“When will this be shipped? Why is it taking so long?”

“Will the initial version of the product do <x> too?”

“I just spoke with <Customer X> yesterday and they want the product but need it to do <x>.”

“Will this product work for <non-target customer segment>?”

“What about <feature that’s out of scope for the initial version>? When will we be able to do that?”

Every product review, held on a regular basis with the founders, or sometimes the entire executive team, is different. One week the team is fending off tactical product ideas and solution suggestions which undermine their confidence in their ability to figure out the “how” for a particular customer problem. The next week, they’re wrestling with unpredictable questions which send the meeting careening down a path the team isn’t prepared to provide a confidence-inspiring answer. After each product review, the team feels less confidence in their work, less clear on the direction they should be pursuing, and less autonomy to drive alignment across the team on the contradictory directives and requests they’ve received. In the worst case scenario, the inconsistent “guidance” that comes out of these meetings causes the team to repeatedly change direction and ship something that fails to deliver value to customers. Over time, trust between the team and the founders and executives erodes. Unable to control what is debated in the meeting, the team optimizes for avoiding all debate and resorts to a “safe” agenda which consists of rehashing already circulated updates and uncontroversial discussion topics.

Every Product Manager, Designer, or Engineer has experienced product reviews that have gone something like what I’ve described above. Despite the oft-stated objectives of “empowering the team” and “increasing decision-making velocity,” most product reviews remain highly ineffective at achieving these goals. There are limited resources on this topic, many of which speak to less-frequent, strategy, priority, and roadmap reviews. Having seen this play out at a few different companies, including product teams I myself have led, I felt it would be worth offering my own perspective on how to run product reviews that support the development of a customer-centric, creative, and innovative product culture with empowered product teams that move quickly.

First Principles: What is a “product review” and why is it important?

There is no one single definition of a “product review” but in practice, I define it as being a regular meeting to discuss validated customer insights and the impact of those insights have on current and future product decisions. The product review is an opportunity to review how effectively a product is delivering customer value and to discuss open strategic questions to enable the product team to make better decisions and bigger bets. Even if a company calls this meeting something different than a “product review,” most have a mechanism that’s designed with this purpose in mind.

Product development is an inherently uncertain and risky undertaking. There is uncertainty around the customer need and product solutions that address it. There is often uncertainty around technical feasibility and execution to deliver a solution that works. Given this uncertainty, product reviews are important because they drive alignment across the team on key customer insights and the level confidence in those insights such that over time, the team has a clearer understanding of the customer and how they derive value from the product. Product reviews are analogous to pressing pause in the middle of a hard fought battle to step back as a team, look at the big picture, and make updates to your plans based on what you just learned in the field. The most effective product reviews serve the needs of the team to share and debate new insights and any changes in product direction that should flow from them.

Running an effective product review

When it comes to running a product review, team culture is equally important as getting the execution right. It starts with ensuring the environment in which you’re operating exhibits some baseline characteristics. Without these, attempts to implement effective product reviews, let alone an empowered product culture, are fighting an uphill battle.

• Trusted and empowered teams. Without trust and respect between the product teams and the founders and executives, nothing else matters.
• Psychological safety where people can be creative and debate facts and ideas objectively, which stand on their own merit (vs. the individual they’re offered by).
• A deep understanding of customers, who the target customer segment is, and their needs.
• Continuous discovery of what delivers customer delight. Teams should demonstrate deep curiosity and be willing to question even their most deeply held assumptions.

These cultural factors lay the foundation for effective execution. Well-run product reviews share a few key characteristics:

Limited meeting size

Product reviews with 15–20+ people in attendance are not conducive to deep discussion and debate. Limit product reviews to the core team plus a few key executive-level stakeholders. As a good rule of thumb: if someone is attending the meeting with the intent of just listening (vs. participating), they should be excluded. Those individuals can read the notes or slides that are circulated after the meeting to get a recap.

Set consistent context

The best way to control the focus of the meeting is to consistently and repeatedly remind the group of a few key items:

1. Why we’re doing this
2. Who we’re solving for
3. How we’re measuring success
4. Biggest risks we’re focused on
5. Input/help needed from the group

Laying out this context up front can help remind people that the product review is for the team’s benefit. If the team walks out of the room at the end of the meeting having not received helpful input on the items outlined, the meeting was a failure.

Focus agenda on customer insights

Focus the agenda on new customer insights since the last product review and the implications of those insights on the team’s understanding of what makes the product valuable and delightful, and how they can build on that value over time. While it’s tempting to include a status update or milestones slide, or have the design team demo prototypes, these can often derail the meeting and take time away from more important topics. Every minute spent talking about some specific interaction on a particular screen in the design is a minute not spent discussing what the team has learned from actual customers. In the context of explaining new customer insights, it might be helpful to show designs to help people better understand the feedback. Leading with the customer insights and using the designs as a tool to bring those to light can help keep the discussion grounded in customer insights and avoid derailing into an ad-hoc design review.

*While product reviews are a great place to surface critical decisions facing the team, they should not be a forum where decisions are made. Product reviews should focus on debating the options associated with key decisions and collecting input from others. The decision itself should be left to the team outside the product review. Once product reviews become decision-making meetings, others will demand that they are included in the meeting so they can participate in the decision-making process. This causes the attendee list to balloon. When you leave decision-making to the team outside of the product review meeting, you empower them follow an appropriate decision-making process so stakeholders who weren’t in the room are included. This allows the product review to remain focused on its primary purpose of discussing customer insights and the impact of those insights on product decisions.

Choose the right cadence

Keeping product reviews focused on customer insights is a great forcing function for setting the appropriate cadence of product reviews. If you’re in the early stages of product development and collecting new feedback weekly, a weekly review may work well. If you’re in the middle of shipping the next major feature and won’t have new insights until it’s in the hands of customers, dialing back the product review cadence makes sense.

What this means for Product Managers

It’s the Product Manager’s job to control the meeting. That means setting the appropriate context, ensuring the room is clear on what guidance and input the team is looking for from the product review, and then keeping the discussion on track. This means you may need to politely defer questions that are not in scope or redirect the conversation if it gets off track.

What this means for founders and executives

As a founder or executive participating in a product review, your job is to:

• Approach the customer insights objectively: Your opinions carry more weight with the team and modeling an objective approach will encourage the team to do the same. While you should not hesitate to share your opinions, ensuring you’re doing so in a way that demonstrates a willingness to be proven wrong by customer insights affords the team lattitude to disagree when they identify insights that contradict opinions you hold.
• Keep comments in scope: Manage your temptation to comment on things that are out of scope of the product review. It’s easy to let a question slip that threatens to derail the meeting. Demonstrate support for the team when they politely defer your comment to keep the meeting on track.
• Frame questions and comments to reinforce the autonomy of the team: When providing feedback, it’s helpful to ask if the team has learned anything from customers to support any personal observations or comments you make. This framing helps keep the discussion focused on validated insights from customers while positioning the team, the ones closest to customer, as the experts on the customer needs. It also creates an opening for the team to disagree with assertions you may make based on their own evidence from the field.

