Health and Our Decline

May 20, 2014 by bobyurkovic

What is Health About?

Our health is a combination of several key things that need to stay in balance in order to remain healthy. We need to feed our bodies, we need to flex our bodies, we need to rest our bodies, and we need to manage the external forces that affect us. If we are out of balance, chronic diseases and other disorders may occur.

There are 7 components to health and to be healthy, all 7 must be in balance.

How far out of balance are we?

Sometimes tough facts are difficult to swallow, but denial is no longer an option. Let’s take a look at two chronic diseases, obesity and diabetes. About 1 in three people are obese in America. The alarming statistic is the increase from 15% of the population in 1990 to 34% in 2013. The figure rises 6% year over year. A study in 2010 by the Organization for Economic Cooperation and Development (OECD) said 75% of Americans will be overweight by 2020. Obesity is responsible for 5-10% of total health expenditures in the United States. An obese person incurs 25% higher health expenditures than a person of normal weight in any given year. In the United States, obese people are 76% more likely to suffer short-term disability adding production losses to health care costs that account for over 1% of the GDP. The costs will rise as obesity related diseases develop. A Johns Hopkins University researcher claims, in the 2008 journal Obesity that about 65% of Americans will be overweight by 2030. Costs to treat obesity and health related costs could also rise at staggering amounts. Our economy may not be able to support those increased costs.

If we look at diabetes, about 7% of the population has been diagnosed with diabetes. The alarming facts is about 26% of Americans are on the verge of diabetes or undiagnosed. Complications due to diabetes lead to more serious diseases such that the related costs are $245 billion in 2012. According to the CDC, 1 in 3 adults could have diabetes by 2050 if current trends continue. The International Diabetes Federation predicts as many as 438 million people in the world will have diabetes by 2030.

The trends in both diseases are similar and growing at high rates. How we address chronic diseases in people requires immediate attention if we are to manage medical costs and the population’s health.

Excerpted from my book titled, “Commercializing Consumer Engagement.”

The path to consumer insights and engagement

April 8, 2014 by bobyurkovic

In a dynamic and highly personalized industry such as healthcare, consumer insights are vital in order to create useful experiences, tailored health management programs, and ultimately craft a more successful, profitable brand. When people speak about consumer insights, they are typically talking about the collection, analysis and deployment of data in the effort to attract and keep customers. Developing better consumer insights requires careful analysis of the features of the brand in relation to the interests and responses of the consumer. With better consumer insights, healthcare brands can understand and appreciate the wants, needs, desires, motivations and mindsets of the consumers in their targeted market in order to foresee future trends and create a more positive user experience.

The Role of Health and Profile Data

Health data is vital to the modern healthcare industry because it provides an array of useful information about the incidence of various conditions and diseases in the patient population. There are a number of trends that become more evident with the analysis of health data, which enables healthcare providers, insurance firms and other health-related enterprises to design better products and services, and better serve the needs of their patients. Profile data is highly specific, enabling organizations to assess the relationships between particular groups of consumers in order to uncover various patterns and offer support targeted to these populations. Health and profile data may include information about behaviors, biometrics, devices, claims, prescriptions and tests. Master data files for profiling are the most specific and segmented, containing demographics, ethnographic information, personal health records, socioeconomic information and other critical data.

Assessing Data for Clearer Results

In the effort to profile consumers and develop insights into their behavior, the goal should always be to attain better analytics and ultimately drive higher-quality healthcare initiatives for the marketplace. There are numerous tools for assessing data in order to develop consumer insights to create better experiences that drive engagement. Data layering tools enable decision-makers to view information about their current and prospective customers or users in a number of formats. For the healthcare industry, a planar view of layered data can enable more scrutinized assessments of data in a spatial or geographic format. These tools can ultimately enable more customized dashboards to present information to consumers, collect data from consumers, keep this information organized and secure and develop better relationships with consumers stretching into the future. The consumer data that is collected must be audited for quality and usability, first of all, but after that, there are many different options for analyzing this valuable information, which your team can discuss with your business strategy consultants. Analytical tools can enable you to perform propensity modeling to predict future consumer behaviors, cross-selling analysis to spotlight relationships between successful products and services, critical lag analysis to design custom communication campaigns and many other options.

To simplify how we look at complex data, we view it in data planes that share commonality.

Positive Consumer Experiences is a Path to Member Engagement

In order to stay on the path of member engagement, we need consumer insights to create the kind of customer experiences that inspire loyalty and strengthen your brand image. Analytics and technology are the backbone to support building profiles and gain consumer insights. By exposing more insights from consumers you serve; it will ultimately enable better relationships through more successful marketing campaigns, personalized communications and health management programs that cater to their specific wants and needs. With data about the consumer marketplace and about specific groups within that marketplace, you will be able to target on two levels and develop personalized, relevant, multichannel campaigns. And with tracking and profile buildup, you’ll have the tools to continue improving consumer understanding and offer even more personalized health programs for increased retention and a reduction in medical costs. Staying on this path is critical for success in an increasingly complex healthcare world as it simplifies the experience for consumers.

