By 2030, the youngest baby boomers will be eligible for Medicare, and the population aged 65 and over will about 70 millionIt should be a golden age of opportunity for healthcare payers, but there is a fiercely competitive market behind the growth. About 3,850 Medicare Advantage Plans Available to seniors in 2022. According to Deft Research, The percentage of Medicare beneficiaries purchasing a plan in 2022 increased by 166%, and those switching plans increased by 50% from January 2021. Retention risk remains a glaring issue, and the motivating factors that beneficiaries say drive the switch are very well known: cost, provider network, drug coverage, and customer service.
Additionally, rapid unsubscribe rates (where subscribers switch plans within 90 days of enrollment) continue to rise (Industry ranges from 5% to 30%), which has a significant impact on the financial performance of health insurance. Poor communication is an obvious cause of dissatisfaction, but understanding the consumer experience is never obvious and all too often becomes a tipping point for members who decide to unsubscribe.
Without understanding which services need to be improved, we cannot fully understand the negative experiences our members find ‘forgiveable’ and what completely breaks the relationship.
Extraordinary rewards await payers who can provide access to key plan information, coverage details, and benefits in a seamless, holistic customer experience. Many companies in this space are adopting an IT-first technology approach at a time when key audiences like our members are rapidly adopting new consumer technology trends and are expecting ever higher levels of digital services. is no longer employed. The best digital strategy is no longer a “nice to have”. Central to future positioning, especially when his 50% of consumers say a bad digital experience can ruin the entire health insurance experience (Accenture 2020 Digital Health Consumer Survey).
research from JD Power 2021 U.S. Corporate Membership Health Plan Survey shows that the investment in transforming member information and communication pays off significantly by expanding digital options. Plans that provide members with personalized and relevant information have a 23% higher customer satisfaction score and net his promoter his score increased year-over-year, indicating good future growth . increasingly important, CMS Star Rating Given that these measures could quadruple the weight of patient experience in 2023 and impact reimbursement for PMPM and CMS rebates, we have included these measures in the STAR strategy for Medicare Advantage health insurance. forced to be an important factor.
In contrast, digital engagement was slow to scale, and plans that evolved from a disjointed and chaotic communication experience to a seamless, member-centric approach with personalization, content simplification, and digitization saw lower retention and Sales and profit growth slow down. .
When digital transformation streamlines complex back-end processes and delivers next-generation capabilities but doesn’t integrate with client platforms, customers can easily turn to competitors. If your switching costs are high, such as in a B2B context, you may not lose customers, but you’ll lose revenue to competitors who offer value-added services or better experiences.
It is critical that healthcare payers relens their business as an organized digital brand ecosystem. From other consumer-centric industries, we understand that to increase member satisfaction, organizations must leverage data, technology and multi-channel communications to create personalized welcome and onboarding experiences. I’m here. From shopping to usage to renewal.
I firmly believe that a co-innovation approach to brand and experience transformation will produce the breakthrough impact organizations need to compete and win. Organizations must deploy solutions designed to reach the people they serve, improve access to quality care, and improve health outcomes. Our team believes in carrying out that mission by focusing on her two main priorities:
- Bringing healthcare closer to people
- Solution design with health impact in mind
When talking to healthcare organizations, it may be helpful to describe and rank their digital maturity on the following scale: accidental, intentional, integrated, and innovative.
Medicare payer organizations can accelerate progress on this framework by using a joint innovation approach. The digital transformation co-innovation methodology emphasizes key strategic partnerships based on common goals and shared commitments. Innovation cannot be outsourced, but neither can it be done entirely in-house. Payers have found that they particularly benefit from his three co-innovation concepts:
Generate critical insights
After all, data is new oil, not new oil.amazing 30% of the world’s data volume is generated by the healthcare ecosystemWell-polished data can yield what we call key insights: moments of discovery that optimize patient journeys or redefine brand positioning. Key insights come from zero or first-party data, third-party data from clinical platforms, rigorous quantitative market and customer service research, mature voices of customer programs, or carefully crafted insider interviews . Strategic partners are experts in collecting and refining the right data that can be transformed into valuable insights. In other words, if you’re drilling for oil, it’s helpful to have a geologist know where to look and demonstrate the process before you start drilling holes in the earth.
Leading partners should be able to align the above with the many healthcare platforms and engagement datasets available in leading organizations. Facilitate an ideal “use-phase” experience that encourages ongoing member engagement, promotes improved health outcomes, and reduces medical and administrative costs.Investing in data supports and facilitates minimizing technical debt data orchestration.
Examples really make the concept of key insight revive.according to Waystar analysis of the company’s healthcare clientsAccording to Waystar, providers who have transitioned to electronic statements and payments have seen a 55% reduction in the average number of days they receive patient balances and a 23.4% increase in the number of full payments submitted. This is the kind of insight that can impact your entire digital roadmap to reduce payment friction to directly impact revenue and increase patient member satisfaction.
common goal
Defining shared partnership goals is not just about playing well with others. The best strategic partnerships are created with joint incentive structures that enable both parties to deliver innovation. This can extend to jointly developed intellectual property (IP), dedicated collaborative team structures, and centers of excellence models responsible for delivering innovation.
In a new study, Forrester describes this result as a “common cause” and details how organizations can use it to align innovation cycles that can maximize results through value-aligned partner strategies. .
Cross-domain approach
Organizations that have invested in consumer experience leadership are hiring from other industries to leverage that knowledge. for example, Anthem made headlines when it hired key Apple executivesAs technical debt and process fatigue stack up, organizations cut through the quagmire and seek out people known to create agile products and experiences. Digital product expertise is a new priority in the healthcare sector It is a skill that can be
A key value of working with a strategic partnership is absorbing the partner’s education, design thinking, and use case library. This partner has deep expertise in the health industry and also works outside and around the health sector to maximize trends and domain knowledge when launching brands. Experiences, digital payments, digital products for customers.
Managing Medical Loss Rates (MLRs) and Digital Transformation
The MLR standards of many private market health insurers and insurers may be of concern when planning investments in innovative consumer experiences. The plan should be to operate your business as usual while investing and launching new digital technologies and insights that underpin great experiences. Strong co-innovation partners work with the Medicare Advantage business unit to identify and leverage digital innovations underway in other parts of the enterprise organization, such as marketplaces and large group products. GoodPartners also identifies and plans investments with the greatest his ROI over a 3-5 year period, sets an annual budget, and manages the contribution of digital initiatives to his MLR spending to ensure that he is achievable. support the development of a comprehensive innovation roadmap.
take action
Medicare payers think strategically and holistically about how subscribers shop and use services after enrollment, simplifying major digital projects to improve patient outcomes, and helping them reach their next goal. By working toward it, you have the opportunity to leapfrog to category leadership. “technology” It will eventually bring them closer to the people they serve.
