Health Insurers: It’s Time For Better
First and foremost, we abhor violence. Like so many others, we were dismayed by the murder of UnitedHealthcare CEO Brian Thompson. But our dismay wasn’t the only response. This event revealed widespread negative views of health insurers: Stories of coverage denials, care delays, and medical bankruptcy spread across social media.
Understandably, health insurers have asked us how to respond. These questions have ranged from concerns about potential impacts on KPIs to how to rebuild trust with customers. We’ve also seen some insurers deflect, looking to blame the system or other parties (such as hospitals), doing little to acknowledge their role in the problems that consumers face. Health insurers: We have a lot of work to do, and the call to action started well before December.
Eight Essential Strategies For Health Insurers To Repair And Enhance CX
In 2024, trust in health insurers hit a three-year low, with just 56% of consumers reporting that they trust their health insurer to do what is in their best interest. The industry’s Customer Experience Index (CX Index™) score also hit a five-year low, underscoring significant shortcomings. The most basic reasons why an insurer exists, such as “processes transactions quickly,” landed among the top drivers of CX. Performance on this driver and others has been decreasing since 2022. In December, transaction issues such as denials and delays in care galvanized public dissatisfaction. To climb out of this hole, here are eight things health insurers must do:
- Start your listening tour now. Don’t just imagine what customers might be going through. Immerse yourself in the customer’s world and experiences by conducting the right kinds of research. Analyze your existing data first. Show that you’re listening by acknowledging these issues and demonstrating empathy to rebuild trust.
- Communicate your plan. Be transparent about what you learn and what you are going to change. Transparency is a key lever of trust. If it’s a customer-facing change, tell them how you plan to do it and set expectations for how long it will take to deliver. Follow the same approach if the change is more targeted to the experience of providers, employers, brokers, or other key ecosystem partners.
- Stop paying lip service and start taking action. People know empty promises when they hear them. Focus on incremental improvements that you can deliver quickly. Demonstrate that you will continue to listen and collect feedback to stay on the right track. Ensure adequate investment for improvements to the experience — yes, health insurance leaders, the ROI is there. The right improvements can deliver value to members, providers, and insurers.
- Cocreate with your customers. Engage and collaborate with your customers at each phase of creating experiences — not only to test the solutions you’ve already created but also to identify needs and problems and ideate solutions. What is their job to be done? Are you helping them with what they need or chasing what you think they want? Place a special focus on collaborating with groups that are often left behind, such as customers with disabilities. Customer obsession means putting the customer at the center of your leadership, strategy, and operations. Get aligned to customer needs and build experiences that work for them, and then the business outcomes will follow.
- Get the basics right to rebuild trust. Rebuilding trust, especially for health insurers, hinges on competence, reliability, and accountability. Understand your customers, clarify complex processes, and prioritize their value perception over yours. Value creation is based on an exchange — what customers get versus what they give up — and it’s influenced by their value network. For instance, unexpected bills, like a $25 copay, can negatively impact their experience with you due to misunderstandings about cost-sharing.
- Revisit broken processes. Today, 77% of healthcare practitioners report that health insurers create additional hurdles to patients getting the care they need, with just 20% agreeing that the policies and procedures established by health insurers align well with the needs of their patients. Explore gold-carding and waiving prior authorization for specific procedures.
- Focus on improving CX — not scores. Yes, you will see the impact on scores like Net Promoter Score℠ (NPS) and customer satisfaction. But the impact is not the result of December’s events alone. Customers loudly expressed their frustration and anger. These emotions are not new. Feedback is a gift (even when someone shouts it at you). Tear it open and use it to meaningfully to move the needle on CX.
- Prepare for the next crisis. Health insurers lacking a crisis communication plan risk long-term reputational and financial damage to their company. Develop a response plan now, including how you will communicate with customers and the public across all relevant channels.
Health insurers can take action in response to this tragic, watershed moment. New research on the state of trust for health insurers and the power of plain language is on its way for Forrester clients. Schedule a guidance session now to discuss how your business can respond today and in the future. Not a client? Learn more about how you can have Forrester on your side and by your side.
Join us at CX Summit North America from June 23–26 in Nashville to delve into these topics. Reserve your spot to join the conversation.