Improved customer experience drives down care delivery costs, reduces administrative expenses, improves patient and member retention and fosters better patient decision making. The key is a bone deep CX vision that leverages customer experience technologies across healthcare organizations.
By bone deep we mean a commitment to delivering a superior customer experience that goes way beyond the sales and marketing groups and includes clinicians, technicians, billing departments, IT and…everyone. Including the executive suite. Front, middle and back offices are all integral members of the CX team—just as it is at premier consumer organizations like Amazon. Accordingly, successful CX organizations broaden the definition of CX technology to include all technologies that help create, or can be drawn on to produce, a more satisfied, knowledgeable customer who is actively engaged in his or her health.
Committed use of these leveraged technologies deliver what we regard as the four capabilities that define effective, multi-channeled customer experiences:
- Customer Experience (CX) Strategy & Design—Developing a vision and blueprint consistent with the brand promise.
- CX Information Management—Integration of data, including big/unstructured, to develop a single customer view.
- CX Insights—Leveraging information-based customer intelligence, analytics, modeling, segmentation, and research.
- CX Delivery—Using data, insights, and technology to make an optimal customer experience operational.
Front Office
Customer data is the critical foundation for building relationships. Taking an outside-in approach by using consumer research and in-depth customer is key to understanding needs and behavior motivators. Maintaining a customer and product history and robust customer analytics provides insights on how different segments interact with a payer. Understanding and honoring customer preferences enhances engagements and builds trust.
Personalized experience strategies enhance engagements and cultivate relationships. There is not a ‘one size fits all’ approach to building relationships with customers; different segments have different needs and behaviors. Relationship strategies should be aligned to the brand identity and reinforce segment value propositions.
Omni-channel customer experiences creates a consistent dialogue and enables customers to engage the organization through their channel of choice. It provides a consistent dialogue with customers regardless of channel. Channel escalations should be clearly articulated to customers in order to not create confusion/disappointment. A good omni-channel experience provides a fuller picture of how customers engage and improves measurement activities.
A supporting infrastructure is necessary to orchestrate relationship development. An engagement architecture comprised of profile, preference, campaign automation, channel, content and interaction management capabilities is necessary for executing designed experiences and measuring success. Robust analytics ensure continuous improvement; Sophistication needs to evolve from retrospective analysis to predictive modeling. Enhanced data management and integration is key to deliver timely/appropriate information and address privacy concerns.
Product strategy must evolve with the world. Products are no longer just major medical; major medical needs to be thought of as a component of a larger product design. Ancillary/cross-sell and up-sell products are a continual focus to supplement core offerings. Tools that were traditionally thought of as self-service (i.e. transparency, member portals) need to be a part of the product design.
Flexible product design is table stakes in every other industry. Consumers are used to the ability to configure their own products in most industries, healthcare shouldn’t be different. Consumer-friendly interfaces must be developed to access the catalogue during order capture. Tools should direct sales teams to preferred options.
Product starts a multi-functional workflow that needs to be right. Product is the top of a multi-functional workflow, if you don’t get it right you don’t get the rest of the business right. Business processes need to be well defined to ensure effective hand-offs between business functions throughout the product lifecycle. Process automation ensures process consistency while reducing admin costs. Business rules to govern the product customization capabilities and the overall process must be established.
Each year should build on the last. Data from previous year configurations should inform future product designs and portfolio management efforts. Customer product configurations should be stored and serve as a starting point for resale efforts. Product data should inform cross-sell/up-sell opportunity identification. Considerations for product retirement and transitions.
Middle Office
Care management is about behavior change. Customers are often “passive,” overwhelmed, and unaware of how they should be taken care of themselves. Members and patients play a large role in determining both the need for, and the outcomes of care; however, they are ineffective managers of their own health and health care due to lack of tools, knowledge, and motivation.
Traditional customer engagement channels (letters and phone calls) and strategies are often one-sided. These channels are not aligned to consumer preferences or needs and only produce marginal engagement rates. Controlling costs and achieving health care quality improvements require the participation of “activated” and informed patients and their care team. Enabling customers with the knowledge, skills, and confidence to manage their health is critical to bettering care outcomes, for all customers, not just those traditionally classified as “high risk.”
It’s not a “one size fits all approach.” Care management teams currently treat all customers across populations (group, retail, government) equally, not accounting for the unique needs of individuals within leading to customers disregarding the attempted engagement by the organization. Customer engagement capabilities are often front-office focused and absent within the middle office. Tailored capabilities by population are required to assist with care improvement outcomes. Personalized multi-channel engagement, driven by actionable analytics, and tailored messages/programs are necessary to activate customers and improve outcomes—right message, right channel and the right time.
The operating model needs to change. The ways the organization currently structures people around processes does not enable activation but rather just high touches. How the organization engages with care teams, caregivers and other associate parties needs to shift to activation. They must enable capabilities to understand conditions, have the right resources and motivate act. Technology and operations must be flexible enough to support emerging health management programs and provider care delivery models.
Data must be integrated across the ecosystem. Walls need to come down. Data needs to be shared and aggregated across the ecosystem (pharma, clinical and payer) in order to effectively improve care and meet the objectives of care management.
Back Office
Supporting CX requires a strategic approach that emphasizes cost savings, flexibility, and solutions that provide creative and productive approaches. Collaboration with sales, marketing, network management and care management is important to understand the impact of what is being sold on what can be serviced—and at what cost. Managing and automating regulatory and service level compliance enables focus on differentiators like customer experience.
A bone deep CX approach requires full commitment from the entire organization, and the leveraging of technologies in the front, middle and back office. As the whole organization aligns around CX, customer loyalty and lifetime value will grow.
