I am fortunate to live amid incredibly smart, driven, hard-working people who care about making an impact. Sometimes, some of them trust me enough to come to me for business and career advice.

Before every such meeting, I try hard to set aside my beliefs and biases and just listen. For me, it takes genuine effort to actually listen and remember that listening to someone isn’t really the same thing as just waiting to talk. I do my best not to make someone clearly in pain feel good with the formulaic “10 steps to happiness” psychobabble.

The problem usually starts with a clear symptom : “I hate my boss,” “I don’t have faith in my CEO,” “I deserve more equity,” “I need a bigger title,” etc. Having been in their shoes as an employee, a manager, a CEO, I’ve dealt with many of these feelings myself, so I can often relate to where people are coming from. I suppose that’s the real value of talking to someone—it helps separate problems from symptoms, and knowing the problem is half the solution.

A lot of times, what I discover in these conversations—once we talk through what’s going on and dig deeper into the situation—is that these surface emotions are just really reflections of the real problem, which is larger, more corrosive and harder to admit.

Entitlement.

The problem is we all feel entitled to something. Entitlement is a subtle and implicit belief that we deserve things, that the world owes us something.

The truth, something we all know, is that the world owes us nothing. However, it is hard to remember that at the right time, when you are feeling entitled.

I am not suggesting that having expectations, desires and sometimes taking things for granted is unnatural or even bad. I am saying that if you stop for a minute and zoom out, you’ll start to realize that a lot of your pain goes away if you stop feeling entitled and that dealing with the reality of your situation becomes a heck of a lot easier.

So the next time you are feeling upset about something, try it . Zoom out and tell yourself, "The world owes me nothing," and see what happens.

When I do it mindfully, I can tell you I feel a sudden emptiness, followed by a delightful lightness. Sure, it may only last for a minute, but that little lull puts things in perspective, replacing the heaviness of “I deserve better” with “I am grateful for what I have. There will always be more I want. It will never be enough, but it will all be OK.”

Try this for a week: Every morning, tell yourself , "The world owes me nothing." See if it subconsciously affects your thoughts, alters your tone and orchestrates your actions throughout the day. Note how that sets you up for a simple but powerful call of duty, to be useful to people around you—your family, friends, co-workers, customers, investors, neighbors, strangers, everyone! Be grateful for the many, many things you have.

We begin life with a cry. In the end, the only thing that matters is how many people cry when we die. Or maybe that, too, is an entitlement.

Originally published on Medium

Things happen fast in the start-up world. Early yesterday, I wrote a post on how Zenefits’ compliance challenges in Washington state could cost the company millions of dollars in lost commissions. While noting that it was only a matter of time before someone at Zenefits lost his job over the situation, I had no idea that Zenefits CEO Parker Conrad would resign later in the day, citing the compliance problems. In a press release cited by VentureBeat.com announcing Conrad’s departure, Zenefits' new CEO, David Sacks, who had been COO, declared, ”I believe that Zenefits has a great future ahead, but only if we do the right things. We sell insurance in a highly regulated industry. In order to do that, we must be properly licensed. For us, compliance is like oxygen. Without it, we die. The fact is that many of our internal processes, controls and actions around compliance have been inadequate, and some decisions have just been plain wrong. As a result, Parker has resigned.” (The entire press release is worth reading). The loss of a founder and CEO is another cost Zenefits will pay for the alleged failure to comply with states’ insurance laws. I don’t believe they’re done paying for their mistake, however. What follows is a slightly edited version of my earlier article: Washington regulators are investigating Zenefits’ alleged use of unlicensed agents selling insurance policies in the state. This is not only embarrassing for a company as brash and boastful as Zenefits, but the company’s finances could be substantially affected, too. Not just because, if found guilty of this felony, Zenefits could face a multimillion-dollar fine. The far greater risk to Zenefits is the prospect of losing commission income — a lot of it. William Alden at BuzzFeed News has done a great job pursuing the story of Zenefits’ unlicensed sales. Now Alden is reporting that, based on public records, it seems “83% of the insurance policies sold or serviced by the company through August 2015 were peddled by employees without necessary state licenses….” The potential fallout is quite substantial even though only a small number of sales are involved -- just 110 policies out of 132 sold or serviced by Zenefits in Washington between November 2013 and August 2015. “Soft dollar” costs include a damaged brand because of the bad press, distractions at all levels of the company and the need to address whether the company is ignoring other consumer protections. Then there are the hard costs. 110 policies times the maximum $25,000 per violation that Washington can impose means fines of as much as $2.8 million. Financial penalties imposed by other states could add to this figure. While paying a $2.8 million fine is no laughing matter for a company losing money every month, this represents less than 0.5% of what Zenefits has raised from investors. However, the legal fines are, potentially, just the tip of the proverbial iceberg. As Alden points out, the fallout from this investigation could result in carriers dumping Zenefits, and that could cost the company far more than any criminal fines. Carriers require agents to meet several requirements before contracting with them, and agents must continue to meet these requirements to keep the agreement in-force. Common provisions include being appropriately licensed, maintaining adequate errors and omissions coverage and not committing felonies or breaching fiduciary responsibilities. Fail to meet any of these requirements, and agents can find their contract terminated for cause. Terminations for cause usually allow insurance companies to withhold future commissions from the agent and, depending on the specific terms of the contract, from the agent’s agency, as well. If an agency or agent knows or should have known he was in violation of contract terms when executing the agreement, carriers may be able to rescind the contract and demand repayment of commissions. Being found guilty of a felony in Washington state could allow a carrier -- any carrier, anywhere in the country -- to terminate Zenefits’ agent contract for cause. Late last year, Zenefits CEO Conrad claimed the company was on track to earn $80 million in 2015. So, let’s see, millions times 50% … carry the one … yeah, this hurts. A lot. A nuclear outcome is highly unlikely. The Washington state investigation into Zenefits is continuing, and Zenefits, to date, has been found guilty of nothing. Even if Washington regulators find Zenefits committed a felony, for reasons described in a previous post, the outcome is highly unlikely to be a fatal blow to the company. Insurance regulators have considerable leeway in determining fines and penalties. Absent proof that Zenefits intentionally violated state law or that consumers experienced actual harm, the Washington State Department of Insurance is likely to conclude that this situation resulted from incompetence. The department might then impose a modest fine on Zenefits and subject the company to enhanced review of its licensing practices for a few years. Let’s put this in perspective. Richard Nixon resigned the presidency as a result of what started off as a two-bit break-in. That kind of cascading escalation is extremely rare. What we’re seeing unfold in Washington state is probably not Zenefits’ Watergate moment. Zenefits has already paid a small price for what it allegedly did. I’m guessing the whole mess has been a bit distracting to management. And the fact remains: Mishandling more than 80% of sales in a state is a sign of immense ineptitude, arrogance or both. Having this reality aired publicly is not good for Zenefits’ brand, and resources will need to be expended to make sure it doesn’t happen again. I’m not aware the company has fired anyone as a direct result of the lax licensing controls, but that could happen. As a result of this fiasco, Zenefits has already taken down its controversial broker comparison pages in which the company used carefully selected criteria to compare itself to community-based agents. (I guess the company was reluctant to add “being investigated for multiple felonies” as one of the comparison points). This is a small sacrifice as the comparison page was likely an attempt to enhance search engine optimization rather than an effort to take business from the competition. Zenefits has paid a small price. The open question is: How large a price will the company ultimately pay?

