By Brian Damiani, MBA, CHCIO, Founder and CEO, Wendigo Advisors

In my nearly twenty years working with health insurance carriers I have seen an amazing number of good things come to pass. From the increasing adoption of new technology to the adjustment to value-based reimbursements and the ACA/Medicaid expansion efforts that brought insurance to those who traditionally did not have access. This year will be no different with many companies dealing with new interoperability requirements and benefit changes related to COVID-19. Having an insider’s perspective allows me to see the good side of the health insurance market more easily than most.

However, health insurance companies continue to have some of the lowest customer satisfaction ratings of all companies in the U.S.—rivaled only by cable and internet service providers. While the health insurance industry overall needs some definite improvement there is no reason why they cannot improve relationships with their members. The problem is that the current methods of communicating with members are not effective and, in many cases, actually reinforce the negative attitude members have toward their carriers.

Take members with chronic conditions as an example. According to the CDC approximately 60% of adults in the U.S. have at least one chronic condition and this number increases with age. Additionally, more than two-thirds of deaths in the U.S. come as the result of chronic conditions such as diabetes, hypertension, and heart disease and it is estimated that 90% of the $3.5 trillion annual health care spend goes toward treating chronic conditions.

It is clearly in the best interest of health insurance carriers to work closely with members with these conditions yet members’ trust in these companies remains at all-time lows. According to a recent JD Power survey only 36% of members believe that their health insurance carrier has the members’ best interests in mind and only 25% view their plan as a trusted partner in the members’ health and wellness.  This study also showed that customer satisfaction is directly linked to customer engagement. One of the key components for improving trust, and thereby health care outcomes, is member engagement. Improving how companies interact and communicate with members is key to positively affecting this dynamic.

Traditional disease management efforts by health insurance carriers tend to leverage printing and mailing educational materials to members or placing robocalls in an effort to get members engaged. These methods have resulted in very limited success. However, as new communications technologies come in to play they can, and should, be leveraged to allow members to receive communications in the most appropriate and effective way for that individual, and to allow plans to share critical health related information in a more interactive and conversational way.

Imagine if we could change the traditional, one-way, “fire and forget” communications to efficient, bi-directional, conversations between plans and members. Members would be more receptive to advice and information shared by their carrier. Carriers would be better able to communicate the benefits of programs and would get more traction on efforts to reduce things like re-admission rates and chronic disease impacts. Following up on procedures to ensure complications are caught early also becomes easier. Through these methodologies engagement, satisfaction, outcomes, and trust all increase.

So how do carriers accomplish this? They need technology solutions that not only improve conversations with members but also improve internal administrative requirements such as reducing the number of communication templates while increasing the number of communication channels available for use. Increasing the personalization of communications to members helps them feel less like a “number” and more like an important consumer of the company’s services. All of this can help in changing how members view and interact with their plan carriers.

 

Wendigo Advisors
Wendigo Advisors provides CIO-as-a-Service in part-time and interim roles to health plans across the US.