Insurers: Wake up and smell members' service expectations


Have you ever called your health insurance company to question a claim, report a problem, or determine coverage? I'm going to assume yes. Has that call ever resulted in a genuinely positive experience that made you feel grateful that insurer covers your healthcare? I'm going to assume no.

That's because the health insurance industry isn't known for its customer service skills. Sure, there are the anomalies--employees who are personable and willing to go above and beyond their responsibilities to help out a customer--but by and large, insurers leave their members wanting better customer service.

So the challenge, if insurers want to survive and thrive in the post-healthcare reform era, is to become more customer-centric by identifying and meeting unique and unmet customer needs. At least that's what consulting firm Accenture recommends in its new report, "The 7 Things Your Health Insurance Customers Are Not Telling You And What To Do About Them."

After surveying 1,000 customers between December 2010 and January 2011, Accenture conveys a "loud and clear" message that health insurance customers are more value-driven then price-driven. Customers aren't willing to trade off customer service options or quality in exchange for a lower price, as 44 percent strongly oppose degrading quality for the sake of price. "Such findings should act as a wakeup call for those who make the service investment decisions," the study says. Indeed.

To help insurers maximize on their customers' willingness to pay more for quality customer service, Accenture recommends several steps, the first of which is to view customer service as a differentiator rather than a cost center. "Insurers often miss valuable opportunities that can come when service representatives are empowered to act as advocates for the consumer," the report says. They should maximize the value of their customer-facing employees, which are insurers' most important and influential asset to help realize immediate and substantial improvements in service quality and cost. For example, insurers could make certain that service supervisors spend more time coaching their customer-facing employees.

Rethinking the service delivery model is another step health payers can take to improve customer service. Many insurers organize their call centers along traditional member and provider dimensions and train their customer service representatives to handle all call types in each of these areas. Accenture is recommending that payers instead identify unique customer needs, such as members with chronic conditions, and build unique capabilities around those needs. For example, they could create a dedicated group of customer service representatives to welcome and educate new customers, who usually have a unique set of needs than established customers.

Accenture also recommends that payers invest in proactively developing a comprehensive social media strategy. But instead of jumping into the social media realm without thinking through their strategy, payers should first focus on how to use social media in a single business domain. For instance, they could focus their social media efforts on the marketing and public relations aspect of their business to listen for conversations that mention a company's brands. After analyzing the conversations, an insurer could take steps to reinforce positive sentiment and quickly address any negativity.

The fundamental message here is that health payers must become more customer-centric, understanding current customer perceptions and how to shape and improve those perceptions for future growth. And then maybe phone calls to insurance companies will be informative, helpful and --dare I hope for--pleasant. What a lovely day that will be. - Dina

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