Why Health Insurers Must Improve the Customer Experience

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By David Edelman, CMO of Aetna and advisor to SundaySky

Health insurance isn’t as cut-and-dried as it used to be. In simpler times, most people thought of their coverage as a warranty of sorts—they’d get sick and their insurance company would pay. That’s far from the case now. 

Insurance has become much more complicated, especially in the commercial market that insures most individuals. With healthcare costs climbing, employers are putting more of the cost on consumers in the form of higher premiums, deductibles, copays and out-of-network surcharges. They’re also requiring prior authorization to control the use of expensive procedures. 

The situation has become so involved that close to nine out of 10 people don’t understand the most basic things about their health coverage—a major problem as they’re forced to make more decisions. Not surprisingly, many consumers feel anxious, confused, even resentful. And they’re unhappy—not with their employer, who’s actually calling the shots—but with the insurance company that manages the plan for the company.

Given that the insurance industry bears the brunt of their resentment, it’s in our best interest to correct this problem. When I joined Aetna, our #1 goal was to educate consumers so they could take better care of their health and save money in the process. We realized that improving the patient experience would help us build a better relationship with our customers.

Start with the onboarding process

Upgrading the customer experience was a critical part of Aetna’s strategy. Historically, when consumers signed up with an insurance company, they’d receive a thick book about the plan, a drug formulary and a bunch of brochures—all of which they’d toss aside. When they needed help, they’d pick up the phone and call us. We wanted to change that by educating them and making the onboarding process transparent and friendlier. 

We worked with a technology platform to create personalized videos that would help individuals understand the details and specifics of their coverage. A video-powered experience can be a very compelling way to communicate information, clear up confusion and establish a relationship with customers. By starting off on a friendly, positive note, a company can build customer loyalty over the long haul. The connection can be as effective as with human interaction, but at a lower cost.

We launched these personalized videos in the Medicare market. Because they contained personal information, we didn’t email the videos, but instead provided URLs on member cards and links on our website. Once customers registered, they would see their own unique personalized video experience. The approach was extremely effective: Well over half the seniors watched the entire 4-minute piece.

We also gave registered users access to a dashboard that was constantly updated with their personal information The website explained all the relevant terms and provided tools and links to guide them to whatever action was needed for their specific situation—to find a primary care physician or sign up for paperless alerts, for example. Everything was personalized: If they didn’t have a primary care physician (PCP), they’d be prompted to choose one in their area. If they’d already done that, we’d display the name of the PCP. Information was constantly refreshed and always current.

The results were gratifying. Calls to our service center went down, and satisfaction and renewal rates went up. Encouraged by these improvements, we broadened our approach into the commercial market and saw the same positive reaction.

Communicating and motivating

Another part of Aetna’s strategy was implementing health behavior change communications. The goal was to reach people who weren’t doing everything they should to remain healthy, or who were doing things that increased their costs. For instance, we wanted to encourage them to adhere to medication protocols and remind them about appropriate tests and vaccinations. On the financial front, we’d suggest when they could save money by going to a clinic rather than a hospital that would cost them more. 

To determine what would prompt people to do the right thing for themselves, we created a number of cross-functional teams and constantly tested different approaches. The objective was to ensure that quality wasn’t sacrificed while improving their health and saving them money. 

We also hired a behavioral economist to help us figure out how to frame incentives. That taught us a lot about what it takes to motivate people, allowing for differences in age, health condition, even geography. For example, with customers in southern California, we displayed graphics of palm trees. In the Northeast, we used images of Cape Cod instead. As mundane as that seems, it made a difference. 

Our strategies worked. One concrete measure of our success is in our Medicare ratings: Aetna had the highest number of above-four-star Medicare plans in the country. 

Changing roles and priorities

There’s no question the role of health insurers is changing. Rather than being a financial company that manages premiums and payouts, insurance companies have become partners in health. Customers should enjoy the privileges of membership, with access to resources that help them stay healthy and save money. Given how fragmented the healthcare business is, it’s our role to cut across that and help consumers navigate the system. 

That realization prompted us to relaunch the 166-year-old Aetna brand and become more consumer-oriented. Our priority was to improve patient-engagement strategies. We adopted the motto, “You don’t join us, we join you,” and we rose to the challenge of figuring out how best to do that. It starts with educating customers, but it also requires agile marketing geared to the different populations we serve, which will utilize artificial intelligence. 

It’s critical to embrace technologies and techniques like these, but at the same time, it’s important to keep things simple. Insurers must make things easy for customers. Though the business has become more complex in many ways, developments in digital technology have also empowered consumers and made it more convenient to interact with insurers and providers. There are more tools and channels patients can use to get information, updates and even healthcare, a trend that’s been accelerated by the pandemic.

Looking ahead, it’s clear that insurance companies must embrace these trends and make every effort to improve customer engagement and the customer experience. It’s in our best interest as well as theirs to help people take care of their health in the most effective, and cost-effective, ways possible.

David Edelman is a former chief marketing officer of Aetna. He currently is an executive advisor on digital and marketing transformation for SundaySky, the leading platform for video-powered experiences that inspire action. Proven with companies like Aetna, 1-800 Contacts, AT&T, Citi, Staples, UnitedHealthcare and Verizon, SundaySky delivers value from increased revenue, reduced costs, lower churn and higher customer satisfaction.