Five Steps to Improve Healthcare Consumer Experience


To build trust, health insurers need to demonstrate their value to customers. That means offering a convenient, satisfying customer experience. Here’s how.

It’s no secret that lots of consumers harbor deep skepticism toward their health insurance companies. A 2016 Harris Poll found that only about 16% of U.S. consumers think health insurers put patients above profits.

So as insurers mobilize to prepare for a new era of competition including, potentially, against formidable disruptors like Google and Amazon and savvy retailers like CVS and Walmart, restoring that trust will be a crucial task. And while that won’t be easy, it’s not particularly complicated either.

To build trust, health insurers need to demonstrate their value to customers. That means helping them get healthier and save money and providing them a convenient, satisfying customer experience.

Which is sad because between them they have tons of useful data that could provide value to consumers and enormously powerful computer systems that can-and do-streamline the provision of care and payments.

Little of this is visible to healthcare consumers, however, and what they can see is often cloaked in impenetrable codes or balky and counterintuitive user interfaces. It’s hard to get your customers to trust you and buy into the goal of improving care and lowering costs when they can’t understand what you’re saying. The message you must get across in every customer interaction is you’re not using technology to save the health plan money, but to keep members healthier and happier. You need to demonstrate the value they’re getting from the system if you want them to utilize the tools you are building.

Here are five of the most important steps toward improving trust and customer experience:

  • Speak their language. EOBs, EOCs, COBs-what do they mean in ordinary English? Dedicate time and resources to making every communication understandable to every customer. That includes paper letters: If customers can’t understand them, the first thing they will do is reach for the phone. The wording and style of messages resonates differently from one person to the next, so get the right message to the right person. A message one consumer finds useful may cause anxiety for another. The language, the tone, and the medium are factors that decide whether messages get people to take actions that keep them healthy, avoid expensive and unnecessary procedures, or prescriptions and hospitalizations that pile on costs.
  • Make the member portal a self-service destination. Invest in desktop and mobile portals that are highly functional and allow users to manage their preferences, obtain pre-authorizations, opt into or out of e-mail campaigns and generally take care of their needs online. Make members understand you’re constantly working toward a more user-friendly experience and reward their trust with visible improvement. Today people would rather do nearly anything to avoid navigating their insurer’s website. It’s hard to find the information or answers they need and most attempts end in a phone call anyway. We’ve seen interfaces that have 100 different links on the member page. In the era of one-click shopping, consumers don’t want to have to work hard at finding what they need. The objective is to teach them to get answers to their questions online so they don’t have to pick up the phone.
  • Simplify call centers. They’re not going away, but you can make them less of a resource suck and hit to your reputation. Customers who haven’t been able to solve their problems online shouldn’t find the call center an even more frustrating experience. Operators must have all of a customer’s information available at their fingertips so they can provide answers better and more quickly. This can require a substantial investment in software and systems to automate work flows and access databases that were assembled through multiple acquisitions. The big opportunity is to bring disparate data together into a single system, reducing the time and expense of training as well as employee turnover driven by frustration with outmoded systems. We should also give reps a better interface rather than forcing them to go to a public search engine to hunt down information about providers the caller has questions about.
  • Provide useful information. Insurers, providers and payers have vast amounts of data that can help consumers improve their health, determine the most cost-effective treatments and make the best use of benefits. Show them alternatives to the most expensive option that provide as good or better care. Plan administrators and insurers also have the capability to integrate wearables into the equation, improving the treatment of chronic conditions and helping patients stay on top of their meds. Your job is to deliver useful information to them through whatever device or medium they choose, whether that’s a workplace computer or a text message.
  • Get consumers to share their information. Create a high-value, trustworthy user experience and users will reciprocate by sharing more of their own information, making it easier for providers, payers, and plan administrators to deliver healthcare more efficiently and at lower cost. Communications is a two-way street and one of the objectives in investing in your customer experience is to enhance the flow of information in both directions.

Mark Nathan is CEO of health insurtech company Zipari, which develops solutions for carriers to engage with consumers in new and innovative ways.

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