Innovation is key to satisfying health insurance consumers

The recently launched state healthcare exchanges created by the Affordable Care Act are designed to function as one-stop shopping for healthcare consumers, where Americans can compare benefits and prices and choose the plan that is best for them and their families. As of this writing, roughly 5 million Americans have selected a plan from a state exchange, a number that the consulting firm Accenture projects will grow to 30 million by 2017.

At the Alliance of Community Health Plans, where our 23 member health plans focus every day on improving the health and well-being of the 18 million people they serve, we strongly believe that health plans operating in this rapidly changing environment must sharpen their focus on consumer satisfaction, particularly as more individuals select coverage on their own.

ADVERTISEMENT
With the right leadership, and a commitment to quality and customer service, we believe all health plans can deliver powerful results for their customers. Recently, J.D. Power and Associates, in concert with Fortune, included four ACHP members—Capitol District Physicians’ Health Plan (CDPHP) in Albany,  HealthPartners in Minneapolis, Independent Health in Buffalo and SelectHealth in Salt Lake City—among the 50 Customer Champions that exceed their customers’ expectations, a lofty list that includes Amazon and the Four Seasons.

So how did they do it? Independent Health President and CEO Michael W. Cropp notes in an accompanying Fortune article that consumer decisions in the new marketplace are driven more by the quality and variety of services offered by a given plan than the overall price. Indeed, all four health plans recognized the need to rethink the services they were offering members to help them receive effective, efficient care.

At Independent Health, leaders focused on transforming their payment model for primary care practices to make sure members have access to “teams” of clinicians—including nurse educators and behavioral therapists—who work together to provide the best care for each patient. Members also receive key educational materials, like a quick start guide to understanding how to get the most out of their high deductible plans, and monthly statement updates tracking their deductible costs.

CDPHP employs health coaches—who include nurses, dieticians and respiratory therapists—to help members monitor their health needs in concert with their physician. The coaches are available for regular, one-on-one check-in calls with members to talk about their upcoming appointments, medications, diet or exercise plan and check in on serious chronic conditions. The coaches are available 24 hours a day, 7 days a week, by phone or online — and the service is free.

HealthPartners offers members access to an enhanced web portal—available online and through a mobile app. Members can use the portal to find a doctor, speak to a nurse, check plan balances, view their claims history, make appointments, refill prescriptions and receive health reminders.

At SelectHealth, member advocates work with patients to help them find the right doctor for their needs, schedule appointments or find a nearby health care facility with availability appointments.

The personal touch resonates with consumers; one SelectHealth member recently noted their “tone and attitude let me know that they were on my side, which was a very pleasant surprise.”

At the end of the day, quality service is the key to superior customer experience and engenders a feeling of trust and dependability. In a rapidly transforming industry, all ACHP members know that meeting that goal requires innovation, and we’re encouraged that their efforts are bearing fruit.

Smith is the president and CEO of the Alliance of Community Health Plans.

More in Healthcare

Fifty million life-years saved through medical innovation

Read more »