News flash! You are not an insurance agent. Yes, you sell insurance products and services for commissions, but that’s not why your clients buy from you. Every successful insurance agent today understands that they do much more than transfer risk for their clients. Today’s successful insurance agents understand that they are first and foremost marketers, publishers, creators, innovators, speakers and value providers. This may seem like a foreign concept, but it’s true. No insurance producer can help clients financially if she can’t first paint an emotional picture through words and ideas. Marketing is not about manipulation, tricks or tactics. Today’s insurance buyers are too educated and untrusting to fall for inauthenticity. Today’s marketing is about great content. Content is not limited to a website, emails or product and service descriptions. Everything a customer or prospective customer comes into contact with about you or your agency is content. Content is any medium through which you communicate with the people who may use your products or services. It could be the words on your webpage, the email sent to a client, a headline on your brochure or the words used during an appointment with a prospective client. There is no hiding from content. It will make or break you. However, most agents don’t seize this opportunity. In fact, most agents don’t even know the opportunity exists. Ann Handley, author of “Everybody Writes,” says it best: "Ours is a world where technology and social idea have given us access and power: Every one one of us has the awesome opportunity to own our own online publishing platforms—websites, blogs, email newsletters, Facebook pages, Twitter streams and so on. "I don’t use the phrase 'awesome opportunity' lightly. The opportunity to change how we communicate with people we are trying to reach—and what we communicate—is tremendous, yet we aren’t taking full advantage of it.” With this great opportunity, why are the vast majority of insurance agents still standing on the sidelines, simply watching and waiting? Some think they lack time, others say they lack of knowledge or skill, and others still believe that there is no need to change. I contend you don’t really have a choice.

• Your prospective clients have more options than ever before.
• Your prospective clients have more resources than ever before.
• Your prospective clients expect more from their agent than ever before.

Those agents who deliver on these expectations will stand out and earn business from their ideal clients. Those who don’t will continue to fight and scrape for what’s left. So, I ask you a basic question: Are you a marketer or an insurance agent? Trick question. You have to be both. One is expected, the other will make you successful. You are expected to understand policy terms, definitions, exclusions, coverage gaps, underwriting, endorsements and what all those strange acronyms mean. You get paid for providing a positive experience through your content. Providing that is not easy, and that’s why most agents are struggling. It requires that you are much more than just smart, friendly and able to ask if you can provide a quote.

• You have to help your customers achieve something that’s important to them.
• You have to provide a unique viewpoint.
• You have to put 100% focus on your customer and view the world through his eyes.

All three listed above take hard work, hustle, training, continual personal development and a passion that burns deep inside you. This passion doesn’t come from outside sources. It starts and ends with you.

• How badly do you want to make an impact?
• How badly do you want to help others?
• How badly do you want to become the industry leader?

To succeed, you must decide you will not settle for being just another insurance agent. You are a professional who earns trust through consistent and valuable content, offline and online, to your clients and prospective clients. To be a successful insurance agent today, you must first be a marketer ... and a good one.

