We hear from those whose opinions matter most to the success of your product, service, or campaign.
Insights that Inform
Strategic Decisions
Our Services
Nexus Insight Advisors helps you understand your market, your competitors, and the people whose opinions shape your results: the decision-makers and influencers who determine what their organizations buy, how much, and when.
Over more than twenty years in healthcare, our team has built relationships with these leaders. When we don't know someone, we usually know someone who does. That means we can often reach more senior, more influential people than most research and strategy firms can, and turn what they tell us into clear recommendations for your next decision.
Payers
Provide health coverage and related insurance benefits to consumers and employers.
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Commercial health insurers
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Government health programs (Medicare and Medicaid, including coverage for dual-eligible populations)
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Employer-sponsored health plans (private and public sector, including Taft‑Hartley plans)
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Affordable Care Act (ACA) health insurance marketplaces
Our Core Customers
Payers, Providers, Partners
Providers
Deliver care and services to patients across hospital, clinic, community, and home settings.
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Health systems and hospitals
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Physician groups and outpatient clinics
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Community health centers and FQHCs
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Behavioral health and substance use providers
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Post-acute and long-term care facilities
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Retail and urgent care clinics
Partners
Companies that serve and rely on payers and providers.
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Pharmaceutical and biotech companies
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Medical device and diagnostics companies
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Health technology, SaaS, and digital health firms
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Pharmacy benefit managers and specialty pharmacies
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Consulting, analytics, and market research firms
Our Process
01
Objectives and Scope Confirmation
We start by understanding the business question behind the research and the decisions it needs to support. Together with your team, we confirm what you want to learn, who we need to hear from, and the timing and budget.
02
Secondary Research and Discovery
Before we talk to anyone, we learn what's already known. We review public data, industry and competitor information, and your internal data and past research. We also talk with the members of your team closest to the project. This sharpens the questions before fieldwork begins.
03
Research Design
We choose the approach that fits the question and the people we need to reach, using in-depth interviews, focus groups, or both. Sessions take place by phone, online, or in person.. We define who qualifies to take part, write the screening questions and discussion guides, and plan recruiting and logistics, all reviewed with you before fieldwork.
04
Fieldwork
Recruiting is one of our core strengths. Our experience and relationships help us reach senior decision makers and other hard-to-reach participants whom other firms often struggle to recruit. We learn from them by phone, video, online focus groups, or in the field.
05
Deliverables
We carefully review every interview and focus group to find the themes, differences, and insights that matter most to your objectives. The deliverable is written for the people who will use it. You get clear findings, supporting quotes, and practical recommendations.
06
Debrief and Next Steps
We walk your team through the findings, answer questions, and talk through how to put the recommendations to work in marketing, sales, communications, or strategy. We help set priorities and point out where more research could help. Our support doesn't end with the report; we stay available as new questions come up.
A consistent, thorough process helps us deliver the insights you need, not the ones you already have.
Case Study
Medicare Advantage Member Outreach: Communications Test
A regional Medicare Advantage plan wanted to understand why many lower-income members had not applied for Extra Help, which lowers prescription drug costs, or a Medicare Savings Program, which helps pay Medicare premiums and other costs, and why many were not using the extra benefits already included in their plan. The plan was developing new outreach materials, a dedicated member website, and a new way to offer Extra Help screening during in-home health visits. Leadership needed ongoing feedback from these members, and from the family caregivers who help them, to refine its messages, materials, and channels before launch.
Nexus heard from the same members and caregivers three times over nine months in three low-income markets within a single state. Each session built on the one before. The first session explored what members knew about their benefits and the programs that could lower their costs. The second went into more detail on specific benefits and programs, and the third tested outreach materials in development. Because participants returned, they became a standing sounding board, and wording that confused them was adjusted before the next session. Plan staff attended each session to hear directly from members and answer technical questions. The work gave leadership member and caregiver input to support its own decisions about messaging, channels, and how to help members apply.
