How to assist employers in employee well-being using the CCR principles of engagement. Published in the Employer Well-Being supplement of USA Today on September 26, 2015. The article is located on page 14.
August 27, 2015
By Robert Yurkovic
When interacting with consumers, there are many channels for the delivery of communications. Multi-channel and Omni-channel are buzz words many of us use and they enable organizations to deliver communications to consumers through various methods and technologies. The issue I have is it is not a consumer-facing point of view and in some ways companies are abusing the technology that enabled them. With so many channels aimed at a consumer, the consumer feels like a bullseye resulting in an experience that is frustrating and chaotic. This often results in communications that are ignored and discarded, which decreases the opportunity to engage them.
To engage consumers, communications must be cogent … clear, strong and convincing as well as being able to influence the mind and behaviors. The goal should be meaningful communications and not worthless junk mail.
Why does this occur in healthcare and other industries? In healthcare, silo’ed organizations are common place. Each organization wants to reach out to the consumer with their message. Multi-channel platforms and applications provide access to the consumer and if each organization sends their unique communications, the consumer is bombarded with confusing, conflicting, and irrelevant content. No consumer wants pieces of an encyclopedia thrown at them requiring them to fish out relevant information. Consumers have short attention spans and scan material for relevancy in 2-3 seconds.
Organizations are not coordinating their communications across the business so a communication over mobile may be different than a communication over email or a web site. The outcome is a confused consumer, which may result in a phone call to the contact center or discarding the messages altogether as unimportant. If a consumer receives 2, 3, or 4 different communications from various company representatives, they will likely be discarded as the consumer’s perception is all communications are incorrect. Consumers will not spend time validating which communication is correct … this is a formula for a bad game show. The opportunity for engagement suffers and the customer experience deteriorates.
Organizations tend to delivery different communications to one consumer even on the same channel. For example, I reached out to a healthcare payer’s contact center for a fairly simple question and received 3 different answers as I stumbled through their IVR system and multiple organizational representatives. 40 minutes of my time was wasted and my goal was not achieved so I was frustrated. The damage doesn’t end there since I communicated my experience with neighbors and friends. Now I am influencing a community and the company’s brand suffers. The lack of consistency of communications results in hours of wasted time and causes a degraded customer experience. The company disengaged me.
A communication is no good if you cannot understand it. Useful communications that have impact are simple and clear and refine the message to its essential core. No long, endless diatribe and no spouting paragraphs of information. Your audience must be able to understand the message quickly and without confusion.
It is a B2C world and everyone wants to touch a consumer within a company and across different companies resulting in an increase of information sent through every possible channel. But is “more” better than “less”? Or is it a question of the right information to the right consumer? Relevant communications has the best chance of capturing a consumer’s attention and engaging them. For example, I receive newsletters from my primary physician’s office, the local regional medical center, urgent care, and several other health-related sources. The print matter ends up in the trash and the emails end up in junk mail. Why? The content does not pertain to me. Why do I want to hear about asthma or diabetes in a generic newsletter since I and my family do not have or are at risk for those conditions? There may be something relevant on page 4, however I did not get that far since I dismissed the communication at page one. The result is the communications deemed useless and failed to engage me. I also associate that company with other companies that send me junk mail, which damages their brand image. I am now conditioned to discard future communications swiftly and they have a very little chance of engaging me in the future.
Why Channel Unity?
Channel Unity means all channels communicate to the consumer with one cogent voice. To the consumer, it doesn’t matter what channel they use, they want to experience useful communications from the company. Companies need to shift their thinking to a B2C Model and embrace Consistent, Coordinated, Clear, and Relevant (CCCR) interactions and communications. Consumers don’t care about all the channels that reach them. They care about a connection to the company and expect it to act with a cogent voice.
I have never seen a company transform and eliminate their deeply embedded silo’s quickly so the solution to Channel Unity must enable data, content, and processes to overlay a company’s business in a way that offers consistent, coordinated, and relevant communications to consumers. Autonomy is protected in the silo’s and a company does not need to wait 5 years for a major cultural shift to occur.
In my recent book, Commercializing Consumer Engagement, I describe best practices and approaches to achieve Channel Unity and consumer engagement without disrupting what is currently working within company. Engagement is all about consumer behaviors and connecting with them in a way that supports their lifestyle.
We tend to focus on disruption in technology, but we should notice a disruption in culture as well. This may sound strange coming from a person educated in engineering but I found that healthcare requires cultural disruption in order to fix healthcare as we know it … broken pieces to a consumer’s eyes.
Everyone loves technology and it surrounds us cradle to grave. Why not? Technology disruption creates opportunities, instability (catalyst for change), and perspective shifts in our thinking. The issue is that we tend to focus on technology disruption while ignoring the potential for cultural disruption. Technology disruption enables things to change using technology as a tool. Technology enablers include such things as mobility, devices (IoT), cloud, and analytics. They are very important and have led to great discoveries and cool tools such as smartphones and innovative medical devices. We design them based on usability standards and consumer needs. But, is that enough?
Wearables are gaining in popularity and also end up in your dresser draw in a few weeks or months once the novelty wears off. The reason we stop using them could be due to several reasons.
- Lack of usefulness – there is no health program attached to them so their value is limited to monitoring data – that can get boring quickly
- The coolness factor dissipated
- There is no consideration for cultural disruption and conversion
It is fine to offer cool technologies that have the potential to add value to our lifestyles, but if you want true sustainable engagement, cultural disruption must also occur.
Cultural disruption focuses on our and the larger communities behaviors. Behavioral change can lead to sustainable shifts in what we do and how we act. Cultural enablers include social, community, personal behaviors, customer experience, and organizational behaviors. Cultural disruption can lead to sustainable change because it focuses on us, the consumers and our surrounding community. Our inner core being must be touched in order to make and keep a change in our behavior. We look to other people as influencers to help us with decision-making and on what we adopt. Localization has a strong impact on health programs. Health care is personal and local programs tend to work better than pushed remote, corporate programs because they deal with the cultural aspect of our lives that reside in our homes and community. Cultural disruption can help consumers manage chronic diseases by altering their perspective on their health and in decision-making behaviors.
