Selling to Employers: Identifying Qualified Opportunities (Part 3)

Introduction

This article is part of a six part series written by Ryan Russell at HTN sharing his learnings on employer sales. Click the links to jump to any of the other articles in the series:

Overview | Employer Primer | Qualified Opportunities | Average Deal Size | Win Rate | Sales Cycle

In this installment of our series on Sales Velocity, we’ll take a look at two items that drive the number of qualified leads:

1. Leveraging partnerships to increase leads hitting your funnel 

2. Leveraging the first interaction to ensure leads are qualified into opportunities

Marketing also drives leads but that’s for an entirely separate conversation. Let’s take a look at each of the metrics above:

1) Leveraging partnerships to increase leads hitting your funnel

The digital health world is full of quotes these days from press releases like this one:

Organizations that are finding success have found a way to partner with a number of different organizations that all play a role in the employer benefits space. In the quote above, Hinge is partnering with insurers (BCBS MA), benefits consultants (Willis Towers Watson, Aon), benefits navigators (Accolade, Castlight) and other digital health startups (Buoy Health, BridgeHealth). Let’s unpack why they’re partnering with so many players, focusing on two partnership opportunities in particular: 1) Benefits Consultants / Brokers and 2) Health Insurers/TPA’s

Partnering with Benefits Consultants / Brokers

Whether you are targeting small or large employers, brokers and benefits consultants are present and important. Why? A while back, a benefits leader at a small company described it to me as such:

In the large group market, there are most definitely employers that have invested in internal healthcare domain expertise, but benefits consultants are often an important voice at the table driving the conversation with their employer clients. Especially, when it comes to what’s new in the space. For evidence of how important these relationships are, check out these two examples:

• State of Delaware
  https://dhr.delaware.gov/benefits/sebc/subcommittee-materials.shtml
  This is the State of Delaware HR Subcommittee meetings where the state health plan is discussed. The vast majority of content shared at these meetings is created by - guess who? Willis Towers Watson. This is not uncommon - these consultants are driving the conversation for employers.
  ‍

• San Francisco Health Service System (SFHSS)
  https://sfhss.org/sites/default/files/2018-12/SM_062218_Strategic_Plan_Presentation.pdf 
  Even if you don’t want to peruse all 129 pages of this deck, it is worth noting the intro overview pages. This is Aon hosting an innovation day for 40 leaders from SFHSS, a large client in San Francisco. SFHSS engages Aon as subject matter experts to discuss problems and future needs of SFHSS. They also bring in ten vendors to pitch their solutions to the SFHSS team. Put yourself in the shoes of a SFHSS leader if you want to look through the 129 pages of that deck - how exhausting must it be to listen through all of that? 

Those two examples are intended to highlight the breadth of the conversations that Aon and Willis Towers Watson are having with these organizations. Aon and WTW are crafting the innovation agenda, serving as subject matter experts informing the dialogue, reporting on ongoing operations, and providing updates on status of innovation projects. If you want a seat at the table with large employers who use benefits consultants, it behoves you to have a relationship with those consultants.  So how do you do that?

Align incentives with your Consultant/Broker partners.

First, segment your potential broker and consultant partners based on how they provide value to employers. Then think about incentives that align to the goals you need along with how your partners are structured to actually drive your intended behaviors.

Second, clarify for yourself what the goal of the relationship is for both parties. Note the one commonality across these relationships - you’re giving a cut of your sale, in some way shape or form, to a broker in exchange for them being a channel partner. There are a number of approaches that digital health vendors take with consultants / brokers.

Third, seek to understand which of these goals and incentives will work for your different segmented partners.

Smaller Employers: Brokers

Here are a few examples I’ve seen with the broker market (smaller employer) based on various goals:

With brokers, it’s important to understand how the agencies are structured and who will receive the incentives. If you make an arrangement with a national brokerage at the corporate level, will the local brokers responsible for quoting and winning business directly see those incentives? If not, will their behavior actually change or will they continue to go with what they know works? 

Asking the question of “where will these incentives go?” makes a big difference in understanding the specific individuals at these firms who are actually going to partner with you to get your product in front of their clients.

