This action might not be possible to undo. Are you sure you want to continue?
The 7 Things Your Health Insurance Customers Are Not Telling You
And What To Do About Them
With The Patient Protection and Affordable Care Act adding 40 million new customers and with individual and Consumer Directed Health Care (CDHC) plans exploding in popularity. Right at the fore is customer service. Technology trends like social media have ignited a new consumer activism whose reverberations have only begun to be felt. Customers have become more diverse and more demanding. Insurers operating in this “new normal” face an unprecedented level of competition. and the commensurate risks of failure. we surveyed 1.The seismic shift in power to the customer has come at last to the US Health Insurance market. US health insurers will need to invent new healthcare solutions for competitive success.000 customers in the US between late December 2010 and early January 2011. . Using a web-based questionnaire. From that research we distilled the surprises and secrets of customer service that together outline the alchemy behind superior customer service performance. health insurers must understand current customer perceptions. the entrée to productive customer relationships that will withstand the test of time. wanting service offerings. Accenture Healthcare conducted a survey of customer attitudes toward the customer service practices of US-based health insurance providers. To help crystallize these factors. experiences and communications increasingly on their own terms. unparalleled opportunities to expand. They have also become more technology savvy and less shy in broadcasting their experiences. as well as how to shape (and improve) these perceptions for future growth. With customer service emerging as the “X Factor” of high performance.
Moreover. Despite their general satisfaction. they would be unwilling to buy them. our research found that 42 percent of customers have a high degree of satisfaction. customers feel satisfied with their health insurance providers. customers are divided about equally on their feeling of loyalty to their health insurer. few would purchase more services from their health insurer. if offered. Loyalty and Advocacy Not at All How satisﬁed you are with the Health insurance companies you do business with today? Extremely 7% 42% Do you trust Health insurance providers to keep your personal Health information conﬁdential? 14% 39% How loyal you feel to your Health insurance provider? 26% 23% The extent to which you will buy more products/services from your Health insurance provider? 41% 7% % respondents giving top 3 of 10 boxes ratings % respondents giving bottom 3 of 10 boxes ratings . in fact.Seven Surprises About Customer Service Surprise #1 Being satisfied with high customer satisfaction is a mistake. current satisfaction levels do not translate into loyalty and revenue opportunities. while only 7 percent indicated that they would be willing. while only 7 percent have a high degree of dissatisfaction (Figure 1). Figure 1—Current State of Satisfaction. However. 41 percent of customers indicated that if offered additional services. Overall.
We found that 20 percent of customers indicated that their expectations of the customer service function increased. Figure 2—Customer Service Characteristic Importance & Satisfaction Having employees who are knowledgeable and well-informed? 85% 47% 79% 48% 79% 39% 78% 37% 41% 76% 39% Having customer service available at convenient times (for example. 41 percent stated that their expectations increased in the past five years. 80 percent said that they “expect customer service to be easier/more convenient to obtain” and 75 percent said that they “expect customer service representatives to be more knowledgeable and better trained.” Yet for all five of the characteristics rated most important. In fact. after work and weekend support availability) The amount of time I have to wait to be served The amount of time it takes to completely resolve my issue or problem Having customer service people who can deal with my issue without having to refer me to another person % respondents rating characteristic as “important” (top 2 of 5 boxes) % respondents rating “satisﬁed” with characteristic (top 2 of 5 boxes) . They want greater ease and better support: When asked how their expectations increased.” As customers are growing more exacting. While “having employees who are knowledgeable and well-informed” ranked as the most important customer service attribute. including “the amount of time I have to wait to be served. the gap between customer expectations and insurer performance was significant (Figure 2).Surprise #2 Payers are not keeping up with rising customer expectations. their health insurers are struggling to pass service muster. just in the past year. our research found a large gap between what matters to the customer and the perceived performance of health insurance companies. The current tenuous nature of customer loyalty to their health insurers may have its roots in their rapidly rising customer service expectations. several other qualities were rated nearly as important. Furthermore.
In fact. more than one-third of the people surveyed said they regularly experience long hold times and have to repeat information. Figure 3—Top Five Frustrating Customer Experiences & Frequency of Occurrence Having to contact customer service multiple times for the same reason Dealing with customer service agents who cannot answer my questions 77% 30% 76% 28% 74% 35% 74% 38% 41% 17% 73% Having to repeat the same information to multiple customer service agents Being on-hold for a long time when contacting customer service Dealing with customer service agents who are unfriendly or impolite % respondents rating “extremely frustrating” with the situation (top 2 of 5 boxes) % respondents rating “encounter this a lot” with the situation (top 2 of 5 boxes) . our research suggests that health insurers will need a more balanced approach— one that does not lose sight of service fundamentals. for example. When asked to rate their most frustrating customer service experiences. the five that rose to the top are also the most basic building blocks of the service experience (Figure 3). our research shows that customers get highly frustrated when their basic expectations are not met. Figure 3 also reveals that these frustrations happen far too often. While it could be tempting to focus improvement efforts on areas where service expectations are changing.Surprise #3 Most payers are struggling with service experience basics. Health insurers have no chance of beating the competition in a game of rising expectations if they cannot consistently meet the minimum requirements.