What success looks like

For the product team

They leave the meeting with more confidence, focus, and clarity on their direction forward, feeling full ownership over their ability to achieve the desired outcome.

For the founders and executive team

They leave the meeting feeling confident the team is being thorough when collecting customer insights and interpreting them thoughtfully to drive effective decisions on the product’s path forward.

Measuring Success

I’ve found a simple survey after each product review can help the team measure success and track progress over time. The survey consists of the following questions:

• After our last product review, on a scale from 1–5, rate how well we understand the needs of our customers (collectively as a team)
• On a scale from 1–5, how useful did YOU personally find our last product review?
• For non-core team members: On a scale from strongly disagree to strongly agree, indicate your level of agreement with the following based on the last product review: “I feel confident in the team’s decision-making and direction”
• For core team members: On a scale from strongly disagree to strongly agree, indicate your level of agreement with the following based on the last product review: “I feel we have more focus and full-team alignment on what we need to do to make this product valuable to customers”
• What team are you on? (this question is for segmenting purposes)

Above all, remember that conducting effective product reviews is an organizational muscle that must be developed. You won’t achieve perfection overnight and even when you feel like you’re in a groove, you’ll have one where you regress to old habits. The most important thing is to ensure the entire team is committed to assessing performance and continually improving so you’re eventually running product reviews that people actually look forward to.

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Have other strategies for running effective product reviews to create an empowered product culture? Send them my way at dslate47@gmail.com!

Thanks to Sarah Jacobson for her comments and input on this post!

Running product reviews people actually look forward to was originally published in UX Collective on Medium, where people are continuing the conversation by highlighting and responding to this story.

A recent tweet from the Mixpanel founder perfectly summarized this exact challenge:

As a customer of Mixpanel at the time, I vividly recall the impact of this lack of focus. We had a number of issues that the Mixpanel product wasn’t solving for us when it came to the job we hired the product to do: product analytics that enabled us to understand what our users were doing and reliable reporting on key product metrics. There were still analyses that required us to download and manipulate a spreadsheet and inaccuracies with our funnels due to how they handled unauthenticated users, both of which were critical to the core value proposition of Mixpanel. While the product performance continued to lag our expectations, our account manager always wanted to talk about their new A/B testing, in-app messaging, and automated insights features. As a customer, we had no interest in using those features until the core product analytics issues were fixed. We eventually switched to Amplitude after Mixpanel took too long to address the issues we were having.

This example highlights why broadening product scope and focus should be done with intentionality. Small companies can typically only do one thing well and must earn the right to expand scope by first dominating in that original area. In other words, expanding product scope should come as a consequence of winning in your original area, not out of necessity to compensate for your inability to do so (that’s called “a pivot” due to lack of product-market fit and should be treated as such). Customers are rarely interested in adopting new offerings from a company that hasn’t first delighted them and won their trust. While it’s tempting to chase new opportunities to hedge your bets and make it more likely you’ll find a hit, doing so in parallel actually increases the risk of losing to more focused competitors in each area you pursue.

Why the visonary’s dilemma exists

There are a number of reasons why it’s easy to fall into the trap of expanding your product scope too soon:

• Degrees of freedom for early-stage companies are high: When you’re still small and just beginning to gain traction, it’s often difficult to clearly define your “core business.” This makes it easy to rationalize new product initiatives as contributing to the primary reason customers are hiring you, or as experiments that may unlock growth beyond what you’re already seeing. The transition from pre product-market fit exploration to post product-market fit execution is never black and white.
• Founders and product people love building new stuff: This is a personal bias of founders and many (though not all) product people. You don’t start a company or join an early-stage company unless you’re energized by building new things from the ground up. This bias can result in under-weighting the customer value associated with improvements to existing products that shore up your core value proposition to your initial customer segment.
• You’re always on the look-out for step function opportunities: In a venture backed business, you have to always be looking for opportunities that produce a step-function change in value for customers. This mindset and the urgency it creates can naturally lead you to pursue these opportunities too soon at the cost of nailing your initial position in the market required to make these opportunities possible.

Managing the visionary’s dilemma: a framework for Product Leaders

As a Product Leader, how can you know when it’s possible to consider tackling a new product line or problem space for your customers, or an adjacent customer segment altogether? There are a few helpful frameworks out there on how to think about product strategy as you expand your offering (examples include Gib Biddle’s “GLE” framework and “WTF is Strategy”). There is much less written on exactly when it’s the right time to make those investments so that you maximize the likelihood of success. The below framework attempts to apply some structure to determining when you as a Product Leader can start to think beyond your original product offering. There are two key elements to evaluate when deciding whether to broaden the scope of a product: product performance and resourcing.

Product performance against customer expectations

You earn the right to pursue new product opportunities when the performance of your product and new enhancements surpass what customers value or are prepared to use. In other words, you’ve hit diminishing returns on product enhancements. To better understand this, consider a simplified version of Clay Christensen’s product performance framework:

Returning to the Mixpanel example, they were on the far left end of the blue line when they decided to invest in net new product areas. There was a significant segment of customers for whom their product was not meeting performance expectations and their movement up that blue line stagnated as they invested resources elsewhere. Meanwhile, more focused competitors had products that continued to progress up and to the right on the blue line, eventually surpassing Mixpanel’s product performance.

At this point, I know what you’re thinking. “Cool framework, Dan, but how am I supposed to know when I hit that intersection point?” Here are a few indicators that you’re nearing or have reached that point of intersection identified in the chart (note that all of these assume you have clear product-market fit):

• Reception of newly released enhancements: Newly released enhancements are met with a luke-warm response from customers. One way to gauge this semi-quantitatively is to conduct quick customer interviews and ask them to rate you on a scale of 1–10 for how much new value you’ve delivered for them over the last 3–6 months. Then probe specifically on the reasons behind their rating. Lack of perception of new value or inability to articulate the ways in which the product has become more valuable suggests you may have passed the intersection point with performance that customers are prepared to use.
• Impact of newly released enhancements on key metrics: Absent other positive indicators of customer value, enhancements produce little to no change in key product metrics or engagement patterns.
• Breadth of usage of newly released enhancements: You find yourself delivering enhancements for an increasingly narrow set of highly sophisticated users and the breadth usage on these enhancements is not growing over time (i.e. less sophisticated users aren’t meaningfully moving up the feature adoption curve).
• Customer reception to roadmap: Customers have a luke-warm reaction to the next 3–5 enhancements you’re planning on your roadmap. There should be some segment of customers that get visibly excited by your roadmap and if that’s not happening for enhancements to your core product, it’s a sign that you have an opportunity to examine adjacent needs that offer an exciting, step-function change in customer value.

