Patient Experience & Payers: Is the term an Oxymoron?

I overheard two trees talking the other day.  They were trying to determine if when a person falls in a treeless area whether the person makes a sound.

Harvard’s Clayton Christensen built a new line of thought around the notion of getting clients to disrupt their business models.  What do you do with an industry that self-disrupted?  If you multiply it by negative one does it revert to normal?

I was starting a meeting with executives of one of the largest healthcare insurers (think totally disrupted industry—if healthcare insurer is supposed to mean the same thing as payer, is that not by definition an oxymoron) when music entered the room. We looked around hoping to spot the source of the intrusive sound.

“Queen, from the Sheer Heart Attack album,” said one executive. Apparently my phone decided to self-activate at an inopportune time.  Fortunately for me he was a Queen fan.

The purpose of the meeting was to talk about the impact of the Affordable Care Act on healthcare insurers, particularly as it related to customer experience.  He wanted to talk about how to grow revenues.  I told him we should be talking about how not to lose customers.

He wanted to talk about changing phone system vendors for the call centers.  I asked him how many customers they had.  I asked him how many calls a year they received.  I asked him how many customers had to call more than once to get what they wanted.

The answers; three million customers, nine million phone calls, one-third of the calls were repeat calls.  Let’s do some math.  It costs about thirty dollars per call.  Two hundred and seventy million dollars to answer the phone—they could hire Lady Gaga for less than that. Who among us with two hundred and seventy million dollars to spend could not figure out how to solve the problems that were causing most of the nine million calls?

For a tenth of that amount they could build a customer portal that could handle half of the calls on the customer’s time and nickel.  Some problems don’t involve solutions that require innovation or out-of-the-box thinking, they just require common sense. Most customers in any industry call because the firm they are calling did not do something right, because they need something, or because they have a question.  They call because the prior process was ineffective.

Most calls can be grouped by category.  Those that can be grouped are what I like to call Easily Repeatable Processes, ERPs.  Why spend millions of dollars answering the same question thousands of times when you can place the answer to those ERPs on an effective customer portal?  Answer it once and let the customer access the answer at a time of their choosing on their own nickel.

(I was going to suggest that to cut down on the number of calls that payer’s could simply pay their customers’ claims, but that would be hitting below the belt, so I won’t.)

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