Culture and its impact on Customer Experience

April 1, 2014 by bobyurkovic

Customer Experience is a blanket of interwoven threads of a company’s culture. If you want to generate great experience for your customers, weave a great blanket first.

By Robert Yurkovic

April 1, 2014

The organization must be of the right mind and follow disciplines to be effective. Culture can be used to explain the organization’s right mind. The organization must be treated as an organism in which care and feeding is paramount. An organization comprised of silos will have difficulty in working together with other organizations.

The consumer expects the company to interact with them in one voice and not as a person with multiple personalities that are always in conflict. The organization embraces its culture and radiates a brand image to attract, retain and manage its customer base.

Where culture comes from

Culture is an organic living thing that, in essence, defines who we are and how we behave. It shapes our routines, habits, and rituals. It can shape our environment and our environment can shape the culture. Deep inside of an organization or a group of people is a set of values or beliefs that governs us. The organization’s culture radiates who the collective body is and what it is capable of. The culture changes as people’s behaviors change and changes can be quick or slow to happen over time. As the organization’s environment shifts, its people adapt to it and their behaviors change which in turn alters the culture. Culture is dynamic and fragile and requires constant nurturing to maintain a steady state of its identity.

A company’s culture communicates its identity in everything it does especially in its customer’s touch points. This does not mean the company’s vision, brand, or mission statement defines the culture but it does impact and permeate all of these. A common disconnect is a vision that sets the tone for customer importance but the culture radiates an internally driven mindset of performance metrics and shareholder values instead of a consumer focused view. A disconnected culture communicates distrust and chaos to those around it as is becomes lost in an identity crisis.

A company’s identity is made up from a core set of values or beliefs. In an organization, the measurement of identity is how the organization defines its values as to who it is with respect to the world. Are they values that align to the consumer’s needs and values? To create a stronger impact to the culture, the organization must choose its values carefully much as it would in determining its brand image. The same goes for individuals who have adopted a set of beliefs that show who they are; it defines them to others. Politicians start their campaigns with a core set of values on which their platform is run. This defines them as it relates to the people. Identity says who we are but that is not enough to truly define us or show our strength.

So the next element is defining the “reason for being” or Raison d’etre. The reason for being (RfB) drives the identity into action since it touches on our belief system and how we make decisions. In an organization, the measurement of its reason for being is how the organization embraces its purposeful existence and identity. An example of measurement could be how its consumer’s health index changed or how many targeted health programs were launched. I have asked many executives a simple question, “what does the company want to be when it grows up?” The question is meant to stimulate a response stating its reason for being. Yet, some executives get flustered by the question. Most executives can communicate their company’s identity, but their reason for being has not been fully shaped. It is a difficult question to answer and requires thoughtful effort. It is similar to, “Now that you know who you are, what are you going to do about it?”

Employees have a difficult time embracing a new identity without knowing its reason for being. This gets into the questions of why we are here. With this, employees experience a sense of bewilderment and think, “Now what do I do with that?” as the new identity (set of values and beliefs) rolls out. If the old identity has been modified with new values and communicated, the culture’s foundation becomes unsettled and cultural implosion occurs leaving everyone trying to figure out what to do next. Even the identity comes into question. If executives modify the culture with a new identity and reason for being but do not “walk the talk” and lead by example, cultural implosion occurs as employees lose faith in their leaders. The new message becomes diluted. This is what I mean by a culture being fragile. It can be easily fractured if you do not manage the transformation carefully. It is not about changing processes and procedures; it is about modifying an organic, living thing in real time.

Cultural Strength index

The “reason for being” defines purposeful existence and along with identity provides a way to measure strength and impact of the culture. Identity and purpose (RfB) craft the elemental pieces of a culture’s core. Cultural strength is about where it is going and what force moves it. This is basically a cultural vector and can be used to measure strength and impact. In physics, a vector is defined as two components – direction and force.

In a cultural vector, the direction is related to identity and the force is related to the reason for being (RfB). The RfB gives the identity a push to its direction. From this point of view, we can calculate a Cultural Strength index (CSi).

The value n represents the total number of identity values. For the purpose of using this in healthcare, let’s measure cultural strength for consumer centricity. The indicators should align to the consumer.

Identity examples:

Charitable – giving to others and helpful
Accomplishment – achieve internal business success, achieve increases member health
Accountable – accept responsibility
Thoughtful – caring and considerate
Respectful – value the person and their values
Empowerment – letting people do what they need to do
Nurture – helping people grow and become strong
Reliable – honest, dependable, and do the right thing
Innovative – taking risks, pioneering, bold steps

For measurement purposes, Identity has a value of 1 to 5 with 5 closely aligned to how well it has been embraced internally and recognized externally.

1 = refusal to support

2 = passive aggressive resistance

3 = recognized by management, the message is apparent but results are limited

4 = partially supported by management, spotty results and adoption

5 = embraced by management, embedded in enterprise, apparent

There can be conflicts in the values such as being charitable and accomplished internally. Performance commitments to shareholders can impact on ability to be charitable. There can also be a gap between cultural norms and ideal values as the organization focuses on moving to an ideal state.