If you’re doing your job well, you’ll have new investments and innovations teed up in your product pipeline to launch just as you’re beginning to observe the above signals on your original offering.

Resourcing

When evaluating when to kick off new product development, develop a perspective on the following:

• How much do we need to invest to maintain dominance in our core product?
• How much do we need to invest to successfully launch a new product?

Answering these questions will allow you to determine if you have the team resourcing needed to do two things at once. Resourcing should “stack” over time to allow you to pursue step-change product investments without diverting focus from your core product. If pursuing a new product opportunity requires diverting too many resources from the core product, it’s an indicator that it’s too soon to make that investment. If the cash flow from that original product doesn’t justify additional headcount to pursue that new opportunity, it’s an indicator that there’s more work to do on tightening up the economics and growth of the core business before pursuing something new. Broadening product scope too soon often results in “resource shifting” from one product to the next, which rarely results in any one product being successful. Failing to do this resource assessment only sets you up to spread the team too thin and under-deliver on both product opportunities, reducing the likelihood that you deliver a product that delights any one customer.

Closing thoughts

There’s no perfect formula for knowing when to expand product focus beyond your core offering, but doing so too soon can compromise your ability to be successful on any of your product offerings, and ultimately to achieve your product vision. Successfully managing the visionary’s dilemma takes a healthy mix of quantitative analysis and qualitative product intuition to balance your core product offering against the delivery of new products that offer step-changes in value.

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Know of examples of other companies that have run into this challenge? Send them my way: dslate47@gmail.com. I’m looking to add more case studies to this post!

Thanks to Paul Koullick for his help editing and refining this post!

For Managers

Communicate the departure swiftly and set expectations clearly as to how that will happen

Delaying the communication of departures places the individual departing in an awkward position and makes it hard to plan an effective transition in a timely manner. If there are good reasons to delay communication (i.e. trying to bundle the communication together with other announcements to minimize disruption, organizational design changes that need to be sorted out, etc.), ensure this is clearly communicated with the departing employee so they understand the rationale behind the timeline and feel bought-in to upholding it (see point 2 in the employee section below). Generally, communication about team transitions are best done quickly and transparently to allow the organization to begin addressing any executional gaps.

Set a reasonable end date that allows for a smooth transition

While it is tempting as a manager to draw out the off-boarding process to provide more transition time and a head start on a backfill, this often creates a sub-par experience for both the company and the departing employee. Two things happen as soon as an employee decides to leave the company:

1. It becomes more challenging for the employee to keep themselves motivated to work on things they may never see the impact of
2. The employee’s decision-making rights begin to get revoked and re-distributed across the team, which makes it harder for them to be productive

Both of these dynamics reduce the value the company and the employee get out of each incremental week of transition. Instead, it’s best to define the major things that need to be transitioned and set a realistic but expedient timeline for completing them (see the next point for more on this).

Collaborate with the employee on their transition plan

As an employee departs the business, it’s easy to find yourself spending even less time with them as you take on planning for their transition. However, it’s more important now than ever to make sure you’re spending time together to plan and align on how the transition will occur. Clearly define which projects you expect them to complete, when particular decision-making responsibilities will transfer and who will be the new owner, and any knowledge that needs to be transferred. Co-creating a single document that outlines all of this that you can refer back to during the transition helps drives accountability, alignment, and transparency for the rest of the team on what to expect (I’ve created a template for this which I’ve used in the past). If the departing employee is a people manager, work with them to transition knowledge of how to effectively manage, motivate, and develop their direct reports. Spend time determining if the people manager’s departure might put others on the team at retention risk and work with them to build a retention plan. It will instill confidence in the team that remains when they see you working closely with a departing employee to ensure a smooth transition.

Spend time understanding why the individual is leaving, even if it hurts to hear the reasons

Exit interviews are a great source of raw, honest feedback, especially when conducted by a more neutral party (i.e. someone from the People Team). However, they should not be used as a replacement for an honest conversation with the departing team member to collect any final feedback they have for you or the company. While it may not be easy to hear some of the feedback they provide, it’s likely they will be more willing to share critical feedback they were uncomfortable sharing prior to making the decision to leave the company. This feedback allows you to be more proactive when it comes to creating an environment that supports building and retaining a world class team.

Celebrate the employee’s accomplishments

This one goes without saying but it’s easier than most people think to forget in the flurry of activity associated with an employee departure. When an employee departs, others in the company are watching your response as an indicator of how much you value the contributions of those who work for you. Whether you realize it or not, your value system is on display not just to the departing team member, but to the entire team. Ensure you recognize and celebrate the employee’s accomplishments in their final days, both privately and publicly.

For Employees

Communicate the decision to your manager before anyone else

This is an easy and common one to get wrong. It’s important to communicate your decision to leave the company face-to-face to your manager before anyone else. When your manager is the last one to find out, it makes it more difficult for them to manage communication to the broader team. To bring this to life, imagine a romantic relationship where your partner tells all your friends they’re going to break it off before they tell you, and the associated feeling of knowing everyone else knew this was coming but said nothing. This erodes a culture of trust and respect across the team. Lastly, if there are changes your manager can make that might convince you to stay, informing others on the team of your departure prior to your manager also limits their ability to make a counter offer.

Allow your manager to determine how and when to communicate with the broader team

It’s important to let your manager determine how and when to communicate your departure to the broader team. They have the full organizational context that would affect how and when your departure is communicated to ensure it’s delivered in the most productive way. It’s important to respect your manager’s judgement on the timing of this communication and avoid pre-empting it for the same reasons outlined above. Should you have individuals on the team that you want to inform prior to an announcement from your manager, align on that upfront with your manager as part of the communication plan.

Give minimum 2-weeks notice, but be flexible

Anything less than 2-weeks notice will burn bridges. There’s rarely a reasonable excuse for this. However it’s also important to evaluate the projects in-flight, time needed to transfer knowledge, and any other major milestones the business is charted against. You should be a partner to your manager in ensuring as smooth a transition as possible. If that means 3 weeks of off-boarding, consider being flexible with your departure date. Not only does this build good will with the manager and team you’re leaving, it may also give you a few additional data points to illustrate your lasting impact on the business. Telling your future hiring manager that you need a few extra weeks to support a smooth transition is a positive quality signal as it demonstrates ownership and maturity.

