tablets” in their interactions with insurers, says Logan. “They’re so used to people going to their phones for the answers.”

Logan Lavelle Hunt started using its own branded smartphone app, designed by, six months ago. A customer can log in through the app and, in the event of an accident, for example, pull up his or her carrier's claims department and upload claims information and even photos. Through the app a customer also can access links to their carriers, make billing inquiries and even access adjustors.

Jans agrees that the number of mobile visitors goes up every month. It's no longer a question of whether your site should be optimized for mobile, but rather, when this can be achieved.

“Almost everyone knows how frustrating it is to view a traditional desktop site on their smartphone,” he says. “If that's what your customers see, you’re delivering a negative experience. If that's what your prospects see, they’ll delete it and find someone else.”

An effective portal also cuts down on the amount of hours your customer-service reps spend servicing clients. Every agency knows that the many hours spent servicing clients is time that would be much better spent selling.

Logan's agency breakdown is 25 percent personal lines, 50 percent commercial P&C, and 25 percent benefits, handled by 60 employees in all: 15 are in sales (other than the five principals), and 45 are service reps. On a daily basis, half of the CSR's day is spent solving billing inquiries.

“It's astronomical how much we spend on billing issues,” says Logan. Trying to connect them right to the carrier, and not be the go-between, is his continued goal. “We’re doing a multitude of things [in order] to spend more time on account rounding and review. Right now, 70 percent of my revenue goes to service, 30 percent to sales. I’d like to reverse that in the next five to 10 years.”

Marketing-automation software 101

Marketing-automation software provides the “human touch” for an entire agency's book of in-force business and its prospects.

“Every mature agency has a sophisticated system that manages its customer data: its agency management system,” says Jans. Serious marketers will use marketing automation technologies to unlock the information that's in that system and turn it into thousands of marketing opportunities. “That's the shortest path to money,” he notes. “Marketing automation is the fastest-growing category of business software in the world. The agent who integrates it with his management system will have an advantage.”

Marketing automation software helps an independent agency attract new clients; convert prospects into customers; cross sell; and boost retention. Those results, he says, are why this new type of software is the fastest-growing category of software in the business world.

It works this way: Marketing automation software “reads” the mass of data that's locked inside an agency management system and turns that information into marketing communications. It helps agencies communicate with prospects and customers in ways that matter to the customer, not just to the agency.

The “human touch” is that communications are set up by the agency decision-makers, and are automatically delivered based on certain criteria. For example, an agency can set up communications to people who request quotes; customers whose policies are expiring in 90 days; customers who have a birthday or policy anniversary; and/or policyholders who have Auto but not Homeowners coverage, and so on.

Marketing automation can integrate with an agency management system, so data can flow back and forth from the system to the marketing automation portal (for example, an interface on the desktop).

Constant outreach that doesn't have to be completely initiated by agency employees is critical, says Logan. The customer has to know the agency remembers who they are.

“They appreciate being asked, even if a sale doesn't happen,” he adds. “You often hear agents who say, ‘The best customer is the one I don't hear from.’ And then they wonder why they lose that person.”

Wanted: a new mindset

The greatest enemy of technological advancement in agencies is the one thing agents don't have enough of: time. The agency principal has long been the salesperson, and then became the benefits guy, and now they’re the tech guy, says Logan: “They don't have time to do the research, and implement it. It takes a lot of thought and time and planning to do it.” His suggestion: Consider hiring an office manager who can take responsibility for many of these kinds of tasks.

“So many times, we take the top salesman and now we’re making him manage as well,” adds Logan. “It's no wonder you see so many agencies hit the wall. There are only so many hours in the day.”

Savino says that agencies would do well to look at technology investments as a sales expense, and budget it that way — requiring a shift in mindset from the traditional model. “The right tech helps you acquire a client. If you’re not apportioning any of these expenses to sales, you have to rethink that [equation].”

It's important, however, for agency owners to know why they’re investing in new systems and tools, because what looks good to the principal might not be so appealing to the troops. Staffs can push back on new implementations. Know why you’re doing it, and communicate that clearly.

Growing agencies have many moving parts; some are strategic, and some are tactical and task-oriented. All of those moving parts need to be synchronized. “It's one thing to be disconnected from the tasks,” he says, “but don't be disconnected from the strategy.”

One helpful tip Savino offers: Negotiate ongoing training for your staff, as part of the deal with the vendor, and take advantage of your user group. Then reward the team for attending them.

“What works for me, might not work for you,” he stresses. Spend the time to decide which is the right vendor for you, don't just buy what someone else has. “Think about what you need, and you’ll find the right vendor. There are a lot of creative people in this space, and the landscape is constantly changing.

