As health plans are planning their 2017 initiatives, customer experience, data and operational efficiency will certainly remain priorities. In order to aggressively move forward, payers will need to first transform the internal culture to a consumer-centric model. Adopting technologies that can synchronize the enterprise, streamlining data and operations, will accelerate this shift enabling them to meet the expectations of today’s consumer.


Looking inward to improve the customer journey and profitability

The truth is that traditional business models were designed in an era before the consumerization of technology. Customers (and employees) are empowered by technology and by the connections and access social media, mobile and connected devices, etc., facilitate. As a result, the basic premise of how companies sell, serve and support customers now requires new models and methods that meet the behaviors and expectations of a more discerning generation. This is why I believe that one of the biggest trends in business today, digital transformation, is as much about technology as it is about people, operations, processes and perspectives.” – Brian Solis, Principal Analyst, Altimeter

Consider these retail consumer statistics which are now relevant to health insurance industry as it has shifted to a consumer-driven market:

  • 71% of online customers expect help within five minutes. (LivePerson)
  • 52% of customers are less likely to buy from a retailer because of a poor mobile experience. (Google)
  • 95% of unhappy customers share their bad experience with others. (Zendesk)
  • Consumers have 60% higher customer service expectations than they did just one year ago. (Parature)

Payers and their cross-functional leadership teams must look across the enterprise and ask the following questions when assessing their customer’s journey:

  • What isn’t working? Where is there a breakdown in the customer experience leading to increasing member churn?
  • Where are the internal barriers that are driving up administrative costs or prohibiting revenue growth?
  • What are the process constraints that can be alleviated through technology?

McKinsey Insights suggests that in order to improve customer experience organizations must truly understand the end-to-end customer journey, which will result in the following financial benefits for the plan:

  • Lowering churn rates by increasing member sentiment and customer satisfaction
  • Adopting innovative benefit approaches designed to bend medical cost trends for commercial accounts
  • Cutting administrative costs by providing member education or through self-service tools to handle routine tasks and answer frequently asked questions
  • Empowering members to take control of their health costs by navigating them to health management programs or to improve medication adherence
  • Increasing member engagement to minimize any external influence encouraging the consumer to seek care outside of their plan

For payors to fully benefit from the revenue driven opportunities mentioned above, they will need to integrate solutions that can accelerate them into transitioning to a consumer-centric organization. Equipped with this, the payor will be able to immediately provide continuous value to throughout the customer journey while strategically addressing the financial goals of the business.