Leave a tidy house

No one likes a roommate who moves out and leaves a mess behind for the next person to clean up before they move in. Similarly, as you transition out of the business, look for opportunities to complete outstanding tasks and make decisions that will be easy for you given your experience and context on the business but time-consuming for your colleagues or your backfill. For decisions that will have significant impact on the business long term, ensure you are aligned with those who will be responsible for executing on those decisions after you’re gone. Here’s a simple framework for evaluating opportunities to clean up before you depart:

Stay positive and focused during your final few weeks

It’s easy to become disengaged and lose motivation as your departure date nears. But just as you would run hard through the finish line in a marathon or track event, it’s of value to you to hold a similar attitude as you depart the company. Research on a phenomenon called the “peak-end rule” shows that we tend to let the end of an experience dominate our overall attitude toward the entire experience. Losing focus, distracting others, or producing lower quality work in your final few weeks risks having that experience color people’s overall memory of your performance in a negative way. This is particularly important if you want to lean on past colleagues and managers for reference checks in the future (and even if you plan not to provide them as references, good hiring managers will back-channel regardless of whether you offer them directly). Finally, be empathetic and supportive of your manager during your transition. Departures drastically increase your manager’s workload and to the extent you can remove additional burdens from their plate (i.e. things you can clean up and organize for them to support the transition, helping the team stay positive about the transition, etc.), the more likely they’ll be to reflect positively on your work.

Bonus points: identify your replacement

If you are able to identify a replacement for yourself, either internally or externally, this helps build continuity in the business and ensure a smoother transition for everyone involved. This will only cause your colleagues and manager to look more favorably on you as a steward for the success of the business.

Thoughts, comments, reactions? Leave them below or shoot me a note at dslate47@gmail.com!

An Example: Confusing OKRs for Strategy

Let’s take an example to bring this challenge to light. At Stride, growing active users was a company-level objective. We created an OKR around this that looked like the following (grossly oversimplified and altered for the sake of illustration):

Objective: Grow our weekly active users

KR1: Acquire X users by the end of Q1

KR2: Increase 1-week retention to X by the end of Q1

The product team responsible for this OKR then began developing a list of features that would impact this OKR, prioritized them, and developed a roadmap for how we’d tackle them. When the team and I stepped back and looked at the resulting roadmap, we noticed it didn’t reflect the things we actually felt we needed to build to deliver more value to customers and make progress toward our product vision. Instead of letting customer needs guide the roadmap, the team gravitated toward incremental changes and optimizations. In trying to address this disconnect, we made another implementation error: we began trying to get overly crafty with our OKRs to tie them more directly to the things we wanted the team to build. Once again, we found this didn’t achieve the outcomes we were looking for: the team felt overly constrained and disempowered, as if we were playing a manipulative game where a set of predetermined features drove the objectives vs. the other way around. In retrospect, this outcome may seem obvious but it was perplexing at the time.

OKRs as a complement to product strategy

This experience has led me to a sharper perspective on how OKRs should be used to guide an organization, specifically as it relates to the connection between OKRs and product strategy. OKRs are a tool to measure success. They should be used to guide the execution of and measure the success of the company and product strategy, not as a substitute for crafting sound strategy in the first place. The product strategy should dictate most of what the company chooses to build. OKRs should be used as a tool to measure whether those things are delivering the desired business outcomes. In other words:

Start with the product strategy grounded in an understanding of the customers needs you want to solve, then develop your OKRs as a mechanism for managing the execution and measuring the effectiveness of that strategy.

Represented visually, here’s what that looks like:

This new framework for thinking about the relationship between OKRs and product strategy changed my behavior as a product leader in a few ways. First, in crafting OKRs with my team, I began to focus the team on asking the question “do these KRs effectively measure success against the defined objective and will achieving that objective further the execution of our stated strategy?” This allowed us to decouple product strategy and roadmap development from OKR formulation and prevented us from trying to force-fit our roadmap to OKRs that may not be effective measures of success. Second, this forced me and the team to think about our product roadmap from the perspective of our customers and their needs first and prevented us from slipping into the dangerous mode of OKR-driven roadmap development. This freed us to use and discuss OKRs as they were intended: to align the team around clear and consistent measurement of desired business outcomes and success.

Applying this framework

To really understand how this framework drives a different approach, let’s return to our earlier example, but this time with a bit more detail.

When OKRs drive the roadmap, the features that rise to the top are often incremental optimizations to existing functionality, in this case, activation improvements for actions we know correlate with 1-week retention. It may be that these are the most important things to work on but notice how they are driven by the need to move the metrics listed versus being driven by more effectively solving customer needs. Compare this to the diagram on the right where the features are driven by a customer-first statement of strategy. This approach forces us to define the needs we must address to achieve that outcome, which then informs the features we build. In this approach, we ask the following question when evaluating the OKRs: does “growing our weekly active users” and the associated KRs indicate that we are successfully executing our strategy? As a result, some of the KRs have changed to better measure success of the things we need to build to execute the stated strategy.

Where this framework breaks down

There are a few specific instances where this framework may be less useful:

• In businesses that are in optimization mode: If you’re in a business that has saturated a particular market and most growth is being driven by optimizations of the existing product (versus product and category expansion), it may be more likely that you can let OKRs drive your product roadmap and priorities directly.
• In teams with more narrowly defined scope: As organizations grow and OKRs cascade down the organizational chart, they become more narrowly defined in scope. If you’re in a really large organization and working on a very scoped part of the product with similarly scoped OKRs (for example, your team’s charter might simply be to improve onboarding conversion for your product), then you can get away with leaning much more heavily on your OKRs to drive your product roadmap.
• In companies too small or early to warrant OKRs: I’ll elaborate on this topic in a future post, but OKRs work well once you’ve found some pockets of product market fit and understand the basic levers that drive the growth of the business. This framework obvious only helps once the business is mature enough to warrant the use of OKRs.

Was this helpful? Shoot me a note at dslate47@gmail.com to let me know what made sense and what needs further clarification.

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Additional reading — In case you didn’t catch all the links in the opening paragraph above, here they are in an easier to access format for further reading on OKRs:

• Rework’s Guide to OKRs
• Helpful OKR Guide and Template
• Google Ventures video on OKRs
• Yet another guide to OKRs
• First Round article on how LinkedIn used OKRs to drive execution

As the Stride Health Product team has grown, I’ve found myself reflecting on all the things I wish someone had told me when I started managing a team. I created an internal guide for new managers on my team to capture some of the things I’ve learned along the way. I’m sharing it externally in the hope that it will be useful to others and as a way to continue to refine these with the input of a broader community. These principles are a reflection of my experience to-date — they will continue to evolve as I continue to learn and evolve my perspective. In the meantime, comments welcome!