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What keeps lower-income members from applying for Extra Help and Medicare Savings Programs and from using their plan's extra benefits
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How members and caregivers respond to the proposed components of a dedicated member website
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What information members are willing to provide to apply online and whether they prefer to apply online, by phone, or in person
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Which email subject lines, postcards, and letters would get members' attention
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How best to offer Extra Help screening and help applying when members schedule an in-home health assessment
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How members and family caregivers talk about benefits and what would help them work together
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Which educational topics, channels, and locations would best reach these members
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Conducted member councils of 12 to 16 participants in each of three markets, with the same participants attending all three sessions over nine months
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Included lower-income members likely eligible for Extra Help or a Medicare Savings Program and the family caregivers who help them
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Screened participants with a commitment assessment developed by Nexus, in addition to standard qualification criteria, to select people likely to attend all three sessions
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Provided participant incentives that increased with each session to encourage attendance at all three
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Held sessions in lower-income areas, in hotel and community center conference rooms, with dinner provided
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Built each session on the one before, opening with what participants had noticed, used, or discussed with family since the last session and following up on earlier topics that needed more depth
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Arranged for plan staff from member experience, outreach, care management, and quality teams to attend, answer technical questions, and ask follow-up questions
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Explored members' awareness and use of plan benefits and why they had not applied for Extra Help or Medicare Savings Programs
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Tested proposed website components and the information members would provide to apply online
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Tested email subject lines, a postcard, and two versions of a member letter, collecting individual workbook rankings before each group discussion
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Role-played the call-center script for scheduling an in-home health assessment to test different ways of offering Extra Help screening and help applying
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Explored member and caregiver communication and rated educational topics, channels, and locations by market
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Compared perspectives across audiences and markets and developed recommendations
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Member awareness and use of plan benefits and barriers to applying for Extra Help and Medicare Savings Programs
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Member and caregiver rankings of proposed website components
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Willingness to provide information online and preferred ways to apply
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Preferred email subject lines and feedback on the postcard and letters, with suggested changes
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Recommended ways to offer Extra Help screening and help applying
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Perspectives on member and caregiver communication
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Preferred educational topics, channels, and locations by market
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Executive summary, recommendations, and detailed findings by audience
Case Study
Retail Pharmacy Capabilities Presentation: Message Testing
A national retail pharmacy chain had developed a capabilities presentation for health plan executives describing its adherence, specialty pharmacy, clinical support, and pharmacy network programs. Before taking it to market, leadership wanted to know whether the presentation would resonate with the pharmacy, clinical, and business leaders who make or influence pharmacy partnership decisions at health plans. It also needed to know what to add, remove, or change, and what information or data executives would expect to see.
The client heard feedback directly from the audience the presentation was built for. Senior executives at national and regional health plans viewed the full presentation in one-on-one online sessions, with pauses at key points to capture their reactions while they were fresh. The presentation was then revised and shown to additional executives to confirm whether the changes worked. The work gave leadership an understanding of how health plan decision makers responded to each part of the presentation.
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Whether the presentation is effective with health plan executives who make or influence pharmacy partnership decisions
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How executives respond to each section, including the slides, the spoken script, and the programs described
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What executives would delete, add, or change to improve the presentation
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What information or data not in the presentation would strengthen the message
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Which programs and topics matter most to health plans and should receive more emphasis
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How executives view the programs in relation to what their pharmacy benefit managers and other partners already provide
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Whether revisions to the presentation address the issues executives raised
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Conducted in-depth online interviews with 14 executives from 12 national and regional commercial health plans
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Included chief medical officers and chief medical directors, a chief pharmacy officer and an executive pharmacy officer, vice presidents and directors of pharmacy, a vice president of strategic initiatives, a senior vice president of marketing and sales, a senior vice president of health and provider relations, and a chief financial officer
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Included plans working with a range of pharmacy benefit managers
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Presented a capabilities presentation developed for research purposes and not tailored to any one organization, explaining that feedback should focus on content rather than presentation skills
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Paused at select points during the presentation to gather reactions to the slides just shown
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Organized feedback into three areas: slide content, the spoken script, and missing information or suggested additions
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Asked participants to choose words that best described the presentation
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Tested the revised presentation with two additional health plan executives
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Compared responses participant by participant and noted differences by plan size and reliance on pharmacy benefit managers
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Executive summary and recommendations
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Section-by-section feedback on slide content, the spoken script, and missing information
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Executives' suggestions for deletions, additions, and changes
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Data and proof points executives expect to see
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Programs and topics executives want emphasized
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Participant ideas for added value and partnership
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Words executives used most and least often to describe the presentation
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Participant-by-participant response summary and differences by plan size
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Participant profiles
Case Study
Physical Health Growth Opportunity: Market Analysis
A regional Medicare Advantage plan wanted to understand why many lower-income members had not applied for Extra Help, which lowers prescription drug costs, or a Medicare Savings Program, which helps pay Medicare premiums and other costs, and why many were not using the extra benefits already included in their plan. The plan was developing new outreach materials, a dedicated member website, and a new way to offer Extra Help screening during in-home health visits. Leadership needed ongoing feedback from these members and the family caregivers who help them to refine its messages, materials, and channels before launch.
