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How Understanding Unhappy Members Makes Healthcare Better for Everyone

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Why focus on unhappy members?

When members have a bad experience with their healthcare provider, they give negative feedback. This will have a negative effect on the healthcare provider’s CAHPS score (Consumer Assessment of Healthcare Providers and Systems), by lowering their star rating. 

Low star ratings will manifest into membership churn, as members will shift to health care providers with higher star ratings, resulting in reduced rebates that will in turn negatively affect the quality of service they can deliver. Inevitably, this will further lower their CAHPS score and star rating.

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Essentially, American healthcare providers rely on good star ratings in order to do well as this downward spiral can have severely detrimental effects on them. This enforces the importance of finding the root cause(s) of members having bad experiences and eliminating it as soon as possible. 

The best way to do so is by understanding unhappy members and their issues with your organization, as well as their expectations of it.

Unhappy members can give you insights about where the flaws lie within your organization. Whether they had trouble while booking an appointment or were dissatisfied by a doctor’s bedside manner, they will be best at pinpointing where your services are lagging and where the issue is in the entire member journey. This creates opportunity gaps for providing better healthcare by identifying the pain points within the chain and attempting to eliminate them.

Identifying and targeting the patients who are most likely to switch providers can lead them to becoming loyal to your practice if the right steps are taken. Providers that can obtain information on their problem areas and use this information as an opportunity to address and eliminate customer pain points, and significantly improve member experience as a whole.

How to deal with unhappy members?

  • Find out the root cause of the issue
  • The first step to eliminating pain points is to identify what they are. To do so, providers can use follow up Healthcare surveys to send their members, asking them open-ended questions related to their issue. This will help find out their experience through their visit(s), and will also help identify their expectations and where they think the issue arises. After this is done, the provider must aim to understand and rectify all the problems identified.
  • Maintain a line of communication with the members
  • It is important that members feel heard and understood, and know that their complaints are being taken seriously. To do so, it is important to communicate with them through phone call or email to understand their cause of concern and to let them know that their feedback will be used to improve their services.
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  • Research pain points in-depth 

Once the root cause for members having bad experience is identified, providers must send out more surveys in order to investigate if multiple patients are having similar issues. If multiple members are facing the same issue, it becomes clear that the provider isn’t providing adequate service and they must improve on members’ pain points. 

Additionally, Healthcare surveys should ask multiple follow-up questions that are relevant to pinpoint where exactly the organization’s weak points lie so that they can be eliminated from the root. Providers must find out what the negative experience drivers are, whether that be with the doctors, receptionists, wait time, or something else. By identifying the party at fault, providers can get a better understanding of why the issue arose in the first place and who they must communicate with in order to fix it.

  • Get back to the patients/members

Clearly communicate with the patients about issue resolution & rectification via multiple channels. Inform them about the changes that the organization is going to make in order to eliminate the problem from ever occurring again and the ways in which they are going to improve to meet member expectations. Members need to know what the organization is going to do to eliminate pain points so that they realise that their feedback is being taken seriously. By providing a high level of care and attention to your patients, they will become happier with your service and may become loyal customers who then spread a good word about your organization.

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Just as negative feedback can have tremendously negative effects on your organization, good feedback can do just the opposite. This is why understanding unhappy members through healthcare survey tools in order to turn them into happy members can exponentially improve the services you provide and inevitably your star rating as well.

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