Principles of People Management (a.k.a. Leadership)

How you’re evaluated fundamentally changes

• It’s about the output of the individuals on your team.
• You only have full control over two things that affect team output: hiring the right people and keeping them motivated.
• You’re now a coach in addition to a player. You will be evaluated on the basis of your ability to hire, develop, and amplify talent.
• Sometimes, motivating your team will mean leaning on your manager to motivate in ways you can’t. This says nothing about your capabilities. Your ability to identify when you need help and to team-up with your manager to keep people motivated does.

It’s always your fault. Always.

• If your team fails, it’s your fault.
• When things go wrong, always start by looking at yourself first and asking what context you failed to set, what resources you failed to provide, or what guidance you failed to articulate clearly.
• You exist to serve your team. Study servant leadership.

Objective-setting, the context and guidance you provide, and your framing is 10x more important

• Your team (and others) will repeat the words you use. Choose your words carefully.
• Similarly, your team (and others) will emulate your behavior. The way you behave implicitly indicates the behavior you consider acceptable for others on the team. Choose your behavior even more carefully than your words.
• By nature of your positional authority, your opinions and words carry more weight. Be aware of that weight and exercise restraint appropriately. Study this decision-making framework.
• When in doubt, over-plan for important discussions.
• Understand task maturity and provide more hands-on guidance appropriately.

You’ll also have to deal with lots of annoying things

• Expense reports, PTO requests, and many other administrative tasks are now your responsibility. Joy!

Things you might experience (they’re normal!)

• Insecurity when your team does a better job at something than you could have done yourself or knows more about a topic than you do. Embrace this as an opportunity to learn from your team. It’s a sign you’ve built a high-performing team.
• Difficulty managing emotions when things go wrong. Something will always be going wrong. Learn how to maintain control and avoid in-the-moment reactions. Take a walk when necessary.
• Embrace the discomfort that comes with truly delegating ownership over an outcome. There will be times you’re tempted to do things yourself when they should be done by your team. Resist the urge to get things done quickly in favor of empowering the team to take ownership. Sometimes this will take longer but if you’ve hired great people, the long-term results will be better.
• You will micromanage at times. It will annoy people on your team (or it should if you’ve hired great people). Accept it, openly acknowledge it, and be comfortable asking for help avoiding it.
• You might be tempted to pass-down “shit” to your team. Don’t. Be the umbrella.
• You will often be tempted to add too much value. Resist the urge. Sometimes the most impactful thing you can do as a leader is to say nothing.

Above all else, the most important thing is that you listen (even when it’s hard to listen to what you’re hearing) and continually grow and improve!

Things I wish I knew as a first-time manager was originally published in Vunela on Medium, where people are continuing the conversation by highlighting and responding to this story.

At Stride, we’ve helped people who drive with Uber find and use their health insurance for over three years as part of our suite of benefits for independent workers. Since August, tens of thousands of drivers have tracked over $60 million in tax deductions with our app, Stride Drive, to save money and stay compliant at tax time. Tax time is particularly stressful for drivers, many of whom are filing taxes with a 1099 income source for the first time. No tax filing solutions in the market addressed the unique challenges drivers face, let alone other independent workers. At Stride, we are uniquely positioned to deliver a solution and be the ”tax guy” every driver wished they had (plus, we’re a lot more fun to talk to!).

Free Guidance, Free Support, and Free Tax Filing for Uber Driver Partners Nationwide

This tax season, Stride deepened its integration with Uber and partnered with Credit Karma Tax™ to deliver a completely free tax preparation and filing suite to driver partners nationwide. Drivers who start their taxes with Stride this year have access to software and a team of tax experts designed specifically for driver partners to ensure they don’t overpay on their 2016 taxes.

Free Guidance

Drivers can now use Stride to get a consumer-friendly 2016 tax report based on their 1099 income with Uber. Using Uber’s Driver API, and with a driver’s consent, we retrieve an entire year’s worth of trip and payment data for a driver, parse apart the various ways they were paid by Uber (trip payments, incentives, and referral bonuses) and identify deductions like fees and mileage. We then return an easy-to-understand report of what a driver earned, the fees and mileage they can deduct, and what they’ll owe in taxes.

But we also know that fees and mileage are only two of the many things drivers can deduct to save money on their taxes. Using the data we’ve captured from serving thousands of drivers, we help them find other deductions they may have missed that reduce their tax bill even further. We’ve found that on average, we cut a driver’s tax bill by over 50%. When it comes to tax filing, we know that tax software doesn’t always effectively guide drivers to input their income and deductions correctly. We solved this by mapping every major tax filing product, offering custom filing guides for each, tailored to the needs of Uber drivers.

Free Support

Most drivers who attempt to get tax guidance from Uber are often met with a common response: “Talk to a tax expert.” This year, Uber driver partners now have a single place they can go to get answers to their tax questions — Stride is offering drivers 100% free access to our tax experts. We pair that with content we developed to address the most common questions we receive while supporting hundreds of thousands of drivers to date. And we promise we’re more fun to talk to than your average CPA!

Free Filing

Last, to close the loop on a completely free tax preparation and filing experience, we partnered with Credit Karma Tax™. Most drivers spend between $200 and $400 on tax filing with a Schedule C to report their business income. With Credit Karma Tax™, we’re cutting that cost to $0 (and truly, we’ve checked, it’s completely free!).

Free tax support and filing is our newest solution in our growing suite of benefits for independent workers. This is one more step closer to our vision of making independence achievable for Uber driver partners, and the more than 50 million independent workers, nationwide.

If you’re responsible for buying your own health insurance, you may be wondering how some of the recent press about the health insurance marketplaces will affect you this Open Enrollment (which starts on November 1st and is the one time of year you can purchase or change your health insurance). The withdrawal of United and Aetna from many markets, increasing premiums, and changes to plan designs make re-evaluating your options this year even more important. Fortunately, the team here at Stride Health has your back when it comes to navigating these changes to protect your health and your wallet: we’ve made updates to our product to help you maximize savings, reduce the impact of premium increases, and find plans that offer unique value when you select your health insurance for 2017.

What we’ve heard from our members (you!)

“Premiums seem to be going up — how am I going to afford this?”

At Stride, we spend A LOT of time thinking about how we can save our members money. We’ve even been known to build apps that help with this. So when we saw some premium increases upwards of 20%, we knew we had to act to help our members maximize their savings this Open Enrollment. The good news is, government subsidies can almost entirely offset the impact of premium increases (if you qualify). This is because subsidies are determined based on the prices of plans in your area. If those prices increase, so does the amount the government will contribute toward your monthly payments.

Recent data released by the Department of Health and Human Services provides a concrete example of this:

A 27-year-old with an income of $25,000 will see a 62% increase in government subsidies this year and will actually pay a dollar LESS this year for the same plan!

