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Why Health plans need to prioritize member experience

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Over the last few years, the healthcare sector has had to adapt to multiple tech advancements and new challenges. Health plan providers and hospitals need to put in the effort to track and improve patient and member experiences. 

With customers becoming more demanding about what they expect from health plans and healthcare organizations, it’s up to the healthcare industry to create meaningful patient and member experiences that secure their customers and improve bottom lines. 

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Why focusing on member experience is necessary

Patient and member experience is becoming increasingly important for customers as they weigh their options, for treatments as well as health plans. 

There's a financial impact if you don't

Healthcare providers are finding it a challenge to improve patient experience and patient satisfaction levels. This is directly tied to their organizations’ financial health, as value-based payment models are using member satisfaction as a key metric for reimbursements.

CMS (Centers for Medicare & Medicaid Services states that approximately $1.5 billion in value-based incentive payments were at stake for hospitals in 2016. This is why performing well in CMS mandated CAHPS and HCAHPS surveys (Hospital Consumer Assessment of

Healthcare Providers and Systems) is a must for any healthcare organization based in the USA.
Research shows that there is a relationship between HCAHPS scores and a hospital’s profitability. It is likely that a similar link exists between STAR ratings and health plans.

Lower member and patient churn

A focus on creating a positive patient and member experience improves customer satisfaction levels. Customers who are satisfied with their experience at key touchpoints with their health plan providers and hospitals will keep it in consideration and are unlikely to churn. 

59% of patients spend a lot of time researching options before choosing a healthcare provider. Patient and member experience are now key considerations for customers before they pull the trigger. 

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Better patient and member engagement

Patient or member engagement is the relationship between healthcare providers (hospitals as well as health plans) and patients working together to achieve better member experience, improve health and reduce costs.

A holistic member experience goes hand in hand with high levels of patient engagement. Patient engagement helps health plans in offering personalized experiences which can contribute to a customers’ decision to remain with your organization. 

Increased engagement requires regularly taking feedback from customers and equipping healthcare staff with patient history, preferences and metadata. This is especially important for customer-facing staff, as having employees be cognizant of their treatment history can feel reassuring.

Improved patient engagement shines in improving overall health in a community. This is done by making the patient more knowledgeable of their treatment, their plans’ coverage and by regularly following up on the same. Knowledgeable patients are healthier and happier, which makes them less likely to churn.

Focusing on member engagement also ensures that they are less likely to need expensive treatment, and can manage their health more cost-effectively.

Member and patient satisfaction will play a bigger role than customer loyalty

91% of Americans surveyed have said they are likely to evaluate other options if not completely satisfied with their current healthcare provider. 88% of dissatisfied patients claim they would switch providers.

Different demographics, different considerations

Businesses today have the unenviable task of fighting for market share with demographics that are polar opposites of each other. Access to the internet, and by extension, more information is leveraged by each demographic in different ways. 

58% of Millennials surveyed say responsiveness to follow up queries via phone or email communications outside of their appointment is extremely important to their overall satisfaction with their plan or provider. Their needs to be factored in while developing a member experience program just as much as those of older members.

The risk of churn is high if member satisfaction not achieved

92% of millennials are likely to switch providers when satisfaction is in question. Member priorities are clearly shifting towards getting a positive experience from their health plan/ healthcare provider. 

Acquiring a new customer is far more expensive than retaining existing customers, which is why plan providers and hospitals must incorporate member feedback to improve the overall experience. 

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Drivers behind patient and member satisfaction

Choosing a hospital or health plan is just the beginning of a typical patient or member journey. Retaining customers for the long term requires that they are satisfied with your services. Customers typically face issues with

Wait times

50% of members reported that their satisfaction with healthcare services can be improved by shortening wait times. This is clearly a sore spot for a lot of people, and one that is inhibiting customer loyalty. 

Conducting healthcare surveys can help find out what exactly is causing delays, and which touchpoints can be quickly improved. Additionally, augmenting your services with a comprehensive telehealth platform can reduce the burden on healthcare staff by cutting down on in-person visits.

Clarity on coverage

Members tend to be more satisfied when they have clarity about their plans’ benefits. This may sound like a simple fix, but simply putting all required information on your website is not enough. Many people are unaware of the full extent of benefits covered by their plan. This can be improved with a more personalized member experience, where health plan staff regularly communicates with members and keeps them updated.

Out of pocket costs

Irrespective of demographics, this is a big factor in how a member perceives their experience with a health plan or health care organization. Medicare Advantage plan members surveyed who were happy with their plan providers’ ability to provide savings on out of pocket costs had an NPS® of 80% vs 26% for unsatisfied members.

Improving member experience across the board

Addressing issues with key patient drivers is where providers need to step up. Tech advancements have made it easier for health plans to engage with their customers, and improve satisfaction levels across the board.

Omnichannel feedback management

Healthcare survey software like Voxco allows plan providers to reach out to members across any channel for holistic feedback management. This can help

  1. Uncover insights into issues faced by members
  2. Improve patient engagement
  3. Drive word of mouth marketing via NPS® feedback management

However, customer feedback often tells you things that you may not want to hear. It’s an emotional topic, and experience management teams need to be prepared to use this feedback constructively. Regular feedback also helps improve brand image in your members’ eyes and reduces the risk of churn.

Telehealth

Different demographics have varying preferences about how they want access to care. Younger generations are more likely to rely on telehealth services, while older patients would prefer the traditional patient and member experience.

However, the pandemic has made even older demographics more receptive to telehealth services, which is why health plan providers need to ensure that they’re seamlessly offering access to telemedicine.

Patient data needs to be easily available to them, and patients need to have the option to seamlessly switch between online and offline appointments as per their need. 

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