According to patent applications recently filed with the U.S. Patent and Trademark Office, Allstate is planning a driver safety scoring system that will take into account speed laws, road signs, traffic signals, weather and possibly even biometric data such as your heart rate. These driver safety ratings would then be used to determine what kind of car insurance you can buy and how much you’ll pay. Allstate’s plans are part of a wider effort in the industry to gather telematics data from today’s advanced vehicles, smartphones and other devices. Many insurers already offer “usage-based insurance” programs that set rates based on actual driving behavior, such as Allstate’s Drivewise, Progressive’s Snapshot and State Farm’s Drive Safe. If you tailgate, speed, drive through high-crime neighborhoods or even drive at night, insurance companies might be able to justify charging higher rates, regardless of whether you get a ticket or cause an accident. You’ll probably find yourself getting a driving score for each trip, even paying different insurance amounts each time you go out. Filing a patent application doesn’t guarantee that a plan will ever be used, but, within five years, it might be hard to find an auto insurance company that doesn’t have a plan to score your driving and use that score for setting your rate, says David Lukens, director of telematics at data analytics company LexisNexis. If insurers don’t want to develop their own scoring system, they can buy one. LexisNexis, which has tracked and analyzed more than a billion miles of driving behavior based on data from insurers that have telematics customers, has developed its own system for scoring driving behavior and offers it to insurers. Allstate declined to comment on details of its patent but said it “is committed to shaping the future of insurance to add more value and best serve customers’ changing needs.” The company's statement to NerdWallet added that “Allstate treats this information confidentially, enabling customer control over the distribution of their personal information.” Allstate’s system wouldn’t necessarily operate silently while you speed and blow through stop signs. The patent application describes incorporating real-time feedback such as warnings that you’re driving over the speed limit or approaching a stop sign—much like a spouse who yells “Watch out!” from the passenger seat. This is similar to a system being developed by State Farm (first described by NerdWallet) that would measure driver emotions and respond with in-vehicle stimuli such as music and even fragrances to improve driving. Allstate’s proposed system for rating drivers could incorporate more than just data from the car. For example, the insurer is considering monitoring and evaluating your heart rate, electrocardiograph signals and blood pressure through sensors embedded in the steering wheel. According to another patent filed in 2014, Allstate is also working on a game-like system where groups of drivers would encourage each another to drive better to improve the overall driving score of the group. Allstate calls it “geotribing.” Allstate imagines this as a kind of high school scenario where the baseball team is competing with the basketball team to see which group can capture the better score to earn rewards. Real-time driving scores could be monitored remotely by all members of the group. Allstate’s hope is that this “creates a self-policing atmosphere.” The sense of always being watched should make drivers “more conscious of practicing safe driving habits,” according to the patent. Lukens says such group encouragement can make a big impact on driving habits—if done the right way. “It gets iffy when it comes [down] to allowing people to comment on other people’s behavior,” he says. “You can’t control the way people talk to each other.” Encouragement could devolve into bullying. Many consumers seem interested in getting driver scores and improving their own driving. In March 2015, LexisNexis asked slightly more than 2,000 consumers whether they would be interested in a smartphone app that measures their driving score and offers ways to drive better, without any insurance discount. Fifty-nine percent said it would be nice to know their score, and 50% liked the idea of improving their score. But only 28% said they were interested in comparing their scores to others. Although you might not be forced into a scoring program, Lukens says you should expect to pay higher rates in the future if you opt out. Allstate says, in one of its patent applications, that drivers who decline to participate might be signaling concern “that the information would demonstrate less-than-ideal [driving] behavior.” Allstate is also considering how to leverage all this data for additional business opportunities. For example, it says a person who has a specific spending and credit profile—and who refuses to share her driving data—“may be particularly receptive to an ad campaign for luxury sports cars or certain vacation travel.” Similarly, NerdWallet has previously reported that State Farm has made plans to collect customer data for targeted advertising. Driving scores aren’t on the horizon; they’re already here. Insurance companies are, right now, internally testing them. In fact, Lukens says, if you are a customer of a usage-based insurance program, you already have a score, even if your insurer hasn’t told you about it.

Last year, as Airbnb’s $25.5 billion valuation surpassed Hilton Hotels' and Uber became the world’s most valuable privately owned company, it became clear the on-demand economy is no passing fad but is, in fact, a force to be reckoned with. The on-demand marketplace is growing at a dizzying pace as new companies emerge daily, helping connect a diverse workforce of tradespeople, licensed professionals and unskilled laborers to a market of willing buyers through the company's platforms. Intuit projects the population of U.S. on-demand workers will more than double by 2020, which means that, if you can’t already summon a doctor, lawyer, babysitter or dog walker right now via an on-demand app, then sit tight—they’re coming soon to a smartphone near you. But the scale and speed of the on-demand economy’s growth also means policymakers, regulators, insurers and on-demand companies will have to huddle quickly to resolve the issues that arise with this expanding marketplace and its workforce. Here are the three key questions we need to address immediately:

