Contributed By Elizabeth W. Boehm & Bruce D. Temkin
Health plan executives are confronted by a daunting challenge – they face increasing cost pressures, more complex plan designs, rising demands for disease and wellness management programs, and a looming market of individual rather than group members. These challenges are compounded by the fact that, with more channels to use and more access to information, members are getting more difficult to serve.
To win and retain members in a largely consumer-directed future, plans will have to adopt Experience-Based Differentiation, an enterprisewide effort that focuses on three principles.
Obsess about member needs. Today, plans focus too heavily on competitive comparison, which just perpetuates industry-wide mediocrity. As with most industries, organizational structures and incentives push groups like product management, service, sales and marketing to optimize performance around their own metrics. As a result, plans don’t pay nearly enough attention to what’s really important – meeting member needs. To do this, health plans need to clearly identify target customer segments, whether by health status, technology acumen, age or health attitudes.
Ethnographic and other qualitative research approaches are critical to understand target users’ needs, behaviors and contexts that, when met, lead to fulfilling member experiences. In addition to influencing member service, research also drives compelling new product and service offerings that set one plan apart from its competitors. However, such differentiation occurs only when goals are shared broadly across the company so all facets of the organization are working to support the same needs.
Reinforce brands with every interaction. It’s one thing to hype a brand statement that promises to “make healthcare easy.” It’s quite another to enable the kinds of communication, service, tools and product innovations that fulfill the promise. In addition to broadly communicating brand attributes, health plans need to translate their brand promises into interaction requirements. An “easy” brand positioning needs to be made manifest to members through courteous and knowledgeable member service reps, facilitated handoffs to carve-outs like pharmacy benefit managers or disease management vendors, and a Web site that decodes esoteric plan terms and conditions into language the members can readily understand.
For members who have to coordinate their insurance benefit with a savings or spending account, it will be crucial to offer debit cards or other mechanisms that make it easy to access the right funds at the right time. Plans don’t necessarily need to radically overhaul every aspect of their member service. Rather, they can focus on moments of truth, such as when a new member makes a transition to a new benefits structure, especially if she needs to adjust to a new formulary or treatment protocol.
Treat customer experience as a competence, not a function. Customer experience, like quality, needs to be everyone’s business. Plans frequently offload responsibility for customer experience from the broader organization to a small set of people. To make the transition to Experience-Based Differentiation, CEOs and their executive teams need to be involved in the experience, not just bought in. That might mean that an executive vice president might have to get on the phone with a newly diagnosed member whose condition is likely to be more costly and unpleasant if it’s not managed well.
Employees, too, need to be engaged in, not mandated into, the process. Plans need to provide the information, training and incentives that employees need to satisfy customers. Customer service representatives and other employees who deal with customers need the authority and know-how to escalate tricky cases to the right resources that can satisfy their needs. And to ensure the organization can evolve with the needs of the member, plans need a systematic and continuous approach for incorporating customer insights into their efforts.
To succeed with Experience-Based Differentiation, plans must commit to a multi-year journey. In light of the complexity of plans’ business challenges and the unknowns and uncertainties of members’ changing health and financial needs, transitioning to it will not be an easy voyage. A firm tell if it’s ready for the challenge by assessing its executive team – if the CEO and his staff doesn’t place customer experience transformation as one of the company’s top three initiatives, then it’s not worth starting.
While the executive team should never relinquish responsibility for achieving the Experience-Based Differentiation objectives, they will need some help coordinating the effort. That’s why plans should consider assigning a chief customer officer or chief customer experience officer to take the lead on things like the institutionalizing voice of the customer programs and driving internal communications plans.
However, even before there’s a formally developed voice of the customer program, executive teams should find ways to listen to customers. They can start by regularly listening to feedback from customers by sampling communication like blog postings, call center calls and inbound e-mails, and by reaching out to front-line employees for their input. If Forrester’s research on leaders in other industries is any indication, the rewards of making Experience-Based Differentiation a top priority will be well worth the effort.