Cultural disruption causes a shift in our thinking and expectations. It also sets up new internal rules for us to follow. From this disruption, we may decide to integrate something into our lifestyle, decide what we focus on, or behave in a different way. If we want to make a change in how we manage our health, a wearable device by itself is not enough. We need cultural disruption to occur.
Apple did it
Steve Jobs performed cultural disruption very well with his innovative mobile products and those products were more about cultural change than they were about technology. That technology had been around a while, but Jobs focused on how it would impact our lifestyle, particularly around entertainment.
Disruption in Healthcare
Health care needs to focus on cultural disruption and continue to make advances in the areas of technology. Technology alone will not make a sustainable difference. Businesses allocate large budgets on IT and they should think about allocating resources around culture as it impacts their organization and products. Technology disruption must be aligned with a cultural disruption to make a difference in consumer engagement or any engagement for that matter. We need more cultural disruption in all industries.
What would it be like to attend a customer engagement conference where the presenters, panelists, and audience were truly engaged and shared what they know? I chaired the Customer Analytics and Engagement in healthcare conference in Chicago this week and I found out. It was not like an ordinary conference with fancy slides and polished speakers. It was about real professionals working in the healthcare trenches with a desire to make significant changes and learn from others. I witnessed the walls of silos disintegrate.
Experts shared their points of view on issues facing healthcare. Topics for discussion included predictive modeling, readmissions, B2C market shifts, behavioral trends, social media, customer experience, engagement strategies, ACOs, provider strategies and more. We had presentations, interviews, and panel discussions on the hottest topics facing the healthcare industry. The audience was truly engaged as tough questions were given to experts on our panels.
This conference was extremely useful as influential companies in healthcare worked together. Payers, providers, ACOs, and health services companies attended. Humana, Cigna, Aetna, and Anthem represented from the top 5 payers with many Blues attending as well. Dr. Furno represented CMS and talked about the work CMS is doing around readmissions. Stuart Hanson at Citi attended to share what they have learned about B2C in banking and if their experiences could translate to healthcare. Thomas Sondergeld, from Walgreens, shared his insights on engaging the employee workforce with corporate wellness programs. Vijay Murugappan, VP from HCSC, delivered a keynote and shared his thoughts on analytics and technology. Kimberly Higgins-Mays, VP from Aetna, shared her views on Accountable Care Solutions and how Aetna is changing their thinking to adapt to the market shifts in healthcare. Bryan Bennett, predictive analytics adjunct professor, from Northwestern University lit up the panel with insights on predictive analytics. Jim Tincher, customer experience expert, provided insights and an education around persona development and journey maps on Thursdays morning session showing us that a just creating a journey map with bubbles is not enough. These are professionals with diverse perspectives but with one common goal .. to help healthcare get better.
The conference actually turned into more of a workshop since collaboration, interest, and expertise within the group was so strong. It is what made this gathering unique and a blueprint of how a conference for change should look like. I am convinced that collaboration such as this is the best way to bring together Payers, Medical Providers, and Pharma together to define what healthcare should be in the future … and with the consumer in mind.
Well done to those that attended and contributed. You are the movers and shakers that are changing healthcare for the better. Everyone showed passion for making healthcare relevant and useful for consumers. It is time to remove what is complex and listen to our consumers … not an easy task.
Hats off the FC Business Intelligence for putting the conference together.
Brian Solis talks about Connected Consumerism and Generation C in his book “What’s The Future of Business”. I believe connected consumerism in healthcare is an investment in product relevance and meaningful relationships to improve the state of a consumer’s health throughout their life cycle. In order to engage your consumers, trust is a required element before consumers will engage with you. The concept of providing health care is about being connected and remaining connected with your consumers and offer services that integrates with their lifestyle. However, a relationship needs to be developed in order to build trust. Why? Health is personal. The best examples of engagement in health are personalized services. Services should be local and embedded in the community since the community is a natural support group for people reaching for health goals or trying to change a behavior to fight a chronic disease.
Health is Special
Remember that health is very personal unlike many consumer product goods so the connection should be real and meaningful. Decades ago, doctors had genuine relationships with their consumers. They knew the consumer as they followed them along their life cycle. With increasing medical costs, doctors built larger practices and focused on cost efficiency and service speed. Consumers don’t visit the same doctor every time due to availability and scheduling in larger practices. As doctors lost the personal connection with their consumers over the past few decades, trust eroded and consumers left those doctors and chose their doctors from a list of provided by healthcare insurers. Consumers also began to obtain health advice on the Internet instead of from doctors since they were difficult to get a hold of and expensive if an office visit was required. In the consumer’s mind, doctors could be replaced easily as long as they could get a doctor covered under their medical plan. Keeping costs down instead of a continued relationship with a doctor was now a higher value to consumers. Most consumers with plans have to pay more to go out of network.
Commoditization for primary care was taking hold as consumers were sacrificing quality over cost and convenience. This was exacerbated as many employers switch health plans during renewal periods and with that; a consumer received a list of different in-network doctors. Now doctors are fighting to regain the trust once earned and grow their customer base. For a doctor, it is like pushing mud uphill as regional health practices form to manage operational costs and drive consumers to large practices. To lower costs, some doctors practice defensive medicine to avoid malpractice issues and push more consumers in a tight schedule. This is not an environment that nurtures and grows trust. Doctors are no longer connected to their consumers as consumers are now connected through social channels. Searching for health information is a top search category on Google and consumers also reach out to others seeking advice on a procedure or condition, or references about a doctor.
