Open for Business: Four Ways Healthcare Can Reduce Confusion and Improve Member Experiences During Enrollment Season

Updated on October 30, 2020

By Keith Wicklow 

Healthcare payers are preparing for the kickoff of open enrollment season in November — traditionally, a confusing and frustrating time for consumers. Results from a Policygenius survey noted 96% of Americans couldn’t define some key basic terms like deductible, out-of-pocket maximum and coinsurance. Only 40% felt very confident in selecting the right plan. Bewildered consumers often throw up their arms in frustration and spend just minutes choosing a plan, putting themselves at serious financial and physical risk with the wrong coverage.

Complicating matters today: a novel pandemic that has taken employees out of the workplace for that annual insurance briefing with their carrier, which provides an efficient way to increase understanding and build the member relationship on a personal level. That can’t happen now, and further, many have lost positions due to the economic slowdown. As a result, insurers will likely face a much higher volume of contact center calls, questions and concerns from members than before COVID-19.

Thankfully, consumers are increasingly well versed in the online realm and have digital expectations of payers to the likes of the digital retailers they shop with everyday, like Amazon and Apple. Members are ready to do business with payers  and carriers who are well prepared for a digital future and benefits it can bring to the customer experience (CX). These savvier members are already using digital tools to manage their healthcare, just as they do for other services handled online. Companies that have been slow to embrace digital clearly have a greater task in front of them in dealing with the looming open enrollment period, but it’s not insurmountable.

Regardless of where your organization stands, paying attention to the following four areas can help reduce consumer confusion, improve CX, add to your bottom line and build loyalty. 

Emotional rescue

Emotions are running high these days due to COVID-19. Plowing ahead in the same manner as always will set the wrong tone, whether it’s for open enrollment or any other purpose. Healthcare communications must now evoke empathy; recognizing that these are challenging times and showing gratitude to customers who select you for services will go a long way toward putting patients at ease.

It’s called emotional intelligence — and it doesn’t require a major overhaul, just a focus on messaging and its delivery. As an example, Kaiser Permanente quickly modified their existing digital CX strategy for member onboarding with empathetic messaging when the pandemic hit. What’s more, they leveraged sight, sound and motion, providing a video-powered experience (VX) that made their communications particularly compelling. This not only rescued members from confusion, video helped them onboard more quickly and begin taking advantage of their health plan to better their lives.  

The right VX can ease processes and enrich experiences. And in addition to explaining “how” to enroll, it can explain “why” using digital tools add value and help members achieve their goals. 

Timing is everything

Consumers have increasingly been testing the digital waters. Led by the success of the remote-working migration, they’re now diving in. According to a recent study by, patients are relying on online resources nearly two times more than they do on referrals. Things will not go back to the way they were, but at the same time, this unique set of circumstances presents a unique opportunity, especially with open enrollment. 

Remember, this initial touch point comes at a time when the member is motivated to learn new behaviors and take recommended actions. The right CX can show them how easy it is to work with you, enabling the relationship to begin on a positive first step that can be cultivated to produce greater loyalty and reduce churn. 

Yes, timing can be everything. And it’s also crucial to be there with the right answers, right when the member needs them. 

UnitedHealthcare (UHC) has done very well in educating and supporting confused members exactly when important health decisions are being made. Video has been particularly useful for demystifying coverage, out-of-pocket costs and other plan details. UHC realized the power of employing VX at critical moments along the member journey, such as the onboarding process and upon a medical claims moment, an approach that can be adapted for open enrollment purposes. 

By using a modular approach to video messaging, UHC ensures members won’t have to sit through all-encompassing videos or sort through a paper packet of collateral. Based on an individual’s data points, they can deliver an easily digestible VX to meet the member’s  exact needs. For instance, upon the first login to the account portal, the member’s own personalized video experience walks them through their healthcare plan for the upcoming year. 

With video as a memorable and engaging part of the member experience, UHC gained the full benefits of individualized communication while lowering service expenses, which produced the same value as an actual human interaction. Nearly 100% of members who have gone through the process reported they were satisfied, and 8 of 10 watched the videos to the end, all of it leading to fewer service calls, higher customer satisfaction and greater cost efficiency for the company.

Get personal

A March 2020 study conducted by HealthSparq included a survey of more than a thousand U.S. residents. It produced some interesting data about changes in consumer behaviors related to healthcare:

  • 60% of respondents said they’d appreciate their health insurer identifying that they are at risk of developing a condition and sharing recommended strategies for prevention.
  • 59% said they’d have greater trust in their carrier’s transparency tools and websites if they used personalized information. 
  • 56% said they’d be more likely to take action with health communications that use personal information.

Five years ago, given the public’s wariness of such tactics, these survey results would have been much different. Getting personal by addressing someone on an individual level — either through personalization or something like interactivity where their input is required — is now not only acceptable, it’s preferred.

And that’s naturally very useful for establishing emotional intelligence in communications. 

Keep it simple

Choosing the right physician for a member’s needs can be a taunting and overwhelming task. As we all know, Covid-19 has had a tremendous impact on how people are handling their healthcare. More than ever, consumers are becoming more proactive with their health and who they’re seeing as a physician. As such, health insurance providers must take this into consideration when they are providing information that’s important to today’s members. When members choose a physician, 56% of respondents in the survey said access to relevant and accurate information online is make-or-break as to whether they will use that healthcare provider moving forward. Simple information such as the physician’s location, if they use telemedicine for their practice, patient/care rating and in-network coverage are essential for members to have upfront. And not only does content need to be delivered in a clear and engaging way, digital tools need to be just as understandable and simple to use, such as using the mobile app or checking Flexible Spending Account balance. 

Simply put: providers that don’t provide a solid CX during the enrollment period may experience more membership churn, meaning less growth in the future. Let’s not forget, major leading retailers who have developed sophisticated CX strategies and have set the bar for consumers’ digital expectations have been more likely to explore new markets, even within healthcare.

Patient empowerment is important and more are handling healthcare from their couches, on the road, and on an assortment of digital devices. Be sure to keep it simple, keep pace, and you’ll always have a place alongside them. 

Keith Wicklow is with SundaySky.

The Editorial Team at Healthcare Business Today is made up of skilled healthcare writers and experts, led by our managing editor, Daniel Casciato, who has over 25 years of experience in healthcare writing. Since 1998, we have produced compelling and informative content for numerous publications, establishing ourselves as a trusted resource for health and wellness information. We offer readers access to fresh health, medicine, science, and technology developments and the latest in patient news, emphasizing how these developments affect our lives.