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Article | Your Path to a World-Class Customer Experience

Five Opportunities for Improved Payer Experience

With the extended March 31 enrollment deadline fast approaching, the implementation phase is picking up speed, and the spotlight is shifting from the exchanges to individual insurers, which, as a result of the ACA, are seeing the largest influx of new members in several decades.

This creates enormous opportunities for the healthcare industry. To take advantage of this situation, we have identified five opportunities that payers should leverage:

1. Manage the influx of calls: Navigating the healthcare landscape is complicated at best. Especially the first-time insured are likely to need help understanding their eligibility and gaining familiarity with their benefits and terms. Moreover, because of the complex issues and sensitivity of healthcare, members are more likely to want to speak with another person.

This means that insurance providers need to equip their contact centers to cater to this growth while still delivering a good experience. There are two approaches—either ramp up their internal contact centers or team-up with a partner that can help with staffing the contact center and providing the necessary training for agents. Since traffic is expected to fluctuate, it's good to have a scalable system, both in the member service centers and in supporting technology.

While call centers are expected to be the main mode of contact, insurers shouldn't forget other touchpoints, and their communication strategy should consist of multi-touchpoint interactions, including leveraging smartphones through apps or text capabilities.

2. Leverage data and member insights: Healthcare is a sensitive topic, with members and patients expecting that their information is respected and kept private. However, non-medical information can help insurance providers understand where they need to make improvements to their messaging and can highlight areas in their campaigns to educate members. Insurance companies need to understand what is working well and what needs to be improved by leveraging data from different touchpoints. For example, if many members are calling their insurer with a similar question, there might be an opportunity for an outreach campaign to inform members about that specific topic.

Front-liners need to be recognized as great sources of information since they are constantly in touch with members and can identify trends in member pain points. Further, their additional exposure to member insights means that agents can often be instrumental in identifying the reasons behind customer issues and help find a speedy solution.

3. Embark on a targeted messaging campaign: Equipping members with the correct information can be instrumental in ensuring that they have access to the right treatment, as well as take preventative action to avoid future health problems. This is a win for both insurance providers and members themselves. Therefore, insurers need to leverage member data to create very targeted and personalized outreach programs, with information that resonates with individual members.

TeleTech's customer growth services unit worked with a health insurance provider to send hyper-targeted communications to employees, who were also members. After collecting data from 16 disparate repositories and analyzing it, the insurer was able to identify individual concerns. For example, a member suffering from high blood pressure that increases his risk of cardiovascular disease could be sent tips on lifestyle changes that could help address his hypertension problem.

4. Create a member acquisition strategy: Resources-strapped providers are struggling to find time to reach out to prospective members who are healthy, which would help them gain a more balanced member-base. Providers need to embark on an outreach strategy that acknowledges and leverages prospective members' different needs. Social media and digital marketing can be integral parts of the campaign.

5. Design an integrated multichannel and multi-model marketing approach: The most successful state health insurance exchanges have leveraged multiple channels with varying approaches including traditional media, email, text, and social media. An integrated multi-channel approach is critical since different customer segments use various channels both to interact with brands and to gain information, which has been an important part of the ACA rollout.