The data also indicated that 22% of individuals who purchased a plan last year without a subsidy have incomes that will qualify them for a subsidy in 2017 due to the increase in plan prices.

That’s a long way of saying: determining if you qualify for subsidies is VERY important this year. We also know that it’s particularly hard for independent workers who have multiple income sources to figure this out. We’ve made three changes to make this easier:

#1 It’s faster to see if you qualify for a subsidy

First, we now provide an explicit “income threshold” to make determining whether you qualify easier. We found that when we asked many of you whether you wanted to check for subsidies, you gave us blank stares and often said “no” when you probably should have said “yes.” You were leaving money on the table. But when we asked you if you made more or less than $45,000 a year (as an example), you found it very easy to provide a quick and accurate answer.

#2 Predicting your income is simpler

Second, we now allow you to break-down your income into specific jobs (since we know many of you have multiple of them!). We found that asking some of you for a specific income for your full year produced some hems, haws, and “fuzzy math.” But when we allowed you to break your income down into your specific jobs and income sources, you quickly produced a number that was in-line with what you expected to earn for the year.

#3 It’s now easier to minimize taxable income and maximize subsidies

Third, we made capturing your business expenses and tax deductions more explicit so you can minimize your taxable income and maximize your savings through government subsidies. About 85% of our customers declined to enter tax deductions when applying for health insurance on Stride last year. We’ve updated the product to make this faster and easier (and if you use our free expense and deduction tracking app, Stride Drive, this becomes even more painless).

“Deductibles are increasing — what value can I get from my plan without spending hundreds of dollars?”

At Stride, we think about more than the single transaction of purchasing your health insurance. We stick with you throughout the year to help with things like finding an in-network doctor, finding discounts on prescription drugs, planning for your annual physical, and getting concierge-style assistance from our award-winning Member Experience team. As plan prices and deductibles increase, we heard you asking for even more ways to ensure you’re getting value out of your plan each year.

This year, our team went on a mission to identify all the free and discounted care available from each health insurer. We knew many of them had special discounts and free services included in their plans but we also knew that those perks are mostly unknown and hard to access by consumers. We now surface additional free and discounted care available in each plan on the plan details page. Our favorite examples include:

• Fitness programs (like gym membership reimbursements!)
• Nutrition counseling
• Telemedicine (like free and discounted telemedicine visits whenever you need them!)
• Weight management programs (like discounted Weight Watchers or Jenny Craig memberships)
• Plans that offer the first 2 or 3 primary care visits for a low co-pay amount

To find out if the plan you’re interested in has free care, simply look for the “your plan has additional free care” note in the “Free Care” section of the plan details. No other site has this — it’s only available on Stride!

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As the 2017 Open Enrollment Period begins, the team here at Stride couldn’t be more excited to help you find your perfect health plan while saving you money. If you have feedback on any of our most recent product updates, I’m always interested in hearing directly from customers: dan@stridehealth.com.

If you’re self-employed or an independent worker who’s purchased health insurance for yourself before, you probably remember the process as being time-consuming and painful (unless you used Stride!). As we near Open Enrollment for 2016 on November 1st — the one time period during the year you can buy or switch insurance plans — you’re probably wondering why on earth you should go through the process again.

Re-evaluating your health plan each year will save you money, and you might be surprised by the amount. A recent article by the Kaiser Family Foundation helps bring this to life: let’s assume you’re a 40 year old man living in Seattle, WA. In 2015, you purchased a plan from Bridgespan for $254 per month. That same plan will cost $286 per month in 2016, a 12% increase. If you instead re-evaluated your options for 2016, you’d find a comparable plan from Ambetter, another insurance company, for $225 per month, a 10% decrease in your cost from 2015! This example from Seattle has been proven to be true across the country: Last year, a study of the health insurance marketplaces found that 70% of consumers could save money by switching to a new plan during Open Enrollment.

At Stride, we believe it should be simple to re-evaluate your needs each year, to make sure you have a health plan that saves you the most money while meeting your health needs. Today, we’re rolling out product enhancements that simplify the process of comparing and selecting a plan for 2016. As Stride’s Product Lead, I wanted to share some of the customer insights behind these exciting improvements.

What we’ve heard from our members (you!)

“I love the recommendation, but where are the other options?”

At Stride, we take a lot of pride in our ability to crunch the data to find you the perfect plan, taking into account your existing physicians, prescriptions, health conditions, and estimated care costs. Our personalized plan recommendation has proven to save our customers an average of $418 per year on their health insurance. Yet, when it comes to making the recommendation, we consistently heard that you wanted to see more than one option. There were many reasons for this: you had a prior bad experience with the insurance company we recommended; you had a preference for plans with a higher monthly cost, but fewer out-of-pocket expenses; or you knew a surgery or baby (congrats!) was in your future and wanted a plan that offered good benefits for these services. We learned that presenting various insurance options helps you determine if the plan we recommended is actually the best plan for you.

When you come to Stride to pick a plan this year, we now show two additional plans alongside our recommended plan — we show you plans that might better meet your specific needs that aren’t captured by our recommendation. For example, we’ll show the lowest premium plan to help cost-conscious shoppers quickly view that option. We’ll show a plan that’s similar to the recommended plan but from a different insurance company, in case you prefer Blue Cross Blue Shield over Kaiser (you know who you are!). Or we’ll show a plan with a lower deductible than your recommended plan, in case you prefer fewer out-of-pocket costs throughout the year. These additional plan options are designed to help you quickly find your perfect plan even faster (than our current average time to purchase of 10 minutes!).

“It’s not easy to compare between two plans I’m considering.”

When deciding between two different brands of the same food at the grocery store, most people pick up both items and simultaneously look them over — they do the classic “side-by-side comparison.” This is straight-forward when comparing physical goods, but it becomes much harder when comparing two health plans online, particularly when designing an experience that works well on mobile devices.

We dug into usage data on our product, and we noticed you were digging deep into a plan’s details then backing all the way out to select another plan to dig into. Many of you would drill into our scenario modeling feature to see what you’d pay for different emergencies under each plan. Others would dive into the specifics of our estimated care costs to see what we were forecasting for your doctor visits or specific prescriptions. Some of you would repeat this behavior 5+ times before settling on a final choice for your health plan. We realized it was time that we take on the design challenge of a mobile-first side-by-side comparison for health plans.

With this product update, we’re introducing the only mobile-first side-by-side comparison of health insurance plans. This new feature will allow you to place two plans side-by-side on your mobile phone and compare the specific benefits of each. Gone are the days of waiting until you’re back around a computer to do research on your options or read the fine print of each plan. You won’t find this functionality on any other site.

