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Working Together to Improve Healthcare Payor Customer Experiences

In November, customer experience (CX) professionals in healthcare gathered at the Horizons Summit in St. Petersburg, Florida, for a roundtable discussion focused on the complexities of CX in the healthcare payor space. Andrew Black and I had the privilege of facilitating the roundtable along with Lorraine Schumacher. 

What a privilege and a learning experience for each of us to share from our own programs, discuss pressing challenges, and ideate on pioneering solutions. We were all candid about challenges and collaborated on solutions. Competitors became colleagues as we all worked to lift customer experiences in healthcare. 

Participating in the routable were professionals from various healthcare payors, including UnitedHealthcare, Centene, Arkansas Blue Cross and Blue Shield, AmeriHealth, and Blue Cross and Blue Shield of Kansas City. Qualtrics professionals working with healthcare companies, along with some of our Farlinium colleagues, also participated. 

Looking back on the discussion, there were nine buckets for what was discussed.

The Role of Payors in Member Experience

Our discussions opened with a critical examination of the payors' role in shaping member experiences. They recognize the overly complex challenges in healthcare, including strained networks, provider burnout, and rising costs. The burning questions centered around the growing responsibilities of payors to support members and providers. How do payors influence expectations and outcomes in the healthcare journey? The consensus was clear: payors aren't just financial mediators but pivotal players in the member's healthcare narrative.

Evolution and Impact of CX in Healthcare Payor Space

Attendees shared insights into the evolution of CX in their respective careers. The landscape of healthcare payor space is ever-evolving, and so are the methods and aspirations of CX teams. We dove deep into the desired outcomes for these teams and their vision for the future in this dynamic field.

Measuring Member Experience Beyond Traditional Metrics

A significant challenge identified was the adequacy of traditional metrics in measuring member experiences. Our roundtable emphasized the need to capture the human aspect of healthcare, acknowledging the uniqueness of each member's experience. We discussed the limitations of current KPIs and explored ways to represent a more holistic view of member experiences.

Bridging Contact Center and Digital Experiences

We then tackled the necessity of integrating contact center interactions with digital platforms. The discussion ventured into the importance of sharing successes and learning from omnichannel analytics. This topic underlined the challenge of breaking down silos between different communication channels.

Navigating Shifting Government Policies

A recurring theme was the challenge of adapting to shifting government policies, especially in scenarios like group conversion to Medicare. We discussed strategies to manage experiences amidst these changes while ensuring consistency and maintaining ROI.

Quantifying Value and Building Partnerships

Another focal point was the quantification of the value brought by CMS’s Star Ratings and the importance of building partnerships across the payor and provider space. Rallying support across various teams and understanding the downstream impact of these ratings were identified as key to advancing CX.

Humanizing Data and Predictive Analytics

A substantial part of our discussion revolved around humanizing data. We explored how predictive analytics could be used to forecast trends and outcomes. The group also highlighted the importance of appealing to executive emotions and utilizing tools like regression analysis for impact prediction.

Frontline Experience and VoC/CX Teams

Innovative programs like AskJeff and JeffChampions at Jefferson Hospital were cited as exemplars in incentivizing immediate improvements in care. The significance of measuring the impact of CX recommendations was underscored, particularly in terms of their non-monetary value.

Integration Challenges and Member-Centric Approach

Finally, we acknowledged the challenges in merging different data sets and parts of the member journey. The limitation isn’t enough data, it is finding the data that matters most to our members so we can transform the healthcare industry.

Next Steps

The Horizons Healthcare Roundtable was more than a meeting of minds; it was a confluence of visions and aspirations for the future of healthcare CX. As facilitators, we witnessed first-hand the commitment of industry leaders to not only anticipate but actively shape a more member-centric future in healthcare. Farlinium, in partnership with Qualtrics XM Discover, remains dedicated to fostering these dialogues and advancing CX in the healthcare landscape.

Look for more in-depth articles in the coming weeks and months as we dive into specifics, share case studies, and think through what innovations are on the horizon. 

How can we help you? 

If you are a healthcare payor, provider, or medical technology solution provider, reach out to us and set an exploratory meeting to walk through your challenges and opportunities and how we can partner with you.