Some companies are trying to earn the consumer‘s trust so doctors have much more competition now. New entrants such as Google and Apple have entered the market and while they are not providing diagnostic services, they are providing information and acquiring health data from devices that support healthy lifestyles. These companies understand consumerism and how to deliver a great experience; qualities that are little used in established medical businesses. Other companies, such as Walmart and CVS are offering local, affordable basic health care services once provided by primary care physicians. Local urgent care centers are providing care services without the wait and cost issues associated with emergency departments. Doctors and hospitals are left with specialized health services as general health services move to other businesses.
Path to Trust
For a consumer, who do you trust? Trust is a key component to retention and consumer engagement so we know it is of upmost importance. What are the connections between trust, relationships, engagement, and behaviors?
- Behaviors drive consumer engagement
- In order to influence a behavior, you need to build trust
- In order to have trust, you need a meaningful relationship … a connection worthy of the consumer’s attention
- In order to build a valued connection, you need to interact where the consumer lives while combining a great experience with useful services and information that supports the consumer’s lifestyle and goals
For consumers trying to manage their health, they need tools and information to make informed decisions. Communications plays an important role in making this occur as a conduit for exchanges between the consumer and the business.
Healthcare Payers operate in a transaction mode such as when a health transaction, such as a claim, occurs for the consumer. At that point, an interaction is started with the consumer. An example of this is an Explanation of Benefits (EOB). A claim is placed and an EOB is sent to the consumer explaining the transaction that occurred. Better communications during the claim processing phase with create a better experience such as sending an email to a consumer saying, “Your claim was received on January 3, and is being processed.” Interactions and communications could include additional suggestions for improving the consumer’s health around an existing condition or personal objective for health. Extending the interaction with useful and relevant content helps the consumer manage their health issue and learn more about their health. A relationship starts to develop as content is exchange with the consumer. Relevant, trusted content is essential to a dialog between a Payer and consumer.
Coordinated, Consistent, Relevant
Coordinated, consistent communications that are relevant supports a valuable dialog and the relationship begins to form. This is much the way a doctor communicated with their patients many decades ago. The desired goal is to be embedded in a relationship that impacts the consumer’s lifestyle and daily living. The consumer is able to better manage their health and make proper decisions when equipped with relevant information and tools. The triad of healthcare, Payers, Providers, and Pharma, must work together and share consumer information and speak to the consumer in a coordinated manner; speak in a singular health voice. This approach offers the consumer a superior experience and the value of the combined effort would be multiplied as opposed to speaking as 3 separate voices. Relationships can grow as Payers, Providers, and Pharma jointly build relevant interactions around consumer’s lifestyle. What could the next C level position be? Perhaps it could be a Chief Alliance Officer responsible for making the connections between businesses, leading joint initiatives, and readying technology systems and processes to be able to exchange information readily and support a singular voice.
More about consumer behaviors, trust and building relationships, and consumer engagement in my new book titled, “Commercializing Consumer Engagement” at http://www.commercializing-consumer-engagement.com/
When interacting with a consumer regarding health care, it is important to remember that health is personal and consumer’s emotions will be a major influence their decision-making around health engagement. Engagement starts on an emotional level as the consumer learns and seeks to validate value of a health program. The mind moves from thought to action as the consumer tests to see if the health program is worthy enough to be adopted into their lifestyle. Often we see health programs pushed to consumers only to observe that their use decays quickly. Enthusiasm wanes even though continuing its use is the right thing to do. It is possible that engagement may be adopted and sustained as the emotional and analytic sides of a consumer’s mind agree to justify the action for engagement with each side of the mind validating the other.
Consumer Engagement Stages
Four stages occur in the path to engagement. It starts with an awareness of a health condition or situation. At this stage, curiosity is stimulated by the emotional side of the mind. We then begin to analyze information with the analytic side of our mind and then include the emotional side of the mind as we test to see if it will work for us. When both sides of the mind are in agreement, we usually take action. At this point, it becomes a matter of prioritization in the mind’s queue for which actions are taken.
Engagement Stage What happens in this stage
Recognition What is it? Does it affect me?
Internalization How does it affect me? What are ways to fix it?
Validation Does this fix or solution work for me?
Authorization Should I do it?
Understanding the consumer is paramount to any planned interaction. Building experiences around consumer understanding with enable a business to communicate in a relevant, consistent manner. Engagement programs can then be created that target a consumer’s needs and personality for adoption and sustained use.
Partners in Health Care
Consumer centricity in healthcare requires useful interactions with the major players in the health industry. Key players include Payers, Providers, and Pharma, or the health triad. There are more partnering opportunities to support better health for consumers beyond the health triad. I am seeing new players enter the health market and making significant improvement in consumer’s health. One such business is the supermarket. Supermarkets are employing Registered Dietitians, RDs, in their stores to help consumers make healthy choices. RD’s are also involved with local education, YMCA, elder care with VNAs, and the local library, and provide an array of services to people, families, and kids. The health triad would do well to coordinate their consumer interactions and partner with businesses providing local health services that are already embedded in the community such as supermarkets. Health is personal and engagement has a larger effect when localization is considered.
Culture and Trust
Businesses in health care would benefit from working together to build internal trust among them. Instead of thinking of the consumer with ownership in mind, it would be far better to share information and offer programs to consumer with the consumer’s health in mind. To do this, companies need to shift their business model to B2C and nurture an internal culture to support the consumer. Without the proper culture and B2C mindset, a business will probably witness disconnects in their journey mappings, product offerings, and in their communications to the consumers.
Consumer Centric Points
Twelve points should be considered for the maximizing the value for the consumer.
- Realize that consumers are in control
- Create a company culture and values that focus on the consumer
- Understand the consumer and what motivates them
- Build relationships and trust for stickiness/loyalty
- Provide coordinated services across business
- Generate consistent experiences across preferred delivery channels
- Offer usable tools and content/information to consumers
- Deliver relevant communications and interactions
- Partner, do not collide with other health services and their offerings
- Health is personal, trust is earned and required for engagement
- Support comes from a local community
- To be truly engaged with a consumer’s health, you must interact with them in such a way that it affects and supports their lifestyle
To explain more of these concepts, I published a book in January 2015 titled, Commercializing Consumer Engagement. It dives deeper into consumer behaviors, methodologies, and approaches to help people live a healthy and satisfying lifestyle through consumer engagement techniques.
