April 15, 2013


Delivering exceptional Member Experience: Need of the hour?

The health insurance environment has gone through significant changes over the past few years and continues to evolve at a rapid pace. There is an industry-wide focus on ways to manage the rising cost of care, improving quality and achieving improved health outcomes. By 2014, millions of newly insured individuals will be joining the system and health plans will be under more pressure than ever before to improve the quality of services and deliver greater transparency to members, providers and other stakeholders.  Lack of a focused strategy that differentiates health plans in terms of enhanced customer service interactions and dedicated retention programs can significantly impact business growth.

Current statistics indicate no major improvement in member experience in the health insurance industry over the last five years. To make matters worse, member expectations continue to rise, with demand for fast, consistent and accurate information as well as the ability to communicate across different channels such as mobile, web, email, kiosks etc. All these call upon payers to collaborate better with members and become more proactive about improving member satisfaction.

Many health plans are yet to adopt innovative member engagement and technology strategies to determine how they are interacting with the members. These strategies focus on superior customer service and advanced, real-time member data profiling providing a 360-degree view of the health plan member interactions. Adopting such a model is a transformational change for payers and will require new technology investments, cultural and behavioral change and greater understanding of member preferences. These investments will play a big role in improving member enrollments, reducing costs and promoting overall member wellness.