The research was independent of the health plan's internal data and assumptions. It combined public data with interviews with employers, benefits consultants, potential partners, and representatives of other health plans. Leadership received an objective view of the market and the partners available to it, so it could weigh its options and make its own decisions with confidence.
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How many employers, by size, offer each type of physical health benefit
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How employers that offer these benefits provide and manage them
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How large the addressable market is and how much of it is accessible
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What drives employer and benefits consultant decisions in each segment
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Which digital and specialty companies help health plans manage these benefits and how they compare as potential partners
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Defined employer segments by size, from small group (2 to 50 employees) through mid-market and large group, with public employers as a separate segment
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Determined whether employers in each segment offer each benefit and, for those that do, whether they provide it through their health carrier or a separate vendor
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Built a market-sizing model for each segment from public sources, including federal employer and benefits surveys, Census business data, Department of Labor plan filings, and state insurance data
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Separated the addressable market, which includes all employers, from the accessible market, made up of employers that already offer the benefit in some form
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Conducted in-depth interviews with employer benefits decision makers and benefits consultants to test assumptions, fill gaps in the public data, and understand how buying differs by segment
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Identified, profiled, and interviewed digital and specialty companies that manage these benefits for health plans, along with leaders at health plans that already outsource them
• Percentage of employers, by size, offering each type of benefit
• How employers that offer these benefits provide them, by segment
• Addressable and accessible market size by segment
• Key factors in how employers choose physical health benefits
• Profiles of potential partners and a shortlist with contacts
• Perspectives from employers, benefits consultants, and potential partners
Case Study
Case Study
Faster Life & Disability Underwriting Through Patient Portals: Concept Test
A national life and disability insurer wanted to understand how consumers and agents would respond to a proposed underwriting process designed to shorten the time between application and decision. The concept asked applicants to authorize access to their electronic medical records through patient portals. Leadership needed to know consumers' feelings about sharing access, agents' willingness to support the process, and what would encourage participation beyond faster turnaround.
The research examined the proposed process from the perspectives of both the people buying insurance and the agents helping them apply. Each participant recorded reactions individually before the group discussion, so early opinions did not shape what others said. Leadership received a detailed assessment of consumer and agent reactions, questions, and concerns to support its own decisions about refining the concept and moving forward.
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How consumers and agents respond to the proposed underwriting process compared with the existing process
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How comfortable consumers are authorizing access to their electronic medical records and whether they prefer to do so through an agent or directly with the insurer
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How consumers respond to the access link, application steps, and information requested
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How much faster underwriting would need to be to encourage consumers to participate
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What consumers would need beyond faster turnaround to participate
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How agents feel about identifying applicants' health care providers and helping clients through the proposed process
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What would encourage agents to recommend the process to their clients
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Conducted six focus groups across two U.S. markets, with four consumer groups and two agent groups
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Included consumers earning more than $100,000 a year who had considered buying life or disability insurance within the previous two years, about half of whom had been through underwriting
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Included agents with at least two years of experience who had sold at least 100 life and disability policies during that period
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Collected individual workbook responses before group discussions to capture participants' experiences, reactions to the concept, and suggestions for improvement
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Presented diagrams of the existing and proposed processes, along with examples of the proposed application screens, to explore reactions to each step
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Explored preferences for authorizing record access, expectations for turnaround time, agents' roles, and what would encourage participation
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Compared consumer and agent perspectives and documented perceived advantages, concerns, and participant suggestions for addressing those concerns
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Consumer and agent perspectives on the existing and proposed underwriting processes
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Consumer preferences for authorizing access to electronic medical records
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Feedback on the application steps, access link, and information requested
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Turnaround expectations and other factors affecting consumer participation
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Key factors in whether agents would recommend the process
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Participant concerns and suggestions for improving the concept
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Executive summary, recommendations, and detailed findings by audience
Case Study
Home Weatherization Program Community Partner: Outreach Study
A regional electric utility had a well-established weatherization program that improves indoor air quality and addresses social determinants of health for lower-income homeowners, with upgrades paid for through the Inflation Reduction Act for those who qualify. The utility's challenge was identifying and connecting with eligible homeowners, especially in rural areas. Electric companies are not accustomed to this kind of outreach and are often not trusted by these households, so leadership wanted to find trusted community-based organizations that already reach them and learn whether those organizations would be interested in partnering.