Our research shows that only 11 percent of respondents strongly agreed that the increased use of technology in customer service has improved the level of service significantly in the past five years (Figure 4). While technology lends itself to handling higher service volume. implementing advances such as automated phone attendants. and/or value to them. and/or value to the business. To date. From a service perspective. preferences. despite their willingness to invest in service advances. Only 10 percent of respondents strongly agreed their health insurers “tailor my customer experience to match my needs. a key tenet of consumerism is the ability to tailor the experience to match the customers’ needs.” More than twice that amount (22 percent) strongly disagreed. Agree 17% 27% 48% 11% Strongly Disagree Somewhat Disagree Somewhat Agree Strongly Agree . however. given an increased focus on “patientcenteredness” across the health system as a whole. mobile applications) has improved the level of service significantly in the past five years. it has tended to have little impact on individual experience. live chat via the Internet. preferences. Figure 4—Use of Technology in Customer Service Disagree The increased use of technology in customer service (e. Payers have made a huge investment in customer service technologies over the years. self-service on a web site. these technology advances have delivered tangible benefits in the form of higher self-service rates and lower handling time.” In contrast. Similarly. automated phone attendant. For the most part. health insurers seem to have failed to provide the personalized experience customers crave. live chat via the internet. Crafting a personalized service experience will only become more important in the post-reform marketplace. only 9 percent agreed that their health insurers’ “communications make me feel a connection to them. is dramatically improve the customer service experience.g. 32 percent strongly disagreed.Surprise #4 The benefits of technology investments have been decidedly one-sided. self-service on a website and mobile applications. What they have not done.
more than 7 times as many customers (44 percent) strongly oppose degrading quality for the sake of price (Figure 5). In contrast. In fact. The message that comes across loud and clear is that health insurance customers generally are more value-driven then price-driven. Such findings should act as a wakeup call for those who make the service investment decisions. Figure 5—Price Tradeoff Preferences Disagree Lower levels of product quality if it ensures I get the lowest price Agree 61% 3% Lower levels of customer service if it ensures I get the lowest price 44% 6% Lower levels of product options if it ensures I get the lowest price 41% 7% Lower frequency of communications if it ensures I get the lowest price 41% 28% 23% % respondents agreeing (top 3 of 10 box ratings) % respondents disagreeing (bottom 3 of 10 boxes ratings) . our research shows that only 6 percent of customers are willing to compromise on levels of customer service in exchange for a lower price. Our research clearly shows that customers are not willing to trade off customer service options or quality in exchange for a lower price.Surprise #5 Service quality trumps price.
and 8 percent are actively engaging in conversations about payers.Surprise #6 Customers are social. health insurers are not leveraging social media in any major way. 54% 5% Agree 28% 21% 52% 8% 58% 6% 23% 66% 5% % respondents agreeing (top 3 boxes) % respondents disagreeing (bottom 3 boxes) .). friends. Yet our research also finds that. The use of social media sites has increased my overall awareness about products and services from Health insurance companies I did not know of before.. has increased my overall engagement with my current insurance company and their brands.. bulletin boards. yet payers are not socially engaged. MySpace. etc. Comments posted on social media sites inﬂuence my opinions about Health insurance companies or brands in general. currently. I tend to trust comments about Health insurance companies/brands on social media sites posted by people I know (family. social channels are becoming an increasingly important way of sharing information—40 percent read about healthcare through these channels at least a few times during the year. For these respondents. Social media has come of age and has begun to redefine not just individuals’ personal relationships. Figure 6—To what extent do you agree with the following statements? Disagree I tend to trust comments about Health insurance companies/brands on social media sites posted by people I don’t know. but their business ones as well. Facebook. Twitter. and only 5 percent say that their use of social media sites has increased their overall engagement with their current insurance companies and their brands (Figure 6). The use of social media sites like blogs. Our research shows that a majority of respondents (76 percent) went online looking for information about health insurers at least a few times during the past year. Only 6 percent of respondents agree that the use of social media sites has increased their overall awareness about products and services from health insurance companies that they did not know of before. co-workers.
