InstaMed Blog

There are several “pain-points” in the member journey that are accepted as the status quo in the healthcare industry today. However, just like no one asked Amazon to create Prime, your members may never verbalize what exactly they want to improve their experience with you.

In a previous blog post, we talked about how Amazon Prime sets out the perfect blueprint for payers to successfully drive member engagement. Now, let’s take a closer look at the member journey for all of the untapped opportunities for payers to deliver a similar experience.

  • Member Journey Stop #1 – Selecting a Health Plan

On this point of the journey, the data is clear on what members want when searching for a plan. From the very beginning, members have healthcare payments on their minds when it comes to interacting with health plans. Three out of four members reported that they prefer health plans with payment functionality when they were selecting a plan.

It’s important to call out payment security at the start of the member journey. There will be more on this later in the post, but for right now, let’s just say it can be a deciding factor when it comes to picking a health plan.

  • Member Journey Stop #2 – Experiencing a Health Encounter

At this point of the journey – a health encounter – there isn’t much activity between the member and health plan. The member may look up potential providers from the member portal and try to determine future costs, but most of the interactions here are between the provider and member or payer and provider. Instead, this is the catalyst for the activity that comes later.

  • Member Journey Stop #3 – Getting the Medical Bills

This is the point in the journey when the confusion and frustration usually set in for the member. Sometime after the health encounter, the member receives an explanation of benefits (EOB), which explains exactly what is owed but also says “This is not a bill. Do not pay.” It’s no wonder that three out of four members are confused by their EOBs.

Then comes the actual medical bills from the providers. For a member who has a complex health encounter, they may get multiple bills from many different providers. Most bills are sent by mail, but almost all will have different payment options. Some providers may accept online payments, some may not. Sometimes, members may even get multiple paper bills from the same provider.

The payment experience with providers may seem like it is out of a payers’ hands. However, it is actually an opportunity to give members exactly what they want. When surveyed, 73 percent of consumers prefer to make all of their healthcare payments in one place like a member portal. There, the member can easily see all of their payments due in one place and understand how it impacts deductibles or out-of-pocket maximums.

  • Member Journey Stop #4 – Navigating Roadblocks

Inevitably, a member’s journey will include a few roadblocks. For example, what if a member forgets to pay their premium during a health encounter. It’s not totally unreasonable to think that someone who received a serious medical diagnosis could miss paying a bill or two.

Earlier, we said that members want a health plan with payment functionality. Now, let’s be clear on what exactly that means. Overwhelmingly, members want electronic and automated options:

  • Four out of five members want to pay their premiums online
  • 58% of consumers want to schedule an automatic deduction for premiums
  • 86% of consumers want to use an electronic payment method for premiums

To put this in perspective, members want to pay premiums like they do their gym membership or Netflix account. They sign up once with a payment card and the money is automatically withdrawn every time a payment is due. They never have to think about it until it’s time to make a change – like adding a spouse or a new baby to the coverage. (Think this data only represents younger members? Read this blog to understand why age has nothing to do with payment preferences.)

Another unfortunate yet common roadblock for members is the threat of a data breach. In fact, one in four members experienced their healthcare data being breached. Payment security influences the perception of a payer organization. Consider that two-thirds of consumers would change their online behavior if it led to safer experiences. Payers have the opportunity to work with vendors who meet the highest standards in the healthcare and financial industries to build trust and loyalty with their members.

The moral of the story is clear. It’s time for member engagement to be the top priority for payer organizations by quickly implementing real solutions that answer member needs. As shown in the member journey above, a streamlined healthcare payments process is the only way to do that.

All data included in this blog post can be found in the Trends in Healthcare Payments Seventh Annual Report: 2016.

 


The views expressed within posted comments do not necessarily reflect the views or opinions of InstaMed.

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