The 7 Things Your Health Insurance Customers Are Not Telling You - And What To Do About Them
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Insight Driven Health The 7 Things Your Health Insurance Customers Are Not Telling You And What To Do About Them
The seismic shift in power Right at the fore is customer service, With customer service emerging as
the entrée to productive customer the “X Factor” of high performance,
to the customer has come relationships that will withstand the health insurers must understand current
at last to the US Health test of time. Customers have become customer perceptions, as well as how to
more diverse and more demanding, shape (and improve) these perceptions
Insurance market. With wanting service offerings, experiences for future growth. To help crystallize
The Patient Protection and communications increasingly on these factors, Accenture Healthcare
their own terms. They have also become conducted a survey of customer attitudes
and Affordable Care Act more technology savvy and less shy toward the customer service practices
adding 40 million new in broadcasting their experiences. of US-based health insurance providers.
Technology trends like social media Using a web-based questionnaire,
customers and with have ignited a new consumer activism we surveyed 1,000 customers in the
individual and Consumer whose reverberations have only begun US between late December 2010 and
to be felt. Insurers operating in this early January 2011. From that research
Directed Health Care
“new normal” face an unprecedented we distilled the surprises and secrets
(CDHC) plans exploding level of competition, unparalleled of customer service that together
in popularity, US health opportunities to expand, and the outline the alchemy behind superior
commensurate risks of failure. customer service performance.
insurers will need to invent
new healthcare solutions
for competitive success.
Seven Surprises About Customer Service
Surprise #1 Overall, customers feel satisfied with
their health insurance providers; in fact,
our research found that 42 percent
Being satisfied with high of customers have a high degree of
satisfaction, while only 7 percent
customer satisfaction have a high degree of dissatisfaction
is a mistake. (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 1—Current State of Satisfaction, Loyalty and Advocacy
Not at All Extremely
How satisfied you are with the Health insurance
companies you do business with today?
7% 42%
Do you trust Health insurance providers to keep
your personal Health information confidential? 14% 39%
How loyal you feel to your
Health insurance provider? 26% 23%
The extent to which you will buy more
products/services from your Health 41% 7%
insurance provider?
% respondents giving top 3 of 10 boxes ratings
% respondents giving bottom 3 of 10 boxes ratings
Surprise #2 The current tenuous nature of customer
loyalty to their health insurers may have
As customers are growing more exacting,
their health insurers are struggling to
its roots in their rapidly rising customer pass service muster. In fact, our research
Payers are not keeping service expectations. We found that 20 found a large gap between what matters
percent of customers indicated that their to the customer and the perceived
up with rising customer expectations of the customer service performance of health insurance
expectations. function increased, just in the past year. companies. While “having employees who
Furthermore, 41 percent stated that are knowledgeable and well-informed”
their expectations increased in the past ranked as the most important customer
five years. They want greater ease and service attribute, several other qualities
better support: When asked how their were rated nearly as important, including
expectations increased, 80 percent said “the amount of time I have to wait
that they “expect customer service to be to be served.” Yet for all five of the
easier/more convenient to obtain” and 75 characteristics rated most important,
percent said that they “expect customer the gap between customer expectations
service representatives to be more and insurer performance was significant
knowledgeable and better trained.” (Figure 2).
Figure 2—Customer Service Characteristic Importance & Satisfaction
85%
Having employees who are knowledgeable and well-informed?
47%
Having customer service available at convenient times (for 79%
example, after work and weekend support availability) 48%
79%
The amount of time I have to wait to be served
39%
The amount of time it takes to completely
78%
resolve my issue or problem 37%
Having customer service people who can deal with my issue 76%
41%
without having to refer me to another person 39%
% respondents rating characteristic as “important” (top 2 of 5 boxes)
% respondents rating “satisfied” with characteristic (top 2 of 5 boxes)
Surprise #3 While it could be tempting to focus
improvement efforts on areas where
service expectations are changing, our
Most payers are research suggests that health insurers
will need a more balanced approach—
struggling with service one that does not lose sight of service
experience basics. 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 rising
expectations if they cannot consistently
meet the minimum requirements.