According to Procter & Gamble, shoppers make up their minds about a product in 3 to 7 seconds, just the time it takes to note a product on a store shelf (Proctor & Gamble, 2006). P&G calls this time the First Moment of Truth (FMOT), and it’s considered the most important marketing opportunity for a brand at the time (WSJ, 2005). The First Moment of Trust occurs at the “shelf” or buying area. The stimulus represents advertising, which influences the decision to purchase and occurs before the consumer reaches the shelf to make a purchasing decision.
Proctor and Gamble’s View of Marketing
Google came up with the Zero Moment of Truth or ZMOT (Lecinski) . This occurs before the First Moment Of Truth and influences the decision making process before the time of purchase. The Second Moment Of Truth (SMOT) occurs after you take the product home and use it. If the SMOT is shared, the SMOT becomes the next person’s ZMOT, providing a constantly evolving influencing cycle. You can see how experiences can go viral rapidly through social sharing.
Why is the ZMOT important? It was found that the ZMOT is a major influencer in making purchasing decisions; even more so than the point of stimulus. It is also important because most of us use it and we are not even aware of it.
Would it surprise you to know that:
- 70% of Americans now say they look at product reviews before making a purchase? (Google Z. M., 2011).
- 79% of consumers now say they use a smartphone to help with shopping? (MediaCT, 2011)
- 83% of moms say they do online research after seeing TV commercials for products that interest them? (Google O. , 2009).
Shoppers today use twice as many sources to arrive at a decision than they did in 2010. This is almost 100% growth in four years. In health care, about 11 sources are used in ZMOT (Sciences, The Zero Moment of Truth page 9, 2011).
The following diagram uses data from a study asking the question, “When you were considering purchasing, what sources of information did you seek out to help with your decision?”
Number of Sources Used in Decision-Making
The real power of social media and social channels is this is where the influencers are connecting with consumers. It is where the influencing is done and where consumers learn. Decision makers seek out influencers in order to make decisions. Decision makers want to be advised, so targeted messaging needs to occur from the influencers. This is the reason why content is so important in the new rules of marketing since relevancy matters.
Content becomes the basis for teaching influencers. In the health management space, members will make health decisions based on what others say and the content supporting it. Content is the fuel and social is the conduit. Mobility is the accelerator.
The following diagram uses data from a Google study asking the question, “When you were considering purchasing, what sources of information did you seek out to help with your decision?” (Google/Shopper Sciences, 2011).
Sources of Information Used in Purchasing Decisions
Google (Sciences, The Zero Moment of Truth page 12, 2011)
It was found that the ZMOT was more influential in making decisions than the FMOT or Stimulus stages. Many companies are shifting advertising budgets from advertising to social areas to gain greater impact in the consumer’s decision-making process. The role of social media is very important since it acts as a platform for the ZMOT to occur, thus replacing Stimulus as the predominate influencer.
Companies no longer create brands; they are now created by consumers and companies during the moments of truth and based on experienced emotions and perceived value.
- Companies can earn relevance through moments of insight from consumer interactions or see brand deterioration when negative experiences goes viral
- Post-commerce experiences contribute to the customer relationship through moments of emotions
The value of engagement must be determined if a great experience is to be realized. The value, if not measured alone, is what it does or fixes; it must have an emotional satisfaction component with it. An experience can be disrupted in any MOT so thought must be taken during experience development since it affects all MOTs.
The value is impacted by the customer’s experiences and those experiences are shared and can influence other people’s experiences. A shared experience can be “owned” once embraced, even those it was not realized personally (perceived reality). The relationship can be altered through an indirect interaction – someone else’s experience.
Brian Solis developed a concept called the Ultimate Moment of Truth (UMOT) in his book, “What’s The Future of Business” (Solis, 2013). The UMOT occurs long after the date of purchase and after consumers have experienced the use of the product or the company’s customer service.
ZMOT and Healthcare
I observed similar behaviors between buying products and in decision making for health care, since decisions made for your health are similar to purchasing a product or service.
Engagement is about adopting and deciding to manage one’s health. So a process and system for coaxing buyers down the funnel to a buy decision is basically the same as a process to engage members in health management – engaging them in small steps through awareness/informing/education using content. Marketing automation calls this lead nurturing. In the health engagement space, I call it health nurturing.
Moment of Truths in Healthcare
It is important to understand why the ZMOT and customer experiences are important for Payers and Providers.
Reasons why the ZMOT and the UMOT are important
- Influencers in health plan purchasing choices, plan use, and customer service.
- The brand is ever more important in a B2C world and the brand is crafted in the ZMOT and social media by consumers.
- Relationship building can increase in the UMOT to support consumers’ use of health benefits.
- Good customer service and engaging consumers both happen in the ZMOT.
- You need to understand the ZMOT in building experiences for consumers. Generating useful experiences will impact organization alignment to be more consumer-centric.
- Managing social network interactions directly influences the ZMOT.
- The ZMOT occurs in real time and anywhere through mobile enablement.
- Information captured in the ZMOT is used to enhance processes, products, and services.
As the industry shifts and business strategy changes, making changes requires communicating those changes and listening in the ZMOT.
Excerpted from my book titled, “Commercializing Consumer Engagement.”
Companies launch products and services to consumers with the thought that their product will offer so much value to the consumer without considering the bigger picture. It is a holistic view of the consumer experience that matters if consumer centricity is to be attained. The combination of a product’s functionality and the experience it offers sets a condition for potential consumer engagement and relationship development. Translating this to healthcare, it is important for payers to provide information and tools so members manage their health while offering a connected experience to simplify and navigate the complex maze of healthcare.