Note, the Consolidated Appropriations Act passed in 2021 now mandates the benefits brokers disclose to employers how much they make from insurance carriers and vendors. It will be important to understand the implications of these on how brokers think about these types of partnerships and incentive arrangements.  

Larger Employers: Consultants

Consultants don’t really operate in the two sided incentive game - they are generally paid by their employer clients to act as “trusted advisors” not playing both sides of the market. Note, there are more brokers moving into these types of arrangements with employers to avoid conflicts of interests caused by incentives. 

For these partners, the question (and goal) becomes - how do you get the consultant to believe in your product or value prop such that it becomes part of every “new solution” section of their annual review decks. Remember, these partnerships are as much about generating more revenue for the consultant as they are for you as the vendor.

Doing so becomes its own sales cycle in that you need to:

• Create awareness of your product / solution 

• Sell the value prop with the consultant innovation teams

• Get the buy-in of the consultant actuary and medical teams

• Pass the legal team and compliance tests

• Make the regional/local market rounds 

• Work through partnership details should you get that far

Getting in front of the consultants can be half the battle. Leveraging your network is obviously key, but innovation forums like Business Group on Health, Employer Health Innovation Roundtable (EHIR), Silicon Valley Employers Forum can be valuable places to attract attention from both employers and consultants. 

Once in front of the consultant audience, one of the key value props these consultants provide employers is data analysis and insight. So how do you win them over? Data (and storytelling with data, of course). You could try to go out and run your own third party analyses or use your book of business data to attempt to prove your point but consultants will always find some bias in that data, especially early on. But remember, consultants operate on project based work by nature. Why not try to engage them in a project-based “study” to validate your data so they have their own proof points to sell to employers? 

This can be a very effective tactic to generate partnership, assuming of course, you have enough belief in your solution’s effectiveness to have someone else try to verify it and that belief turns into positive results. 

Virta and Hinge Health are two examples where they’ve been able to partner with WTW on demonstrating effectiveness with data that presumably all of WTW clients will be exposed to.

1. Virta & WTW engage in a pilot to test effectiveness (this WTW waiver shows what an employer signs up for):

2. Hinge Health partners with WTW and puts together a sales doc for WTW:

Willingness for a consultant to put these types of partnerships out there may take time, but that time could be accelerated by thinking about creative ways to pay these consultants to help validate your data that helps avoid the potential conflicts of interest that would undermine their value to employer clients as “trusted advisors”. Again, this is as much about driving revenue for them and if they are bringing validated solutions to a client or prospect, it can help with that.

Treat the Brokers/Consultants as Partners

Aligning monetary incentives with these partners is a big part of the battle, but being good human beings with empathy is another critical part of driving leads. Imagine this situation:

A vendor is selling a fertility solution to an employer who partners with a consultant throughout the process. A relatively significant contracting issue has come up and the vendor is debating telling the consultant before the employer for fear the consultant will sabotage the deal.

It can be tempting to try to avoid dealing with the consultant and bring potential solutions just to the client to avoid the perceived risk of the consultant pegging you as the “new, don’t have your act together startup.”  However, while the risk might seem high, the rewards of doing the opposite can be higher. 

A key value prop of a broker and consultant is to manage vendor relationships and solve problems for the employer. If you don’t include the consultant, they are caught flat footed in front of the employer potentially diminishing their value. But if you do partner with the consultant on the potential solutions, they are able to take a proactive approach and even take credit for the resolution, making them look good. 

Additionally, you have shown an ability to partner with the consultant in good faith and lifted them up in front of the client. In which alternative process do you think the consultant is more likely to refer you to other clients as a good partner? It is generally in your best interest in the long run to do what you can to make the consultant look good for their client.

Understanding how to successfully work with brokers / consultants can make or break a digital health startup selling to employers. In a world where employee benefits leaders often lack subject matter expertise in healthcare and are overwhelmed by the sheer volume of companies pitching them, these brokers / consultants serve as the trusted advisor guiding employers on decisions. Find ways to make it easier for them to be viewed as that trusted advisor (more on this in the “Make your Product Easy” section of the Win Rate article.

While these brokers/consultants are one key partnership channel, payers are another. 