Figure 3—Top Five Frustrating Customer Experiences & Frequency of Occurrence
77%
Having to contact customer service multiple
times for the same reason 30%
Dealing with customer service agents who 76%
cannot answer my questions 28%
Having to repeat the same information to
74%
multiple customer service agents 35%
Being on-hold for a long time when contacting
74%
customer service 38%
Dealing with customer service agents who are 73%
41%
unfriendly or impolite 17%
% 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)
Surprise #4 Payers have made a huge investment
in customer service technologies over
To date, despite their willingness to
invest in service advances, health
the years, implementing advances such insurers seem to have failed to provide
The benefits of as automated phone attendants, live the personalized experience customers
chat via the Internet, self-service on a crave. Only 10 percent of respondents
technology investments website and mobile applications. For the strongly agreed their health insurers
have been decidedly most part, these technology advances “tailor my customer experience to match
have delivered tangible benefits in the my needs, preferences, and/or value to
one-sided. form of higher self-service rates and them.” More than twice that amount (22
lower handling time. What they have not percent) strongly disagreed. Similarly,
done, however, is dramatically improve only 9 percent agreed that their health
the customer service experience. While insurers’ “communications make me feel
technology lends itself to handling a connection to them.” In contrast, 32
higher service volume, it has tended percent strongly disagreed.
to have little impact on individual Crafting a personalized service experience
experience. Our research shows that will only become more important in
only 11 percent of respondents strongly the post-reform marketplace, given
agreed that the increased use of an increased focus on “patient-
technology in customer service has centeredness” across the health system
improved the level of service significantly as a whole. From a service perspective, a
in the past five years (Figure 4). key tenet of consumerism is the ability
to tailor the experience to match the
customers’ needs, preferences, and/or
value to the business.
Figure 4—Use of Technology in Customer Service
Disagree Agree
The increased use of technology in
customer service (e.g. automated
phone attendant, live chat via the
internet, self-service on a web site,
17% 27% 48% 11%
mobile applications) has improved
the level of service significantly in
the past five years.
Strongly Disagree Somewhat Disagree Somewhat Agree Strongly AgreeSurprise #5 The message that comes across loud and
clear is that health insurance customers
generally are more value-driven then
Service quality price-driven. Our research clearly shows
that customers are not willing to trade
trumps price. 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.
Figure 5—Price Tradeoff Preferences
Disagree Agree
Lower levels of product quality if it
ensures I get the lowest price
61% 3%
Lower levels of customer service if it
ensures I get the lowest price
44% 6%
Lower levels of product options if it
ensures I get the lowest price
41% 7%
Lower frequency of communications if
it ensures I get the lowest price
41% 28% 23%
% respondents agreeing (top 3 of 10 box ratings)
% respondents disagreeing (bottom 3 of 10 boxes ratings)Surprise #6 Social media has come of age and has
begun to redefine not just individuals’
Yet our research also finds that, currently,
health insurers are not leveraging social
personal relationships, but their business media in any major way. Only 6 percent
Customers are social, ones as well. Our research shows that of respondents agree that the use of
a majority of respondents (76 percent) social media sites has increased their
yet payers are not went online looking for information overall awareness about products and
socially engaged. about health insurers at least a few services from health insurance companies
times during the past year. For these that they did not know of before, and
respondents, social channels are only 5 percent say that their use of social
becoming an increasingly important way media sites has increased their overall
of sharing information—40 percent read engagement with their current insurance
about healthcare through these channels companies and their brands (Figure 6).
at least a few times during the year,
and 8 percent are actively engaging in
conversations about payers.
Figure 6—To what extent do you agree with the following statements?
Disagree Agree
I tend to trust comments about Health insurance
companies/brands on social media sites posted by 54% 5%
people I don’t know.
I tend to trust comments about Health insurance
companies/brands on social media sites posted by people 28% 21%
I know (family, friends, co-workers...).
Comments posted on social media sites influence
my opinions about Health insurance companies or 52% 8%
brands in general.
The use of social media sites has increased my overall
awareness about products and services from Health 58% 6%
insurance companies I did not know of before.
The use of social media sites like blogs, bulletin boards, 23%
Facebook, MySpace, Twitter, etc. has increased my 66% 5%
overall engagement with my current insurance
company and their brands.