The reason for being is coupled to an identity value and in this case is given a value based on consumer alignment. Some of the example below can be tied to more than one identity value. Reason for being examples:

Company financials – margin expectations tied to accomplishment
Member cost control – reducing medical costs for members tied to accomplishment
Company growth – number of members tied to accomplishment
Caring for members – making decisions for member health tied to thoughtful and nurture
Care quality – the best care for the member
Enablement – enabling members with tools and information to make better decisions tied to innovative
Engagement – engaging members in better health with programs and information
Relationships – connecting with members in a personalized manner
Logistics – focus on health logistics (locate care, travel, payment) so the member can focus on their health
Medical cost control – reducing medical costs to meet financials
Health threats – working with data and research to minimize future health threats to members tied to innovative

For measurement purposes, RfB has a value between 0 and 1. This value shows how well it is aligned to a consumer.

0.00 = 0% consumer aligned

0.25 = 25% consumer aligned

0.50 = 50% consumer aligned

0.75 = 75% consumer aligned

1.00 = 100% consumer aligned

CSi Example for Consumer Centricity

For example, let’s take a fictitious healthcare company and create an identity and reason for being for those values.

The values are: Accomplishment for shareholder value, respect for members and employees, reliable, and innovative. Across the business, we see limited acceptance and adoption for these values and this is shown in the following score card:
Place the final score on the CSi diagram. With 5 being the maximum score, a score of close to 2 shows the company’s strength to support consumer oriented programs. A goal of 4 is chosen to represent where they want to be. The goal is to partially embrace its 5 identity values. The question arises, “Are they focused on the right things and are their priorities correct to be consumer driven?”

In this example, the company is strongly focused on achieving growth and financial targets for internal purposes and for its shareholders. Accomplishment received an identity value of 5 due to its strong support but received an RfB value of .25 since the value is more closely aligned to internal business needs as opposed to consumer needs. The company chose a strong identity value of nurture with an RfB value of 1 but its identity value is 3 since it has not been embraced fully in the company so its effectiveness is diminished. For the company to succeed in a consumer environment, it must look at values that align to that objective and embrace them for full effectiveness. Only then can it deploy great customer experiences.

Creating a strong set of cultural values by itself does not translate to a strong culture. Having a strong set of values can produce a weak cultural impact by the organization’s reluctance to embrace its desired identity and its reason for being.

Steps to Cultural Rejuvenation

In order to generate a better customer experience for its customers, the company’s culture must be customer centric first. There are several steps to cultural rejuvenation and I call it rejuvenation because a culture is always already in existence. In order to generate a new culture, you must first deal with the old culture and its identity. If you do not acknowledge the embedded culture, contamination to any cultural changes will occur with deleterious effects. The original or embedded culture must be dealt with before proceeding. People need to acknowledge what was there and let it go willingly. It is human behavior to hold on to something even though it can be bad for them and others.

There are five basic steps to cultural rejuvenation:

Look at who you are deeply – Current State Analysis
1. Identify the old culture
2. Identify the root causes for what is not working
Create your identity and Raison d’etre – Future State
1. What are the values that define the organization? Impactful. Simple. Real. Soulful.
2. What is the organization’s reason for being? What do you want to be when you grow up? Where are you going with your new identity (values)?
Generate awareness of where you are and the right path to follow – Gap Analysis
1. Communicate what you learned about the old identity and what is does or has done
2. Show the organization the problem areas to correct behaviors
3. Provide tools to correct root causes
4. Show a path to the new direction, new identity and reason for being
Build a roadmap and make it actionable
1. Provide tools that correct behaviors and stimulate people to embrace a better way
2. Validate that executives are buying in
3. Create metrics to measure your actions
4. Communicate internally and externally
Maintain and monitor your progress
1. Provide oversight
2. Provide a feedback mechanism to all
3. Reinforce in a positive manner
4. Own and correct mistakes in real time
5. Validate direction and policies are inline
6. Review threats and risks

Experience and Culture

Today, many businesses desire to have better experiences for their customers. They want to be customer centric especially as the world shifts to a B2C model as seen in many industries. Healthcare companies are moving to generate better customer experiences to increase retention and improve member engagement.

The diagram below is a Customer Experience Maturity Model with 5 stages. Many healthcare companies are in stage two and ready to start stage 3 as customer experience management obtains funding and acknowledgement by executives.

At stage 4, companies have embraced the B2C model and are ready to generate engaging experiences for their customers. At this point, the culture is more aligned to consumer values and with that, customer experiences can be generated to build out engagement programs and manage all consumer/member interactions across the business. In this stage, customers see coordinated and consistent interactions and a positive brand image begins to form.

If you are still in early stages of cultural rejuvenation, you can still generate better customer experiences by fixing problem areas and optimizing processes and coordinating organizational connections. Both cultural rejuvenation and customer experience generation can be grown in a multi-stage maturity model as shown above. Customers will see value as you shift your business to a consumer driven model over time.

