BUILDING STRONG CUSTOMER
RELATIONSHIPS FOR BETTER
DECISION MAKING
A Healthcare Case Study
A regional health insurance company with a strong brand and
competitive rates found itself with an influx of new customers
from the passage of the Affordable Care Act — an increase
in membership that required it to adjust on many fronts. Also
fielding customer complaints that included a suboptimal
billing process and lack of access to care, the health plan
knew that taking a customer-centric approach was the right
way to tackle the challenge. But with a small team dedicated
to the effort, it needed help.
Working worked closely with the health plan, North Highland — along with
experts from its experience design division, Sparks Grove — helped foster
a better understanding of customers and the reasons they were unhappy
with their experience with the organization. The team laid the foundation for
the health plan to more effectively and systematically consider customer
needs, preferences, and behaviors in the future when making decisions
affecting the business and the member experience. To do so, the team
created a program to connect and engage with customers and embarked on
an intensive, fast-moving effort to understand the journey the health plan’s
members took from enrollment through renewal. The team also provided
insights about customer preferences and motivations to help inform the
design of a new automated phone system.
PUTTING A FACE TO THE NAME —
Understanding an Emerging Customer
Base after ACA
THE CHALLENGE
An influx of new customers due to the Affordable Care Act meant that
the organization needed a better understanding of who it was serving.
THE TEAM LAID THE
FOUNDATION FOR
THE HEALTH PLAN TO
MORE EFFECTIVELY
AND SYSTEMATICALLY
CONSIDER CUSTOMER
NEEDS, PREFERENCES,
AND BEHAVIORS IN THE
FUTURE WHEN MAKING
DECISIONS AFFECTING
THE BUSINESS
AND THE MEMBER
EXPERIENCE.
The health plan wanted to implement a voice-of-the-customer program to
capture insights about its members' expectations, preferences, and desires
and use those insights to make better business decisions. A robust program
would allow the health plan to keep its finger on the pulse of member
satisfaction levels and changing needs - and focus resources on what
matters most.
THE SOLUTION
North Highland and Sparks Grove worked with the health plan to create
a program to connect and engage with customers at key points in their
journey to learn their needs and expectations. The health plan was
already interacting with its members at various touchpoints, including
surveys, but didn’t have a good process in place for interpreting feedback,
reacting in a meaningful way, and monitoring whether a given solution
actually fixed the problem.
To address these issues, the team identified more than 20 customer
feedback channels within the organization, from online chats to social media
and surveys. The team then identified channels where the customer voice
was not being heard and acted upon, revised surveys and created new ones,
and harnessed insights from live chat sessions and call center records.
Using an agile approach to make and test changes quickly, the team piloted
five enhancements to help the health plan more effectively react to customer
feedback and monitor improvements.
The team also identified hurdles and governance gaps that needed be
remedied in order to establish the voice-of-the-customer program
throughout the organization and implement far-reaching customer
experience improvements.
THE RESULTS
The work instilled a framework for listening and responding to customers
throughout the health plan’s organization, laying a foundation that will help
its teams make changes in a practical, scalable manner — and to continue
to do so in both the short- and long-terms. By streamlining and improving
customers’ interactions with support representatives, the organization
anticipates higher levels of satisfaction in addition to financial savings.
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North Highland
Building Strong Customer Relationships for Better Decision Making
TO ADDRESS THESE
ISSUES, THE TEAM
IDENTIFIED MORE
THAN 20 CUSTOMER
FEEDBACK
CHANNELS WITHIN
THE ORGANIZATION,
FROM ONLINE CHATS
TO SOCIAL MEDIA
AND SURVEYS,
AND PILOTED FIVE
ENHANCEMENTS
TO HELP THE
HEALTH PLAN MORE
EFFECTIVELY REACT
TO CUSTOMER
FEEDBACK.
The voice-of-the-customer program also served as the backbone that
allowed the health plan to systematically incorporate member preferences
as it identified and prioritized improvements related to two key areas:
billing and payments and its automated phone system.
