Feeling pressure from industries that are doubling down on consumer experience—and raising consumer expectations in the process—health insurers have made significant investments in this area over the past decade. Even so, they lag cross-industry performance in customer service.

What’s more, many do not fully understand the difference that customer service excellence can make in customer perceptions. However, Accenture research makes the case. It found that great customer service—not good customer service—is a catalyst for meeting insurers’ promotion, retention and loyalty objectives and generating revenue.

Time to stop admiring the good and start accelerating to great with a whole new standard of customer service excellence.

A gap between good and great

Accenture analyzed average customer satisfaction across nine consumer experience touchpoints. See Figure 1. The research results show that members who are very satisfied (80 to 89 percent satisfied) with their experiences with health insurers give insurers an anemic Net Promoter Score®1 of 8. (The index ranges from a low of -100 to a high of 100.) Only 40 percent say that they would definitely stay with their current insurer over the next year. And just 31 percent find it easy to do business with their insurer.

Compare these results to those for consumers who are extremely satisfied (90 to 100 percent satisfied). They give their health insurers a much higher NPS of 63. Most (74 percent) would definitely stay with their current insurer over the next year. And a strong 71 percent say it is easy to do business with their insurer. Health insurers must push past the 90 percent customer satisfaction threshold to truly impact promotion, retention and loyalty.

What great looks like

The top experience factors that differentiate members who are extremely satisfied from those who are very satisfied reflect how they think insurers perform in three customer-service related areas. This reinforces just how critical customer service is.

The first area is omnichannel access. Seventy-two percent of extremely satisfied consumers—compared to 36 percent of very satisfied—say their insurer provides consistent and accurate responses regardless of the method used to contact them. The next area is first contact resolution. According to the research, 73 percent of extremely satisfied consumers—compared to 35 percent of very satisfied—say their insurer provides accurate information and answers to issues at first contact. Finally, there is responsiveness. Sixty-four percent of extremely satisfied consumers—compared to 25 percent of very satisfied—believe their insurer hears and responds to their feedback when its provided.

Always raising the bar

Consumers’ high expectations in these areas are not an anomaly. Even more concerning for health insurers is that the bar is only going to get higher and higher faster. Consider the impact of demographics, for example. Extremely satisfied consumers are typically older (age 37 and above) and less likely to use digital channels. Only 26 percent of extremely satisfied customers are millennials—a significantly lower proportion than in the very satisfied range (37 percent). With millennials the fastest-growing segment in healthcare, and healthcare consumers becoming more digitally savvy, the future holds more of those consumers who are difficult to satisfy, retain and turn into brand promoters. Health insurers must start to prepare for the inevitable now.

90 percent or bust

Here’s how they can get started. Health insurers can take specific actions to support high-value interactions and elevate customer service excellence.

  • Push the limits on satisfaction. Set satisfaction targets higher, ensuring the baseline is strong and continually pushing to the next level with an eye to what consumer experience pioneers in other industries are doing.
  • Double down on omnichannel. Make improvements across the entire member journey. For most insurers, this will require addressing blind spots from operating model silos and organizational boundaries.
  • Invest in analytics and AI. Take advantage of artificial intelligence to unlock relevant data insights faster, automate simple customer service tasks, and free customer service staff to focus on higher-value interactions.
  • Tune in to millennial mindsets. Account for younger consumers’ different needs and higher expectations and evolve the role of the service channel to meet the expectations of today’s consumers across generations.

1Net Promoter, Net Promoter System, Net Promoter Score, NPS and the NPS-related emoticons are registered trademarks of Bain & Company, Inc., Fred Reichheld and Satmetrix Systems, Inc.

Jean-Pierre Stephan

Managing Director – Payer Front Office Lead

David Klimek

Managing Director – Advanced Customer Strategy

Loren McCaghy

Director – Consumer Engagement and Product Insight​​


AHIP consumer experience & health forum
Healthcare system complexity
The new laws of consumer attraction

Subscription Center
Stay in the know with our newsletter Stay in the know with our newsletter