% respondents agreeing (top 3 boxes)
% respondents disagreeing (bottom 3 boxes)Surprise #7 While poor customer service performance
is not usually the driving factor for
Given the unique structure of the health
insurance marketplace, insurers so far
switching insurance providers (Figure have been granted some immunity
Customers are not 7), our research has found it is the against the impact of poor service
driving factor in other industries. In performance: the primary reason
voting with their feet fact, Accenture’s 2010 Global Customer individuals switch health insurance
(yet), but they’re doing Multi-Industry Research Study found companies is because they have been
that 64 percent of consumers switched required through changes in their
plenty of talking. from at least one service provider in corporate enrollment options. However,
the past 12 months—a bank, utility, or as the “consumerism” trend in health
wireless carrier, for example—due to poor care increases in line with increased
customer service. 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 retention—much like it is
in other industries today. The individual
consumer’s voice will undoubtedly gain
more influence, and already, people are
speaking up loud and clear.
Figure 7—Customer Motivations to Switch Providers
Required by change in company open enrollment options 45%
Other reason(s) 28%
Price 18%
Product/service options were too limited 7%
I lost trust in the company 6%
Overall poor quality of the customer experience 5%Our survey found that 40 percent of Perhaps even more striking than the
customers told a friend, family member, prevalence and importance of word-
or co-worker about a negative customer of-mouth is the fact that 7 percent
service experience in the past year. As a of our survey respondents reported
source of information, our respondents posting negative comments about their
rank word of mouth in the top three, experience online (Figure 9). While
by a margin four times greater than the percentage posting online is still
their fourth most important information comparatively small, the impact will be
source (Figure 8). As we move to a much greater, as the posted comments
consumer-driven market, the importance have the potential to reach a global
of word of mouth should only go up. 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.
Figure 8—How important were these information sources or channels to you in deciding to do business with the company?
Employer educational materials 58%
Corporate web site 47%
Information from people I know 40%
On-premise/in-store information from... 11%
Online information from other sources 9%
Direct mail or telemarketing 9%
Print advertising 5%
Online advertising 4%
Paid advertising on TV or radio 4%
Others 3%Figure 9—In the past year, have you done one of the following after having a bad experience with a Payer
41%
59%
Told people around me
about the experience (e.g.,
friends, family, coworkers) 40%
Posted negative comments
about the experience online
(e.g., blogs, Facebook,
7%
Twitter) − Yes
Actions being taken by these % respondents after Respondents who took no action
having a bad experience online (one respondent
can select multiple actions as response) Unique respondents who took
at least one actionSeven Secrets to
Delivering Service the
Way Customers Demand
Secret #1 Secret #2
View customer service Accenture’s experience has shown Rethink the service
that by implementing established high
as a differentiator—not a performance workforce techniques payers delivery model.
cost center. can better realize improved performance,
Many insurers organize their call centers
decreased time to proficiency, and
along traditional member and provider
Often insurers treat customer service greater employee engagement. For
dimensions; they train their customer
as a “check the box” reality versus example, Accenture has seen that service
service representatives to handle all call
a differentiating capability, missing supervisors often spend too much time
types in each of these areas. However, as
the valuable opportunities that can performing administrative tasks and
the health care model changes, payers
come when service representatives are too little time coaching. Furthermore,
need to optimize their service delivery
empowered to act as advocates for the we often find that supervisors receive
model to keep pace. In this regard, the
consumer. Insurers should recognize little to no training themselves on how
health insurance industry can learn
that controlling costs need not be to perform their role. Implementing
valuable lessons from other industries.
mutually exclusive from meeting service supervisory training programs and
For example, wireless providers have
expectations. By maximizing the value setting measurable performance
learned that they get better customer
of their most important, influential (and expectations can have a profound effect
retention and satisfaction by having a
fundamental) asset—their customer- on operational performance, employee
dedicated group of customer service
facing employees—health insurance morale and the customer experience.
representatives to welcome and educate
companies can realize immediate and Similarly, high performance reporting,
new customers. New customers have
substantial improvements, in both service analytics and quality monitoring
different needs than established
quality and cost. capabilities will help improve the overall
customers and the welcome call group
quality of the interaction and reduce the
is trained to anticipate and meet these
standard deviation of performance levels.