The shift to consumer-driven health is evolving rapidly. Payers need to adapt to retain their members, stay relevant, and manage costs. With medical costs rising and consumers managing their health, payers want to engage them in healthy behaviors and cost-effective decision making. To engage members, payers need to develop trusted relationships and form useful interactions with their members. Relationships require a combination of a superior experience and products that help members manage their health.
A once antagonistic relationship can turn into a productive, lasting relationship by forming an experience high in usability around services and products that interact with consumers, as well as creating the whole experience or journey in dealing with a payer.
Traditionally, healthcare payers focused on providing support to their members through transactions. Transactions include such tasks as looking up benefits, submitting claims, and looking up providers. This is a “get the job done” mentality and lacks a good experience. Transactions support only a fraction of what members need in a consumer-driven world. Health reform and Consumer-Directed Health Plans (CDHPs) started the transformation to consumer-focused healthcare. CDHPs put the consumer or member in control of their health, which places demands on the payers to provide relevant information and useful tools that support decision making and healthy living.
Payers cannot develop meaningful relationships through transactions alone. They need to go where consumers engage with life every day: their lifestyles. Lifestyle is the day-to-day living where healthy behaviors are set and routines developed. Enablers in healthcare, such as biometric devices and mobility, offer a strong connection to consumers, providing immediate monitoring and feedback of their health indicators. The devices and their applications are tools that support members’ healthy lifestyles. A great experience with useful products that target a member’s lifestyle is a winning combination to improve personal health and manage costs.
Doing The Job
There is a need to combine experience and function into a consumer model, and I believe there is a strong use for it in healthcare to achieve member engagement. An idea came to me after I read about the work of Clayton Christensen and a fellow researcher. It was an article on “Milkshake Marketing” from Harvard Business School published in 2011. Clayton’s claim is that 95% of new products fail, and companies need to look at products in the way that customers do: how a product “gets the job done.” Jobs have functional, emotional, and social dimensions.
I was fascinated by this article, which followed the role of a milkshake in the eyes of a consumer. The goal was to increase the sales of milkshakes. The study found that consumers bought the most milkshakes in the morning and for a common reason. Consumers faced a long commute and needed something to make their commute more interesting. They were not hungry but would be by 10:00 a.m. The milkshake was thick, so sucking through a straw gave them something to do. They were in business clothes and the milkshake was less likely to get their clothes dirty than a donut or bagel would; it was contained enjoyment.
Traditional marketing says to segment the market by demographics and product. Clayton’s argument was to segment according to jobs-to-be-done. Focusing on the job, they found that by increasing the thickness and adding chunks of fruit, they enhanced the job-to-be-done and sales increased. They also had another version, a treat for children with a thinner consistency so parents would not have to wait for them to finish it. This shows two jobs that needed to be done. Now add experience.
I noticed a correlation between a product’s job and the overall experience the person has with it. It seems that more than just user experience (usability), this involves the journey or customer experience of the event before use, during use, and after use. I observed that products that were lean on features but robust on the experience were more likely to be adopted and succeed. The concept of consumers choosing packaging over content has been around for a while. We choose a laundry detergent because our family used it when growing up (brand) or the color of the package is striking (packaging). Not many people actually read and understand the chemistry of the ingredients (content). Maybe we are seeing a shift in consumer behavior and the new form of “packaging” is the experience. Personally, I sacrifice features to remove the hassles of product selection, purchase, and use. To me, experience became the product differentiator, if for no other reason than to avoid adding frustration to my busy lifestyle. If a vendor has a useful product with a great experience, then I do not mind waiting in lines to get it, either. Even the wait can turn into an interesting experience if we design the experience well.
The following figure shows a model for connecting the experience and functionality with consumer relationships
Scenario 1 – High excitement and limited use
Product type Fad
Consumer feeling Excited
Consumer mode Courtship
If you have a useful product that offers a great experience in purchasing it and using it, you could see strong user adoption. The excitement may not be sustained over time, as users realize the “fun” is gone and the usability of the product has waned. Remember the fads of yesteryear. Clothing can fit into the category of a fad. Articles of clothing that have lost their excitement include bleached jeans, hoop earrings, penny loafers, and leggings. They are still functional, but a shift in the experience occurred. Experience can impact the functionality, as well. If a style no longer creates a good feeling while wearing it, the clothing no longer “performs its job” to make the person feel good, and it will be discarded for another piece of clothing. In this mode, you create a short-term relationship and the product seems more like a fad with a short lifecycle.
Scenario 2 – High use and limited experience
Product type Commodity
Consumer feeling Bored
Consumer mode Acceptance
A product such as phone service and cable TV from a cable provider, which does an OK job and provides a poor customer experience, may not have a foundation for a relationship to develop. Forrester reports the customer index for cable TV providers is in the poor range. From a consumer perspective, we put up with the cable TV provider and consumers accept what they are given but will jump to another provider at an opportunity if the product stops performing or they are fed up with the experience. This industry has retention issues, which could be more severe if there were more vendors offering services. The barrier to switching to another provider is low.
Scenario 3 – High use and high experience
Product type Valued
Consumer feeling Satisfied
Consumer mode Engagement
If you have a service with great products and a satisfying experience, such as Amazon. com, there is a foundation on which to build a relationship – even online. Amazon ripped business away from brick-and-mortar stores and offers excellent customer service throughout my shopping experience. I get reviews of products, updates on my order, and an evolving shipping status in real time. The experience supports two tenants of consumerism: It is convenient and fast. Facebook is another example of a product that does the job without getting overly complicated and offers a good experience. Users of Facebook are truly engaged and we see this in how much time is spent on it. It has integrated into the user’s lifestyle – a powerful combination.
To sustain the relationship and use, you must either tune the experience to keep it fresh or maintain the usefulness of the product. I believe I see this in Apple’s iPods. I own four iPods and wondered, “Why?” Apple generated a fun experience for me with their initial product launch. For me, it hit the fad stage first and moved into the valued area. Early iPods did the job of playing music, but over time I began to retire my iPod to a drawer. Why? I found that the excitement of having one diminished and the experience decreased. I then moved into the commodity area.
