In my last column, I discussed the value of information in the consumer-driven health insurance market that starts in January 2014. In this new world, those insurers that strike the right balance of managing costs and connecting with consumers in a meaningful way will likely be the winners.
There are two key factors for success in a consumer-driven market: holding down costs and retaining members. And a cohesive multichannel digital media strategy that includes social media tools - used effectively in retail and other industries but less so in healthcare – can help with both.
First, let’s look at the medical loss ratio, which is what health plans call the proportion of premium they spend on healthcare services for their members. Emergency room visits and hospitalizations are two of the biggest sources of medical loss. And members with serious chronic illnesses – diabetes, heart failure, asthma, COPD – are at the highest risk for these expenses. Can social media help these patients better manage their healthcare and lower costs? Long-term research and tracking has yet to be done, but there are many examples that highlight the potential benefits.
Promoting wellness and preventative care will be critical for health plans to attract and retain healthy members, as well as to control costs long-term. But providing world-class customer service will be just as important in a competitive marketplace.
In the 2012 Temkin Experience Ratings, which looked at customer service at 206 companies across 18 industries, the health insurance industry was at the very bottom. Another survey found that customers are willing to pay more if good service is part of the package. Clearly, if an insurer invests in customer service, there is an opportunity to take market share.
The heart of customer service is giving customers/members easy access to the information they need, from pre-enrollment and beyond. An essential component is an interactive website and related mobile platforms that function as a patient/member portal and tailor content to the individual. Whether a member enrolls as an individual or through an employer, health plans should consider enhancing the customer experience by creating tools and content that help members become more health conscious, manage their health conditions and connect with primary care physicians and other caregivers.
In an age where consumers are overwhelmed with information, they need a trusted healthcare advisor. Health plans need to offer dynamically delivered content, messages and products based on consumer profiles, behavior and engagement history. Data analytics can further help determine the needs of individual members.
Considering the poor state of customer service among health plans today, the reward for investing in this area could be improved member recruitment and retention and long-term sustainability in the marketplace. If the plan has what a member needs, and the customer service is good, the member is likely to stay, even if the premium is a little higher than the competition. Health insurance is one of those areas where consumers are willing to pay extra for good service, and the right technology and tools can help ensure success.