1. When the safeguards of the traditional corporation no longer exist, how do we protect the on-demand workforce?

Uber is currently appealing a case it lost against the California Labor Commissioner last summer regarding whether a driver is an independent contractor or an employee. While establishing this distinction is a critical issue, we still need to address some big questions about the vast self-employed workforce in the on-demand economy. A good primer question: How do we get the information we need to make informed policy decisions? Independent contractors in the on-demand economy are classified as part of a larger pool of temporary, seasonal, part-time and freelance workforce called “contingent” workers. A 2015 U.S. Government Accountability Office report cites this workforce as somewhere between less than 5% and more than one-third of the country's overall labor pool. The big gap in this measurement is because it depends on how jobs are defined and on the data source; the broad definitions and lack of clear data on this workforce makes on-demand independent contractors and their needs tough to track and evaluate. How much of this workforce depends on this income for supplementary purposes as opposed to relying on this income as a full-time living? According to Intuit’s study, contingent workers will make up 40% of the U.S. workforce by 2020. That’s a lot of people working without the safeguards provided by the traditional corporation—guaranteed minimum wage, steady income, unemployment insurance, healthcare, workers' compensation and disability insurance. What kind of safety nets do we need to put in place to protect this workforce? And what does this growing workforce mean in terms of policy development? How does the social contract change?

2. How should we regulate hybrid commercial/consumer activities?

A sticky issue surrounding the on-demand economy is how to regulate commercial activities that are conducted by individuals rather than by traditional businesses. While some argue that an Airbnb property should be as heavily regulated as a hotel if a host is accepting payment for lodgings, drawing an apples-to-apples comparison between the two is a challenge. For example, treehouses, yurts, igloos and lighthouses were among the top-10 most desirable vacation destinations on Airbnb shopper’s wish lists last year, some fetching upward of $350 a night. Who exactly should you call about making sure the igloo is up to code before guests arrive? Some of the services and products offered by the individual through on-demand platforms have never been available through traditional enterprises; they’re unique, intimate experiences and, before on-demand platforms made them accessible, were difficult to find. We’re entering a new frontier where many tourists covet a culinary experience they can book at a local’s house via apps such as Feastly or Kitchensurfing rather than a fine dining restaurant, or they prefer offbeat accommodations booked through Airbnb to a 5-star hotel. We can’t assess how to best regulate these individual commercial activities until we have more data and understand the risks. How do we collect that data? How do we ensure the safety and protection of the individuals operating and participating in these activities until we have the information necessary to adequately regulate them?

3. How can a square peg workforce function in a round hole system?

Mortgages, loans, credit cards, leases … these are just a few of life’s niceties (or necessities) that are challenging for an on-demand independent contractor to secure. Our current financial services, systems and policies were built to work for employees who collect a regular paycheck as well as freelancers who have reliable cash flow through long-term contracts and monthly retainers. Independent contractors working through on-demand platforms tend to rely on short-term gigs often generated through multiple sources, and they have difficulty predicting their day-to-day income, never mind their annual net or gross. This isn’t a niche workforce. If independent contractors represent 40% of the U.S. working population in 2020, they’re significant drivers of the economy. They generate income and pay taxes; they need homes, cars, work equipment and all the other stuff that keeps their businesses running and makes their lives worth living. We can’t dismiss their needs, because we are measuring their 21st century income with a 20th century yardstick. How do we retrofit our round-hole systems to include this square peg workforce? If we want a thriving economy in which people enjoy the benefits of the on-demand economy, and doctors, lawyers, drivers, plumbers and everyone else serving the on-demand marketplace have equal opportunity to succeed, then the time to talk about these questions and issues is now.

Cargill, Monsanto, Wells Fargo and John Deere are officially out of the crop insurance business, according to a recent article from Bloomberg. Large companies like these expanded into different aspects of the agriculture industry over the past few years, and their debut in the insurance industry made quite an impact. With their newly acquired insurance operations, they were the market players to watch – and now we’re watching them leave the industry. Behind this exodus is the matter of profit. Large companies, especially those that are publicly traded like Monsanto and John Deere, have a different perspective on risk and profit than the typical insurer. Let’s take crop insurance profit and loss over the past couple years, which is driven by fluctuations in crop prices. As Bloomberg explained, “Bumper harvests have sent corn, the biggest U.S. crop, to less than half its 2012 peak, ratcheting down the premiums farmers pay to insure against loss. Other crops have also seen steep price declines.” At the same time, the broader insurance industry has been seeing lackluster results. The most recent numbers from the Congressional Research Service indicate an underwriting loss of $1.3 billion in 2012 and profit of $657 million in 2013. For insurers, although these are not welcome results, the reality is that there will be challenging years – and insurers are accustomed to anticipating them. They are in for the long haul. But large, diversified commercial companies such as Cargill, John Deere and Monsanto have a much harder time adjusting to these financial results. So, were these big external players a collective blip on the map, or a real disruption? A pattern visible across many industries offers a possible answer. Large companies diversify around their current offerings, and, if the results are disappointing, they realize the expanded offerings are not core to their business. Google has been extremely successful in most of its diversification, but Google+, its social network offering, never became the powerhouse the compay had hoped would challenge Facebook. If these large companies are unsuccessful, they often leave the new industry. This is not to downplay the role that new entrants have in the insurance ecosystem. They push our thinking and ways of doing business in directions that might otherwise have taken years for the industry to adopt. New players like Haven Life and Google are not attempting to be the same old insurer, only better. Their goal is to disrupt the business of insurance and to create something in a niche that the industry had not perceived. The disruption they cause can take many forms, from new solutions to new distribution channels. They can go after these markets without owning the entire process – and, in doing so, they create real changes in how the insurance industry has to operate. Driverless cars will present similar challenges. Volvo and Ford have both mentioned the possibility of covering product liability insurance. How will this affect the insurance industry? Will automakers really cover the liability, or will they front it? Autonomous vehicles will change the insurance landscape by opening doors for these new thinkers. But will the insurance industry need to step in to present new insurance products that provide the necessary coverage? What role will insurers play in the new auto world? Disrupters like Monsanto, Cargill and John Deere were not in the market for a long time, but they do have an impact. They invested in changing the claims process, and they applied data, analytics and automation in areas that were previously very manual – which causes us to rethink other processes. We can hope that their new ways of doing business opened some eyes in the industry. They did not change the game so much as establish that the game needs to be changed.