INSIGHTS INTO ACTIONS —
Evolving Business Processes Based
on Real Customer Feedback
THE CHALLENGE
To get a handle on increasing attrition rates that exceeded 60 percent, the
health plan wanted to find out why its customers were so unhappy. The
team found customers were reporting headaches with the health plan's
billing and payments processes, specifically, with a high level of confusion
over eight-page bills filled with legal and financial jargon. Other members
complained of long waits to speak with a representative in order to pay
their bills via phone or said they were missing critical doctor appointments
due to the health plan's delinquent payments process.
THE SOLUTION
The team embarked on an intensive, fast-moving, 13-week effort to
understand the journey the health plan’s members took from enrollment
through renewal. In-depth interviews with three dozen members mapped
out interactions with customer service representatives and other channels
at each step along the way. The team identified patterns and groupings of
people who tended to go through the process similarly and developed
composite profiles that embodied the organization’s customer base.
The team then interviewed front-line customer service representatives to
understand their approaches, opinions, and hurdles when serving members,
and brainstormed with the health plan’s teams to identify the root cause of
each of those pain points before identifying and prioritizing the improvements
that would have the largest effect on the customer experience.
In total, the team delivered more than 150 recommendations that touched
on every aspect of the member experience, including improvements related
to the health plan’s billing and payments process.
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North Highland
Building Strong Customer Relationships for Better Decision Making
IN TOTAL, THE TEAM
DELIVERED MORE THAN
150 RECOMMENDATIONS
THAT TOUCHED ON EVERY
ASPECT OF THE MEMBER
EXPERIENCE, INCLUDING
IMPROVEMENTS RELATED
TO HOW THE HEALTH
PLAN’S CUSTOMERS
EXPERIENCED THE
BILLING AND PAYMENTS
PROCESS.
THE RESULTS
The insights uncovered led to an enhanced customer experience, with
improvements that included the creation of a tutorial about the payment
process for new members and a redesign that led to simpler, shorter bills
— four pages, compared to eight before. The health plan also redefined how
it handled delinquent payments, ensuring that customers who paid their
premiums would be reinstated quickly.
EMBRACING A TECHNOLOGY SHIFT
with Customer Experience at the
Heart of Change
THE CHALLENGE
Customer complaints made it clear that using the health plan’s antiquated
self-service phone system was a last resort for members. As the
organization prepared to revamp its system, it wanted to learn more about
how its customers preferred to interact with support staff and tools.
THE SOLUTION
The team held 75 qualitative interviews with members and providers
and spent nine weeks analyzing the most recent contacts with the health
plan’s customer contact center. The team then mapped the members’ and
providers’ journeys, identified general preferences for self-service and
automated call systems, and developed five composite profiles to personify
aggregate customer preferences, motivations, and needs.
To help inform the design of the new automated phone system, the team
provided more than 40 insights and recommendations. Among the suggested
improvements for self-service channels were the ability to assign a priority
to calls, ensure seamless integration with data in the organization’s
customer relationship management system, and offer self-service options
for claim status, billing status, and ordering new identification cards.
THE RESULTS
The work guided the design of new technology to ensure it met customer
needs and preferences, and fueled an awareness of the importance of taking
these customer needs and preferences into account when making business
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North Highland
Building Strong Customer Relationships for Better Decision Making
decisions. By equipping the health plan with a framework for incorporating
customer preference, the team helped the health plan better take member’s
wants and needs into account when redesigning the phone system and when
making future service changes.
SUMMARY:
Better Decision Making Across
the Organization
Working together across many areas to accelerate change, North Highland
and the health plan were able to implement a strong, highly effective voiceof-the-customer program and quickly leverage those insights to prioritize
and pilot improvements to the billing and payments processes and its
automated phone system. As the first chapter in a new corporate story, one
that centers on a thorough understanding of customer needs, preferences,
and behaviors, the work helped fuel a change of direction toward a more
customer-centric organization.
ABOUT NORTH HIGHLAND
North Highland is a global management consulting firm that delivers
unique value, relevant big ideas and strategic business capabilities to
clients around the world. The firm solves complex business problems
for clients in multiple industries through an integrated approach and
offers specialty services via its Data and Analytics, Managed Services,
and Sparks Grove divisions. North Highland is an employee-owned firm
that has been named as a “Best Firm to Work For” every year since 2007
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