Summary

An organization’s culture has the amazing capability to leak its identity and Raison d’etre to consumers. Experiences, good or bad, are remembered and shared instantly in the mobile world through social channels. This can be harmful if your company has unresolved issues or disconnects embedded in its culture. Bad news can go viral as well so care must be taken in managing social channels. Social channels can be used to amplify cultural values with consumers taking the role of marketing your messages to others.

Customer experiences create the framework for member engagement. Culture creates the framework for customer experiences. When considering how to create great experiences for your customers, think about weaving the experiential blanket using strands of culture at the onset.

The Power of Personalized Newsletters

January 18, 2014 by bobyurkovic

With so many different channels to engage customers in order to build new relationships and strengthen existing ones, including a myriad of digital methods, it can be difficult to figure out where to focus an organization’s efforts. There are a few tried and true methods though that should not be forgotten amidst all the new technologies and media. Newsletters, both print and digital, are a well-known way to engage customers. But in many industries they have been virtually swallowed up by other forms of communication such as email, blogs, social media pages and other digital mediums. Digital newsletters however, continue to be highly effective for certain industries, particularly for the healthcare and insurance industries with an open rate of 32.2% and 43.7% respectively according to MailChimp, a leading email service provider.

The Benefits of Personalized Newsletters

The idea of digital personalized newsletters may be generally associated with the advertising and marketing days of the past, but there are many ways to reinvent this medium to benefit healthcare and insurance providers as they engage the demand generation consumers. The consumer’s appetite for relevant and real-time health information is insatiable as proven by searches for health information on Google. This “old” idea can be reinvented in many new and engaging ways to deliver personalized, relevant health content. Just think about some of the current advantages personalized newsletter can provide:

Can position your organization as a trusted advisor and dispenser of dynamic, one-of-a-kind personalized health information offering transparency to your knowledge bases
Has the potential to show customers that an organization cares about their customers and has the customer’s best interests at heart
Helps build trust with customers by maintaining a top-of-mind presence
Helps to remind customers of the positive value an organization can bring to them

Why Personalized Newsletters are Ideal for Healthcare Members in 2014

Digital personalized newsletters compared to their printed counterpart are particularly appropriate for healthcare and insurance payers in 2014. The digital communication piece offers an ideal way to build relationships and engagement with healthcare customers regardless of changes in the landscape of the industry. Healthcare payers have a great deal of incredibly useful health-related data that they can use to create personalized newsletters to form a deeper relationship with each individual. Here are just a few of the ways healthcare payers might use this format to engage with their customers:

Include personal health tips specific to the needs of that customer
Provide healthy recipes based on that customer’s health information
Create different informative health-related articles based on the different segments of the healthcare market
Utilize graphics and other custom touches based on demographics, ethnicity, and other factors
Include upcoming appointment reminders to healthcare customers in their newsletters, along with click-to-call functionality connecting the customer with their physician
Remind customers of their health benefits when entering into a health event, such as pregnancy as well as special programs to keep you healthy during that time

The Importance of Segmentation and Personalization of Newsletters

The fact of the matter is that there are few promotional tools that can do as much to promote a brand for as little money as newsletters. There is a world of ways to reinvent the medium for very modern results. Health food stores and other businesses in niche markets understand how important newsletters can be in building and maintaining personalized relationships with their customers, and the same can be said for healthcare. The key is segmentation, personalization and relevancy. When talking about personalization, we are not referring to only changing the recipient’s name, but including specific health-related information that pertains to each customer individually. No two newsletters are the same. Sending the same newsletter to every healthcare customer would be highly impersonal and for most it would be useless. By changing the format with relevant content based on the needs of the specific customer, healthcare payers can truly personalize and build their relationships with customers like never before. This entail would provide a great deal of value by improving public perception and implementing a personal presence in the lives of healthcare members.

In case you’re still not convinced, consider a few more of the possibilities of personalized newsletters to engage your healthcare members:

They allow an organization to market new services and products immediately to those who would be most interested in them
They allow an organization to describe the benefits of their programs in a detailed manner, considering the needs of each target audience
They allow an organization to reemphasize the value of their services in a friendly, conversational format
Newsletters may be the only comprehensive opportunity for positive interaction between the customer and the organization
They allow the customer to obtain health information and reminders because no one has the time to sift through Google and customers can’t remember all the do’s and don’ts in their busy world

Many experts agree that personalized newsletters are going to be a strong and effective tool to engage healthcare customers in 2014. As long as healthcare payers remember to personalize with relevant content, there are many contemporary possibilities.

Security … the last frontier to better health.

December 18, 2013 by bobyurkovic

Without security measures in place, all health engagement programs and monitoring applications with biometric devices will fail if personal and health information is leaked/stolen by hackers. Even out-of-industry marketers would pay for personal health and behavior information to drive their retail sales. Angry dissidents could have direct control over a personal device’s functions causing harm and fear. There could be black market potential for that information because the value of it is so high.

Health programs store information and devices add to the health data and this data builds up over time building an incredible profile of who we are. The devices are even more vulnerable since they are light operating systems lacking in security. They only acquire and send data based on the identity of a person. Identity has been set but nothing is governing authority and as such may be vulnerable to outside attacks through the network. Do we control our health devices or can they be hacked and controlled by an outsider? If it’s connected, it can be hacked. No one wants to wear a device that can control their heart if another person with a mission can wreak havoc on them. If my connected device that measures and records glucose levels shows me false data, I may take the incorrect amount of a drug. If this happened, it is so invasive that I would cease all activity with the program and device. My trust would be broken.