Soon, Apple released a newer model, which increased my excitement, and the bonus was the newer model had a new feature, making it seem more useful to me. So I bought it. I believe that I quickly moved back to the fad area. Usefulness and experience are high again, so I drift into the valued area. Repeat that cycle nine months later.
It seems like the experience was being pulsed to hook me into buying “upgrades” to keep the experience going. I call this “Pulsating Experience Marketing.” I was an experience junkie, and the behavior seemed a lot like the way I play with a cat. I would put a toy on a string and then tease the cat by moving the toy close and then pulling it away. Repeat for a sustainable experience. Without the introduction of a new experience, the first iPod would have gone to my daughter’s play box with no repeat of the cycle. I believe that experience and usefulness are closely linked to driving consumer behavior, and behaviors drive consumer engagement.
Experience + Job = Relationship
Expanding on the concept of “Milkshake Marketing” and translating it to healthcare and consumer engagement, payers “do the job” of providing benefit plans and services to consumers. In their annual customer experience index, Forrester ranks health plans in the “poor-to-very-poor” range, mostly because the experience of purchasing and using health plans is less than desirable. On top of this, payers lack differentiation between themselves, and there is a low barrier to change payers for consumers. This is largely because payers do not practice relationship building with consumers.
Contrary to popular belief, payers want to engage consumers and help them live a healthy life, but consumers do not want to be engaged by payers at this early stage. Instead, consumers prefer to have an existing relationship in place with payers in order to build a deeper relationship. Only when the consumer experience and the “job to be done” are considered acceptable by the consumer, can a payer then begin to build and nurture the relationship.
If you ask them, payers may say there is a lack of consumer or member experience during the claims process because payers process the claims internally and the member does not participate directly. The payers to a degree can be considered right and wrong in this regard. They are right in that payers do not in fact generate a member experience during this process and it is possible that the member will start wondering what happened to their claim. Payers are wrong in that there is no managed experience – a missed opportunity in relationship building. After all, it is human nature to think the worst, and in this case, members imagine their claim is not going well or something has gone wrong.
After a period of time, the member will enter the frustrated stage and call their payer to find out the status of their claim. This call will end up costing the payer approximately $3 to $5. If payers could generate a better member experience around the claims process, the payer would not incur the cost of this call. Perhaps, payers could provide a message to members using SMS or email to advise them where their claim is in the process. They could use a simple graphic with a five-stage process or a text message stating the claim is in “Stage 3” with “We are processing your claim with no expected delays,” which provides the necessary and relevant information to prevent the consumer from entering the “frustrated stage.” Does this sound familiar? Amazon accomplishes this feat by communicating order-tracking information to show consumers their order statuses. Seeing order activity or progress eases the concerns of consumers as they wait for their order to be processed and shipped.
In a consumer-driven world, we usually do not like to wait. That being so, if payers were able to communicate the status of a consumer’s claim as it traveled through the process, the member experience would be much more enjoyable. Members would become satisfied, since the payer took the action first and generated a dialog around the claim event. This may even sound like a reassuring voice, such as, “Don’t worry, we are providing personalized attention to your claim.” With this capability, members would be able to choose how much information they want to receive, how often, and even select their preferred channel of delivery. After all, it is all about “me” in the world of the consumer.
By providing a positive member experience coupled with products that do the required job, payers are now able to build relationships with members through useful communications and interactions. Over time, as the relationship grows, the opportunity for engagement by the payer will be created.
In order to build relationships with members, however, payers must focus on the following three guidelines:
- Offer a product that does the job for members in a way they want the job to be done.
- Provide a grand experience in two areas: a well-designed member experience on all member touch points and a tuned member experience so that consumers are happy interacting with the payer.
- Extend their products to be more than benefit plans and provide members the tools to help them in their pursuit of healthy living and enjoyable lifestyles. The result is that the “doing the job” indicator goes up.
Building relationships aids in member engagement and increases retention. It is about the quality of the interaction, and not the quantity. The relationship is formed around common goals such as improving members’ health. If the interaction is pointless and without value, it becomes annoying to the member and the experience deteriorates.
Engagement is Good for Everyone
Engagement at a member level has many benefits, not only for members, but also for payers and the health system. At the “Engaged Stage,” payers can:
- Modify member behaviors to lower likelihood of chronic diseases
- Promote healthy living for members
- Offer information and tools to help members make intelligent health decisions
Because medical costs are increasing at an alarming rate each year, member health is a priority for payers and providers in order to manage costs. The CDC says chronic diseases account for $3 of every $4 spent on healthcare and that chronic diseases are preventable by modifying consumer behaviors. This is a perfect example of how consumer engagement solutions can help lower costs and decrease chronic diseases, but member relationships are required for engagement programs. For payers to engage their members, they need to focus on two areas:
- The customer and user experience
- A product or service that performs what the member wants to do
By bringing these two items into the design of a mobile app that supports healthy behaviors with relevant content, healthy tips, and encouragement, the payers open the door to engagement with members by helping them modify their behaviors that lead to chronic diseases. That is a lot to say, but you can see how it is all connected, and healthcare has many moving parts.
A rise in priority of consumer centricity is just as important as cost management is for payers. Engaging members in healthy living and using self-service tools is important to lowering health costs and empowering members in an era of consumer-driven healthcare. Therefore, in the end, a sustainable solution to lowering health costs and having a healthy member base over the long term can be achieved through consumer centricity. This approach takes time and is an investment in the health system and in its members.
If you are looking for low-hanging fruit and easy successes, focus on the user experience. The fastest road to a good experience is to remove pain points in services and products that touch customers. Usability testing can provide enlightening results and insight into any such pain points. An annoyed customer can be transformed into a satisfied customer by assessing online assets and updating the design based on the findings.