“Make the options and terminology easier to understand at a glance.”

We pride ourselves on putting health insurance terms into language that YOU understand. When your insurance company says “deductible,” we say “the amount you’ll pay out-of-pocket before your insurance company starts to pay for services.” When your insurance company says “maximum out of pocket,” we say “the most you’ll pay out-of-pocket in a year in a worst case scenario.” We know all you care about is how your choice of plan will affect your health and your wallet. We make it our job to translate everything into language and numbers that are relevant specifically to YOU! Plus, Noah Lang (our CEO) really hates for the word “deductible.”

Yet, we realized we needed to go a step further in helping you understand many of the data points you rely upon to make a decision about your health insurance. In this product update, we’ve made two changes to solve these challenges. First, we’ve updated the plan summaries with a few additional data points and changed the visual layout to make them easier to scan when stacked in a list. This will save you time when reviewing different options to figure out which plans are worth exploring further. Second, we’ve added explanatory sections to key data points when you view a plan. For example, we made it clearer that our estimated care costs are a forecast of your out-of-pocket expenses on top of your monthly premium payments. This number is designed to help you assess each plan in the context of what you might spend in a normal year, so you can find one that minimizes your costs.

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We’re excited for you to try out these important updates and let us know what you think. 2016 health plans are being added to our site each day. You can begin building your profile and exploring your options now so you can save even more time finding your perfect health plan for 2016 come Open Enrollment on November 1st.

If you have any feedback on your experience with the product, I’d love to hear from you directly: dan@stridehealth.com

Modern Healthcare recently published an article announcing the launch of Guroo, a website that enables consumers to educate themselves on various healthcare procedures and compare costs. As I reviewed the site, I thought it provided yet another illustration of how so many products that seek to bring information transparency to healthcare miss the mark. To be fair, this goal is not easy and Guroo did a few things that were unique. But, when it comes to making the consumer experience with healthcare better, Guroo provides a good case study of a product that failed to consider the end-to-end experience.

First, here’s a couple areas where Guroo went wrong:

Average Prices

Guroo provides average prices for each care bundle and procedure. If there’s one rule to pricing in healthcare, it’s that averages are incredibly misleading. Government data on hospital pricing has revealed up to a 7x variability in prices for the same procedure, even within the same region (raw data located here). “Average price” is a horribly inaccurate indicator of the actual amount you’ll owe when such large variability exists in the market. To Guroo’s credit, they also provide a range of prices so you can see the potential best and worst case scenarios.

Lack of Personalization

In the same vein as average prices, Guroo does not provide the price for your specific health plan. If you tell me the average consumer in my area pays $400 for an MRI, that’s far less trust-inspiring than if you tell me that, given my insurance plan, I will pay $400 for an MRI. Guroo also uses data from a limited number of participating insurers to calculate the average cost and price range. Aetna, Assurant Health, Humana, and UnitedHealthcare currently participate. If you’re covered by Blue Cross or another insurer, Guroo’s average is unlikely to accurately reflect your specific cost.

Failure to “Close the Loop”

Guroo does not expose data on the prices for specific physicians and facilities. After visiting their site, it’s natural to ask: “So if I want the average price for procedure X, which physician should I go to?” Unfortunately, this data is completely absent from Guroo’s product, let alone even viewing a list of phone numbers for physicians that perform procedure X in your area. Without the ability to channel more volume to specific, higher value providers, information transparency in healthcare adds very little value. Think about how you might react if Amazon allowed you to search for a product on their site, displayed an average price without any reviews, and had no “add to cart” button or check-out functionality. This is the state of healthcare today. No one has succeeded at closing the shop and buy user experience loop and Guroo is no different.

Quality, where art thou?

Guroo provides price information and some questions to ask your physician but exposes no data on how you as a consumer might be able to assess the quality of the various physicians who perform a given procedure. Nor do they expose any quality measures for physicians in your area. Sure, quality in healthcare is hard but I would have at least expected the normal half-hearted attempt.

Fragmented Tools

Guroo is completely unintegrated with any of the places consumers might go today to educate themselves on their healthcare decisions. It might be a nice feature to add to a health insurer’s online portal or to an employer’s internal benefits site. Alternatively, Guroo could try to own the entire consumer experience themselves. Building a feature and delivering it as a standalone site, completely out of context, only contributes to the fragmentation in healthcare’s “consumer tools” ecosystem, increases adoption barriers, and hardly makes the consumer experience any easier.

Endorsement by UnitedHealthcare

*Cue Cynicism* You know something’s fishy when you see an explicit endorsement of information transparency in healthcare from a large insurance company. Quoted from the Modern Healthcare article:

“[Guroo] is going to use this data to ultimately create a national source of truth for consumers,” said Tom Beauregard, executive vice president of UnitedHealth Group.

UnitedHealthcare has this data for their customers already. They could create a single source of truth for their customers tomorrow if they wanted to (minus the provider systems who have pricing gag clauses in their contracts). But they choose not to. Instead, United relies on endorsements of sites like Guroo to pay lip service to transparency. Meanwhile, they continue to build a business model that depends on obscurity of information instead of attempting to repair the consumer experience. Castlight Health, which has been the most successful at reverse-engineering a plan and provider specific pricing database for self-insured employers, continues to struggle with accessing data from insurers who champion transparency in public, but refuse to provide access in private.

— — — — —

Notwithstanding everything above, Guroo did do something unique on their site that I hope becomes a model for other products in this area. They created a list of common “care bundles” which group together all the line items associated with a given procedure and provide a total, all-in cost. If you’ve ever reviewed a healthcare bill before, you’ll recall that they consist of many indecipherable line items. There’s no such thing in healthcare today as “the cost for a knee replacement.” Yet, Guroo has attempted to move in this direction, which provides a welcome simplification for understanding the total cost of a given procedure in a more intuitive, consumer-friendly way.

This morning, I had an experience which perfectly captured many of the problems that plague the U.S. healthcare system. What follows is a timeline of the events that unfolded for me this morning.

2 months ago: I realize I am almost out of contact lenses. I attempt to order a new supply, and am told my prescription has expired and that I need to visit an eye specialist to obtain a new prescription. This is annoying because my current prescription is perfectly fine. But, I think to myself, “how hard could a quick eye appointment be?” I quickly realize I have no idea how to find an eye specialist that takes my insurance. I can’t even find my insurance card, which I haven’t seen for over a year. I procrastinate for 2 months until I realize I won’t have enough contact lenses to last the duration of a trip I’m taking overseas for the last two weeks of March.

2 months later, 10AM: The process to book an eye appointment begins. I identify a local eye specialist based on recommendations from friends and a quick google search.