One of the common challenges insurance companies face when it comes to claims is how they can make the process more efficient for customers. Processing claims takes time and resources regardless of size, especially for claims valued at $10,000 or less, where it is not cost-effective to have an adjuster evaluate the damage onsite. Mobile changes customer expectations  Customers' today are demanding. They want instant results. Mobile technology is transforming customer expectations. Nigel Walsh, who is the head of insurance in the UK for CapGemini, stated at a recent TechUK meeting that. “Customers are getting more savvy. Expectations have gone up, but insurers are not meeting those expectations.” Traditional claim processes meet disruptive technology Using technology to engage with the customer, the InsurTech transformation is addressing the gap between self-serve applications and traditional onsite visits with video. Solutions such as SightCall Visual Claims are using mobile video to allow policyholders to file claims in real time. It is all about the customer using technology that engages them and allows them to show the damage with their smartphone. Here is a quick example of how it works. Don’t fall short of customer expectations. They are ready While starting in early stages of implementation, major insurance companies were only expecting 10% of their customers to accept this new approach. Instead, they reported receiving more than 80% positive participation. The mobile mind definitely shifted the expectation that “I can get what I want immediately.” Providing an instantaneous solution to customers has become essential in how successful insurance companies distinguish their value from the competition. Is insurance ready? Reducing claim cycle times from days to hours not only results in high customer satisfaction but also creates massive savings. The monthly cost of the technology can usually be covered by one single video session that avoids an onsite visit. Decision is a no brainer. Now the challenge resides in the change management. Insurance customers are ready, but are insurance employees ready to change their way of working?

We all know the current healthcare system in the U.S. delivers erratic quality at unsustainable, yet ever-increasing, costs. Workers’ compensation medical care is affected by those costs.  A major shift in the health industry, value-based healthcare, will benefit workers’ compensation. Embracing selected new medical management methodologies put forth in value-based healthcare has the potential to be powerful. Value-based healthcare means restructuring how medical care is organized, measured and reimbursed. It moves away from a supply-driven system organized around what physicians do to a patient-centered system organized around what patients need. The focus is shifted from volume and profitability to patient outcomes (quality care). When fully implemented, the overall impact will be nothing less than staggering. Porter and Lee, healthcare industry strategists at Harvard, have described six value strategies necessary to achieve healthcare industry transformation. Many of the changes are now underway in ACOs (accountable care organizations) such as the Cleveland Clinic, proving the concept. These defined initiatives produce desired results—quality care at less cost.  Six components of value-based healthcare The following briefly describes the methodologies necessary to transform healthcare, according to Porter and Lee.

1. Integrated practice units (IPUs)—meaning multiple specialists practice together, resulting in comprehensive and integrated medical care rather than fragmented, duplicated services

2. Measure true outcomes and costs for every patient--When outcomes are measured and reported publicly, providers are under pressure to improve. Fraud and self-dealing are reduced.

3. Bundled payments--Payment bundles are capitated single payments for all the patient’s needs during defined episodes of care, such as specific surgical procedures. Providers are rewarded for delivering quality while spending less.

4. Integrate care delivery systems--Services are concentrated and integrated to eliminate fragmentation and to optimize the quality of care delivered at any given location.

5.  Expand geographic reach--Centers of excellence are developed where expertise is gained through higher volume of similar procedures.

6.   Information technology--Data mining powerfully enables the first five initiatives and informs services and decisions.

As Porter and Lee say, “Whether providers like it or not, healthcare is evolving from a proficiency-based art to a data-driven science, from freelance physicians to hospital-employed physicians, from one-size-fits-all community hospitals to vast hospital networks organized around centers of excellence.” Value-based medical management in workers’ comp The goal of value-based medical care is to enhance quality outcomes for patients (injured workers) while reducing costs. Focusing on quality (what the patient needs) actually reduces costs. For group health, the measures are physical and philosophical, requiring widespread disruption in how services are organized, delivered and reimbursed. However, workers’ compensation payers can benefit by incorporating three of the six value measures into their medical management process now.

2. Measure true outcomes and costs for every patient (the injured worker)

Physician performance is scored based on injured workers’ experience and outcomes along with cost. Providers who score poorly can be avoided.

3. Bundle payments

Bundling is capitating payments for all the services required for procedures such as specific surgical procedures, including all associated pre-op and post-op care. The costs are kept in line because providers need to stay under the cap to be profitable. They also focus on quality, because re-dos, redundancy and complications add cost to the service bundle, thereby diminishing profits. Prepare to see bundled payment options available to workers’ compensation sooner rather than later.

