Evolving Healthcare for Healthier, Happier Customers

Jeanne Bliss, the keynote speaker at Healthcare Evolved, said it best in her presentation on building a customer-driven growth engine: “We need to change the way we unite our organizations to earn the right to growth by improving customers’ lives.”

In the healthcare industry, member expectations are increasing, and healthcare insurers are seeking answers on how to keep these customers happy and most importantly, healthy. This was the key driver behind two days’ worth of conversations during Pega’s Fifth Annual Healthcare Evolved Summit, where industry minds gathered to tackle the major issues, challenges, and opportunities facing the industry.

The question was present throughout the summit: how can the healthcare industry ensure it is providing members with the best care and experience possible, while meeting increasing demands in a new consumerism-directed market? As a result, three major themes prevailed:

Today’s customer is more empowered than ever

Today’s members are more empowered than ever before, as they’re increasingly becoming responsible for their own healthcare decisions. If an insurer doesn’t offer the highest quality of service, a member has more freedom to switch. Based on their level of empowerment, increased self-awareness of their health due to wearable technology, and experience with other industries, today’s member has high expectations, and wants interactions from healthcare providers through all channels used on a daily basis.

The healthcare industry is at an inflection point in its evolution of customer relationship management (CRM) into truly meaningful interactions. Definitions of what constitutes good customer service are universal – it’s fast, effective, and personalized. This can be achieved with an omnichannel approach that enables insurers to provide the right information at the right time in the patient’s health journey to ensure the best possible outcomes. It’s about the meeting of the common good, with the uncommonly spectacular – it’s what we call “Healthcare Evolved.”

Technology is impacting healthcare decisions

As technology improves, wearables and personal connected devices (the omnipotent “Internet of Things”) are becoming a day-to-day reality for members. Technology is changing the game, making people more aware and active in their healthcare decisions, and they want interactions with their insurer to reflect this heightened participation. Healthcare payers need to provide members with personalized, relevant interactions to keep them healthy, involved, and as members.

With this level of connected wearables and other medical devices, the potential for deeper member interactions becomes possible. This technology has given the industry the ability to use a combination of real-time and contextual data to provide even better, more personalized interactions with members. If a member has a wearable and/or connected device, such as scales, biometrics, or step trackers, care managers can add this data (with patient permission) into their patient dashboard and run business-defined analytics to track data in context of the patient profile and identify outliers/alerts that need to be addressed by a case manager. Care is further personalized, making customers much more involved, and more likely to continue with their care plan.

“Earn the right to growth”

Jeanne Bliss, the keynote speaker at Healthcare Evolved, said it best in her presentation on building a customer-driven growth engine: “We need to change the way we unite our organizations to earn the right to growth by improving customers’ lives.” For healthcare, this means knocking down silos that work independently of each other and connecting the back and front office to change the way insurers interact with their members.

Consider a situation many of us are familiar with, what Bliss called “service roulette:” the random service experience you get depending on which representative is on the other end of your conversation. Depending on the experience, you keep calling back until you get the right answer. Providing the right answer the first time (and every time) should be the rule, not the exception in member service. For this to happen, healthcare insurers need to arm everyone in their organization with the appropriate information so each patient receives answers that ensure the best possible decisions.

Healthcare insurers need to provide reliable, consistent, personalized, and informed interactions to their members, so how can insurers measure if they are meeting these customer service musts? Bliss shared three questions that everyone should ask themselves to evaluate their customer service: Were they reliable? Did they improve the customers’ life? How did the customer feel? If the customer received a reliable, helpful experience that left the customer feeling good, that’s a job well done.

It is possible for today’s healthcare insurers to achieve great things when it comes to customer service. As healthcare moves from a transactional model and refocuses on wellness/preventative care, the need to ensure an informed, involved, and satisfied member increases. The combination of connectivity, service, efficiency, and insight into each member, combined with the best technology, will create the deserved member experience and, as Jeanne Bliss said, earn insurers the right to keep them as members.