I heard a health plan CEO say that he is focused on "EPS and NPS" (earning per share and net promoter score, the latter a measure of customer experience). This struck me as shortsighted.

If a health plan is ever going to deliver on a Starbucks, Amazon, or Facebook-like NPS, they need a different mindset. A mindset that say that they will invest relentlessly in the consumer experience/solving customer problems or even diluting them — this will in the short term hurt EPS. Amazon has lost money forever. Facebook burned billions in capital before making an EPS. Snap will spend $500M this year. They all do this because this is what it takes to make a great, useful and engaging technology product.

A health plan that's metering their spending, effort, and attention to satisfy EPS will never catch up and deliver a great NPS experience. And they will remain vulnerable to start-ups who can recruit better technical talent who have this ethos. It is why Castlight won the price transparency battle, and why Oscar caused so much existential fear.