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Three digitized ways to improve the member experience


Abhishek Danturti Sharma, HGS’S Assistant General Manager and Lead Data Scientist for Business Transformation

Article originally published on Electronic Health Reporter
Written by Abhishek Danturti Sharma

Health plans are all too familiar with the challenges of member experience—that perfect storm of call/processing volume surge, staffing challenges, and critical moment-of-truth engagement pressures. According to JD Power research, the stakes are even higher for 2021.

The organization’s fourth annual study found that member satisfaction averages dropped from 712 on a 1,000-point scale in 2009 to 701 in 2020. J.D. Power and Associates measures health plan satisfaction of 133 health plans in 17 U.S. regions in seven areas: coverage and benefits, provider choice, information and communication, claims processing, statements, customer service, and approval process.

To be successful, today’s digital-led member engagement must meet the needs of Generation “C” – the “connected” customer demographic that spans generations. These consumers make purchasing decisions based on brand reputation and a more personalized experience. A strong digital toolkit, containing interaction analytics; AI-powered data capture; and automation, will elevate and customize engagement to earn and retain these buyers. It may be counterintuitive, but digital enablers such as analytics, AI-powered intake, and bots can deliver a more empathetic, customized member enrollment experience—one that earns and retains customers for life.

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