Crushing Demand Presents Opportunity to Rewire Member Experience

This is the time – between enrollment periods, even while handling fallout from the last enrollment – to transform your member experience. Now that consumers are more engaged in and responsible for choosing health plans, their overall experience and the role of service will be increasingly important. In addition, state and federal exchanges are likely to provide quality ratings for health plans, so customer service could well be a factor in member sign-ups.

Leading payers will use the challenge of crushing demand as an opportunity to rewire operations to deliver a differentiated experience based on a clear understanding of consumer needs. Payers will want to develop more flexible and scalable models to handle uncertain demands in capacity and may want to contract with external providers. All will need to optimize operations by looking at where cross-training, skill building, and reassignments could benefit consumers.

To build a future customer-service vision, payers need to understand what consumers really want by segment and channel. They've got to identify consumer needs and the value propositions specific to those consumers. Then select the operations and technology best designed to provide the signature moments that make the experience palpable for consumers. Ideally, you can focus on value propositions that are most consistent with your brand and mission.