“Foresight is very important in the insurance industry right now around operations,” adds Savino. “If you keep your eye on the future, it lends some clarity on what you need to do today.”

The digital ‘John Hancock’

The future of document delivery is going to be through customer portals and e-doc delivery, says Keith Savino, a principal with Warwick Resource Group LLC in Warwick N.Y., and a huge proponent of e-sign. The solutions he is implementing are for both internal and external business needs, and not always for insurance documentation.

Savino says most agencies hesitate to implement electronic signatures into their agency workflows because they either don't understand what an e-signature is or because certain carriers have pushed back or are bullish with the ones that they do use, and push them on agencies.

Using this mechanism has several practical advantages, however. It provides quick turnaround and digital confirmation that the customer really did receive a document, and that the client signed off on it.

As his agency has done for years, Warwick shares its experience with other agencies looking to try new tools. “Folks that told me two years ago that they would never use e-sign, now they’re asking about it.”

The value, Savino explains, is in the productive hours that are saved: “When someone spends 20 minutes on completing documentation or chasing a client, that's not productive time. Productive time is time spent interacting with the client. The more we get rid of the minutiae administrative tasks, the more time agency professionals can spend with clients. That's our goal: To increase the percentage of purely productive time.”

Digital marketing: A new wwist on a proven method

“Insurance was the fastest-growing industry after World War II. This was a sweet place to be, and if you could reasonably run a business, your agency would grow,” says Michael Jans, CEO of Agency Revolution. “But those days are over. Competition is more fierce, and rivals are well-funded. You have to be a dedicated entrepreneur.”

One such way to grow an agency is through marketing automation — a technology that is not new, but has been largely unavailable or useless to the insurance industry because data has been siloed in agency management systems.

But more recently, software is available to read the information in an AMS and automatically trigger marketing campaigns to individuals at the right point in time.

For an agency that has 10,000 clients, Agency Revolution identified 141 scenarios that can take place on any given day. And each of these scenarios requires specific marketing materials, with detailed language tailored just to the client's event.

Through data collection, the Agency Revolution platform triggers its marketing campaign. It's a pretty simple process, says Jans: Install the software, continue using your AMS through normal business operations, data is collected, the platform detects life-cycle changes and then automatically launches a campaign. Users are able to opt out or change any campaigns.

In this way, agencies can use technology to multiply value and meaning to clients, Jans advises. “Good marketing automation makes people feel that you care about them and represent the values of your agency,” he stresses.

He recommends marketing automation for agencies that have $1 million in revenue and 10 or more employees. Such operations have the time and capital to invest in and adopt new technologies, he says.

Chris Dik, vice president at Knight-Dik Insurance Agency in Worcester, Mass., understands the value of digital marketing. This strategy has helped the agency grow its Workers’ Compensation line from practically nothing and triple his WC commission in just the first year.

The Workers’ Compensation market is unique in Massachusetts — it's the 44th cheapest in the country and there aren't a lot of players due to its high effort and low returns. But Dik viewed this as an opportunity.

About five years ago, the agency, which writes about $2.5 million in commission each year, decided to jump into the Workers’ Compensation market with both feet. It branded a program called Workers’ Comp Results, which has its own dedicated website and offers third-party services with the biggest impact on reducing premiums, such as reserve reductions, audits and HR support.

With help from agency interns, Dik builds data profiles — including experience mods, rating systems and current premiums — on these potential insureds from free and publication information from the state, and puts all of that information into an Excel spreadsheet. “We are taking the old way of marketing — of getting the data first — and then letting the system work,” he says.

From there, Infusionsoft — a platform offering contact management, CRM, marketing automation and e-commerce — takes over. The software identifies certain niches that Dik wants to target for specific campaigns: Contractors or landscapers, for example, who are paying at least 10 percent more than their competitors.

The software pulls these names and their data, and sends out a letter that includes actual premium numbers and comparisons.

This language grabs the potential insured's eye, and from there it's inbound marketing, Dik says: “Ninety to 95 percent of my business is from inbound calls after a client receives those letters.”

Infusionsoft automates the onboarding of new clients — across all lines, not just Workers’ Comp. The software continues to send e-mails quarterly to potential clients, a programmed process so successful that Knight-Dik closes about three policies a month based off of marketing campaigns that ended four or five years ago.

Jan agrees with this strategy, and applauds the payoff: “How many times are you contacting your customers?” he asks. “Only at renewal? If the nature of your message is a Halloween cartoon with a picture of pumpkins — that doesn't add value to your relationship.”