Partnering with Insurers / TPAs (third party administrators)

As Hinge demonstrated with its press release, benefits consultants are not the only partnership for digital health vendors to target. Insurers/TPAs also play an important role in the decision making process for many employers, and they can be valuable friends for digital health vendors. Time and time again, employer clients would tell me how valuable it was for them to leverage our ability to vet, partner with, and recommend specific clinical and digital health vendors. 

The reasoning why is rather intuitive. In most cases, the employer has spent an incredible amount of time vetting and building trust in an insurer/TPA. That trust often then extends into the insurer/TPA’s recommendations about healthcare topics, including evaluation of digital health companies. Similar to the consultants/brokers, the insurer/TPA’s often have standing quarterly or even monthly meetings with their clients to review claims, engagement, etc. It is far easier for the insurer/TPA to bring forward a new idea in one of those standard meetings than for a startup to get a meeting with a cold call. 

Let’s take a look at an example of the roles insurers can play with employer customers:

• City of Boston. 
  BCBS Massachusetts presented to the City of Boston back in December 2018 highlights regarding the overall performance of the plan, identifying opportunities in a number of different disease states among the population, including behavioral health and MSK. Understanding what the payers and employers are talking about as key problem areas can help you as a digital health vendor hone in where you spend your time with employers.  https://content.boston.gov/sites/default/files/embed/file/2019-01/bcbs_annual_meeting_presentation.pdf 

There is also a convenience factor for working with employers via an insurer partnership, especially when you think about three key pain points of the employer:

1. Vetting all the various solutions takes a ton of time

2. Contracting and integrating with the different vendors takes even more time and resources

3. Driving utilization and engagement of programs is hard

Leveraging their trusted relationship, the employer is more comfortable outsourcing some of this work. Generally, if a digital health vendor works directly with and integrates with a payer, there is the operational benefit of eliminating BAAs, security audits, and integrations that otherwise take up time and attention from both the vendor and the employee benefits team. 

On the utilization and engagement front, health insurers/TPAs are working on becoming more consumer friendly with digital interfaces and front doors that presumably can bring these solutions front and center to the consumer without bifurcating the experience into hundreds of apps. That becomes valuable to employers trying to find the most effective ways to get employees to pay attention to offerings. Collective Health is an exampleof a company finding product market fit targeting these three employer pain points in its value prop that benefits the partners in access to the employees Collective is in front of.

We'd be remiss not to include benefits navigators as another group to look into for partnerships. Companies like Accolade, Transcarent, Included Health, and Quantum are aiming to help simplify the complex benefits experience that exists for both the employer and the employee. In doing so, they are playing a much more significant role in what solutions are presented to both parties and will likely be an increasingly more important potential partner for digital health solutions.

Putting it all together successfully: Livongo

When you put it all together, partnering with benefits consultants/brokers and payors/TPAs/Navigators can be an effective means of increasing the top of funnel activity for your digital health organization. To give you a sense of this, Livongo is a good example of one of the best employer sales growth stories out there. At the time of its IPO, Livongo was generating 61% of its sales via its top 5 channel partners - Express Scripts, CVS, Health Care Service Corporation, Anthem, and Highmark.

However, just increasing opportunities at the top of the funnel will not help drive improvement in Velocity. While the partners should theoretically help qualify leads, unless you don’t have to do any selling yourself, it will be imperative to qualify leads yourself to spend time effectively. 

2) Using your first sales interaction to effectively qualify your lead 

Effectively qualifying these new leads will help you avoid sinking months of work and time only for a prospect to tell you: “Really appreciate all the work here over the last several months, it’s really interesting... but let’s connect early next year.” Ouch.

A typical first live sales interaction is a 30 to 60 minute discussion with someone on the benefits team. I have seen (and put together) a number of  sales “playbooks” or “bluesheets” that include what seem like strong, tangible goals coming out of a first meeting that would indicate success in qualifying a lead. Things like:

• Second meeting scheduled

• NDA signed

• Data analysis / modeling requested

• Request for additional materials

While these are solid, tangible next steps, most of them require work on the vendor’s side that can be easy to sink a lot of time into based on a simple, yet unhelpful word, that employers will often say: “interesting”.

