Health payers’ opportunity to humanize the consumer experience

It’s common these days for people to expect anytime, anywhere products and services via their smartphones. It’s also natural for them to convert their preferred experiences from other industries into expectations for health organizations. Have you noticed how innovation from hospitality, transport and retail is redefining expectations and business models in healthcare? Just look at Uber Health, for example.[1] Those transferred expectations are enhanced by innovative services from national and local plans, Medicare plans and disruptors like Oscar and Bind.

It’s no secret that the health landscape has become more complex, and society’s healthcare challenges ever bigger. We’ve seen massive, costly growth of chronic diseases such as diabetes, cancer, mental health issues and, lately, viruses add to the burden. COVID-19 has highlighted the importance of consumer relationships, but healthcare has been slow to evolve, even though the importance of a people focus has grown. It’s unsurprising that patients often feel dissatisfied and dehumanized.

Mind the gap—consumer experiences are falling short

Accenture did research among Chief Marketing Officers (CMOs) and consumers across several industries. The results confirmed that consumers give health payer experience the lowest consumer experience rating—while payer CMOs overestimate the quality of the consumer experiences they’re creating. As a result, most consumers are switching payers. The good news is they can be lured back if CMOs course correct.

There’s a clear gap between what health payer executives in general think their consumers experience, and what their consumers actually do. In general, it’s observed that payer marketing leaders think they provide consumer experiences at least as good as leading industries. Our research[2] says otherwise.

Despite lower Net Promoter Scores[3] (NPS) (a sign they’re under-delivering on consumer expectations), 33 percent of payer CMOs think they are “extremely successful” at delivering relevant customer experiences. That’s compared to just 17 percent of CMOs in industries with high NPS scores (like retail and banking) who make the same claim. Most payer marketing leaders’ perceptions don’t add up with reality, so they need to mind the overconfidence gap. Other industries’ success at meeting consumer expectations shows that consumer brand loyalty correlates with consumer trust in the brand. That´s the way to change the tide. They need to invest in simple vision-driven, measurable positive experiences that build trust.

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With NPS ratings among the lowest of all industries, interviewed payers are underdelivering on experience where it matters most—in consumers’ eyes.

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Together, these dynamics create a consumer experience gap which threatens payers’ market positions. Of course, it’s understandable that healthcare might lag in some areas and not roll out every new consumer experience immediately. The stakes are high when it comes to people’s health and lives, and new experiences should help and not jeopardize them. However, the transfer of expectations is inevitable, and patience is finite.

For healthcare experiences to be relevant, people need easy access to them—and the experiences need to improve outcomes. In the past, Health organizations had to trade experience vs. access vs. outcomes, but no longer. In healthcare’s bold new era, organizations can do better in all three areas simultaneously.

Close the gap, don’t fall into it

While the health consumer experience gap could be a pitfall, it’s also a golden opportunity for CMOs to lead the market by improving consumer experiences. The Accenture 2020 Payer Consumer Experience Benchmark Survey[4] revealed major opportunities for retention and re-acquisition. 70 percent of consumers (of the 17 percent with group coverage who recently switched health insurers) could have stayed with their previous insurer, and 83 percent of those would consider switching back.[5] So payer CMOs can reverse the tide by providing the right incentives. Winning those switchers back requires an experience strategy that builds deep trust.

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Brands like Amazon and Uber have shown that effective customer-focused simplicity is the way to go. If people are clear about what providers do, and they trust them to do it effectively and reliably, they’re likely to be won over. The Payer Consumer Experience Benchmark Survey indicates the same applies in the payer industry:

  • 82 percent of people who trust payers strongly agree that their insurers provide consistent and accurate communication.
  • 84 percent of people who trust payers agree that their insurers pay claims accurately.
  • 74 percent of people who trust payers strongly agree that their insurers provide accurate information in the first contact.

So, how can payers close the gap rather than falling into it? From our perspective, there are three main ways.

Develop a driving vision: finding a strong leader to own development of a vision with key performance indicators and get buy-in from other key executives.

Mix up the metrics: measuring the experience outcomes that consumers want and prefer so that you can adapt with customer needs and ensure that experiences stay relevant.

Elevate the experience: while finding a champion and creating experience-based metrics, keeping your eyes on the prize, using consumer preference data to improve personalization, creating seamless service interactions across channels and ensuring that products are appealing and understandable.

The wave of creativity and experimentation unleashed by COVID-19 and enabled by technology is accelerating and multiplying changes that have been gathering pace for some time. Soon, the healthcare industry could look and behave very differently, and new health experiences could replace previous ones that were clunky and disjointed.

In the end, consumers will likely stay if their health coverage is going to work for them. Even beyond COVID-19, consistent, accurate and reliable healthcare experiences are the secret sauce needed to build trust and make the most of the opportunity the consumer experience gap presents.

[1] https://www.uber.com/newsroom/uber-health/
[2] Accenture 2019 CMO Insights Survey
[3] Research America, 2020, Net Promoter Score, research measuring customer loyalty, (accessed 11/30/2020).
[4] Accenture 2020 Payer Consumer Experience Benchmark Survey
[5] Ibid.

Anoop Bhogal

Senior Manager – Consulting, Health, Customer Engagement, North America


Cayla Meinert

Manager – Consulting, Health, Payer Practice

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