The most popular aspect of our health plan Voice of the Member studies has been the “top digital features” list, in which respondents rank the importance of health plans’ web and mobile features. That list didn’t change much from our 2016 study to our 2018 results, with “looking up benefits/confirming coverage” ranking first and “finding network providers” second. 

Something else didn’t change: Whenever health plan executives see the digital feature list, they tell me their plans already offer members each of those capabilities. That raises a few questions: Why, then, are call center use rates still high? And why do members still say they’re looking for these features? Based on our member surveys and my own personal observations and experience, I think the industry has a digital adoption challenge to address.

Resolving the Digital Tools Disconnect

Here are several areas for plans to evaluate for insights into what’s going on.

  • Design. Were the tools and features created in an empathetic, human-centered way? A cost estimation tool that requires a member to enter comparative data from several providers probably isn’t going to work because most members won’t easily have that data at hand. A function that takes half a dozen clicks to access probably won’t be found by any but the most determined member. Another issue is that industry terms are still confusing: From a member’s perspective, what does it mean that a claim was “processed” vs. “paid”?  Plans must invest in human-centric design to understand how members experience processes so they can eliminate these friction points and deliver tools that members find valuable and easy to use.
  • Awareness. Do members know about a plan’s digital tools? In our 2016 survey, we advised plans to heavily promote their digital tools as part of an effort to build a closer, persistent relationship with members. That advice still holds – and based on this year’s study, social channels may be one of the best ways to build that awareness. Whereas in our initial study, plan members didn’t seem overly inclined to use social tools, now they’re researching plans via social platforms. Health plans need to get in front of these searches to control their messaging. Marketing digital capabilities provides a sharp focal point for social campaigns.
  • Intelligence. Are members presented with the choices they need, when they need them? Proactive analytics aren’t used enough among health plans to push the right features and functions to members. Analytics and customer journeys informed by AI can offer next-best-choices based on members’ real-time activity via a website or app.
  • Web-first vs. mobile first. Are members able to seamlessly switch between their plan’s web and mobile channels? Plans have created better web portals over the last two years; yet, members are steadily being schooled on how to use mobile. Members have also said in both studies that they want to use their smartphones to interact with payers – except when they’d rather use the web. Plans need omnichannel strategies to ensure members can start a transaction in one channel and pick it up without interruption in another. We still recommend designing for mobile first instead of shoehorning web offerings onto mobile platforms.

A Growing Appetite for Digital Tools 

Here’s another good reason why health plan executives should address these issues, and soon: Digitally-adept groups are aging into Medicare services, with baby boomers between 54 and 72 years of age this year. Our respondents from this demographic have told us it’s important for health plans to offer digital.  Age clearly isn’t a barrier to digital adoption – virtually all generations now expect and want to manage business relationships with digital tools. Some age groups may want more capabilities than others, but the appetite for digital highlighted in our 2016 survey has only grown.

Another key point: This year’s survey showed members are ready to transmit health data to their plans.  It’s easy to imagine digitally savvy Medicare Advantage plan members transmitting data so plans can help monitor chronic conditions, prescription adherence, nutrition intake, etc., all of which can have positive effects on health outcomes and member experience. In short, for plans to succeed in the very competitive Medicare Advantage market, they may need members to use digital tools – and not just to check coverage.

A Necessity for Remaining Competitive 

When health plan executives say they offer all the digital capabilities members want, they probably are literally correct. But if these capabilities were meeting member needs, they’d be used much more often, deliver cost benefits and differentiate plans competitively. That doesn’t seem to be happening. The threat here is that new entrants looming on the horizon have mastered design, awareness, intelligence and seamless experiences.  

Amazon’s not the only concern: Any of the emerging on-demand healthcare platform economy players will nail these capabilities.  Being an incumbent in a highly regulated and complex industry like healthcare offers some protection from disruption – but only initially. Boosting members’ adoption of digital health plan tools, whether through a great marketing campaign or via a complete human-centric redesign of member engagement tools, is a much better strategy than relying on legacy strength to fend off new competition.

To learn more, please read “Extending the Case for Digital: Member Speak.”

William Shea

William Shea

William “Bill” Shea is a Vice-President within Cognizant Business Consulting’s Healthcare Practice. He has over 20 years of experience in management consulting,... Read more