A few years ago we published: Empathy-based Design in Health Insurance Technology discussing the importance of improving the customer experience based on what consumers think, feel and do. We wanted to build on this post and share how sophisticated CRM technology can help carriers bridge the gap between operational efficiency and customer experience.  


Starting from the inside out

Health plans that are focused on improving their customer experience strategy, will need to ensure that their organization is ready and equipped to:

  • Personalize experiences
  • Create well informed customer service reps
  • Build a trusted and respected brand
  • Streamline customer data

According to Gartner Analyst, Mike Maoz, customer empathy and processes often fail for the following reasons:

  • There was no executive mandate that empathy matters
  • Employees do not understand the needs of the customers and therefore create a lack of trust
  • Current software design and workflows fail at delivering an experience that is improving operational efficiencies or processes
  • Legacy applications are counter-productive resulting in demotivated and frustrated employees

Consider the following stats: 70% of buying experiences are based on how the customer feels they are being treated.  (McKinsey). It takes 12 positive customer experiences to make up for one negative experience. (Parature).  The consequences of a negative experience can be costly and long-term for a company.  To avoid this, it is necessary for leaders within the organization to promote customer experience as a priority. This trickle down approach is critical in motivating employees to deliver consumer-centric service and incorporate empathy into every consumer interaction.  To ensure consistency across the organization, will require technologies that are industry specific, provide an aggregated view of customer data and allow automation of regularly occurring tasks and workflows.

Using technology to drive empathy and increase lifetime value

A well planned CRM strategy has the ability to drive empathy through design and processes that build trust between the consumer and health plan. Specifically, an industry specific CRM that is driven by real-time data and analytics, can remove fragmentation within the enterprise and provide a clear understanding of the customer’s needs, pain points and barriers. A sophisticated, industry specific CRM can allow health plans to be proactive by leveraging automated workflows and predictive intelligence to alert a customer service representative with an issue, opportunity or task. This added layer of real-time customer insight would foster a consumer focused enterprise that is empathetic to their customer’s current and future needs, while driving member loyalty and lifetime value.

Gartner analyst, Mike Maoz,  lists 8 required traits that make an inventory of empathy with the customer.  We have elaborated on these a bit to demonstrate how carriers can achieve these traits.

  • Channel convenience
    • Automated whenever possible
  • Timely response
    • Industry specific workflows.
  • Deep knowledge of the solution to the customer’s problem
    • CSR knowledge base and call scripts
    • Automated industry specific workflows
    • Real-time data capture from consumer facing tools
    • Aggregated view of the customer
  • A “best guess” as to why the customer is reaching out
    • Service center with a centralized view into all member activity
  • Reaching out to the customer whenever possible before an issue arises
    • Predictive analytics that identify significant events impacting members
    • Automated recommendations
  • Perception of helpfulness, friendliness and care
    • Aggregate view of all member interactions
  • Perception of fairness
    • Ability to provide timely options
    • View of all member interactions
    • Segment members into personas to personalize the experience
  • Perception of honesty
    • Increased transparency
    • Data aggregated across all business units