Health insurers look to flip the script on consumer experience

For decades, U.S. consumers have experienced interactions with their health insurance providers that feel confusing, bureaucratic, and indifferent. Care that their doctor has recommended gets inexplicably denied, obviously necessary procedures require infuriating weeks of paperwork and hoop-jumping, bills (and documents that look like bills) arrive in the mailbox listing startling costs.

Payers are now moving aggressively to fix their broken consumer experience, shore up their beleaguered brands and invest in getting their technology and business process houses in order.

Big Tech Companies Moving to Own Healthcare Consumer Relationship

Big tech is a significant and more imminent threat to the healthcare establishment than ever before. Changing healthcare laws and rules have fundamentally altered the way insurers manage risk and cost.

Amazon has made its intentions to expand its Amazon Care service to major metro areas across the country. The U.S. healthcare establishment has downplayed the big tech threat for years, but today they recognize that the threat is more imminent than ever before and must be taken very seriously.

Payers Investing to Counter the Big Tech Threat

Health plans are looking at both front- and back-end changes to radically transform how they interact with members. Ultimately, they want to eliminate internal bureaucratic mindsets and project a proactive desire to delight consumers. But to do that, they know they need to think outside of their traditional box, tap expertise from other industries, and get much much better at learning and communicating with their customers.

A New Era in the Consumer Experience of Healthcare

Today, health plans take member experience very seriously and invest in a wide range of new capabilities which include omnichannel communications, telehealth services, digital intake, care facilitation apps, and much more. All are designed to facilitate better communications and take a more active role, leveraging clinical and claims data to interact with members intelligently and help guide them to the care they need. These initiatives will not only increase member loyalty and satisfaction but also reduce long-term medical costs.

Focusing on Communication

A centerpiece for payer organizations seeking to become more consumer-centric is transforming the way they communicate with members. It includes moving beyond the phone and fax machine and leveraging conversational voice/chat interaction, in-, and outbound digital engagement apps and communication centers to drive care participation, adherence and completion. 

Leveraging the Incumbent Advantage

Health plans know a ton about their customers, having built detailed individual profiles including clinical, financial, and demographic data. They also tend to know a lot about the communities their members belong to and the prominent health issues they face. This is a powerful resource, but it is also a double-edged sword because health plan members expect their insurers to know them well. When their insurer fails to get the data and communication right, they can pay a very steep price to consumer loyalty.

Motivated by the threat of big tech, payers are finally starting to catch up with other industries and make innovative use of technology to give consumers the kind of experience they expect. The first movers will be positioned to take maximum advantage of this trend and will need to partner with experts for the technology, best practices, and process improvements required for long-term success.

This article was written by Venkatgiri Vandali, Head- Healthcare at Firstsource. This was earlier published at  Medcity News