The problem with “interesting” is that it does not mean “important.” I would argue your goal for the first discussion should be your ability to answer the following questions:

1. Can I articulate the core problem(s) the employer is facing?

2. Are the problems that I’m able to solve both important and urgent?

3. Have I defined the next steps around the next interaction with time on the calendar?

The only way to really be able to achieve those goals is to listen in that first interaction. Far too often startups/vendors spend the vast majority of the meeting walking through a nice looking slide deck that talks through the following topics:

• High level stats of how much overall waste exists and how big of a problem your space is

• How cool your product filled with screen shots of features and stats on NPS, utilization and savings

There are several problems with this approach:

1. You spend the majority of the conversation talking about you, not listening to the benefits buyer and his/her needs.
   Sales Hacker put out a chart a few years back analyzing theTalk to Listen ratios of B2B sales conversations indicating the benefit of listening more - top closers are pitching 40% / listening 60% of the time, while bottom 20% of closers are pitching 65% / listening 35% of the time. What this doesn’t uncover though is what is actually being talked about and therefore listened to? Depending on how you frame the conversation, it becomes easy for the conversation to surround things that are unhelpful for both you and the employer (see the following bullets).

2. Employers see hundreds of these pitches so they already know the high level stats. 
   For mental health, the top well-being priority for benefits teams, benefits teams have numerous mental health vendors they are evaluating (see here). Not all of these are B2B but you can see how many times an individual benefits leader likely hears the same stats around mental health. This is just one space taking mindshare from employers - now think about all the spaces employers are hearing pitches across with similar dynamics (MSK, women’s health, diabetes, cardio, general navigation, etc). You can see why they’re overwhelmed.

3. Your product isn’t as shiny and cool as you think it is
   Here are marketed product screenshots from four different health insurance startups selling to employers. See how these could start to blend together? Couple these with the screen shots navigation companies are pitching and it becomes a complete blur.

Tactics for the First Sales Interaction

Some tactics to avoid wasting a meeting talking about your company to an employer prospect that has zoned out:

• Time your sales presentations and see how much time you spend talking - work on getting that down to at least 50/50 and strive for 40/60.

• Disarm your pitch by telling stories that connect emotionally with the buyer and their problems on a personal level. We can tease the core problem(s) we’re solving in the story to see how the buyer reacts and ask questions from there. (more on this in the Win Rate article)

• Get 10-15 minutes ahead of the meeting with the broker or consultant to get their view on the employer’s core problems, benefits strategy over the next 1-3 years, mandates from leadership, targets/goals needing to be achieved, areas of focus, etc. 

• Create a 1-2 minute overview presentation you send in advance along with a key question or two just to spark thinking (they likely will not respond to the question)

• Ask a simple question to start. One of my favorite examples I’ve heard is: “Why did you take this meeting?” The person who uses this said, “50% of the time I'm surprised at the answer and it leads me down a totally different path”

• Set a goal and track how many (and the type of) questions the buyer asks you in a meeting. Typically when someone pushes, digs in and asks hard questions, there is a reason for it.

All of these might seem straightforward yet feel uncomfortable in practice - it is hard. Benefits teams see so, so many pitches that they often seem like they just want you to get to your point, not ask them questions. But it’s less about asking them a whole bunch of questions, rather finding ways to get them to talk about their needs and problems. It is a fool's errand to let them just focus the conversation on your point. When you focus so much on you, how can you possibly understand what is important to them?

Conclusion

Maximizing the number of inbound leads through both marketing and partnerships is imperative, but improvements to Velocity require keen focus on qualification of those leads. If we go back to the sales Talk to Listen ratio, we need to spend enough time listening to be able to answer the question. Once you’ve created the habit of more listening than talking in that first interaction, it is far more likely that you’re able to answer those questions to qualify the lead:

1. Can I articulate the core problem(s) the employer is facing?

2. Are the problems that I’m able to solve both important and urgent?

3. Have I defined the next steps around the next interaction with time on the calendar?

It is critically important to move away from what is just ‘interesting’ to get to understand what is not only interesting, but also important and urgent. 

The beauty of Velocity is: try these tactics to see if they improve the metric and if not, try something else. Let’s now move on to the next metric in the equation, average deal size.

Jump to other articles in the series:

Overview | Employer Primer | Qualified Opportunities | Average Deal Size | Win Rate | Sales Cycle