accenture 7 things health insurance customers not telling you

8/2/2019 Accenture 7 Things Health Insurance Customers Not Telling You

1/16

The 7 Things Your Health

Insurance Customers Are

Not Telling You

And What To Do About Them

Insight Driven Health


2/16

The seismic shift in power

to the customer has come

at last to the US HealthInsurance market. With

The Patient Protection

and Affordable Care Act

adding 40 million new

customers and with

individual and Consumer

Directed Health Care

(CDHC) plans explodingin popularity, US health

insurers will need to invent

new healthcare solutions

for competitive success.

Right at the fore is customer service,

the entre to productive customer

relationships that will withstand the

test of time. Customers have become

more diverse and more demanding,

wanting service offerings, experiences

and communications increasingly on

their own terms. They have also become

more technology savvy and less shy

in broadcasting their experiences.

Technology trends like social media

have ignited a new consumer activism

whose reverberations have only begun

to be felt. Insurers operating in this

new normal face an unprecedented

level of competition, unparalleledopportunities to expand, and the

commensurate risks of failure.

With customer service emerging as

the X Factor of high performance,

health insurers must understand current

customer perceptions, as well as how to

shape (and improve) these perceptions

for future growth. To help crystallize

these factors, Accenture Healthcare

conducted a survey of customer attitudes

toward the customer service practices

of US-based health insurance providers.

Using a web-based questionnaire,

we surveyed 1,000 customers in the

US between late December 2010 and

early January 2011. From that research

we distilled the surprises and secrets

of customer service that togetheroutline the alchemy behind superior

customer service performance.


3/16

Seven Surprises About Customer Service

Surprise #1Being satisfied with high

customer satisfactionis a mistake.

Overall, customers feel satisfied with

their health insurance providers; in fact,

our research found that 42 percent

of customers have a high degree of

satisfaction, while only 7 percenthave a high degree of dissatisfaction

(Figure 1). However, current satisfaction

levels do not translate into loyalty and

revenue opportunities. Despite their

general satisfaction, customers are

divided about equally on their feeling

of loyalty to their health insurer.

Moreover, few would purchase more

services from their health insurer,

if offered. 41 percent of customers

indicated that if offered additional

services, they would be unwilling

to buy them, while only 7 percent

indicated that they would be willing.

Figure 1Current State of Satisfaction, Loyalty and Advocacy

7% 42%

39%14%

26% 23%

7%41%

Extremely

How satisfied you are with the Health insurancecompanies you do business with today?

Do you trust Health insurance providers to keepyour personal Health information confidential?

How loyal you feel to yourHealth insurance provider?

The extent to which you will buy moreproducts/services from your Healthinsurance provider?

% respondents giving top 3 of 10 boxes ratings

% respondents giving bottom 3 of 10 boxes ratings

Not at All


4/16

Surprise #2Payers are not keepingup with rising customerexpectations.

The current tenuous nature of customer

loyalty to their health insurers may have

its roots in their rapidly rising customer

service expectations. We found that 20

percent of customers indicated that their

expectations of the customer service

function increased, just in the past year.

Furthermore, 41 percent stated that

their expectations increased in the past

five years. They want greater ease and

better support: When asked how their

expectations increased, 80 percent said

that they expect customer service to be

easier/more convenient to obtain and 75

percent said that they expect customer

service representatives to be more

knowledgeable and better trained.

As customers are growing more exacting,

their health insurers are struggling to

pass service muster. In fact, our research

found a large gap between what matters

to the customer and the perceived

performance of health insurance

companies. While having employees who

are knowledgeable and well-informed

ranked as the most important customer

service attribute, several other qualities

were rated nearly as important, including

the amount of time I have to wait

to be served. Yet for all five of the

characteristics rated most important,

the gap between customer expectations

and insurer performance was significant

(Figure 2).

41%

Having employees who are knowledgeable and well-informed?

