Two years ago, a pack of startup consumer-driven health plan (CDHP) companies were hoping to carve out a niche for themselves. Today, mega health insurers seem to be jumping into the market every week.

This is a sign that CDHPs are emerging from their infancy. The next step? Brokers need to educate customers about what these plans are and how they work.

CDHPs are health plans that, with the help of price and quality consumer information tools, give customers control over benefit decisions at enrollment and medical choices at point of care. Most combine high deductible health policies with a health care savings account (HSA) that the employee can draw from to pay non-insured medical costs.

In this market, to be a CDHP player, innovative product design is important. Robust technology tools are essential. Tightly integrated claims processing is vital. Customer-focused service is mandatory. And, like any viable insurance program, financial stability is imperative.

Still, the difference between winners and losers is coming down to customer education.

Employers and employees alike must understand–upfront–that they are taking on new responsibilities and new financial and clinical exposures. That means they need to learn the “rules of engagement,” or the basic CDHP tenets. Reliable customer education is therefore crucial. Here are a few education strategies that should help you bridge this education gap.

Employ change management. For instance, note that co-pays are out under these plans. The underlying goal of CDHPs is to change customer behavior by transforming the way consumers interact with their health care benefits and make their medical decisions. CDHPs introduce new cost-sharing mechanisms and have a benefit structure that uses intimidating tools to communicate volumes of information about price and quality of care. Providing an ID card to flash a $15 co-pay at the billing office will not cut it anymore.

Set appropriate expectations. From point of sale to point of care, setting realistic expectations about the consumer experience is crucial. Anticipate and address your customers questions: Is there a chance of balanced billing? Are there restrictions on HSA funds? Do I have to use the Internet to find a provider? Remember, this is a new product, with new features, new roles and new responsibilities. By addressing the expectations at the front end, you will help your clients avoid problems and disappointment with CDHPs at the back end.

Keep up a baseline communication with your client. And keep it simple. You might as well throw away all the health insurance jargon and industry acronyms you have used over the years. Use the launch of the CDHP to change the way you present benefits plans. That is, use fewer words, more pictures and larger typeface. Make sure you clearly explain the “rules of engagement.”

And, before making your new presentation, give your communications the acid test by showing draft sales collateral, member handbooks and related material to someone outside the industry. If you get that “glazed-over” look, go back to the drawing board!

Provide superior customer service. Keep in mind that content is king, and consistency is queen. CDHP plan designs have thrust consumers into the middle of determining benefits and choosing “the right” providers. The plans raise the financial and clinical stakes. This elevates the importance of customer service. Service representatives must be adept at answering a multitude of questions quickly and accurately, such as about benefit tradeoffs, provider selection, HSA management, clinical support, pricing comparisons and quality of care benchmarks.

Provide clients with continuous education about the CDHPs. Sales presentations, Web interface and fulfillment collateral lay the groundwork. But ongoing visibility through frequent customer “touches” will make these plans really work. Thats because continuous communication strengthens the company-broker-member connection and reinforces product functionality. It is a process of repetition, educating customers on scheduled events such as plan activation and renewal, as well as transactional events like HSA rollover and care management.

Emphasize that this really is a consumer-driven product. Too often, CDHPs are positioned as low cost alternatives to traditional managed care. In some cases, they are touted as the new reality–a way for employers to shift costs to employees. If low price is the powerhouse behind a sales strategy, youre in trouble. Inevitably, a price-based decision that forces a CDHP onto unsuspecting employees leads to broken promises and dashed expectations.

CDHP customers are asked to drive upfront benefit decisions and stay involved throughout care delivery. To do this, they need to be motivated “health care consumers” that voluntarily make economical, efficient choices about services they want and their willingness to pay.

An information-based customer education strategy is the linchpin for success. CDHPs dont sell themselves, and customer satisfaction doesnt come without an investment in practical, education-based consumer communications.

Lindsay R. Resnick provides strategic marketing communications and business development services to the health care and insurance industry. His e-mail is lindsayresnick@aol.com.


Reproduced from National Underwriter Life & Health/Financial Services Edition, August 11, 2003. Copyright 2003 by The National Underwriter Company in the serial publication. All rights reserved.Copyright in this article as an independent work may be held by the author.