The business of healthcare is in transition. Leading payers are beginning to move away from their traditional operations to learn more about end consumers to improve efficiency, effectiveness, and the overall customer experience. One U.S. health plan knew that a fundamental shift in its culture, operations, and interactions was required to deliver lasting impact. It wanted to tap into what previously had been an under-utilized resource: the member experience. It decided to transform the entire member experience by understanding its current state, and then designing a new, customer-centric future.

The company enlisted the help of our CX consultants because of our unique ability to combine deep expertise in customer strategy across industries with an understanding of the specific attributes of the health insurance sector. Together, we embarked on a Customer Centricity Transformation Journey to move from a product-driven, transaction-based company to one that builds trusted relationships and partnerships with consumers for mutual benefit.

The team gathered insight from internal and external sources — including market trends, competitive analysis, and member, employee, and other stakeholder feedback — to understand the current state of the member experience. The research assessed where each division (IT, Health Services, HR, Finance, Customer Support, etc.) fell on a customer centricity spectrum. Overall, the assessment revealed that the organization was almost exclusively product- and process-focused in all departments, rather than focused on consumers and outcomes. We, therefore, outlined steps and methodology to be more member focused, including new product development recommendations, enhanced segmentation, new branding strategies, a value map for new initiatives, and a roadmap for implementation.

We tapped into customer insight by combining member needs, value, and behavior data to create eight integrated lifestyle segments as the basis for marketing and care initiatives. The team then developed a Value Map and implementation roadmap for internal and customer-facing improvements. These models gave the client a better understanding of how decisions impact the organization, and where to focus resources. Now, the organization can identify and prioritize initiatives that will have a positive impact on consumer value.

Literally hundreds of ideas and recommendations were uncovered, comprised of internal and external best practices, quick wins, and longer-term opportunity areas. The client prioritized a few initial projects, including a new internal communication strategy related to the integrated segments, expanded Voice of the Customer programs, product concept testing, and employee training on the benefits of a consumer-centric business model. The company also created cross-functional segment managers and mobilized implementation teams based on segment insight. The client knows this is only the tip of the iceberg in its plans to be more member-focused, and will use customer and employee participation to further its customer-focused vision.