In order to offer a more consumer-centric experience, some solutions could be to offer consumer-centered products and services that are aligned to the consumer’s personalized needs, tune customer experiences to build relationships, or engage members in healthy living and decision making with personalized programs. These are all examples that can contribute to lower costs by improving member health and consumer engagement. Payers now have a raison d’etre and they remain relevant. Payers can use their big data repositories filled with member information to provide members with targeted and relevant information and tools backed by a terrific experience. Why would it work? Payers would take time to build relationships and trust with their members and shift into a consumer mode of business. Moving to a consumer view is a graceful transition toward diversification, since payers can provide solutions that accommodate members where they live the most: in their lifestyle.
The traditional interaction with payers has been around transactions: find a doctor or pharmacy, look up my benefits, and look up my claim. This is the transaction layer in the consumer relationship. There is little opportunity for a payer to develop a relationship and generate consumer stickiness in this area. Members, in this case, only go to the transaction layer to perform a transaction, which for any large payer is about one to two times a year. The main reason that many members perform a transaction is because they are going through a health event, like a sickness or medical condition, and members are already in a stressed state of mind dealing with a personal or family health issue. This is not the best time to generate a relationship. The best way a payer can generate a positive experience in this layer is to provide superior support for the member when needed. This translates to a flawless experience by offering a caring connection, managing administrative tasks and processes, and performing event logistics so members can focus on their health. In order to build productive relationships, payers need to go where the people are when they are in a good state of mind.
The following figure shows a representation of the HealthScape from a consumer perspective. There are three distinct layers around health and consumer involvement, with the transaction layer being at the core. Each layer is different in how often members interact in each layer.
In the “Transaction Layer,” members may interact several times a year with a payer performing a health transaction. In the “Wellness Layer,” members interact far more often, such as one to two times a week, depending on their personal plans for nutrition and exercise. When in the “Lifestyle Layer,” there is a potential for members to be involved in health every day, as it becomes part of a routine in a person’s daily living. In the “Lifestyle Layer,” a payer has the potential to achieve relationship nirvana – stickiness.
While in the “Wellness Layer,” members are focusing on sustaining or achieving a state of wellness. In this layer, the main issues on members’ minds are nutrition, exercise, and healthy behaviors. Members are focusing on their health to minimize the risk of becoming sick and maximize the potential of leading a productive life. Members also begin to enter into a relationship with wellness providers and coaches to engage in healthy behaviors. Telephone coaching is an example of this. However, wellness is one of many personal priorities a member manages, so it may not be their top priority all the time. For wellness to be embraced, a member must absorb healthy thinking into their life on a daily basis and it must become part of their lifestyle.
In a “Lifestyle Layer,” members interact, work, play, and experience life every day. Examples of health in the “Lifestyle Layer” are the many new devices that monitor daily activity, such as sleeping habits and nutrition. The “Jawbone UP” and “Fitbit Flex” are wearable devices providing biometric data to consumers throughout the day. These devices provide feedback to members so they can adjust their actions and behaviors in order to reach their desired goals. These devices become part of the wearer’s lifestyle and that lifestyle changes based on the feedback they receive. If a member works in an office and sits at a desk too long, an alarm will go off, letting the wearer know they need to be more active and move around. If this happens often enough, their thinking will be changed and a new behavior formed, leading to healthy outcomes.
Solutions in the “Lifestyle Layer” focus on supporting consumers in their quest for sustained healthy living. It is important to help members approach health in a holistic manner and offer encouragement in the form of helpful tools that promote education in the areas of nutrition, exercise, stress, care, community, and healthy living habits. In this layer, relationship maturity can blossom. To assist payers in their vision to diversify, they can take advantage of this opportunity in the “Lifestyle Layer” by offering such tools to reinforce healthy behaviors for their members and provide more than just health plans. The definition of health to a payer is more about healthy living for members and not just paying a claim.
Years ago, the same transformation occurred in the banking industry. Banks interacted with consumers simply by performing transactions such as depositing a check. Now banks offer a full suite of services, such as financial planning for retirement, college savings, and family growth, supporting a person throughout their life.
An extension of a payer’s offer could be to aggregate data from multiple biometric devices to provide services to their members such as a health dashboard with relevant content to support decision making and behavior changes in pursuit of healthier living. As mentioned under the “Engagement Section,” healthy behavior lowers the likelihood of chronic diseases, which in turn lowers medical costs in health care.
It may appear that payers are losing some control to consumers, but in reality, they are increasing cost control through member enablement. It is important for payers to trust and empower members to do the right thing for their health. Payers must provide relevant information and decision tools to arm their members in their pursuit of a healthy lifestyle.
The benefits of consumer centricity align well with payer value:
- Coordinated member experience
- Personalized communications to channel preferences for engagement
- Usable consumer tools and online assets to manage the experience
- Align consumer programs with the business strategy to manage effectiveness
- Drive member healthy behaviors to manage chronic diseases and manage costs
- Support consumer health decisions with information and tools to manage costs
- Unified platform for member communications for consistency
- Generate 1:1 relationships with members for retention and engagement
- Increase stickiness with members for retention
- Compliance to CMS and federal disabilities organizations to minimize risks
- Integrated mobile and social enablers to optimize consumer engagement
- Payer remains relevant through useful solutions
Payer centricity and provider centricity is replaced over time with consumer centricity. Consumers begin to take control of their health, with payers and providers transforming to meet the consumer challenge of a long, productive life and quality care while managing costs.
The goal is to have an engaged, healthy community of people. With so many moving parts and interactions, a thorough assessment of the payer’s approach to a consumer-driven world is required before embarking on launching disparate tactical programs, or confusion replaces engagement.
This post is a continuation of the previous post titled’ “Our State of Health – Why are We Here?”
As Humans, we are intelligent beings so perhaps if we were to get information about how to manage our health in a manner we like to receive it and in a way we can absorb it, we can begin to make better decisions and take actions toward better health. We want to do it so perhaps past methods were not the correct ones to motivate us.