Having customer service available at convenient times (forexample, after work and weekend support availability)

The amount of time I have to wait to be served

The amount of time it takes to completelyresolve my issue or problem

Having customer service people who can deal with my issuewithout having to refer me to another person

% respondents rating characteristic as important (top 2 of 5 boxes)

% respondents rating satisfied with characteristic (top 2 of 5 boxes)

85%

47%

79%

48%

79%

39%

78%

37%

76%

39%

Figure 2Customer Service Characteristic Importance & Satisfaction


5/16

Surprise #3Most payers arestruggling with serviceexperience basics.

While it could be tempting to focus

improvement efforts on areas where

service expectations are changing, our

research suggests that health insurers

will need a more balanced approach

one that does not lose sight of service

fundamentals. In fact, our research shows

that customers get highly frustrated

when their basic expectations are not

met. When asked to rate their most

frustrating customer service experiences,

the five that rose to the top are also the

most basic building blocks of the service

experience (Figure 3). Figure 3 also

reveals that these frustrations happen

far too often; for example, more than

one-third of the people surveyed said

they regularly experience long hold times

and have to repeat information. Health

insurers have no chance of beating

the competition in a game of risingexpectations if they cannot consistently

meet the minimum requirements.

41%

Having to contact customer service multipletimes for the same reason

Dealing with customer service agents whocannot answer my questions

Having to repeat the same information tomultiple customer service agents

Being on-hold for a long time when contactingcustomer service

Dealing with customer service agents who areunfriendly or impolite

% respondents rating extremely frustrating with the situation (top 2 of 5 boxes)

% respondents rating encounter this a lot with the situation (top 2 of 5 boxes)

77%

30%

76%

28%

74%

35%

74%

38%

73%

17%

Figure 3Top Five Frustrating Customer Experiences & Frequency of Occurrence


6/16

Surprise #4The benefits oftechnology investmentshave been decidedlyone-sided.

Payers have made a huge investment

in customer service technologies over

the years, implementing advances such

as automated phone attendants, live

chat via the Internet, self-service on a

website and mobile applications. For the

most part, these technology advances

have delivered tangible benefits in the

form of higher self-service rates and

lower handling time. What they have not

done, however, is dramatically improve

the customer service experience. While

technology lends itself to handling

higher service volume, it has tended

to have little impact on individual

experience. Our research shows that

only 11 percent of respondents strongly

agreed that the increased use of

technology in customer service has

improved the level of service significantly

in the past five years (Figure 4).

To date, despite their willingness to

invest in service advances, health

insurers seem to have failed to provide

the personalized experience customers

crave. Only 10 percent of respondents

strongly agreed their health insurers

tailor my customer experience to match

my needs, preferences, and/or value to

them. More than twice that amount (22

percent) strongly disagreed. Similarly,

only 9 percent agreed that their health

insurers communications make me feel

a connection to them. In contrast, 32

percent strongly disagreed.

Crafting a personalized service experience

will only become more important in

the post-reform marketplace, given

an increased focus on patient-

centeredness across the health system

as a whole. From a service perspective, a

key tenet of consumerism is the abilityto tailor the experience to match the

customers needs, preferences, and/or

value to the business.

11%48%27%17%

The increased use of technology in

customer service (e.g. automated

phone attendant, live chat via the

internet, self-service on a web site,

mobile applications) has improved

the level of service significantly in

the past five years.

Strongly Disagree Somewhat Disagree Somewhat Agree Strongly Agree

AgreeDisagree

Figure 4Use of Technology in Customer Service


7/16

Surprise #5Service qualitytrumps price.

The message that comes across loud and

clear is that health insurance customers

generally are more value-driven then

price-driven. Our research clearly shows

that customers are not willing to trade

off customer service options or quality in

exchange for a lower price. In fact, our

research shows that only 6 percent of

customers are willing to compromise on

levels of customer service in exchange

for a lower price. In contrast, more than

7 times as many customers (44 percent)

strongly oppose degrading quality

for the sake of price (Figure 5). Such

findings should act as a wakeup call for

those who make the service investment

decisions.

