This week, leading health plan executives and experts will gather in Seattle for the AHIP Institute
conference. The theme of the conference is “Great Minds Thinking Differently – New Business Models and Innovation.” Now, perhaps more than at any point in the past 50 years, health insurers are facing a new reality -- changing demographics, technology changing at a breakneck pace, the rise of the consumer-driven market, and of course, healthcare reform and the challenges and opportunities it brings. It’s a perfect storm of disruptive forces converging to drive a consumer-centric model for payers.
To navigate through these new frontiers, we have identified five key areas in which health plans can transform member interactions into a customer-centered experience. They are simple concepts that can sometimes get lost in day-to-day business operations.
1. Know the customer.
It sounds simple, but disparate systems and customer touchpoints make this harder than it seems. For a health plan, this means integrating channels and systems so customers don’t have to repeat information when they contact you. It also means that the company knows the entirety of a customer’s relationship with the firm – which family members are in the household, if they have multiple products and services, etc. It’s about keeping information accurate and knowing a customer’s communication channel preferences and needs based on their specific health profile.
Example: We worked with one health plan
2. Remove friction.
on the East Coast on the first steps of its customer-centric transformation. We combined consumer needs, value, and behavior data to create eight integrated lifestyle segments as the basis for marketing and care initiatives. We then developed a value map and an implementation roadmap to identify and prioritize initiatives that will have a positive impact on consumer value related to each segment.
A frictionless customer experience is the best customer experience by removing the things that make it tough for a customer to do business with you. Friction is often the result of inside-out thinking -- putting processes, policies, technology, and sometimes politics ahead of what’s best for the customer. Instead, enable the people, processes, and technology to seamlessly connect sources of interaction.
Example: Blue Cross Blue Shield of Michigan
created a Customer Experience room to help the company’s nearly 7,000 employees better understand and empathize with customer pain points about health insurance. It fosters enterprise-wide employee engagement in improving the customer experience
. This mobile, interactive room offers an immersive learning environment through a series of exercises designed to meet a variety of learning styles. Using self-guided navigation, employees walk through the experiences of three customer “personas,” crafted after extensive research by the company. Employees see how customer experience initiatives undertaken by the company connect with how Blues customers want their experience to be.
As a result, BCBS of Michigan jumped 22 points in one year on Forrester’s Customer Experience Index, from 2013 to 2014.
3. Resolve problems.
This issue may be self evident, but it’s often the toughest to accomplish and has the biggest impact on the consumer. First contact resolution is a hot topic among customer care professionals, and should be a top priority for health plans as they deal directly with consumers and other customer groups more frequently. Empower associates to solve problems without transferring or hanging up. Use knowledge management and customer feedback to continuously learn from employees and customers about how to improve experiences.
Example: The University of Pittsburgh Medical Center Health Plan
4. Eliminate surprises.
doesn’t enforce talk time restrictions, because it believes health insurance issues often require additional time. It instead employs a one-call resolution policy, and trains agents to be experts in a few key areas, so customers can be routed to the best available resource. It also created a Health Care Concierge on-boarding program to offer individualized service. Concierges personally welcome new customers to the plan, and serves as the customer’s chief point of contact throughout his or her first few months in the plan.
This means keeping promises to customer and managing their expectations. Health insurers should be clear and simple with their communications, not using complicated or confusing internal information. In addition, proactive outreach can be key to building a trusting relationship with customers. And basing those communications on specific events or triggers can be a best practice when it comes to eliminating surprises.
Example: We worked with a client on a communication program to address low customer engagement to encourage healthier lifestyles and drive down healthcare costs. We helped them leverage data analytics for event-triggered email and text messaging to be sent from employers who offered the healthcare plan to their employees. We also helped create in-depth customer profiles to develop segmenting criteria and relevant, informational messaging, and identify appropriate communications method. And for communication strategy, we established frequency of contact rules to prevent message fatigue.
5. Protect the customer.
Without a customer you don’t have a business, you have a hobby. It’s important to remember that efforts must be made within your organization to act in their best interests, because now it’s much easier for them to go elsewhere. Protecting the customer cements the bond between the customer and the health plan and ensures that the trust is lasting, not transactional. Be sure to communicate with each customer according to that customer’s preferences – don’t force them to interact with you in a manner dictated by the health plan. And, perhaps most importantly, train and encourage your associates to be empathetic advisors, not just company representatives on the other end of the phone or chat.
Example: Health Care Service Corporation
, which runs Blue Cross and Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma, and Texas, wants to be thought of as an advisor to any consumer seeking advice. It established a contact center specifically to answer questions about the Affordable Care Act for both its own customers as well as individuals from the public at large. The organization received an average of 1,500 calls daily, underlining the need for a health insurance provider to take the time to answer questions and act as an advisor. “We need to take the confusion away,” said HCSC’s chief customer officer Austin Waldron.