I recently had the opportunity to meet with the SVP of member experience at a leading health insurance carrier and candidly shared my frustration with the sundry “This is Not a Bill” communications that all too often clutter my home mailbox. I was delighted to hear that simplifying and digitizing member communications – for billing in particular – is currently the carrier’s top initiative to better serve members.
Billing workflows are one of many areas that are ripe for a digital makeover for health insurance carriers. In fact, over the past year, insurers have prioritized technology investments to catalyze business transformation initiatives. Indeed, the industry has recognized that transitioning to a digital enterprise is critical to keep pace with the ever-shifting healthcare landscape filled with consumer-centric exchanges, cost-cutting pressures, and ongoing compliance requirements of the Affordable Care Act and HIPAA.
How will you keep pace? We have distilled the top 3 digital opportunities for health plans. Read on for pro tips on how digital can help you differentiate your products, improve member satisfaction, and create more collaborative business models – all while saving time and money.
- Health Insurance Exchanges
Exchanges are changing the paradigm for how employers, consumers and plans interact. With the advent of public and private health exchanges, competition is heating up: in 2015, the number of insurers participating in public exchanges was projected to increase by 25% – with rates in 4 states projected to double. Adding fuel to the fire, employers are moving towards defined benefit plans that allow employees to shop around for their own health plans; thus, consumers are growing accustomed to buying health insurance online. Just as retailers have optimized the shopping experience on e-commerce sites and mobile apps, health insurers need to create a simple and enjoyable member experience to stand out from the crowd when presenting new offers and enrolling new users online.
Staying ahead of the competition requires sound digital operations:
- Delight potential members by investing in a simple, fully digital experience for policy contracting and member enrollment
- Allow members to shop and sign up for your plans from anywhere, on any mobile device
- Provide detailed and transparent information about pricing and plan benefits to differentiate your organization and make it easier for the newly insured to understand your plan
- Member Satisfaction
Customer experience is everything, so it isn’t a surprise that health plans who understand members’ wants and needs will prevail and grow in the redefined, consumer-centric healthcare marketplace. As large deductible plans are becoming the norm and more young adults gain coverage, members will become more cost-conscious and more involved in their healthcare decisions.
In this environment, transparency and communication are crucial: members want access to data regarding deductible thresholds, use of benefits, and treatment costs. Employers have taken note and are striving to offer a better benefit experience to their employees in order to retain top talent. Employers also plan to use digital resources to help them manage enrollments and offer more price transparency to their employees.
As an employer or a health plan, providing digital tools to members and employees pays dividends:
- Offer plan coordinators and members the information and services they need, anywhere, any time, on any device, and optimize the user experience for your mobile applications
- Transition to digital to collect member data such as life change events and billing authorization, and send updates on the status of claim disputes and issue resolution
- Improve member services by collaborating with plan members, employers, and healthcare providers, and share data using secure workflows and approvals – resulting in more efficient processes, transparent communication, and consolidated billing
- Cost Reduction
Operational efficiency is a must-have mandate to meet Medical Loss Ratio (MLR) policy regulations and avoid rebate payments. Digital tools allow for significant savings across your organization. Billing and reimbursement is one key area where going digital can positively impact expenses. Commercial health insurers collected just 15% of payments electronically in 2013 compared to 43% across all industries in the US. Using electronic workflows for recurring payment authorization and policy and billing document delivery will help health insurance carriers reduce administrative expenses while improving the member experience.
Digitizing annual group and individual contracting and policy renewal can also reduce costs and cycle times by eliminating the incomplete paperwork that must be returned and resubmitted. DocuSign customers have saved millions of dollars on paper-related costs by switching to digital contracting. Additional use cases that can help cut costs and deliver a compelling ROI include:
- Provider agreements
- Physician credentialing
- Fee schedules
- Eligibility and benefit verification
- Medical and surgical prior authorization
- Employer sales agreements
Integrating digital workflows into existing systems can also reduce the cost of redundant data entry and facilitate increased collaboration with providers, employers and members.
Your Digital Guide
As the health insurance market becomes increasingly competitive, evolving to a fully digital enterprise will be crucial to differentiate your organization, deliver superior member service, and effectively manage costs. Based on our experience working with top health insurance carriers, we created a guide to help health plans accelerate their digital transformation.
In developing this guide, we reviewed well-known health plan use cases across five classes:
- Collect data
From physician credentialing to billing and beyond, we provide guidance on how to sequence your investments in going digital across your enterprise.
Click here to begin your digital journey to differentiate your business and delight your members.