What You Need to Know
- Some health plans now say that 80% or more of their transactions are digital.
- In-house projects often go off track.
- One risk is letting the drive to make one CX detail perfect leave the rest of a CX effort in disarray.
In the decade following passage of the Affordable Care Act, the health insurance industry made dramatic but often gradual progress toward a new era of consumerization — slowly rolling out new digital tools aimed at helping Americans shop for, understand and use their health insurance.
Then came 2020. The onset of the COVID-19 pandemic dramatically, almost instantly accelerated the shift to digital commerce, and digital health. Last year the share of consumer interactions happening on digital channels jumped to 65% — from 41% in 2019 and just 25% in 2018.
Businesses across every industry responded by implementing and launching technologies in months that would normally have taken them years. The number of organizations reporting 80% or more of their transactions as digital tripled.
The result is a shift in consumer expectations that can’t be reversed — and that won’t bypass health insurance. As consumers who now use digital tools for two-thirds of their shopping and purchasing, plan members will no longer be satisfied with manual processes, tedious phone calls or analog tools for managing their health care.
This subject is of obvious interest to the plans. It’s also of interest to benefits brokers or consultant. A health plan’s “CX” (customer experience) strategy is an important part of what the broker is selling.
Plans that hope to attract and retain those members — and their employers — can no longer view the shift to digital member experience as a long-term process. Just as during the depths of the COVID crisis, transformations that would have taken years if begun in 2019 must now be completed in months.
Fortunately, the tools they need to make those transformations already exist. There’s no reason for a health plan to build its own digital experience — it would take too long, cost too much and quite likely fall short of members’ expectations by the time it launched. By partnering with the right software platform, plans can quickly implement and launch digital solutions that will fuel better outcomes, exceed members’ expectations — and win their loyalty.
As they seek the right solutions, plan leaders can improve their chances for success by focusing on three strategic factors: exclusivity, agility and efficiency. Here’s a closer look at each.
Health plans don’t just need CX. They need CX for health insurance.
In the last decade many health plans have implemented off-the-shelf CRM software for use in various aspects of operations — some of which are key CX components. But while these solutions can deliver quick upgrades to sales and marketing processes, care coordination or customer services, they can’t deliver CX transformation on their own.
In health care there are simply too many complexities, too many peculiarities and too much at stake to implement generic solutions. Health plans need CX software that can handle their unique workflows, challenges and requirements. Next-best actions, interoperability, compliance and database integration are all critical to delivering the contemporary CX that today’s consumers expect. Building those functions rapidly requires deep industry expertise — the kind that only comes from working exclusively in the health insurance vertical.
A health plan needs a CX system that can be implemented in just a few months, not one that takes years to create.
So, if exclusivity and health-insurance expertise are so vital, why shouldn’t health plans build the technology themselves? Because when they do, it rarely ends well. Self-builds rarely stay within budget or meet key deadlines, they strain internal resources — but still require immense investments in contractors and consultants — and often fail to keep up with constantly changing technology advances.