Health insurers must prioritize tech to improve customer experience

Customer service is king in health care. At least, it should be. Too often, transactions —scheduling, claims processing, records transfer and beyond — are time-consuming and overcomplicated. Accessing health care shouldn’t add stress to our daily lives. It shouldn’t undermine the health issues we address.

I see great opportunities for improving customer experience and consumer engagement in health care. As an analyst, I’m aware of the need for this. I’m also aware of it as consumer. As a father navigating the system on behalf of my seven children. As one of millions of Americans who too often struggle to have streamlined interactions with our insurers and health care providers. Personally, you, too, have likely encountered issues that could have been significantly better.

The COVID-19 pandemic lit a fire for insurers to adapt to market conditions. Insurers must be flexible and creative to address the internal and external forces disrupting the business. They must meet the rapidly growing demand for digital capabilities, such as the improved telehealth experience, which made life easier for many customers and providers. Health insurers must prioritize the technology required to adapt to customer expectations and improve their product and service delivery models.

Investment is key

Investments in technology can help move the industry into a new realm of improved customer engagement, in which insurers attract and retain customers more effectively. Insurers must meet evolving consumer expectations, predicated on instant and digital access to all products. They must provide a cross-channel customer experience, including digital distribution channels with self-service capabilities. They also must be able to deliver consumer protection and privacy, meeting all regulations.

Yet many insurers struggle with back-office systems that are behind the times — by decades. These systems are not equipped to handle customers’ appetites for digital experiences.

Embracing capabilities to improve the customer experience means investing in technologies that enable data-driven decision making. These include application programming interfaces, artificial intelligence/machine learning, biometrics, data sharing, digital platforms, e-signatures, identity verification, integrations (with partners and ecosystems), low code/no code platforms, mobile apps, robotic process automation tied to intelligent automation, virtual advisors and wearables.

Focusing on customers helps insurers

Deploying these technologies can enable a holistic end-to-end view of the customer and meet rapidly evolving CX expectations. The results help insurers:

1. Get to know target customers: Tools that enable improved anticipation of customers’ needs and preferences can improve the discovery and sales process.
2. Automate the quote and enrollment processes: Straight-through processing of quotes and approvals requires insurers to define sophisticated data-driven rules and pricing strategies.
3. Ease interactions to improve servicing, retention, and loyalty: Consumers want to interact via digital devices and networks for everything: paying a preimium on their phone, buying more insurance without having to speak with someone, using reward programs and more.

Healthtechs help drive consumer engagement

Health insurers can leverage thousands of healthechs (insurtechs) to access transformative technologies. A limited slice of offerings includes:

• Cloud-based consumer tech: Relying on cloud-based platforms can broaden the applications available. Consumer experience engines can modernize core-admin and transform call centers.
• Virtual care delivery: Leveraging AI for an integrated health care experience, mobile apps can facilitate affordable, accessible virtual care for primary, urgent and behavioral health needs, and wellness and health management/tracking.
• Direct-to-consumer virtual health options: DTC telehealth and medication delivery is particularly useful for eliminating stigmas around certain health conditions that may otherwise prevent consumers from seeking treatment for conditions that impact their daily lives.
• Connecting with providers: API-based web-based platforms help consumers evaluate doctors, offering real-time booking for patients and synchronized schedules for providers.

Digitize, automate and improve

This industry clearly has room to improve its value chain. Investing in the appropriate tooling can provide differentiated experiences for consumers, providers and distribution channels (agents/brokers) alike. Now is the time to rely on data, analytics and data skills to create an ecosystem of digital capabilities that will improve customer experience — and industry profitability.

Tom Scales is the health practice lead at Celent. He may be contacted at [email protected].

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