The Reform Nation: Preparing Americans for the Affordable Care Act

As healthcare consumers struggle to understand how ObamaCare will impact their families and their wallets, professionals and providers have the opportunity to prompt an honest dialogue, build trust, and engender long-term loyalty.

Healthcare reform, the Affordable Care Act, ObamaCare—no matter the name, the healthcare industry as we know it will never be the same—both for consumers and health insurers.

On October 1, all 50 states launched their health insurance marketplaces, which allow open enrollment in health plans that will go into effect on January 1, 2014. With more than 30 million new enrollees forecasted to enter the marketplace, health insurers, traditionally focused on their B2B customers, have an opportunity to wipe the slate clean and rebuild the healthcare industry’s reputation with the consumer in mind.

Transparency and trust from health insurers are both essential during this transition, as healthcare reform ushers in an era where consumers can choose to go elsewhere if they’re unhappy with their experience. Confusion and hidden information will only perpetuate the untrustworthy perception most consumers already have of the healthcare industry. Primarily, insurers must make certain that consumers know exactly how much they will be paying both in monthly premiums and out-of-pocket costs for services.

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"We, as an industry, have such an opportunity to help people make the best decisions," says Ingrid Lindberg, chief customer experience officer at Prime Therapeutics. "The insurance model is being turned on its head. The entire structure has been built around B2B communication, and now we're pivoting toward direct consumer communication. And these consumers? They have exceptionally high expectations. They shop at leading, online-only retail stores and they're used to things being very simple, and instantaneous."

In fact, these leading retailers offer important lessons from which healthcare professionals can learn. With customer centricity in mind, B2C companies stand upon a culture that actively engages consumers by embracing meaningful dialogue and providing exceptional experiences. As Ron Wince, president and general manager of Peppers & Rogers Group, notes, while there may be an innate tendency to remain wary of an insurer or provider's actions, such obstacles aren’t insurmountable as long as professionals work to instill an honest, authentic layer of transparency and trust.

Because this process is new for both the consumer and the provider, both must approach this potentially confusing time as partners. Providers must constantly prove they only have the consumer’s best interest at heart, for cultivating loyalty during these early stages will lead to continued success for years to come.

Emphasizing Education and Communication

While consumers will inevitably make their choices based upon pre-existing conditions and whether their preferred doctor falls within the plan's network, much misinformation continues to permeate the healthcare landscape. Whether intentional or not, the healthcare industry has always been one plagued by mistrust, making it difficult to have an honest discussion. However, as Doug Wood, medical director of the center for innovation at the Mayo Clinic, notes, the ACA provides for the education of navigators, for which the Mayo Clinic has applied to be. The federal government has allowed for a provision that enables healthcare institutions to raise awareness and provide outreach for those exploring the marketplace. These government-approved individuals and organizations will be trained through certification programs that teach the underlying policies of healthcare law in order to help consumers, small businesses, and employees exploring the healthcare exchange marketplace. These navigators’ unbiased guidance will offer consumers an outlet for their most pressing questions, including completing eligibility and enrollment forms. As Woods highlights, communication will be critical in helping people make better choices about healthcare. "Communication should be aimed at helping people make better choices about healthcare," he says. "We need to find ways people experience health and explain how their options apply."

Yet, while health insurers and professionals now have the opportunity to educate consumers, they must do so in ways that convey concern. If they focus solely on the products they're trying to sell, they will never instill the trust necessary for long-term loyalty. These professionals must willingly and proactively reach out to consumers by providing content and building websites that outline healthcare reform law, what it means for specific consumers, and their options under said law. Because of the ACA's politically charged nature, the majority of consumers don’t have a firm grasp on what healthcare reform truly entails, as much of what the public has heard centers upon the law's controversial passage. However, numerous insurers and states created websites dedicated to educating current and potential customers.

Integrating Interactive Web Services

EmblemHealth, for instance, created an online hub for New Yorkers that highlights significant aspects of healthcare reform, including FAQs that are on the mind of many individuals. Consumers can explore available plans, find doctors, determine if they’re eligible for financial assistance, and hear stories of other New Yorkers who are also in the process of deciding which options might be right for them. Other institutions, such as UC Berkeley’s Labor Center, offer consumers healthcare calculators for both California residents and the nation so they may estimate their projected tax credit from the government and how that will impact their overall monthly premium. Such tools help to arm consumers with the information they will need to make the best decisions for themselves and their families.

For Highmark Health Services, communication began in 2010, when the healthcare reform laws were first passed. From Web and print, to telephone and social media, Highmark has been working to inform consumers about the healthcare industry overall. "Much of the communication should help consumers understand not only what healthcare reform means to them, but also how health insurance works, why it’s important, and what its cost drivers are," says Janice Maszle, a spokeswoman for Highmark. In response, Highmark created two primary websites designed to educate consumers and answer questions.

While Highmark on Health Reform focuses on the law's timeline and provisions, Discover Highmark helps consumers understand what the law means to them and how to make coverage decisions. From print to digital, Highmark has embraced its multichannel network to inform consumers about these educational destinations and how they can guide customers as they begin to evaluate their options. Both sites also open up the pathway for dialogue—an essential tactic for success in an extremely competitive market—as Highmark has established a dedicated, educated team of telesales people, agents, brokers, and customer service representatives to support new customer enrollment and respond to consumers' needs.

Preparing the Contact Center

Assurant Health has also been working to prepare its contact center for the influx of questions about to flood their telephone lines. Prior to the impending ACA concerns, Assurant Health struggled to glean data from random customer phone calls, as it couldn’t quantify each issue's impact on the situation at hand. However, as part of the company's dedication to providing quality customer care, Assurant Health made an effort to improve the customer experience and call center effectiveness simultaneously.

"Consumers will continue to have questions about health insurance, particularly due to the ongoing implementation of the Affordable Care Act," says Sue Lundberg, vice president, customer experience at Assurant Health. "We want to be able to answer their questions so they can make the best choice possible for their needs."

With an emphasis on serving the unique health insurance needs of individuals and small businesses, Assurant Health implemented an array of customer-centric listening tools that allow the brand to incorporate the voice of the customer into its operations so the company may identify trends that are helpful to the business as a whole. By understanding the volume and frequency of customer concerns, Assurant Health's customer service representatives will be better armed with the tools necessary for continuously consistent service and guidance during this confusing time.

Laying the Groundwork for Transparency and Trust

As healthcare professionals work to bring information directly to consumers, one can already sense the distinct shift in the industry. Though healthcare reform may be confusing, professionals and consumers have the opportunity to work through the challenges together, deepening the bond that will inevitably result in long-term loyalty. Insurers and providers understand that many consumers will struggle to comprehend how healthcare reform will impact their future, but both parties have the chance to approach this future as partners, not adversaries. Together, healthcare professionals and consumers will be able to build mutually beneficial relationships that further revolutionize the face of the healthcare industry.



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