How can we secure this information and keep hackers away from devices that monitor and control our health and environment in our daily lives? A breach may lower adoption as trust is diminished.

Summary

Security must be embedded in your engagement strategy and programs to realize the full potential of a health engagement program. Frankly, we are a nation that requires most of us to jump on the “better health bandwagon” and we need engagement programs with devices to support a healthier lifestyle. We also need it to be secure and trusted.

Consumer Insights: Profiling Consumers to Target Personalized Communications and Sustainable Health Programs

September 18, 2013 by bobyurkovic

The healthcare climate has changed, and consumer centricity in healthcare is now more important than ever. In order to better serve consumers, enact more personalized healthcare communication programs and develop more sustainable health programs that influence the lives of consumers for the better in the future, it is necessary for health providers and payers to leverage big data in new and innovative ways. There are huge stores of data available for healthcare industry insiders to take advantage of in order to profile consumers and ultimately better serve them through programs such as digital dashboards that are easily accessible to consumers, employers and healthcare payers.

What Kind of Data is Most Useful?

Successful healthcare consumer centricity programs take many different kinds of information into account. Healthcare payers and providers can better serve consumers with tailored communications and personalized programs by first obtaining the following types of data in a central repository:

Behaviors – Information about lifestyle choices and behaviors that pertain to diet, exercise, activity, sleep patterns and other habits can be very helpful. These may be obtained through information from various databases, surveys and other records of interactions with consumers.
Claims – All claims tell a story, and can be used to tailor more personalized experiences for and communication with consumers in the future. A well-managed electronic records database is essential here.
Rx – Tracking and measuring pharmacy metrics can be very beneficial to healthcare payers, not only because it provides an opportunity to streamline cost initiatives, but also because it provides another opportunity to see what health choices consumers are making and where they’re spending their healthcare dollars.
Biometric Devices – Since the dawn of the digital age, many advances have been made in the healthcare world, including the development of biometric devices that identify doctors and staff and gather vital information about patients. Statistics from these data records can be used to pinpoint trends, develop more customized healthcare products and services and make better predictions about healthcare outcomes.
Tests (Blood) – The records of blood tests can also be used to develop better products and services for consumers. The more information that healthcare payers and providers have about the unique populations they serve, the more personalized communications, experiences and programs they can provide.
Master Data (PHR, ethno-, techno-, socio- and demographic) – Perhaps the most useful chunk of data for profiling healthcare consumers is a master data file that includes demographics, personal health records, ethnographic information, socioeconomic information and all varieties of useful digital information about the group of consumers that a given healthcare organization serves.

What Can We Do With All This Data?

The goal of any successful consumer-profiling program should be to achieve the kind of strategic analytics that will support better health initiatives. Analytics can fuel tailored dashboards for consumers, employers and payers, which epitomize the new drive toward consumer centricity for healthcare payers. Such a dashboard provides a more convenient way for consumers to receive information from and communicate directly with healthcare payers and providers, which allows payers in particular to foster relationships with consumers that were not always possible in the past. These dashboards can also be used to gather more information about consumers in the future, and do so in a more organized, cost effective and streamlined way. In the end, the more insights a healthcare payer and/or provider can gain about the consumers they serve, the better prepared they will be to target personalized communications and develop more sustainable health programs in the future. It’s a win-win-win for the healthcare payer, the consumers who use their products and services and the employers who help provide health plans to their employees, when applicable.

Consumer Understanding and Intimacy Because Healthcare is Personal

September 11, 2013 by bobyurkovic

Describe healthcare from a personal view. Do terms such as fragmented, fractured experience, inconsistent communications, confusing, irrelevant information, and frustrating come to mind? Is healthcare a personal experience?

Questions arise from a consumer. “Don’t they know me yet? Why do I have to repeat entering the same information? What does this mean? Which one is right?”

Consumers place so much emphasis and energy on how to navigate through healthcare to the point that they hardly have time to focus on their health. Did you ever walk into a store and were overwhelmed by what you saw you forgot why you came in the first place? If health care were a collection of packaged goods in a store, we would walk out of the store.

What do consumers want from healthcare? Five basic words come to mind: Easy, consistent, coordinated, helpful, and connected. And if information and tools are required to make good decisions, they need to be relevant, useful, and personalized to me.

To address the consumer’s needs, we need four elegant solution engines and they form a consumer equation.

Consumer Insight + Customer Experience + Personalized Communications + Relevant Health Engagement

It is more than just adding four items; it is how those items are connected into an integrated consumer view of healthcare – the conduits and glue in healthcare. So, let’s choose one of the four and work our way through them. Why? It’s all about “me” in a consumer world and the “me’s” have choices in a b2c environment. Consumer centricity should drive the business for a payer as it does for CPG companies.

