Disjointed Experiences Cost Insurers Members and Money: The Bleak Reality of Member Experience with US Health Insurers

Customer experience (CX) has become increasingly important to healthcare consumers and regulators. For example, for the 2023 plan year, CX metrics will make up 57% of Medicare Advantage star ratings*.

The health insurance industry’s average member experience is finally “OK**”, but still low compared with other industries. Now is the time for health insurers to invest in solutions that help them provide an exceptional—and differentiated—member experience.

Our commissioned research study, conducted by Forrester Consulting, highlights:
• Ways payers financially benefit from investing in CX
• The top three business and member-focused priorities
• The top 10 CX-related challenges facing health insurers
• Where payers intend to invest over the next 12-36 months
• Where health insurers should be investing to improve CX

The research shows the disconnect between the orchestrated experience members expect and the disconnected touchpoints payers provide. It highlights journeys that matter most to members, versus where insurers are focused today. And it challenges the conventional thinking that insurers must focus on operational efficiency at the expense of experience.

* https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/new-stars-ratings-for-medicare-advantage-prioritize-customer-experiences
** https://www.forrester.com/report/the-us-health-insurers-customer-experience-index-2021/RES176205