utility. In fact. The individual consumer’s voice will undoubtedly gain more influence. as the “consumerism” trend in health care increases in line with increased growth in the Individual market. Figure 7—Customer Motivations to Switch Providers Required by change in company open enrollment options 45% Other reason(s) 28% 18% Price Product/service options were too limited 7% 6% 5% I lost trust in the company Overall poor quality of the customer experience . we expect customer service performance to emerge as a source of differentiation and contributing factor to loyalty and retention—much like it is in other industries today. However. insurers so far have been granted some immunity against the impact of poor service performance: the primary reason individuals switch health insurance companies is because they have been required through changes in their corporate enrollment options. Given the unique structure of the health insurance marketplace. While poor customer service performance is not usually the driving factor for switching insurance providers (Figure 7). people are speaking up loud and clear. and already. for example—due to poor customer service. Accenture’s 2010 Global Customer Multi-Industry Research Study found that 64 percent of consumers switched from at least one service provider in the past 12 months—a bank. our research has found it is the driving factor in other industries. consumer-directed health plans and the like.Surprise #7 Customers are not voting with their feet (yet). but they’re doing plenty of talking. or wireless carrier.
our respondents rank word of mouth in the top three. As we move to a consumer-driven market. Figure 8—How important were these information sources or channels to you in deciding to do business with the company? Employer educational materials Corporate web site Information from people I know On-premise/in-store information from. by a margin four times greater than their fourth most important information source (Figure 8). As a source of information. Should the comments go viral.. consumers are participating in activism at unprecedented levels. the importance of word of mouth should only go up. as the posted comments have the potential to reach a global audience. they have the potential to destroy a brand. As social media growth explodes. Online information from other sources Direct mail or telemarketing Print advertising Online advertising Paid advertising on TV or radio Others 58% 47% 40% 11% 9% 9% 5% 4% 4% 3% . family member.Our survey found that 40 percent of customers told a friend.. Perhaps even more striking than the prevalence and importance of wordof-mouth is the fact that 7 percent of our survey respondents reported posting negative comments about their experience online (Figure 9). While the percentage posting online is still comparatively small. Here is where health insurers will find the real ramifications of having ill-conceived social media strategies. or co-worker about a negative customer service experience in the past year. the impact will be much greater.
coworkers) 59% 40% Posted negative comments about the experience online (e.. friends..g. Facebook.g. have you done one of the following after having a bad experience with a Payer 41% Told people around me about the experience (e.Figure 9—In the past year. family. Twitter) − Yes 7% Actions being taken by these % respondents after having a bad experience online (one respondent can select multiple actions as response) Respondents who took no action Unique respondents who took at least one action . blogs.
the health insurance industry can learn valuable lessons from other industries. high performance reporting.Seven Secrets to Delivering Service the Way Customers Demand Secret #1 View customer service as a differentiator—not a cost center. New customers have different needs than established customers and the welcome call group is trained to anticipate and meet these unique needs. Often insurers treat customer service as a “check the box” reality versus a differentiating capability. . In this regard. For example. Implementing supervisory training programs and setting measurable performance expectations can have a profound effect on operational performance. they train their customer service representatives to handle all call types in each of these areas. as the health care model changes. wireless providers have learned that they get better customer retention and satisfaction by having a dedicated group of customer service representatives to welcome and educate new customers. and greater employee engagement. decreased time to proficiency. Furthermore. Accenture has seen that service supervisors often spend too much time performing administrative tasks and too little time coaching. Accenture’s experience has shown that by implementing established high performance workforce techniques payers can better realize improved performance. However. By maximizing the value of their most important. Similarly. For example. analytics and quality monitoring capabilities will help improve the overall quality of the interaction and reduce the standard deviation of performance levels. payers need to optimize their service delivery model to keep pace. we often find that supervisors receive little to no training themselves on how to perform their role. employee morale and the customer experience. missing the valuable opportunities that can come when service representatives are empowered to act as advocates for the consumer. Many insurers organize their call centers along traditional member and provider dimensions. Secret #2 Rethink the service delivery model. influential (and fundamental) asset—their customerfacing employees—health insurance companies can realize immediate and substantial improvements. in both service quality and cost. Insurers should recognize that controlling costs need not be mutually exclusive from meeting service expectations.
which in turn drives longer training times. those with chronic conditions) and build unique capabilities around those needs. For example. longer CSR time-toproficiency and large performance variations. . Such a capability will become a source of competitive differentiation as the individual market grows in popularity. Over the years. Fortunately. advances in CRM technologies are giving companies the tools to reduce complexity and improve performance for consistent. which will complicate the job on the insurers’ end. integrated multi-channel customer interactions. CSRs spend too much time bouncing between systems or searching within a system to find the information required by the customer—with the common result of a poor overall customer experience. These challenges will be further magnified with the introduction of ICD 10 (international standard diagnostic classification for diseases and other health problems). a workflow-enabled desktop that presents the right information and/or treatment recommendation at the exact time in the process can be implemented faster and at less cost than ever before. Drive to simplicity.Secret #3 A similar opportunity exists in healthcare. Payers should seek to identify unique customer needs (for example. the systems and callhandling processes implemented by health insurers have become more complex.