61%

44% 6%

41% 7%

23%28%41%

Agree

Lower levels of product quality if itensures I get the lowest price

Lower levels of customer service if itensures I get the lowest price

Lower levels of product options if itensures I get the lowest price

Lower frequency of communications ifit ensures I get the lowest price

% respondents agreeing (top 3 of 10 box ratings)

% respondents disagreeing (bottom 3 of 10 boxes ratings)

Disagree

3%

Figure 5Price Tradeoff Preferences


8/16

Surprise #6Customers are social,yet payers are notsocially engaged.

Social media has come of age and has

begun to redefine not just individuals

personal relationships, but their business

ones as well. Our research shows that

a majority of respondents (76 percent)

went online looking for information

about health insurers at least a few

times during the past year. For these

respondents, social channels are

becoming an increasingly important way

of sharing information40 percent read

about healthcare through these channels

at least a few times during the year,

and 8 percent are actively engaging in

conversations about payers.

Yet our research also finds that, currently

health insurers are not leveraging social

media in any major way. Only 6 percent

of respondents agree that the use of

social media sites has increased their

overall awareness about products and

services from health insurance companies

that they did not know of before, and

only 5 percent say that their use of socia

media sites has increased their overall

engagement with their current insurance

companies and their brands (Figure 6).

I tend to trust comments about Health insurancecompanies/brands on social media sites posted bypeople I dont know.

I tend to trust comments about Health insurancecompanies/brands on social media sites posted by peopleI know (family, friends, co-workers...).

Comments posted on social media sites influencemy opinions about Health insurance companies orbrands in general.

The use of social media sites has increased my overallawareness about products and services from Healthinsurance companies I did not know of before.

The use of social media sites like blogs, bulletin boards,Facebook, MySpace, Twitter, etc. has increased myoverall engagement with my current insurancecompany and their brands.

% respondents agreeing (top 3 boxes)

% respondents disagreeing (bottom 3 boxes)

28% 21%

52% 8%

23%

5%66%

6%58%

54% 5%

AgreeDisagree

Figure 6To what extent do you agree with the following statements?


9/16

Surprise #7Customers are notvoting with their feet(yet), but theyre doingplenty of talking.

While poor customer service performance

is not usually the driving factor for

switching insurance providers (Figure

7), our research has found it is the

driving factor in other industries. In

fact, Accentures 2010 Global Customer

Multi-Industry Research Study found

that 64 percent of consumers switched

from at least one service provider in

the past 12 monthsa bank, utility, or

wireless carrier, for exampledue to poor

customer service.

Given the unique structure of the health

insurance marketplace, insurers so far

have been granted some immunity

against the impact of poor service

performance: the primary reason

individuals switch health insurance

companies is because they have been

required through changes in their

corporate enrollment options. However,

as the consumerism trend in health

care increases in line with increased

growth in the Individual market,

consumer-directed health plans and

the like, we expect customer service

performance to emerge as a source of

differentiation and contributing factor

to loyalty and retentionmuch like it is

in other industries today. The individual

consumers voice will undoubtedly gain

more influence, and already, people are

speaking up loud and clear.

Required by change in company open enrollment options

Other reason(s)

Price

Product/service options were too limited

I lost trust in the company

Overall poor quality of the customer experience

45%

28%

18%

7%

6%

5%

Figure 7Customer Motivations to Switch Providers


10/16

Employer educational materials

Corporate web site

Information from people I know

On-premise/in-store information from...

Online information from other sources

Direct mail or telemarketing

Print advertising

Online advertising

Paid advertising on TV or radio

Others

58%

47%

40%

11%

9%

9%

5%

4%

4%

3%

Figure 8How important were these information sources or channels to you in deciding to do business with the company?

Our survey found that 40 percent of

customers told a friend, family member,

or co-worker about a negative customer

service experience in the past year. As a

source of information, our respondents

rank word of mouth in the top three,

by a margin four times greater than

their fourth most important information

source (Figure 8). As we move to a

consumer-driven market, the importance

of word of mouth should only go up.