6. Information technology

The data in workers’ compensation, while in silos, is all organized around individual claims and injured workers. When the data is integrated at the claim level, patient experience, provider performance, outcome and cost analysis opportunities are unlimited. The more comprehensive and accurate the data, the greater the opportunity for gain. Those who cling to traditional seat-of-the-pants medical management will be left behind. Those in group health may be hampered by slow regulatory change, organizational upheaval and resistant providers, while workers’ compensation payers are free to adopt transformative value measures now. Organizations that progress rapidly to implement the value agenda will reap huge benefits.

"Insurance Marketing & Distribution Summit Europe 2015" proved to be a great event. There were interesting speakers, a range of topics and plenty of opportunity for interaction. Plus, it was a pleasure for me to share with this group, but more on that later. Following events that were useful for getting close to leaders on whom insight leaders focus less (IT, digital, customer experience), I was back with marketing  and sales. Most likely, the primary customer for most insurance insight teams is their marketing leader. So, I hope it's helpful to hear the thoughts and plans of a number of leaders from the insurance marketing community. Here are key messages from these insurance marketers:

• Marco Brandt (Agila) shared about Agila's journey from being a broker-based pet insurer to focusing on the Internet channel. It uses digital capabilities for personalization of communication and pricing. Perhaps the biggest opportunity for the company, though, was to use its digital communication and free content to dramatically increase the number of touch-points with their customers (a recurring theme). Agila has a strong story to tell about growth of customer satisfaction and premium income (which doubled in five years). The company's next, self-identified challenge is to embrace mobile.
• Stephan Dequaire (Towergate) provided a review of the growth of price comparison sites in the UK car insurance industry. I was surprised at how much Compare the Market now dominates, above even MSM and Go Compare. It was also interesting to see how much this model varies across the world. By comparison with the U.S., intermediaries (including tied agents) are more the norm across Europe, where there is also a larger share for bancassurers. Some research suggests the shine is coming off them, though, with even consumer advice sites pointing to direct insurers. What was more shocking was to hear how a consumer advice site suggests consumers lie about data to get a better price ("optimizing your job title," etc). It really brought home the erosion of consumer trust, in the UK market especially.
• Phil Bayles (Aviva) reminded us that, across Aviva and insurance as a whole, the intermediary channel still provides the largest profit and volume. He provided a nice segue into my later talk because he stressed how more than 25% of management time was now taken up by conduct risk agenda. The challenge with succeeding with your intermediary channel, including independent financial advisers (IFAs), is that they deal with you day in and day out. You can't persuade an intermediary channel with some catchy or emotive brand advertising. Bayles stressed the need for a focus on adviser satisfaction and ease as well as fixing problems quickly. With a strategy to be "No. 1 for Brokers," there is nowhere for Aviva to hide if tracking does not match up. Transactional net promoter scores (TNPS) suggest that Aviva is well on its way.
• Simon Green (The FCA) talked about how FCA's behavioral economics expertise was influencing policy and reviews, as well as the important role of technology innovation.
• Pollyanna Deane (Simmons & Simmons) brought legal expertise to our proceedings and talked about increasing regulatory scrutiny, including the likely impact of the Insurance Distribution Directive. She also mentioned the risk of European Insurance & Occupational Pensions Authority (EIOPA) becoming a third regulator for UK insurers!
• I then presented on customer insight and conduct risk, where I shared a number of the lessons I've learned from training insurance marketing teams on using customer insight to mitigate conduct risk. This included briefly covering consumer spotlight, behavioral economics and vulnerable customers. I'm pleased to say there was considerable interest afterward as marketing leaders could see the benefits of more focus on conduct and on embedding insight in their processes.
• Louis de Broglie (InsPeer) focused on innovation. He explained the interesting concept on which his start-up, InsPeer, is based. Returning to the insurance origin of mutuality and governance in community, his company provides consumers with a way to pool their excesses. Currently, only available in France, this unregulated solution combines the purchase of high-excess cover from an insurer with a community that contracts to cover a proportion of others' excess in the event of a claim. This results in lower premium and zero excess for each individual, as well as social pressure on claim veracity and lower claims frequency for the insurer. The next stage is intended to be peer-to-peer insurance, akin to the evolving models from Guevara in the UK, as well as others worldwide. Given the explosive growth of Uber and AirBnb, it seems likely some model of peer-to-peer disruption will take off.
• Monika Schulze (Zurich) returned to the theme of greater engagement through marketing. Her recurrent theme was the importance of emotion, using your brand and an emotionally engaging narrative consistently across channels to provoke positive responses and engagement from consumers. Inspired by "Transmedia Branding," Schulze really brought this topic to life through a number of videos that made an impact and examples of clever use of social media. Perhaps the most surprising part of this event was a story about Lidl selling milk in Sweden. Through active monitoring of Facebook comments, Lidl spotted a Swede named Bosse who said he didn't want to buy German milk. Lidl used this as a chance to humanize its brand, and the company renamed its milk "Bosse's Milk" across Sweden, including a photo of Bosse and an explanation that the milk actually is Swedish milk. This action, in response to an individual, captured the public imagination and boosted sales. For a great example of fleet-of-foot and creative marketers using emotional advertising, check out Zurich's #SaveThe Snowmen.