the other benefits will follow: reduced costs.Secret #4 Embrace an outside-in view of self-service technology. or customer service and support) is one way to launch into social media and minimize the risk of fragmentation. . people. the new view is that the voice of the customer should influence technology investments and how the self-service experience is designed. ready . processes. From there. the company could begin expanding into health management applications as part of an integrated multi-channel experience that allows people to connect with other patients like them or access resources to meet a specific health goal. marketing and sales. . enhanced brand image and differentiation from the competition. Secret #5 Don’t be anti-social. health insurance companies have viewed self-service as a trade-off that balances the necessity to reduce costs against decreasing customer satisfaction. policies. culture. Accenture’s client experience across industries finds that companies often jump into creating a social media presence without thinking through their strategy (a “Fire . both to reinforce positive sentiment and quickly address negative sentiment. A logical first step would be to focus on the marketing and public relations business domain to listen for conversations that mention a company’s brands. By leading with what the customer wants. without drowning in social media noise. increased satisfaction. It will also focus the organization on “what to listen to” to support identified business goals. Insurers should proactively listen to and learn from customers to identify any current context. Focusing initially on how to use social media in a single business domain (for example. Then. they can launch. Customers have viewed self service as trial and error: they embrace well-planned and well-designed channels and reject those that are not. After analyzing conversations to understand the chatter. aim!” approach). they should invest in proactively developing a comprehensive social media strategy for their organizations. . Although payers may not need to invest in aggressive proactive social media outreach right now. Given that the customer will look for the right tools to help themselves and help others. and metrics that may need to be modified to support their new social media strategy. In the past. refine and expand the initial strategy into other areas as they learn. . an insurer could implement tactics across customer service.
a key question will be whether the company should use company owned and controlled (on-board) social media tools or offboard (not company owned) ones. Fundamentally. IVR logs. Closing the gaps between customers’ service expectations and their experiences will not guarantee success for health insurers. Get analytical. attitudes and health attributes. behaviors. It’s an expansive challenge that must be taken apart to manage well. yet few companies are good at turning this data into insight. particularly as health payment and delivery reforms demand new types of collaboration among payers and providers. Second. they need to become more customer-centric— not an easy task. and then develop the operational capabilities to deliver these treatments and monitor and learn from them. insurers will need to develop an integrated view of their customers. segmented on values. Without the ability to perform enhanced analytics. such as Facebook. Third. To become customercentric. contact centers and social media generate tremendous amounts of data. . contact records. define segment-specific treatment plans for all customer touch points. First. In all cases. payers need to develop the capability to analyze.) into a single data source. customer satisfaction surveys. high performance will remain elusive. They will need to identify unique and unmet customer needs. etc. mobile. Secret #7 Embrace consumerism. payers need the ability to merge disparate sources of data (call logs. interpret and act on the new data and insights developed. Customer-facing channels such as the web. payers increasingly will need a way to analyze on-board and off-board data about their brand and customer experience.Secret #6 The challenge with social media is finding a role to play while avoiding additional fragmentation in the industry (and losing the voice of the customer across different channels). IVR.
accenture. and extensive research on the world’s most successful companies.000 people serving clients in more than 120 countries. please contact Doug VanWingerden at doug. with with more than 223. business and clinical insights and innovative technologies to deliver the power of insight driven health. That’s why the world’s leading health care providers and health plans choose Accenture for a wide range of insight driven health services that help them use knowledge in new ways—from the back office to the doctor’s office. The company generated net revenues of US$21.accenture.com or 678. comprehensive capabilities across all industries and business functions. efficient and affordable healthcare. its logo.Learn More To discuss how Accenture can help your organization develop the right customer relationship management solutions.com/insightdrivenhealth. Accenture. Combining unparalleled experience.6 billion for the fiscal year ended August 31. 2010. For more information. technology services and outsourcing company. Accenture collaborates with clients to help them become high-performance businesses and governments.com. . visit: www. About Accenture Accenture is a global management email@example.com. and High Performance Delivered are trademarks of Accenture. Its home page is www. Accenture: Insight Driven Health Insight driven health is the foundation of more effective. Our committed professionals combine realworld experience. Copyright © 2011 Accenture All rights reserved.357.
This action might not be possible to undo. Are you sure you want to continue?
We've moved you to where you read on your other device.
Get the full title to continue reading from where you left off, or restart the preview.