We often hear from our payer clients that, due to the highly matrixed nature of health insurance organizations, no one group feels that it truly owns the entire experience of its members.
As many healthcare leaders know, this fragmentation can negatively impact the care journey, health outcomes, cost management, member attrition, and more.
In its recent report, Health Plans Can Reach New Heights (And Connections) In Digital Member Engagement, Forrester states, “If plans use member-facing digital technology to create consistent, frictionless experiences, members will seek opportunities to engage with that provider and become more loyal to their plan.”
Ultimately, healthcare consumers seek opportunities to engage with providers that create seamless experiences. In her quote within Forrester’s report, Marybeth Wrabel, Perficient Senior Solutions Architect, drove this challenge home:
“Why would members spend time engaging with their health plan if they don’t see the benefit in doing so?”
Simply put, members need to be engaged in ways that are purposeful, personalized, convenient, and useful. And technology certainly plays an important role.
However, solving member experience is not about the technology itself. Rather, we see the greatest success when organizations define desired business outcomes then approach technology as a strategic enabler of those goals. Strategic planning, implementation, and optimization, of course, require experience, so it’s important to partner with experts that deeply understand the nuance and complexities within the healthcare industry.
YOU MAY ENJOY: People of Perficient: Meet Marybeth Wrabel
Optimize Member Experiences
Anticipatory, proactive care navigation could delight and influence members, help remove barriers to care, and help change behaviors. And payers – when taking primary responsibility of care navigation – can serve as an empowering resource, equipping members to more-confidently make informed decisions about their health.
We recommend that technology executives work with Chief Experience Officers to understand key journeys, identify major moments of friction, and improve engagement and education at each point.
- Ensure that leaders across operations, digital, marketing and the business segment agree upon the role that digital plays in organizational objectives.
- Align on direct and attributional Key Performance Indicators (KPIs) for member engagement.
- Dedicate annual funding with an identified decision maker that regularly monitors and discusses KPIs, outcomes, and planned improvements.
Increase Consumer Loyalty
Forrester also published a related report, Boost Member Engagement With A Journey-Focused Strategy, and Perficient healthcare experts were interviewed by Forrester as they investigated customer journeys and engagement in health plans. Perficient’s Priyal Patel, Director and Healthcare Strategist, is quoted in Forrester’s report discussing Line of Business (LOB) models. She states:
“There needs to be a shift from traditional LOB models to personalized engagement about what the member needs to do.”
We believe that once members are engaged in useful and meaningful ways, then efforts to influence behaviors for better health outcomes will be more impactful.
LOB refers to the specific types of insurance products or services that a healthcare insurance organization offers. LOB is basically a way to help categorize different areas of coverage and each LOB typically addresses specific healthcare services to meet various needs. For example, Medical, Dental, Vision, and Medicare or Medicaid. It is important to understand and manage different LOB so that insurers can tailor their offerings to the different needs of their customer base. However, as the healthcare landscape continues to shift to consumerism, it is important to not solely rely on LOB alone when increasing consumer engagement.
Perficient is actively working with payers to make claims-driven personalized experiences more purposeful and meaningful. Examples include:
- Next best actions based on gaps in expected routine health claims
- Educational resources and outreach based on patterns of claims for chronic conditions
- Recommendations for well-respected physicians and health systems, supported with transparent cost information, based on the patient’s current plan usage
Have questions? We help healthcare organizations identify outcomes-centered strategies and solutions to optimize care experiences and drive value. Contact us today, and let’s discuss your specific needs and goals.
