Sponsored by West Monroe Partners
Outside forces—from consumerism to health care reform, to digital evolution—have created a marketplace where individual consumers are more engaged than ever before in purchasing insurance and managing their health and wellness. For health care organizations operating in this evolving marketplace, success and competitiveness is not just about being the “best.” It is about delivering an effortless experience that meets—or, preferably, exceeds—health care consumers’ expectations.
When choosing which health care services to purchase and consume, today’s consumers will consider a host of factors that include traditional criteria such as cost, reputation, and quality of service. But they are just as likely to prioritize experience. Do they have easy access to the information they need and want? Can they connect when they want and through the channels they want? Do they receive timely and personalized communication?
What’s important to acknowledge here is that the benchmark for health care customer experience no longer comes from just the health care industry. It comes from the wider marketplace, where companies like Amazon and Uber have set a high standard for shopping and customer service experiences. Health care consumers and patients expect the same type of seamless experience when interacting with insurance and provider organizations.
The struggle to deliver on expectations
In 2016, West Monroe Partners surveyed more than 1,300 health care consumers and conducted a roundtable with health care insurance executives representing plans with member volumes ranging from less than a million to more than 15 million. The purpose of the study, No More Waiting Room: The Future of the Health Care Customer Experience, was to understand how today’s consumers interact with health care providers and payers and how communication preferences are shaping the industry. Findings point to a misalignment between consumers’ expectations and health care organizations’ confidence in delivering on those expectations.
For example: One third of health care consumers have used a mobile app to communicate with a provider in real time. 80% of consumers who have communicated real time via a mobile app prefer this method to a traditional office visit. Yet, 85% of health care executives aren’t confident that they have the right technology in place to evolve patient experience, and 54% aren’t confident they have the right processes to do so.
Start by putting health care consumers first
The health care marketplace is extraordinarily complex, with shifting economic realities, complicated products, emerging channels, and regulatory changes. Insurers and providers that are able to simplify this environment and make it easier for consumers to buy and access health care services stand to gain significant advantages—lower delivery and administration costs, greater patient and member retention, and better patient-centric decision making.
Creating a winning consumer/patient experience starts with a shift from an “inside-out” to an “outside-in” viewpoint—employing a customer experience vision that mobilizes operations and technology solutions around people rather than around traditional enterprise boundaries. Some health care organizations have begun designing from this perspective, but delivering on it is proving to be a considerable challenge. The entire organization and ecosystem—from the executive suite to the front line to the back office—must be involved in shaping consumer experience. It will also require modernizing the systems and technologies that touch consumers and engage them throughout the management of their health.
Following are several keys to adopting a consumer-centric view:
Personas and journey mapping
Developing customer personas and mapping a health care consumer’s “journey” while interacting with the organization are effective techniques for creating an “outside-in” view of operations. Personas identify the various buyers—providers, brokers, patients, prospects, and members—and reveal their feelings, motivations, and attitudes when dealing with an organization. Journey maps identify all touch points, from origination of the relationship through continuing delivery of health care services. A journey map will look at factors such as the channel of interaction, the content, and the user experience. Typically, journey mapping involves conducting interactive workshops with members/patients as well as internal stakeholders. This technique is useful for understanding the customer, the current journey, and how to design the future customer journey and experience.
It is essential that all facets of the organization—sales, marketing, network and care management teams, back office functions such as billing and call-center support, and others—participate in this exercise. Not only does this prevent interactions from being designed in “silos”, it also helps the individuals involved adopt a consumer-centric viewpoint.
Data is the foundation for understanding needs and behavior motivators and a key part of building strong consumer relationships. Patient and product histories, along with analytics, allow organizations to gain an inside look into how patients interact with payers and providers. Learning about and adapting to consumer preferences can boost engagement and create trust.
Health care organizations need to begin developing tools and capabilities for analyzing and assessing consumers—from their engagement with campaigns to their interactions with health care products, services, and channels. They also need to be able to translate that data into plain messages that give internal operational personnel what they need to know to improve experience.
Finally, to improve care and deliver a better experience for patients, these organizations will need to develop capabilities for sharing data effectively and securely across the health care ecosystem of pharmacy, clinical, providers, and payer organizations.
Segmentation and experience strategies
Having engaged customers helps manage costs and improve care. But the same engagement approaches don’t work for everyone. Some health care consumers prefer to pick up the phone to interact with an insurer or provider. Others prefer to do so online—and, as noted above, some prefer mobile interaction. Some are proactive about managing their own health, while others are less so. Some want lots of information, and others want information only as their interests warrant.
Engagement starts with effective segmentation of the patient population. There is no “one-size-fits-all” approach to building relationships. Developing consumer segments allows the health care organization to focus on the different needs and behaviors of a group of individuals. Each segment should have a defined relationship strategy that supports the overall brand identity but reinforces a segment-specific value proposition. From this, the organization can design engagement and experience strategies to accommodate each segment’s channel and information expectations.
Personalized communication and experience
Today, many health care organizations limit communication to e-mail, mail, and phone. These channels typically are one-sided and do little to engage customers. More significantly, this is problematic considering the rising generation of health care consumers prefers online portals, mobile channels, and messaging platforms. While the survey suggests organizations intend to rectify this, time is running short. Given the accelerating speed of technology innovation, by the time they add platforms like social media and instant messaging, they will be behind.
Omni-channel approaches, driven by customer data, will be necessary to deliver personalized messages and drive engagement. Health care organizations should be leveraging technology to develop user-friendly interfaces and self-service tools that allow patients to engage the organization through their channel of choice.
Finally, health care organizations will need a supporting infrastructure to orchestrate relationship development. An engagement architecture comprised of profile, preference, campaign automation, channel, content, and interaction-management capabilities is necessary for executing designed experience and measuring success. For most organizations, this will require a more flexible delivery environment and agile development capabilities.
Enabling sustainable change
Creating the capabilities for putting—and keeping—consumers at the center of operations is a key starting point. Once that is underway, organizations will need to start looking at their operating models to identify functional improvements that have the biggest impact on consumer experience and that allow them to react quickly to evolving trends and competition. Finally, change of this magnitude will require cultural and change management initiatives to ensure that the organization embraces customer centricity and that investments in change are sustainable.
West Monroe is a progressive business and technology consulting firm that partners with dynamic organizations to re-imagine, build, and operate their businesses at peak performance.