Present forms of communicating desired changes to health habits involve spreading fear, shouting threats, punishing wrong doing, and pushing commands to this or that. To make it worse, Payers, Providers and others are doing this in an uncoordinated manner fueling chaos and despair. To a consumer, it is like being in a mad house during a full moon so they shut down all input. Instead of using negative approaches, why not take a positive approach through nurturing? The average person wants to make good decisions but they need information and tools to be able to do it.
No one likes to be told they are fat each morning and then get a threat from a consumer web site after they sign in saying, “You are fat and you need to lose weight” and you will be hounded each day on the site for being FAT. Sound ridiculous? This is what two senior people from a healthcare Payer proposed to be done on their consumer portal during a customer experience initiative. The intent was to force people to lose weight using an “in your face” approach but in reality, it demonstrated a terrible, degrading customer experience. In another example, digital nanny applications in early mobile health programs nagged you when your health parameters did not meet their expectations. So after a few days, consumers deleted the application after experiencing constant frustration. These approaches do not build relationships and it demotivates their customers. They are negative approaches in an attempt to help people. But as consumers, we are not wired to respond to this approach even though it may have worked 30 years ago.
I call the concept of interacting and communicating information with consumers along a series of gradual steps … “Health Nurturing.” These are baby steps and not leaps. Consumers are not pushed forward but instead lead to actions that generate forward progress from with inside them. Consumers accept and digest bits of information at their own pace leading to insights and actionable behavior changes.
If we use the Health Nurturing concept, we begin a path to adoption such as:
- Collaborate with consumers giving them what they need to become aware of a health situation. Help them become aware of potential health issues and their risks.
- Enable consumers to research pertinent information in their quest to understand health issues and how it may impact them or others they know. Offer information that is relevant so they may analyze and internalize it at their pace.
- Allow consumers time to accept the impact and outcome of the situation once they have come to understand it. Let them gain insight to how it affects them and what can be done to assist them in moving forward.
- Enable consumers with programs and useful information so they may adopt new behaviors and execute on steps toward a better outcome.
I use four natural stages of consumer based thinking to achieve behavioral change. They are (1) awareness, (2) research, (3) embrace, and (4) adoption and they guide the consumer down a path to self-realization and self-action.
This approach works because the process is internalized and tuned to the person so that they may accept it on their terms as opposed to it being forced upon them through negative reinforcement. This approach does not force feed and push but instead lets the consumer digest information at their personal pace to, hopefully, gain insights can change their way of thinking to correct a behavior for better health.
Excerpted from my book titled, “Commercializing Consumer Engagement.”
We are what we eat, we are what we do, and we are what we accept … we are unhealthy.
If our health is so important to us and we, as Americans, spend $2.7 trillion dollars on healthcare annually, the question arises, “Why is our health worsening and the quality of care decreasing?” According to the CDC, obesity rises 6% annually and affects one third of the population. Diabetes rises 8% annually with about 26% of the population either undiagnosed or on the verge of diabetes. 75% of medical costs are due to Chronic Diseases and most of these can be managed through behavioral changes. Most people want better health care that is affordable and accessible but we do little to help ourselves stay healthy.
As people, we tend to focus on health when something has gone wrong and not only wrong, but very wrong. For most of us, health does not tend to be a priority in our lifestyles. Why is this? People tend to focus on social activities, material gain, family issues, jobs, or entertainment. Our daily living habits confirm this as we do not get enough sleep, do not get enough physical activity, and do not get the nutrition we need to remain healthy.
The trends of consumerism fueled new behaviors and we shifted our values over time. Convenience, cost, and speed now rule our behaviors since we are so used to getting fast food and products delivered in days as we rush trying to do too many things at once. We sacrificed quality for convenience since we are so used to taking the easy, convenient route. Most of us are strapped with debt and trying to manage a household on a tight budget so we are faced with a dilemma … should we pay $12 for GMO, food additive laden, processed food that is almost ready to eat once nuked to death or pay $32 for quality food products that you actually have to take the time to prepare and cook for yourself and the ones you love? It is usually the cheaper, easier option. The excuses are … “Don’t have the time”, “Can’t afford it”, “I can’t cook”, “I have more important things to do” and “That is too much effort”. We reprioritized how we perceive what is important to our lives and the sad news is health, as a priority, has been dropping steadily. We tricked ourselves into believing that good living is about quick, easy, convenient and cheap. We forgot how important we are and what it takes to keep us healthy to lead productive lives.
There simply are no short cuts to good health. Good health is not quick, easy, convenient and cheap. If your health deteriorates, you may find that repairing the damage is expensive, difficult, takes time, and is invasive to your lifestyle. Contrary to many TV commercials, there is no secret pill you can take to get the nutrients, sleep, and exercise required to maintain a healthy body and a healthy lifestyle. Partly to blame for this is the time lag of an action taken to the results exhibited. When we do something that is bad for our health, it usually takes a while to show up and since it takes a while, most of us do not see the gradual deterioration until a major event occurs … like a heart attack.
Most Americans actually take better care of their cars than they do their bodies … the oil gets changed and our cars fed with gasoline. I never heard of a person jamming a Twinkie down the gas tank. Why? Because we know it is bad for the car. BUT, why is it the same people do not see it may be bad for the body too? What can one Twinkie do? You do not really see the effects immediately but a daily habit will have an effect after time. 5,000 Twinkies later, you are 100 pounds overweight and combating diabetes. If you stop changing the oil in your car, eventually the engine stops running and it fails. So we know better. Admittedly, there are some of us humans that have not changed the oil in our cars, but not 1/3 of the population … but 1/3 of America is obese.
Health takes a back seat … until something goes horribly wrong. There must be a way to increase how we focus on health in our daily lives and adopt it as part of our lifestyle. Payers and Providers have been trying to figure out how to engage patients – members – consumers to manage their health better. One way is to understand them as consumers and the behaviors that drive them.
Excerpted from my book titled, “Commercializing Consumer Engagement.”