As the worldwide pandemic begins to subside, well being plans are confronted with a brand new set of challenges. For a lot of customers, the previous 12-plus months have been tense, to say the least, and for well being plans, holding their members knowledgeable, happy and (most significantly) wholesome has by no means been tougher
And but, at the same time as well being plans deal with the excessive “diploma of issue” on this present local weather, member satisfaction has by no means been extra very important for Medicare and Medicaid plans’ monetary efficiency. With Shopper Evaluation of Healthcare Suppliers and Techniques (CAHPS) survey measures quadruple-weighted for contract yr 2021, accounting for 32% of plans’ total Star Ranking, the stakes for delivering member experiences that drive satisfaction are excessive. These plans with stable member satisfaction ranges should work to keep up their standing, whereas these which can be falling behind must rapidly step up their efforts.
What can plans do to enhance the general member expertise, in flip giving themselves a a lot better likelihood at positively impacting their CAHPS scores (and Star Rankings)? Listed below are 5 issues they need to be enthusiastic about proper now:
- Make the healthcare expertise handy. In right this moment’s world, Amazon has turn into the gold commonplace in relation to providing customers a seamless expertise that makes it simple for them to rapidly discover and buy what they want. Suppliers resembling Devoted Well being, Oscar and Clover Well being have taken an experience-centric method with various levels of success, however plans ought to know that members anticipate the identical degree of comfort and repair they’re used to on this more and more on-demand world. This may embrace providing simple on-line entry to kinds, quick cellphone wait occasions (or higher but, an computerized call-back possibility), and dwell brokers throughout common enterprise hours. Plans are additionally tackling the digital divide in relation to healthcare entry. Working to unravel limitations introduced by the digital divide won’t solely result in increased ranges of satisfaction and CAHPS scores, however will improve the worth the member receives from the plan.
- Personalize the member expertise. Well being plan members usually are not “one-size-fits-all,” so the plan’s engagement technique with members shouldn’t be both. Within the client world, eating places perceive this and have mastered it—should you’re a daily at Starbucks, for instance, your expertise on the corporate’s app is tailor-made to you based mostly in your earlier exercise and preferences. Relating to healthcare, plans ought to know the channels and platforms their members use and the sorts of messages they like to obtain. An efficient multi-channel combine usually contains electronic mail, textual content messages, cellphone calls, conventional mail, social media, interactive voice response (IVR) and in-person interplay (when out there, after all). On a bigger scale, plans must also have packages and providers in place that meet members’ particular particular person wants.
- Talk clearly. Broadly talking, healthcare is a sophisticated matter that may rapidly turn into complicated for some and downright daunting for others. When that is the case, plans want to clarify advanced medical terminology in plain, easy-to-understand language whereas avoiding cliches, idioms and slang utilized by medical insiders. Graphic design additionally performs a job—easy and simple design helps readability.Understanding what drives member engagement, conduct and satisfaction via behavioral analysis exhibits that language and design that resonates with folks’s beliefs and values drives satisfaction as a result of they really feel a connection to the messaging from their well being plan. Most significantly, telling members what they need to be doing isn’t sufficient; additionally they want to clarify to them why it issues.
- Grow to be an training supply for members. When well being plans turn into a go-to supply for up-to-date and correct healthcare data, they turn into a useful resource their members more and more rely on. This began to shift through the top of the pandemic final yr, as insurers turned the fourth most trusted supply of coronavirus data behind solely the CDC, WHO and healthcare suppliers, and forward of TV and on-line information. This makes it crucial for plans to offer data and entry to sources that members could not have even recognized existed, together with these supplied via group partnerships. One other greatest observe is to anticipate potential dissatisfaction amongst members and talk what they need to do if they’ve a nasty expertise. Finally, members respect this degree of transparency.
- Proactively handle recognized member issues. Many plans use mock surveys to gauge sentiment and determine sad members, however the true worth (and alternative) comes when plans handle the problems which can be raised, ideally in actual time. Taking motion on the widespread issues raised in mock surveys— whether or not it’s making vaccine data simple to seek out or linking straight from the survey to care navigators or behavioral well being sources—is an efficient approach to enhance the general member expertise earlier than the member receives the precise CAHPS survey to finish.
Ultimately, plans must place themselves as a invaluable useful resource in members’ healthcare journey that is aware of and speaks to these people in a customized approach. It’s not about simply getting members to care. It’s additionally about holding them educated and knowledgeable about the advantages of the plan itself and the sources out there that make the member expertise even higher.
Photograph: Tero Vesalainen, Getty Photos