The importance of delivering a strong customer experience has risen incrementally in the minds of healthcare marketers over the last two years. Take the life sciences industry, for instance, which has renewed efforts to enhance CX due in no small part to physician ire with its stepped-up volume of digital outreach.
According to a recent report, however, most health insurers have yet to jump on the CX bandwagon. To that point, only about a quarter (22%) of insurers said they have a key person, preferably at the C-suite level, assigned to own member experience.
“So where does the buck stop? Who really cares about member experience if there’s no one titled to take care of it?” asked John Zimmerer, VP of technology firm Smart Communications, which commissioned Forrester to conduct the survey upon which the report is based.
Overall, 75% of health plans failed across the key tenets of member experience: strategy, process, people and tools. Most lacked an articulated strategy in terms of how to measure CX, how it needs to be tied to business metrics and/or the relative importance of various customer journeys.
When it comes to experience, the majority of payers “are flying blind,” Zimmerer said.
The report, bluntly titled “The Bleak Reality Of Member Experience With U.S. Health Insurers,” is based on a custom survey Forrester ran from February to March that involved 119 different health insurers. The plans ranged in size and lines of business, with executives tasked with CX and engagement as the respondent base. Data in the report come from the survey as well as from Forrester’s own Technographics consumer research.
Forrester asked about plan members’ average experience with all the different touchpoints that insurers put in front of them and what members are leveraging when trying to get information from their insurer.
The phone is still the leading channel (42%) that members will turn to when seeking answers from a health insurer. Yet the level of satisfaction with that channel is a middling 51%.
Zimmerer called the reliance on offline resources for information, mainly call centers, “more a capitulation that websites are too hard to use.”
The next most often-used channel is the plan’s website (38%), but roughly a third of members aren’t pleased with their digital experience. The level of digital engagement was relatively low across all types of plans, from individual ACA to group health to Medicare Advantage.
When Forrester asked insurers what they measure vis-a-vis member experience, they were similarly all over the map. “Most demonstrated a lack of understanding of what these metrics are, when to measure them and how to use them,” Zimmerer reported.
For instance, net promoter score (NPS), a lagging indicator of a member’s entire experience, is being used “in-journey” (i.e., within experiences) by 29% of respondents — as opposed to when it should be used, at the end to assess end-of-journey success. Length of time to fulfill a member’s request is used infrequently (21%) as a metric. Overall, less than 40% of insurers even track in-journey and end-of-journey metrics.
“The things that matter to members don’t seem to matter to the health insurer,” Zimmerer concluded.
With most payers not tracking customer journeys at all — or tracking the wrong metrics at the wrong time — members’ disjointed experiences (like filing a claim or looking up benefits to decide whether to use an in-network or out-of-network doctor) repeat themselves over and over again.
Nearly half of surveyed payers (48%) acknowledged this, noting they don’t understand the impact of digital experiences on their organizations’ key business metrics, such as how they tie to revenue, cost to serve and retention.
Another 47% copped to not monitoring members’ sentiments as they engage with them. That’s important because Forrester uncovered some key emotions as part of the members’ experience, including frustration.
“And if you frustrate your members, they’re gone,” said Zimmerer. “They’ll choose a different plan.”
That said, a look at insurers’ business priorities shows they’re working on some projects that could be construed as enablers of better member experience, like improving interoperability and data exchange across back-end systems (61%). But their focus is more on operational efficiency and cost savings, Zimmerer pointed out, rather than on improving member experience. They’re also very intent on increasing customer lifetime value (60%) and enhancing revenue per member (60%).
While plans are internally focused on business metrics, members are more interested in the quality of their engagement. They want better connectivity throughout the journey (63%) and better claims processing (62%). The latter includes a smoother way to ask their plan to reconsider paying a claim, which remains a rather siloed affair.
“The member doesn’t care how many departments need to be brought to bear. They have what they think is a relatively simple question,” Zimmerer explained. “The ability to coordinate throughout that process is important for members, but most insurers aren’t able to do it.”
Plans struggle to provide members with a seamless digital experience in many other areas, too, such as the impersonal way they communicate (think the “dear member” explanation of benefits or the way many insurers ask members to repeatedly submit information on forms). In fact, that was cited by payers as their leading struggle.
In many cases, Zimmerer noted, it’s hard for these companies to connect all of the dots because they’re often still using mainframe computers. Few are linking member experiences across touchpoints, while only a quarter have data systems that contain a complete picture of members, as far as their policy information, claims history and more.
“Part of that comes down to having multiple data stores where you don’t have a complete picture of the member all on one screen,” said Zimmerer. “Even when you’re logged into the website, provided your credentials, raised your hand and said, ‘I’m here to do X,’ they can’t reach into the back end, pull out the information that’s relevant and put it in that form for you.”
Plans want to change this, but over half (58%) said it’s “challenging” or “very challenging” to “consistently personalize member communications beyond greeting them by name.”
When asked what they plan to do over the next 12 to 36 months in order to meaningfully improve their members’ experience, the top answer involved working on the back end. Meanwhile, the “hard work” – orchestrating customer journeys and improving the seamlessness of experiences – sat at the bottom of their lists.
Yet more evidence of the disconnect between business priorities and member priorities came when insurers offered their take on the expected benefits of improving CX. The ability to “cross-sell products to members” was their top answer, while “lowering the medical expense trend” — insurer-speak for enabling better, more effective care — was second-to-last.
Forrester called this “inside-out thinking.” In other words, “They’re still operationally oriented. They’re still thinking about what’s in it for them, versus, ‘How do I better serve the member?’” said Zimmerer. “Creating that seamless experience from start to finish is still outside of their grasp. I’m not even sure they’re reaching in the right direction.”
All of which seems short-sighted, because improving CX has a definite pay-off. When insurers focus on improving member experience, it doesn’t just improve members’ health outcomes. It also improves the top and bottom lines for those insurers, per Forrester.
Indeed, while many execs are focused on acquiring new members, it’s the service side that matters most. Forrester has shown that payers that improve their CX scores by a single point can grow by 220,000 members annually.
Yet the percentage of payers that are customer-obsessed is lower than in other industries. As a result, they’re inadvertently driving up their costs.
“Whereas a lot of insurers are giving lip service to member experience, I don’t think they really understand the connection between improving the member experience and improving their own bottom line,” Zimmerer said.