Health Engagement Programs and What Makes us Tick

August 21, 2013 by bobyurkovic

The shift toward consumer centricity in healthcare can be seen throughout the market, from providers to payers. The healthcare industry is in a state of transition, which is inevitable for any industry that has straddled generations of consumer, economic and societal trends. With a shift toward consumer engagement and digital communication, it is more important than ever for healthcare industry insiders to keep up with the times and develop programs that are relevant to today’s market. Health engagement programs are a big part of that. In order to develop useful and lasting health engagement programs, it is up to providers and payers to better understand what makes us tick, and provide products and services accordingly.

Health Engagement Programs: Segmentation is Essential

Healthcare providers and payers are now more focused on developing programs that drive healthier behaviors in consumers, whether they are in top shape, in need of a few healthy lifestyle adjustments, chronically ill or currently receiving treatment. Segmentation of the marketplace allows healthcare professionals to create more positive experiences for consumers from all walks of life and in all situations. This allows for a more personalized experience for the consumer, with health programs that are tailored for and marketed to different types of people based on their unique wants and needs.

What This Means for Healthcare Payers

The shift toward segmenting the healthcare market and creating more personalized experiences for patients provides a new opportunity for payers to move into the consumer health space, rather than just the health event and transaction spaces, as they have been limited to in the past. It is in everyone’s best interests for consumers to have as many tools and as much accurate information as possible in order to pursue their own good health, and payers can be a big part of this. Historically, however, consumers have not been pleased with the experiences they’ve had with the payers providing health benefit plans and services to them. Payers have not worked hard to build relationships with their customers, and thus do not differentiate themselves from one another, giving consumers little reason to switch from one payer to another. Consumer centricity for healthcare payers is essential as consumers continue to become savvier and demand more comprehensive services designed to meet their specific needs.

The Challenges in Engaging Healthcare Consumers

The fact of the matter is that many consumers are resistant to engaging with their health payers due to a number of factors, including negative past experiences and underdeveloped relationships. Even when payers try to reach out with information that can help consumers achieve healthier lives, they are faced with heavy resistance. It does not have to stay this way, though. Many payers are already beginning to embrace the shift toward healthcare consumer centricity and building the kinds of relationships that see results. There is still much that can be done to engage consumers, better understand what makes consumers tick, segment the market, provide more personalized products and offer better services overall.

The Road Ahead for Healthcare Payers

Focusing on consumer centricity in healthcare is going to become just as essential for payers as keeping costs down and increasing membership – this is how payers are going to keep their customers and attract new ones. In many ways, healthcare payers can benefit from looking at how various retailers handle their business. Many online retailers, for example, engage consumers throughout the processing and delivery steps, and update them as their packages are being shipped. The same model could be used in the claims processing lifecycle to keep consumers engaged, and not frustrated or alarmed. At the very least, healthcare payers will need to provide a more seamless and positive user experience for their members, and begin building a more optimistic relationship with consumers. Then, over time, it will be possible for health payers to design more consumer centric products, engage consumers in healthier behaviors, keep customers happy and distinguish themselves from the competition.

The Customer’s Point of View — Offering A Superior Online Experience

July 15, 2013 by bobyurkovic

In a changing world that is continually influenced by technology, fads and devices of convenience, health plans recognize that their customer relationships are forever evolving. Although the variables are always in motion, there is one constant that demands our focus — health plans must offer a superior customer experience.

As today’s customer service environment increasingly moves toward self-service, learning how to maintain a personal touch as we shift from people to technology is important. Although staying at the forefront of health care may seem complex, it boils down to a very simple solution — understanding the health plan members’ needs relative to the convenience they are accustomed to in virtually every other industry. With this understanding in mind, innovative solutions are the vehicle to driving member satisfaction and garnering loyalty, not to mention making a true improvement in quality of life.

The brutal truth is that most health plan members view their customer service experience as sub par, ranking last among all other major industries, according to a 2009 Forrester report, written by Elizabeth Boehm and titled “Health Plans Face a Member Experience Crisis.” As the report states, “It turns out that customer satisfaction decreases as consumers interact more with their health plan.” The report’s findings also show that members believe their “health plans make things more complicated than they need to be.”1 The question to ask is: How can we make health plan interactions easy, while providing a superior customer service experience?

IT’S AN ONLINE, SELF-SERVICE WORLD
Because we are a mobile society, information has to follow us in our busy lives and not the other way around. Although a health plan’s point of connection with its members occurs in three ways — through their online experience, call centers and mailed printed matter — it is the online experience that has become the primary focus for customer service delivery. Health plans are beginning to use the Web, mobile technology and kiosks to provide the information world to their members on their own terms.

Those of all ages have been able to enrich their lives by connecting to the online world. In fact, as we age and find our physical mobility becoming more limited, reaching out to the online world provides new opportunities for community connections. This is especially true for seniors who are learning to use online social networking as a way to find old and new friends. Instead of walking to the local coffee shop to meet friends and family, they can now chat online, thereby eliminating all physical barriers.

