Rethinking Health Plan Customer Service

Here’s the good news for health plans: In just over a year, as many as 40 million new customers will enter the insurance market.

And the bad news: They’re primarily individuals and small groups.

Yep, the very business that insurers have more or less been giving the back of their hand to for years is going to be front and center. And guess what: these new customers are not going to hit the dance floor with just any health insurer. Nope, these folks are going to need to be wooed to be won because there will be a lot of options out there—including health insurance exchanges—to compete for the affections of this new market force.

A study from Accenture, a global management consulting firm, suggests that appealing to this new market will require a shift in marketing strategy from a wholesale to retail mindset. According to the study, customer service will be at the forefront of this change and health plans need to take advantage of new opportunities.

In December and January, Accenture conducted an online survey of 1,000 health insurance customers to try to get a handle on their attitudes toward the customer service practices of health insurers. The results indicate that customer service isn’t meeting customer expectations in terms of personal service, convenience, and technology. And, 64% of the respondents said they left one insurer and moved to another because of poor customer service.

So what’s a health plan to do?

Doug VanWingerden, who authored the report, suggests there are a couple of things payers can do to refocus customer service to serve as a selling point for attracting new customers as well as keeping existing customers. He says the first step is to stop thinking of customer service as only a cost center. Remember, these are the folks who get face time, or at least phone time, with your current and potential members. Treat them right. Invest in training and incentive programs for this important and influential team.

VanWingerden said health plans should also look for ways to use customer service to differentiate their products and services, especially in terms of meeting individual needs. Only 10% of survey respondents said that their health insurers tailor services to match their individual needs or preferences.

One suggestion: Reorganize your customer service call centers to reflect the specific needs of your clientele. Creating a call center for new customers or one for members with a chronic disease will enable customer service reps to provide the information that really helps members develop a closer relationship with the health plan.

Oh and be sure to staff your specialized customer service centers with people who know what they are talking about. Some 85% of the respondents listed knowledge and well-informed employees among the top considerations for a successful customer service center. Not receiving knowledgeable answers from customer service is a common complaint and it is among the leading reasons that members will change health plans.

It’s good to remember that thanks to technology we live in a 24/7 world. Make sure your customer service centers operate that way. Only 48% of the survey respondents said their health plan provides customer service at a convenient time.

Finally, use customer service to enhance your social media strategy. Although more and more folks use the Internet to look for information about their health plan, only 6% of respondents said they use social media to help them understand or become more aware of the products and services offered by their own health insurance companies. And only 5% said social media sites have helped increase contact with their current insurance company and its brands.

VanWingerden says that probably means that your message is getting fragmented or is lost among all of the other social media noise. He suggests using customer service to reinforce social media messages. “Maybe a health plan is promoting women’s health through its social media sites, customer service could plug into that message by reminding callers to schedule a mammogram.” Even better, he says, is for customer service to have the capacity to go ahead and schedule the appointment.

The bottom line is that every health plan will be looking for ways to differentiate itself in the new normal of healthcare reform. Customer service could become that niche for your company. But VanWingerden warns that the time to act is now before the change becomes a competitive necessity.