Perhaps even more striking than the

prevalence and importance of word-

of-mouth is the fact that 7 percent

of our survey respondents reported

posting negative comments about their

experience online (Figure 9). While

the percentage posting online is still

comparatively small, the impact will be

much greater, as the posted comments

have the potential to reach a global

audience. Should the comments go viral,

they have the potential to destroy a

brand. As social media growth explodes,

consumers are participating in activism

at unprecedented levels. Here is where

health insurers will find the real

ramifications of having ill-conceived

social media strategies.


11/16

40%

7%

Told people around meabout the experience (e.g.,friends, family, coworkers)

Posted negative commentsabout the experience online(e.g., blogs, Facebook,Twitter) Yes

Actions being taken by these % respondents afterhaving a bad experience online (one respondentcan select multiple actions as response)

Respondents who took no action

Unique respondents who tookat least one action

41%

59%

Figure 9In the past year, have you done one of the following after having a bad experience with a Payer


12/16

Seven Secrets to

Delivering Service the

Way Customers Demand

View customer serviceas a differentiatornot a

cost center.Often insurers treat customer service

as a check the box reality versus

a differentiating capability, missing

the valuable opportunities that can

come when service representatives are

empowered to act as advocates for the

consumer. Insurers should recognize

that controlling costs need not be

mutually exclusive from meeting service

expectations. By maximizing the value

of their most important, influential (andfundamental) assettheir customer-

facing employeeshealth insurance

companies can realize immediate and

substantial improvements, in both service

quality and cost.

Accentures experience has shown

that by implementing established high

performance workforce techniques payers

can better realize improved performance,decreased time to proficiency, and

greater employee engagement. For

example, Accenture has seen that service

supervisors often spend too much time

performing administrative tasks and

too little time coaching. Furthermore,

we often find that supervisors receive

little to no training themselves on how

to perform their role. Implementing

supervisory training programs and

setting measurable performance

expectations can have a profound effecton operational performance, employee

morale and the customer experience.

Similarly, high performance reporting,

analytics and quality monitoring

capabilities will help improve the overall

quality of the interaction and reduce the

standard deviation of performance levels.

Rethink the servicedelivery model.

Many insurers organize their call centersalong traditional member and provider

dimensions; they train their customer

service representatives to handle all call

types in each of these areas. However, as

the health care model changes, payers

need to optimize their service delivery

model to keep pace. In this regard, the

health insurance industry can learn

valuable lessons from other industries.

For example, wireless providers have

learned that they get better customer

retention and satisfaction by having a

dedicated group of customer service

representatives to welcome and educate

new customers. New customers have

different needs than established

customers and the welcome call group

is trained to anticipate and meet these

unique needs.

Secret #1 Secret #2


13/16

A similar opportunity exists in healthcare.

Payers should seek to identify unique

customer needs (for example, those

with chronic conditions) and buildunique capabilities around those needs.

Such a capability will become a source

of competitive differentiation as the

individual market grows in popularity.

Drive to simplicity.

Over the years, the systems and call-

handling processes implemented byhealth insurers have become more

complex, which in turn drives longer

training times, longer CSR time-to-

proficiency and large performance

variations. CSRs spend too much time

bouncing between systems or searching

within a system to find the information

required by the customerwith the

common result of a poor overall customer

experience. These challenges will be

further magnified with the introduction

of ICD 10 (international standarddiagnostic classification for diseases

and other health problems), which will

complicate the job on the insurers end.

Fortunately, advances in CRM

technologies are giving companies the

tools to reduce complexity and improve

performance for consistent, integratedmulti-channel customer interactions. For

example, a workflow-enabled desktop

that presents the right information

and/or treatment recommendation at

the exact time in the process can be

implemented faster and at less cost than

ever before.

Secret #3


14/16

Embrace an outside-inview of self-service

technology.In the past, health insurance companies

have viewed self-service as a trade-off

that balances the necessity to reduce

costs against decreasing customer

satisfaction. Customers have viewed self

service as trial and error: they embrace

well-planned and well-designed channels

and reject those that are not.

Given that the customer will look for

the right tools to help themselves and

help others, the new view is that thevoice of the customer should influence

technology investments and how the

self-service experience is designed. By

leading with what the customer wants,

the other benefits will follow: reduced

costs, increased satisfaction, enhanced

brand image and differentiation from the

competition.