While the online world offers many advantages, using it to its full potential can be challenging. Creating a superior customer service experience requires skills in human factors as well as a comprehensive understanding of each audience. Health plans can realize customer service improvements by focusing their efforts on strategic, up-stream activities such as focus groups, usability testing and user experience architecture that will ultimately define the components of a superior experience.

RULES OF ONLINE USE ARE CHANGING
Now that health plan members are beginning to expect and even demand online options, the rules of customer service are changing. Today’s health plan member does not have the time or patience to figure out complex forms and processes. They expect access in real time, along with smart applications and dashboards, to help them make decisions. In addition, they want an interactive experience that engages them with others and immerses them in a supportive community rather than the stand-alone, impersonal pedestals of Web sites with complex navigational mazes that seem to hide information.

In other words, health plan members want a system that is easy to use, and they want to be in control. The table below shows how member expectations have changed over time:

ACTUALIZING INNOVATION
In order to drive customer service innovation, health plans need to define their many member interaction points and deploy focus groups that address the following questions:

What do we need to improve?
Where do we need to be?
How do we improve production to give our members conveniences already offered by other industries?

The lessons learned from these focus groups should be used to build a better model that includes improved online communications, concierge delivery, personalized communications, mobile technology and an expanded “HealthScape.” This will lead the way to an experience that is truly in tune with the customer’s needs.

Online Communications
What can health plans do to improve online communications? Hide the complexity by focusing on audience-centered design and create a simple user interface. This essential step can be accomplished by re-thinking processes in a way that transforms them into a customer point-of-view. Look at the logistics of building your online sites by using a “shopping mall” model that allows for entry at one portal and gives access to many areas. Combining the ports of entry into one area reduces the risk of a fragmented experience.

Navigating through an online maze is the number one frustration for users in all industries. In fact, customers would prefer to take many easy steps to gather information rather than a few difficult steps. Think of an encyclopedia as your model. Although you usually cannot get to a subject in two turns of a page, having the proper topology and guidance system makes it easy to find the information you need.

Concierge Model
Many hotels offer a superior customer service experience by using concierge services. They do not expect their customers to know how to find their way in a new town, who to call for reservations or how to use the hotel’s facilities. Concierge services are provided as a guide for navigating through unknown or complex structures.
Both outsiders and insiders often view their health plan as a complex structure; however, a self-service concierge model can be designed to navigate through this complexity. For example, customer service can take away the logistics issues that members suffer through when encountering a health event. If there is a hospital located many miles away that provides better quality for a better price, then the health plan should provide travel services so the member can focus on what is important to them — their health — and not on making travel arrangements. Taking logistic pain points out of the process enhances the customer service experience during a stressful health event.

Personalized Communications
Offering personalized communications as a standard across all platforms is a best practice in other industries and should be a standard practice for health plans as well. Enrollment forms, plan summaries and physician directories should include member information and data to assist in the decision making process. A personalized document is more appealing and garners better responses than a standardized form letter.
Some payers, such as Regency Blue Cross Blue Shield, no longer send out a traditional Explanation of Benefits. They have replaced them with easy-to-understand and personalized health statements embedded with marketing information. This communication now serves as an engagement tool that is useful to the member while providing an opportunity for the plan to sell additional services.

Mobility Anytime
Some estimates show that up to 50 percent of people will have smart phones within one year. Whether standing in line, traveling or waiting for children to finish school activities, people want the ability to connect online in real time. Health plan tools should take advantage of this technology and make smart applications available that enable members to easily manage their care.

Additionally, kiosks have been a major self-service delivery point in the banking industry for many years. Conveniently located, easy to use and available at all hours, customers love the convenience. Kiosks also entered the health care space a few years ago, offering applications such as way-finding and registration. Now is the perfect time for health plans to expand their kiosk capabilities by offering new, focused smart applications.

The HealthScape is Expanding
Health plans can no longer afford to limit their online customer service offerings to just health events and transactions. As health care priorities shift, members who previously used their plan’s Web site to find a new provider or review a claim now want the ability to do more. In fact, there is a need for a new term that encompasses all of the moving targets demanded by today’s consumers. HealthScape is a new term encompasses the three segments of a successful health plan Web site:

Health Events and Transactions
Wellness
Lifestyles

The primary challenge for health plans is to tie together all three segments into a uniform, connected Web site that provides a superior customer service experience for increased loyalty.

The following diagram shows the information that should be provided within each segment of the HealthScape:

HealthScape

Many Web sites began by providing member services in the health events and transaction segment of the HealthScape. Inquiries pertaining to claims, providers and benefits are the most utilized features of this segment. However, with the increasing popularity of HSA and HRA plans that are designed to lower costs by motivating members to stay healthy and follow wellness guidelines, some plans are adding wellness and lifestyle segments to their Web sites in order to provide a more robust user experience.

The wellness and lifestyle segments of the HealthScape can be linked through a variety of shared experiences. For example, when evaluating data aggregation, health plans can provide their members with high-tech wellness tools such as the Nike Triax Elite, pedometers, the Health Buddy, GlucoPhone, blood pressure monitors and a myriad of other devices designed to acquire personal health information. The health plan can then aggregate this data and make it available online so members can monitor their fitness and make any necessary lifestyle changes. The health plan can also offer incentives based on the member’s progress.

