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Give us digital! Health plan members speak

Building market-share by delivering rich, intuitive experiences is a key goal for all organizations. For health insurers, this customer-centricity is an imperative. Individual consumers now have increasing freedom to shop for health plans and to choose how they spend their healthcare dollars. The key challenge for payers is understanding what constitutes a delightful experience for an empowered health plan consumer and delivering that while balancing competing technology investment priorities.

To find out what experiences health plan members want from payers, we surveyed members of private U.S. health plans, including national, regional and Blues members. Medicare and Medicaid members were excluded. Members told us the building blocks for delivering satisfying experiences are digital shopping and plan management tools delivered via mobile channels.

A strong preference for digital

In general, if a transaction can be done digitally, that's how most health plan members want to do it. Of our 1,600 respondents, 84 percent said they prefer to interact digitally with their health insurance payer.

In particular, members of both individual and employer-sponsored health plans want robust digital features to help them make well-informed choices when they are shopping for health plans. They also want digital features to help them manage their plan activity, from printing ID cards to accessing digital explanations of benefits.

Further, members prefer to use mobile to access many advanced features. When a feature is available both on the Web and from a mobile app, members often find it more satisfying to use the feature via their mobile device. These features include comparing plans, scheduling appointments, locating pharmacies, and refilling prescriptions.

Room for improvement

Approximately 40 percent of members indicated that health plans' website, mobile and digital self-service features have room to improve, with these members reporting less than total satisfaction with those aspects of their health plans.

Similarly, about one-third of the members are only somewhat to not at all satisfied with their plans' communications, claims handling operations and customer support. Members consistently said availability of digital features in these areas was important to them, such as apps for digitally submitting claims and estimating costs for procedures.

Health plan members speak and the word is digital: Survey highlights

We surveyed 1,600 private health plan members, 1,375 of whom come from employer group plans and 225 who carry individual plans. Respondents represented four national plans; 10 Blues plans; and 154 regional plans.

  • 69 percent said it is "very important" for their payer to communicate with them through their preferred channel

  • 84 percent prefer to interact digitally with their health insurer

  • 75 percent are more satisfied with digital shopping and plan management features accessed via mobile

  • Members of all ages are adopting digital features at similar rates, with these findings refuting the idea only younger members care about digital channels.

Members want digital capabilities when shopping for health plans:

  • Ability to shop for a plan via website or app versus interacting with agents, brokers or navigators (80 percent).

  • Online tools to compare and evaluate providers on various quality ratings and reviews (58 percent).

  • Guided selling tools that help them sort and narrow various plan options and help them make appropriate choices (40 percent).

  • Utilization-based recommendations for an appropriate plan, i.e., being offered plans based on their past usage, family life stage, existing health conditions, etc. (40 percent).

  • Transparency and ease in calculating plan premiums, co-pays,co-insurance and out-of-pocket cost estimations (67 percent).

Plan management capabilities members want include:

  • Digital submission of claims (63 percent) and the ability to support real-time digital inquiries about claim status (71 percent).

  • Ability to print out ID cards and/or request them online (61 percent).

  • Delivery of statements (explanation of benefits) via digital channels (70 percent).

  • Younger (18-35 year old) respondents say it is important or very important for them to be able to pay provider bills and health insurance premiums via digital channels

  • Ability to pay via digital channels, including via mobile (51 percent). The finding suggests members could be open to using options such as Apple Pay, Google Wallet and other electronic wallet features.

Respondents weren't particularly social:

  • Just 3 percent chose social media as their preferred communication channel

  • 17 percent visit their plan's social network sites

  • Only 16 percent say social media influences their choice of plan

  • More than half liked the idea of their insurer providing an online or mobile personal health record

  • 60 percent want to choose their own wellness or fitness incentives

  • 70 percent are very concerned about online data privacy and security.

Driving members to digital

As you answer these 12 questions, you can give yourself a rating of high, medium or low for each one. Be aware that you may not want to score 'high' every time. Depending on the business imperatives of your organization or business segment, you can determine the relative weight of each question in your organization.

Once this is done, you can employ our statistical model, the Cognizant Content Maturity Matrix, to help you plot the current state of your content ecosystem, and identify targets for the future. The model divides into 4 'quadrants' depending on how developed, advanced or under-developed your business is, and where you are in the process of becoming a market-leader or game-changer.

The model also makes recommendations on how to proceed, depending on where you are.

Digital Transformation Framework

1
Establish “future-first”

Identify the target capabilities, such as mobile access, critical to the organization’s future success.

2
Focus on the member experience

Define the experience of the future by reimagining experiences with key stakeholders, such as delivering online shopping tools and plan management capabilities.

3
Prioritize capabilities

Inventory target capabilities and categorize them by “on par,” or “table stakes” abilities; “market leading;” and best-in-class.

4
Validation of capabilities

Validate priorities based on industry trends and assessments of competitors.

5
Product selection

Identify best of breed products able to deliver required capabilities.

Payers can also evaluate platforms reaching the market that combine digital "point solutions" and platform-native apps into a common digital consumer engagement layer. Payers can quickly launch so-called table stakes features and functions from the platform, while its engagement layer ensures a consistent experience across all stakeholder touch points.

Powerful digital shopping and plan management features delivered via preferred channels are becoming baseline expectations among healthcare consumers. While payers' specific digital punch lists may differ, members' strong demand for digital engagement tools shows investment in digital transformation must be a priority.

For more survey results and our perspective on them, download The Digital Mandate for Health Plans at: http://www.cognizant.com/InsightsWhitepapers/The-Digital-Mandate-for-Health-Plans-codex1760.pdf


About Cognizant

Cognizant (NASDAQ: CTSH) is a leading provider of information technology, consulting, and business process outsourcing services, dedicated to helping the world's leading companies build stronger businesses. Headquartered in Teaneck, New Jersey (U.S.), Cognizant combines a passion for client satisfaction, technology innovation, deep industry and business process expertise, and a global, collaborative workforce that embodies the future of work. With over 100 development and delivery centers worldwide and approximately 218,000 employees as of June 30, 2015, Cognizant is a member of the NASDAQ-100, the S&P 500, the Forbes Global 2000, and the Fortune 500 and is ranked among the top performing and fastest growing companies in the world.

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