Dont be anti-social.

Although payers may not need to

invest in aggressive proactive socialmedia outreach right now, they should

invest in proactively developing a

comprehensive social media strategy

for their organizations. Accentures

client experience across industries

finds that companies often jump into

creating a social media presence without

thinking through their strategy (a Fire

. . . ready . . aim! approach). Focusing

initially on how to use social media in

a single business domain (for example,

marketing and sales, or customer serviceand support) is one way to launch into

social media and minimize the risk of

fragmentation. It will also focus the

organization on what to listen to to

support identified business goals, without

drowning in social media noise. Insurers

should proactively listen to and learn

from customers to identify any current

context, culture, processes, people,

policies, and metrics that may need to

be modified to support their new social

media strategy. Then, they can launch,

refine and expand the initial strategy into

other areas as they learn.A logical first step would be to

focus on the marketing and public

relations business domain to listen for

conversations that mention a companys

brands. After analyzing conversations

to understand the chatter, an insurer

could implement tactics across customer

service, both to reinforce positive

sentiment and quickly address negative

sentiment. From there, the company

could begin expanding into health

management applications as part of anintegrated multi-channel experience

that allows people to connect with other

patients like them or access resources to

meet a specific health goal.

Secret #4 Secret #5


15/16

The challenge with social media is finding

a role to play while avoiding additional

fragmentation in the industry (and losing

the voice of the customer across differentchannels). In all cases, a key question

will be whether the company should

use company owned and controlled

(on-board) social media tools or off-

board (not company owned) ones, such

as Facebook.

Get analytical.

Customer-facing channels such as the

web, IVR, mobile, contact centers andsocial media generate tremendous

amounts of data, yet few companies

are good at turning this data into

insight. Without the ability to perform

enhanced analytics, high performance

will remain elusive. First, payers need

the ability to merge disparate sources

of data (call logs, contact records,

customer satisfaction surveys, IVR logs,

etc.) into a single data source. Second,

payers need to develop the capability to

analyze, interpret and act on the newdata and insights developed. Third, payers

increasingly will need a way to analyze

on-board and off-board data about their

brand and customer experience.

Embrace consumerism.

Closing the gaps between customers

service expectations and theirexperiences will not guarantee success

for health insurers. Fundamentally, they

need to become more customer-centric

not an easy task, particularly as health

payment and delivery reforms demand

new types of collaboration among

payers and providers. Its an expansive

challenge that must be taken apart to

manage well. To become customer-

centric, insurers will need to develop

an integrated view of their customers,

segmented on values, behaviors,attitudes and health attributes. They

will need to identify unique and unmet

customer needs, define segment-specific

treatment plans for all customer touch

points, and then develop the operational

capabilities to deliver these treatments

and monitor and learn from them.

Secret #6 Secret #7


16/16

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All rights reserved.

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High Performance Delivered

are trademarks of Accenture.

About Accenture

Accenture is a global management

consulting, technology services and

outsourcing company, with with morethan 223,000 people serving clients in

more than 120 countries. Combining

unparalleled experience, comprehensive

capabilities across all industries and

business functions, and extensive

research on the worlds most successful

companies, Accenture collaborates

with clients to help them become

high-performance businesses and

governments. The company generated net

revenues of US$21.6 billion for the fiscal

year ended August 31, 2010. Its homepage is www.accenture.com.

Learn More

To discuss how Accenture can help your

organization develop the right customer

relationship management solutions,

please contact Doug VanWingerden at

[email protected] or

678.357.7902.

Accenture: Insight Driven Health

Insight driven health is the foundation of

more effective, efficient and affordable

healthcare. Thats why the worlds leading

health care providers and health plans

choose Accenture for a wide range of

insight driven health services that help

them use knowledge in new waysfrom

the back office to the doctors office. Ourcommitted professionals combine real-

world experience, business and clinical

insights and innovative technologies

to deliver the power of insight driven

health. For more information, visit:

www.accenture.com/insightdrivenhealth.

accenture 7 things health insurance customers not telling you

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