Analytics Based Member Experience Management
The Situation Today
The healthcare payer industry is in transition. Payers must deal not only with the rising costs of delivering care to their members but also with figuring out how to provide services to an influx of new members while keeping administrative costs below the appropriate medical loss ratio (MLR) thresholds. To succeed, payers must adopt a customer-centric approach, to deliver a consistent and differentiated experience to their existing and prospective customers across all channels of interaction.
How HCL Can Help
HCL has created a comprehensive analytics driven framework to help health plans offer a differentiated experience to their existing and prospective customer base. The componentized solution which is available on the cloud will help a plan to quickly scale up to address the demand on their IT technology and infrastructure while providing the flexibility to choose the modules that can complement their existing systems.
The core element of the framework is an analytics module which aggregates data across multiple sources, to derive valuable customer insights that enable real-time decision making (using HCL Dynamic Recommended Action) across all levels of the organization. The analytics module is in turn supported by a CRM platform, a Campaign Management module (HCL CaaS - Campaign as a Service Platform), an integrated portal framework, and a multi-channel communication layer to execute the actions derived from the analytics module.
What You Can Expect
HCL’s analytics based member experience management solution provides you with the following benefits:
- An analytics-driven CRM module with an integrated feedback loop to create focused campaigns based on members’ attributes
- Analytics to formulate focused interactions, targeted campaigns, and care management interventions to improve health and reduce member churn
- Enhanced customer experience through a system that provides “Best Value Plan” recommendations on the basis of individuals’ predicted usage, plan features, and the network of providers
- Efficient monitoring of member experience linked to business metrics
- Enriched interaction with members through Web 2.0 functionalities such as social media, gaming, and more
- Lower cost of health plan ownership
- Scalable and viable models for BI platforms with statistical models to identify and predict member switchover trigger