unique needs.Secret #3
A similar opportunity exists in healthcare. Drive to simplicity. Fortunately, advances in CRM
Payers should seek to identify unique technologies are giving companies the
customer needs (for example, those Over the years, the systems and call- tools to reduce complexity and improve
with chronic conditions) and build handling processes implemented by performance for consistent, integrated
unique capabilities around those needs. health insurers have become more multi-channel customer interactions. For
Such a capability will become a source complex, which in turn drives longer example, a workflow-enabled desktop
of competitive differentiation as the training times, longer CSR time-to- that presents the right information
individual market grows in popularity. proficiency and large performance and/or treatment recommendation at
variations. CSRs spend too much time the exact time in the process can be
bouncing between systems or searching implemented faster and at less cost than
within a system to find the information ever before.
required by the customer—with the
common result of a poor overall customer
experience. These challenges will be
further magnified with the introduction
of ICD 10 (international standard
diagnostic classification for diseases
and other health problems), which will
complicate the job on the insurers’ end.Secret #4 Secret #5
Embrace an outside-in Don’t be anti-social. be modified to support their new social
media strategy. Then, they can launch,
view of self-service Although payers may not need to refine and expand the initial strategy into
technology. invest in aggressive proactive social other areas as they learn.
media outreach right now, they should A logical first step would be to
In the past, health insurance companies invest in proactively developing a focus on the marketing and public
have viewed self-service as a trade-off comprehensive social media strategy relations business domain to listen for
that balances the necessity to reduce for their organizations. Accenture’s conversations that mention a company’s
costs against decreasing customer client experience across industries brands. After analyzing conversations
satisfaction. Customers have viewed self finds that companies often jump into to understand the chatter, an insurer
service as trial and error: they embrace creating a social media presence without could implement tactics across customer
well-planned and well-designed channels thinking through their strategy (a “Fire service, both to reinforce positive
and reject those that are not. . . . ready . . aim!” approach). Focusing sentiment and quickly address negative
Given that the customer will look for initially on how to use social media in sentiment. From there, the company
the right tools to help themselves and a single business domain (for example, could begin expanding into health
help others, the new view is that the marketing and sales, or customer service management applications as part of an
voice of the customer should influence and support) is one way to launch into integrated multi-channel experience
technology investments and how the social media and minimize the risk of that allows people to connect with other
self-service experience is designed. By fragmentation. It will also focus the patients like them or access resources to
leading with what the customer wants, organization on “what to listen to” to meet a specific health goal.
the other benefits will follow: reduced support identified business goals, without
costs, increased satisfaction, enhanced drowning in social media noise. Insurers
brand image and differentiation from the should proactively listen to and learn
competition. from customers to identify any current
context, culture, processes, people,
policies, and metrics that may need toSecret #6 Secret #7
The challenge with social media is finding Get analytical. Embrace consumerism.
a role to play while avoiding additional
fragmentation in the industry (and losing Customer-facing channels such as the Closing the gaps between customers’
the voice of the customer across different web, IVR, mobile, contact centers and service expectations and their
channels). In all cases, a key question social media generate tremendous experiences will not guarantee success
will be whether the company should amounts of data, yet few companies for health insurers. Fundamentally, they
use company owned and controlled are good at turning this data into need to become more customer-centric—
(on-board) social media tools or off- insight. Without the ability to perform not an easy task, particularly as health
board (not company owned) ones, such enhanced analytics, high performance payment and delivery reforms demand
as Facebook. will remain elusive. First, payers need new types of collaboration among
the ability to merge disparate sources payers and providers. It’s an expansive
of data (call logs, contact records, challenge that must be taken apart to
customer satisfaction surveys, IVR logs, manage well. To become customer-
etc.) into a single data source. Second, centric, insurers will need to develop
payers need to develop the capability to an integrated view of their customers,
analyze, interpret and act on the new segmented on values, behaviors,
data and insights developed. Third, payers attitudes and health attributes. They
increasingly will need a way to analyze will need to identify unique and unmet
on-board and off-board data about their customer needs, define segment-specific
brand and customer experience. treatment plans for all customer touch
points, and then develop the operational
capabilities to deliver these treatments
and monitor and learn from them.Learn More Accenture: Insight Driven Health
Insight driven health is the foundation of
To discuss how Accenture can help your more effective, efficient and affordable
organization develop the right customer healthcare. That’s why the world’s leading
relationship management solutions, health care providers and health plans
please contact Doug VanWingerden at choose Accenture for a wide range of
doug.vanwingerden@accenture.com or insight driven health services that help
678.357.7902. them use knowledge in new ways—from
the back office to the doctor’s office. Our
committed 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.
Copyright © 2011 Accenture About Accenture
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