Nexus attended the national conference of Area Agencies on Aging. Over a few days, we gathered views from a wide range of organizations quickly and at low cost by keeping each conversation focused on the questions that mattered most to the client's decision. Contacts made at the conference then led to follow-up discussions with Area Agencies on Aging across the client's state. The work gave leadership a clear view of which organizations could help reach eligible homeowners and how interested they were in partnering. The same approach can be applied to almost any topic with a relevant industry conference.
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Which organizations conduct outreach to lower-income homeowners who are hard to find and engage, especially in rural areas
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How much these homeowners trust the organizations that serve them and how staff gain access to their homes
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Whether these organizations would be interested in partnering on the program and why
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What these organizations suggest for how the program should be set up
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What home-related hardships agencies' clients face, such as utility disconnections, unsafe heating, drafts, and homes that are too hot or too cold
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What agency staff do when they notice problems in a home and whether they would refer clients to the program
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How agencies work with health plans, Medicaid programs, hospitals, and other healthcare organizations
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Which organizations and people would be good participants for follow-up discussions
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Kept each conversation focused on the few questions most important to the client's decision
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Spoke with 41 conference attendees, from executive directors, CEOs, and finance leaders to front-line coordinators and counselors, including:
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23 from 17 Area Agencies on Aging
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6 from state and national aging associations and advocacy groups
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4 from home care, home accessibility, and meal delivery companies
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3 from federal aging and health research agencies
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2 from community service nonprofits
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2 from a national risk and benefits consulting firm
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1 from a Medicaid managed care organization
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Asked about the outreach each organization conducts, how much clients trust its staff, its interest in partnering, its suggestions for setting up the program, clients' home conditions, how staff enter and assess homes, how repairs are arranged, and whether staff would refer clients
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Reviewed published data on agencies' contracts with Medicaid managed care organizations, VA medical centers, state Medicaid programs, hospitals, and Medicare Advantage plans
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Used conference contacts to arrange and conduct follow-up discussions with Area Agencies on Aging across the client's state
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Overview of organizations that conduct outreach to hard-to-reach lower-income homeowners
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Perspectives on homeowners' trust in agencies compared with energy companies
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Each organization's level of interest in partnering on the program and its reasons
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Suggestions from community organizations on how to set up the program
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Agency perspectives on clients' home conditions and the hardships they face
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Overview of how agencies enter and assess homes and arrange repairs
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Agency willingness to refer clients to the program
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Overview of agencies' existing contracts with health plans and other healthcare organizations
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Recommended contacts and summaries of follow-up discussions across the state
Case Study
Medicaid Benefits: Collateral Improvement Study
A health insurer wanted to determine whether new member literature could make benefit information easier to understand, improve the member experience, and increase Net Promoter Score (NPS). Leadership needed consumer feedback on the new literature versus existing materials to decide what to use and what to refine.
The research examined how adult Medicaid members who make health care decisions responded to new and existing member materials. Individual interviews and small-group discussions provided consumer feedback to help the client refine its materials, make benefit information easier to understand, improve the member experience, and increase NPS scores.
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Whether the new literature makes benefit information easier to understand than existing materials
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Which materials members find clearer and more useful for understanding their benefits
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What members find confusing or unclear in the new literature
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Whether the new literature could improve the member experience and increase NPS scores
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What changes members recommend to make the new literature clearer and more useful
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Conducted in-depth interviews and three-person group discussions with adult Medicaid members responsible for health care decisions
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Included members enrolled with different health insurers
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Reviewed new and existing member literature with participants to explore their understanding, reactions, and preferences
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Compared feedback to assess whether the new literature communicated benefit information more clearly
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Examined participant reactions for implications for the member experience and NPS goals
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Member perspectives on the clarity and usefulness of new and existing literature
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Comparison of how well the materials helped members understand their benefits
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Areas of confusion and opportunities to refine the new literature
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Implications of member feedback for improving the member experience and increasing NPS scores