10:02AM: I call the eye specialist’s office and let them know I’d like to make an appointment. They tell me they have plenty of appointments this week. They ask what insurance I have since they need to pre-authorize the visit. I tell them I have Blue Cross Blue Shield of Texas (I managed to dig my insurance card out of a box in my room). I’m told by the office manager that they can’t do that via their computer system. They ask for the phone number on the back of my insurance card. Turns out there are 5 different numbers. After some confusion, I provide them with one of the numbers. The office manager tells me she’ll call me back after she’s pre-authorized my visit.

10:25AM: I get a phone call from the office manager at the eye specialist. She has some bad news. Blue Cross Blue Shield of Texas (BCBSTX) has outsourced my vision insurance to a 3rd party called Davis Vision. Unfortunately, while they do accept Blue Cross Blue Shield, they do not accept Davis Vision insurance.

10:27AM: I ask the office manager what the cost difference would be if I paid without insurance. She tells me it would probably be about $50 more as long as my prescription doesn’t change (billed as a general exam). If my prescription changes, it could be as much as $100 more (billed as a “refit”). I have no idea where she came up with these calculations, but something in her voice makes me want to trust her. She’s clearly helped people with this decision before. I tell her that I’ll see if I can find something in-network first.

10:35AM: I navigate to the Davis Vision website to try to search for a provider. I quickly realize the provider search functionality is only accessible post-login. I don’t have an account for this website but follow the directions to create one. Unfortunately, the policy ID they ask for does not seem to match my BCBSTX policy ID and I get a host of form errors. I try giving them a call but their phone tree prevents you from advancing without providing a policy ID. I’m stuck.

10:45AM: I decide to try the BCBSTX website to find a provider on the off chance there’s some integration of the search functionality with 3rd party networks. Turns out, my expectations were set way too high. I actually never got to the point where I could even search for a provider. I clicked through 5 different screens (screenshots below), none of which made it clear how to search for a provider before giving up and finding their phone number.

10:48AM: I call BCBSTX customer service phone number. After a few minutes in their phone tree, a human being answers my call. She sounds tired, bored, and generally unempathetic. I explain I need help finding an eye specialist in my area. She first asks me if I’ve tried their website. I suppress every urge to ask her, sarcastically, if she has ever tried their website. Instead, I inform her that I have tried the website but that they have outsourced my vision insurance to Davis Vision and I can’t seem to get the search functionality to work. She quickly sees the opportunity to pass the buck and offers to transfer me to Davis Vision. I cut her off to inform her that I’ve already called Davis Vision and their phone tree requires a policy ID, which I don’t have. She asks if I have tried my BCBSTX policy ID. I tell her that I have and that they both use different IDs. She seems perplexed and tells me that she’d like to try the website herself. I sit on the phone and listen to her struggle with the website herself for almost 10 minutes.

11:00AM: The BCBSTX customer service representative finally tells me she’s found a few eye specialists in my area. She gives me their names and contact information. I thank her and hang up.

11:02AM: A quick google search for these specialists reveals that both are based at Stanford’s Eye Institute. I pick up the phone and call the office.

11:10AM: After an 8 minute wait for “the next available representative,” I am connected to a scheduler at the Stanford Eye Institute. I ask them when the first available appointment is. They mention they only have one appointment at 11:30am on March 13th (the day before I leave on my trip). After that, I’ll have to wait until May, which is not an option given I’ll be out of contact lenses long before that time. I realize I have a meeting that might conflict on the 13th so I inquire how long the appointment will take. I’m expecting 45–60 minutes. The scheduler informs me that they request patients plan to budget TWO HOURS for a visit in case the office staff are running behind schedule. It’s not clear to me why their inefficiency is an excuse to waste my time. I struggle to refrain from tearing my hair out, thank her and hang up.

11:15AM: I call back the original eye specialist and book an appointment for the following afternoon, agreeing to pay the out-of-network costs. The entire process of booking this appointment cost me over an hour of my time.

Now, for the value judgements…

How Blue Cross Blue Shield of Texas Failed

BCBSTX did a few things that made this experience far more difficult than it needed to be. First, this experience highlights how difficult it is to simply locate providers for a particular service. While I would expect my insurance company to help me quickly search for in-network providers, BCBSTX delivered a disjointed and unituitive customer experience. This complexity led me to procrastinate for two months and contributed to many of the struggles when I did actually go through with booking an appointment. The lack of integration with the 3rd party provider of vision insurance left me at a dead end. The poorly designed provider search functionality on their website caused me to give up and call them instead. Even the insurance card design made life difficult by providing 5 different phone numbers and no electronic or mobile version that won’t get lost at the bottom of a box in my room. Perhaps BCBSTX considers all of these things “features” instead of “bugs.” When I struggle to access care, they pay less. However, this is not a long-term sustainable strategy, especially as clear evidence emerges suggesting easier access to healthcare services and proactive care reduces overall healthcare expenses.

Second, this experience provides a (painful) illustration of how poorly insurers manage their networks. Let’s assume the objective is to deliver value by directing patients to low cost, high access, and hopefully high quality providers. In my case above, BCBSTX managed to achieve the exact opposite of this objective. I guarantee, given the brand name and market power of Stanford, their contract includes much higher rates for eye exams than the independent provider I first contacted. Despite these higher rates, Stanford had less appointment availability. I also suspect that for a general eye exam, Stanford does not deliver measurably higher quality. Assuming quality is equal, BCBSTX attempted to shift my business from a low cost, high access provider to a high cost, low access provider.

Third, this experience provider further proof that incumbent insurance companies like BCBSTX have not yet made the transition to helping their members stay healthy. Instead of helping me access care quickly and efficiently, BCBSTX wasted over an hour of my time, which otherwise would have been spent on school work. That work got pushed later in the evening which resulted in less sleep and the worsening of a cold I contracted over the weekend. Instead of making my life easier and healthier, BCBSTX made life harder and less healthy.

Fourth, the customer service from BCBSTX was perhaps some of the worst I’ve ever encountered. The customer service representative did a terrible job of listening to me to understand my situation and provide useful guidance. Instead, she focused on finding a way to pass the buck or point out the obvious ways I should have solved the problem on my own, most of which she struggled with herself when she tried to follow her own advice.

Why I’m Hopeful

For the first time in a long time, there are a number of companies attacking the health insurance space to disrupt incumbents like BCBS, UnitedHealth, Aetna, Cigna, and others. Oscar Health Insurance and Collective Health are two examples of companies rebuilding the health insurance infrastructure from the ground up with the end consumer at the center of all decisions. Organizations like BCBS will be forced to adapt in order to compete on an improved consumer experience. I look forward to the day when they realize this and start to make serious strides toward playing a more productive role in the healthcare ecosystem.