Another HealthScape experience that crosses multiple segments is “at home care.” This type of care increases quality of life while decreasing hospital costs. For example, at home care for diabetes includes the use of equipment to monitor blood sugar levels and medication delivery to patients while in the comfort of their home. Uploading the test results to an online portal offers the opportunity for physician review while results can be made available to the member.

A population that will play an increasingly important role in the HealthScape is that of the Millennials, also known as the “ME” generation. This group, ages 18–29 years old, numbers between 80 and 95 million. They work hard, play hard and consider their lifestyle when making health care decisions. In fact, they will even schedule business events to fit in with their lifestyle, such as scheduling a business meeting around a yoga class.2 The Millennials know their priorities and, as young people, they are tech savvy, “always on” and only take “yes” for an answer. Given their youthful feelings of invincibility, the wellness and lifestyle segments of the HealthScape are their primary areas of focus. An incredible opportunity exists for health plans to provide them with advice on nutrition, healthy living, traveling and more.

As the use of health plan Web sites migrates from health transactions and events to wellness and finally to lifestyles, the HealthScape becomes “stickier” and member retention becomes less of a problem. The plans that limit their Web sites to health events and transactions will only have members visiting their site a few times each year. With such low interaction, retention is difficult because so many alternatives for information exist elsewhere and members will gravitate toward plans with more informative Web sites. However, by providing a well-designed HealthScape, members will visit more often to seek advice and participate in healthy living programs. This, in turn, promotes a higher quality of life and lower health costs.

TRANSFORMATION
Convenience, simplicity and robustness are the building blocks of a superior online experience. As in virtually every other industry, health plan members have become savvy users of technology. Health plans must transform their approach to customer service and remove the current disconnect between customer service and technology and focus on making online customer service easy to use while improving functionality and content.

The challenge? The challenge is creating a “big picture,” self-service platform that satisfies member needs while providing a rich online experience. The bar for customer service has been raised, and plans should view this time as an inspirational turning point or risk missing the opportunity to truly enhance the lives of their members. In fact, the health plan customer service experience should be designed with the following motto in mind: Partners for Life.

Embracing Big Data and Mobile Technology to Create a Better Healthcare Insurance Experience

June 12, 2013 by bobyurkovic

There are many different types of healthcare technology that have the potential to boost the bottom line for insurance companies while simultaneously improving the customer experience. Unfortunately, many health insurance companies have not yet fully utilized these technologies. Big data and mobile technology, including cloud-computing capabilities, can provide many different cost-effective, patient-centered, integrated healthcare payer solutions that both insurance companies and policyholders can appreciate. It’s time for insurance companies to embrace big data and mobile technology, if they haven’t already done so, in order to create a better healthcare insurance experience for all.

Big Data, Mobile Solutions and Health Insurance

As you may know, big data is a term that defines the large and complex sets of information that organizations are collecting in the digital age. As these sets of data grow, it becomes harder and harder to process all the data using the applications and database management software that an organization may traditionally have been utilizing. Since healthcare is the fastest growing industry in the world and is expected to grow and transform even more within the United States when Affordable Care Act provisions go into effect in 2014, health insurance companies have some of the biggest data challenges facing any organization in the 21st century. Many employers will require new healthcare payer solutions as of January 1, when the mandate requiring large employers to provide affordable health coverage to all fulltime employees goes into effect. The sets of data that health insurance companies are dealing with will only continue to grow as more people become insured and the population steadily increases, leaving a huge need for technology solutions to make this data as manageable as possible without negatively impacting revenues or damaging the customer experience.

What This Means for Healthcare Insurance Providers

Healthcare insurance technology consultants are already busy helping many of the leading insurance companies transform their technology systems so they can manage their data more efficiently and improve their customer centricity. Healthcare information consulting firms can help insurance companies embrace the kinds of technology that will help them create a better experience for their companies while improving their bottom line. The first step is deploying an electronic medical record system, which many companies have already done, but this is not nearly enough to handle the big data challenges around the corner. In order to provide accountable, cost-effective, patient-centered, integrated healthcare solutions, insurance companies must make a concerted effort to take advantage of the content they have at their fingertips and automate as many of their operations as possible to make the patient care process nearly seamless. Since this type of effort requires a strategic master plan to be successful, working with a consulting firm is advisable.

The Leading Big Data and Mobile Solutions for Healthcare

Different insurance companies may require different healthcare payer technology solutions depending on the needs of their customers and internal structure, but there are some solutions that may be universally beneficial for the healthcare industry overall. These include the digital integration of enterprise health information, mobile access to healthcare information for employers and employees, the embrace of cloud computing for managing large stores of data that can be accessed remotely and the automation of paper-driven processes so resources can be refocused on customer care. Insurance companies can also utilize big data to provide a clearer picture of healthcare outcomes so medical providers can improve patient care and refocus their attention on initiatives that improve patient lives while cutting healthcare costs nationwide. This new era of big data analysis will require new, skilled workers to answer the call, just as the transition will require experienced consultants to ensure a smooth process overall.

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