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When interacting with industries such as retail, hospitality, and finance, we’ve all become accustomed to quick, effective, and personalized customer service. It’s no surprise that when it comes to healthcare, consumers are now seeking a better customer experience on par with the quality of the clinical care they have come to expect. Today’s members and patients are looking for their health plans and providers to accommodate their technology preferences and provide convenient, empathetic, and helpful interactions as they navigate the healthcare ecosystem.
An Accenture report found that navigation difficulties, including challenges with digital/online services, were driving factors for 80% and 49% of individuals who left their provider and payer groups, respectively. It is clear that healthcare organizations must adapt their technologies based on evolving expectations to avoid losing business – and deploying advanced, intelligent digital consumer experience (CX) solutions that incorporate AI can be a game-changer.
To maximize the potential of digital tools in enhancing member/patient engagement, satisfaction, and growth, organizations must tailor them to target segments’ specific needs, ensure they provide a human-centric element, and establish appropriate AI safeguards.
Customizing CX strategies for diverse populations
Healthcare consumers are growing increasingly open to adopting digital solutions, driven by the convenience factor and desire for greater control over their health, but age and socioeconomic factors can strongly impact needs. Populations covered under Medicare, Medicaid, Marketplace, and Commercial insurance plans have diverse levels of tech-savviness and access, and customizing digital solutions to align with these distinct customer segments is crucial to ensure adherence to care plans.
Medicare’s older generations typically value clear instructions, support, and easy access to human representatives and may require straightforward solutions (i.e. mailed communications and calls from advocates). In contrast, Medicare’s younger consumers anticipate advanced features like health tracking and integrated data and are more inclined to engage via digital communication channels (like chatbots, Interactive Voice Response/IVR, websites, and SMS) and the latest health apps.
In the case of Medicaid, where the population may have limited internet availability and rely on basic mobile devices, healthcare organizations should implement low-bandwidth digital solutions to optimize engagement and yield more favorable outcomes.
Marketplace and Commercial consumers, typically accustomed to the latest digital innovations, expect personalized care and fitness and health management tools. Wellness programs and integrated lifestyle apps will enhance their overall experience.
Boosting engagement with personalized, human-centric experiences
According to McKinsey & Company, 76% of consumers report being frustrated by impersonal interactions. Differentiating customers’ experiences and providing a human-like connection is critical to their satisfaction, and individuals are more likely to engage when they are comfortable with the technology at work.
Healthcare CX solutions should be able to offer multiple contact channels – such as email, chat, voice, and SMS – based on the individual’s preference, and organizations can further optimize engagement by equipping users with straightforward ‘how-to’ guides for digital resources. One health plan that implemented omnichannel outreach for members with pre-existing conditions realized a 300% increase in appointments scheduled and more than 100K member-initiated calls.
Call center advocates’ ability to ‘actively listen’ to the customer is another critical component of a human-centric experience and plays a vital role in continuously refining and enhancing solutions. Organizations can leverage AI’s abilities to understand the customer’s voice, capture notes during calls, analyze speech and sentiment to help prompt the next best action, and train agents. This application of technology also alleviates some of the multitasking that falls on advocates, enabling them to focus their attention on the customer. In the example of a health plan that assisted newly hired advocates with AI-based tools, advocates achieved 15% higher accuracy and 12% higher member satisfaction than those without the support tools.
Organizations should augment their AI capabilities with the human touch, especially in complex customer support scenarios, and tools must be trained in empathetic interactions that address not only the patient’s/member’s immediate needs, but also anticipate their future requirements. Human-centric communications are key to enhancing engagement, efficiency, productivity, and CX.
Applying safeguards to avoid potential AI pitfalls
Understandably, uncertainties exist around trust, credibility, and lack of humanistic care in AI-based solutions, as the technology is relatively new. Incomplete, inconsistent, and inaccurate data can potentially introduce biases and errors into the analysis, affecting reliability and validity and hindering data exchange and collaboration abilities. AI systems need a significant amount of data for training, reducing concerns around security and patient privacy. Additionally, the lack of standardization hampers the integration of advanced technologies like AI, and lagging legislation and policies in this area open doors for liability issues.
Fortunately, there are ways to mitigate these challenges, such as establishing well-thought-out data strategies for standardizing data practices and implementing interoperability frameworks. Establishing zero-trust security approaches, utilizing AI to augment human decision-making, and prioritizing patient-centric care are equally crucial to safeguarding members’/patients’ security, earning their trust, and accelerating adoption.
Emphasis on CX continues to grow
CX has become a necessity throughout the entire healthcare landscape and leaders are taking notice. Harvard Business Review Analytics Services found that 60% of surveyed healthcare executives consider CX improvements a priority. As consumer expectations continue to rise based on other industries’ rapidly accelerating capabilities, healthcare is at a crossroads in which it must leverage new tools or risk falling behind. Ultimately, healthcare consumers’ satisfaction is key to keeping them engaged in their care plans, improving outcomes, and enabling organizations to thrive amongst competitors.
This article was written by Becky Watkins, SVP, ResultsCX for HIT Consultant.