• Gordon Rutherford (Axa) also stressed the importance of emotional communication in brand engagement. Along with warning to not be one of those needy brands that basically use social media to say "please love me," he highlighted the impact of finding a noble cause to really make a difference and to improve brand sentiment. An example is Axa's "glass of consciousness" exhibitions in Mexico, which engage the public with the need to change attitudes about drinking and driving. Axa has found a way to humanize its brand and engage its own employees, all the while making a social difference.
• Edward Rice (AIG) shared AIG'S progress in digital transformation, where the company has gone beyond just using digital as a marketing channel and is using it to reengineer business and customer experience. He noted that the right comparison for customer experience isn't the low bar currently set by the insurance industry but is, rather, the personalized, digital ease provided by retailers. He  then shared numerous examples of how, once you have the basics delivered consistently, you can surprise and delight your customers with personalization and relevance. One interesting example was marketing done by Boden and easyJet that shows customers that the brands remember past purchases and have an apparent growing understanding. Rice also touched on the power of responding to one individual on social media as a way to humanize your brand and be playful and on the importance of providing timely advice and warnings that help customers reduce risks.
• Isabelle Conner (Generali) explained the huge cultural transformation that she is leading, changing a 184-year-old business from product-centric to customer-centric. She stressed the importance of emotional brand marketing and reminded everyone that we are in an ideal position to put this into action, with insurance being about protecting what people love and being there when the traumatic happens. But the marketing has to be grounded in changing the customer experience reality and the internal brand reality, not just be about broadcasting a message. Perhaps the part that had the most impact was when she shared videos of Generali's CEOs from Spain, Switzerland and France calling customers who left detractor net promoter score (NPS) ratings. It is so important to include timely response and resolution in your NPS metric programs, but it has even more of an impact on a company's culture when CEOs get engaged in the experience.
• Stephen Ingledew (Standard Life), although not an insurer, has many of the same challenges in the world of retirement savings, investment and income solutions. Ingledew focused on the importance of customer engagement in redesigning improved experiences. He shared some details of co-creation sessions and agile development, the latter being more than just an approach to IT development but also a mindset of continual learning and iteration. Some of his examples of online tools included elements of "gamification," which is helpful for consumers in the baffling world of pension reform choices. The brand approach of "#ReadyWhenUAre" nicely balances a range of enablers, while avoiding being paternalistic. Another critical customer need is education, but it becomes tricky to do it in a way that is neither boring nor patronizing. Selecting Steph and Dom from the British reality show Gogglebox to host a series of videos to chat in the pub about the issues was inspired choice, and one can see why it has gone viral.
• Zach Goren (Media Alpha) brought the world of West Coast U.S. innovation to the conference. Media Alpha is helping auto insurers, among others, buy targeted "in market" customer leads in real time, rather than just relying on mass market advertising through Google (where insurance keywords cost a fortune). Media Alpha is basically an innovation on the traditional market of selling unconverted quotes, but the company does this in real time and stays on the insurer's site. So, the insurer becomes both a seller of insurance as well as a seller of advertising space to competitors, especially where customer details show this person is unlikely to convert. Media Alpha provides real opportunities to offer consumers more choice.
• James Baker (Vitality) leads the insight team and helps the company's brand understand how to bring about behavioral change in its customers. The company has an interesting approach, providing health insurance but also helping motivate you to not need it, through rewards for a healthier lifestyle. This approach provides more opportunity for engagement with insurance customers and offers tangible value back on your policy (many insurers would love to achieve either). Vitality's insight, built on a hybrid segmentation of FSS and behavioral analytics, has identified a number of actions and rewards, under the concepts of "we'll be there for you" and "we'll make it more rewarding to be well in the first place," that have driven significant engagement and behavior change. Ideally placed to exploit wearables and other IoT innovation, given the importance of employers and employee benefit consultants to Vitality's business, the company can also demonstrate benefits in reduced absenteeism.
• David Stevens (LV=) brought to life the complex world of automated advice in the pensions/retirement income sector. The company has innovated with so called robo-advice (although the process also includes human interaction). LV='s innovation with Wealth Wizards (which it acquired) and the fact it has broken down the steps into manageable chunks should really help. With the high cost of advice, too many in the public are not engaging with such an intangible service. A fixed price of £199 for personalized options after automated fact finding is much more accessible, and the offer is communicated in an emotionally warm way. Once again, you can see the influences of both personalization and gamification in the company's communication. The style of communication and the ease of playing with the tools also contribute to humanizing insurance (as does clear fixed pricing).
• Adam Kornick (Aviva) heads up the company's global analytics capability, and he shared how it is using predictive analytics in pricing and risk modeling. Kornick gave an important reminder that price is the primary selection criteria consumers cite with insurance, so personalized pricing matters every bit as much as, if not more than, personalized communication. One of Aviva's key innovations has been to build on the individual price for quoting (based on captured and average data) that others have done for home insurance and to give customers the price of a product that they are most likely to buy next. It was also interesting to hear of Aviva's progress in broker analytics, another reminder as to the importance of the intermediary channel and how predictive analytics can help there, too.

Phew. Well done for making it to the end of this post! Key themes I took away are the need for: personalization, emotions, humanizing insurance, more frequent engagement through communication, innovations and continued focus on the intermediary channel. Hope all those topics and ideas were useful. Please share the insurance marketers' innovations you are generating from customer insight. Meanwhile, if you're interested, you can download a free copy of my presentation here.

There is a myth out there that healthcare providers are unwilling to adopt new technology. It's just not true. In the last few months, I have spoken to dozens of healthcare leaders at hospitals both small and large, and I am amazed at their willingness to understand and adopt technology. Pretty much every hospital CEO, COO, CMIO or CIO I talk to believes two things: With growing demand, rising costs and constrained supply, healthcare is facing a crisis unless providers figure out how to "do more with less." Technology is a key enabler. There is technology out there to help save more lives, deliver better care, reduce costs and achieve a healthier America. If a technology solution solves a real problem and has a clearly articulated return on investment (ROI), healthcare isn't that different from any other industry, and the healthcare industry is willing to adopt that technology. Given my conversations, here are the five biggest IT trends I see in healthcare: 1. Consumerization of the electronic health record (EHR). Love it or hate it, the EHR sits at the center of innovation. Since the passage of the HITECH Act in 2009—a $30 billion effort to transform healthcare delivery through the widespread use of EHRs—the "next generation" EHR is becoming a reality driven by three factors:

• Providers feeling the pressure to find innovative ways to cut costs and bring more efficiency to healthcare delivery
• The explosion of "machine-generated" healthcare data from mobile apps, wearables and sensors
• The "operating terminal" shifting from a desktop to a smartphone/tablet, forcing providers to reimagine how patient care data is produced and consumed

The "next generation" EHR will be built around physicians' workflows and will make it easier for them to produce and consume data. It will, of course, need to have proper controls in place to make sure data can only be accessed by the right people to ensure privacy and safety. I expect more organizations will adopt the "app store" model Kaiser pioneered so that developers can innovate on their open platform. 2. Interoperability— Lack of system interoperability has made it very hard for providers to adopt new technologies such as data mining, machine learning, image recognition, the Internet of Things and mobile. This is changing fast because:

• HHS's mandate for interoperability in all EHRs by 2024 means patient data can be shared across systems to enable better care at lower cost.
• HITECH incentives and the mandate to move 50% of Medicare payments from fee-for-service to value-based alternatives by 2018 imply care coordination. Interoperability will become imperative.
• Project Argonaut, an industry-wide effort to create a modern API and data/services sharing between the EHR and other systems using HL7 FHIR, has already made impressive progress.
• More than 60% of the proposed Stage 3 meaningful use rules require interoperability, up from 33% in Stage 2.

3. Mobile— With more than 50% of patients using their smartphone to monitor health and more than 50% of physicians using (or wanting to use) their smartphone to monitor patient health, and with seamless data sharing on its way, the way care is delivered will truly change. Telemedicine is showing significant gains in delivering primary care. We will continue to see more adoption of mobile-enabled services for ambulatory and specialty care in 2016 and beyond for three reasons:

• Mobile provides "situational awareness" to all stakeholders so they can know what's going on with a patient in an instant and can move the right resources quickly with the push of a button.
• Mobile-enabled services radically reduce communication overhead, especially when you're dealing with multiple situations at the same time with urgency and communication is key.
• The services can significantly improve the patient experience and reduce operating costs. Studies have shown that remote monitoring and mobile post-discharge care can significantly reduce readmissions and unnecessary admissions.

The key hurdle here is regulatory compliance. For example, auto-dialing 9-1-1 if a phone detects a heart attack can be dangerous if not properly done. As with the EHR, mobile services have to be designed around physician workflows and must comply with regulations. 4. Big data— Healthcare has been slower than verticals such as retail to adopt big data technologies, mainly because the ROI has not been very clear to date. With more wins on both the clinical and operational sides, that's clearly changing. Of all the technology capabilities, big data can have the greatest near-term impact on the clinical and operational sides for providers, and it will be one of the biggest trends in 2016 and beyond. Successful companies providing big data solutions will do three things right:

• Clean up data as needed: There's lots of data, but it's not easy to access it, and isn't not quite primed "or clean" for analysis. There's only so much you can see, and you spend a lot of time cleansing before you can do any meaningful analysis.
• Meaningful results: It's not always hard to build predictive analytic models, but they have to translate to results that enable evidence-based decision-making.
• Deliver ROI: There are a lot of products out there that produce 1% to 2% gains; that doesn't necessarily justify the investment.

5. Internet of Things— While hospitals have been a bit slow in adopting IoT, three key trends will shape faster adoption:

• Innovation in hardware components (smaller, faster CPUs at lower cost) will create cheaper, more advanced medical devices, such as a WiFi-enabled blood pressure monitor connected to the EHR for smoother patient care coordination.
• General-purpose sensors are maturing and becoming more reliable for enterprise use.
• Devices are becoming smart, but making them all work together is painful. It's good to have bed sensors that talk to the nursing station, and they will become part of a top level "platform" within the hospital. More sensors also mean more data, and providers will create a "back-end platform" to collect, process and route it to the right place at the right time to can create "holistic" value propositions.

With increased regulatory and financial support, we're on our way to making healthcare what it should be: smarter, cheaper and more effective. Providers want to do whatever it takes to cut costs and improve patient access and experience, so there are no real barriers. Innovate and prosper!