Healthcare, The Supreme Court, And Customer Experience: What It Means

The Supreme Court decision upholding virtually all of the Patient Protection and Affordable Care Act (AKA “Obamacare”) shifted a balance for customer experience professionals in the healthcare industry. Now they — and the executives they report up to — know that it’s more risky to do nothing than to respond by taking action.

Keeping in mind that “the healthcare industry” is really three industries, here are some of the most important actions that healthcare organizations will need to take.

Health Insurance Providers (Payers)

As we point out in our upcoming book, Outside In, the health insurance industry has owned the cellar of our Customer Experience Index (CXi) since we began that study five years ago. The main reason for its dismal performance is that the CXi is a consumer study, and for health insurance providers, the customer has not been a consumer but a business — or more accurately, a person at a business, like a benefits manager.

The result was that payers didn’t need to focus much on the end users of their products — consumers — so most of them didn’t. But starting in 2014, a greater percentage of their business will come from consumers. That will drive health insurance providers to better understand consumers so they can attract and retain the healthiest ones, who are the most profitable. Payers will also want to get consumers to change their behavior as a way to keep costs down. For example, they’ll want them to opt for generic drugs and to take better care of themselves. But none of that will happen unless the health insurers build a trusting relationship by providing a far better experience than they have to date.

To get up to speed faster, payers need to focus on mastering the practices in the customer understanding discipline, one of the six disciplines that lead to customer experience maturity. Through ethnographic research, persona creation, customer journey mapping, and customer experience ecosystem mapping, payers will begin to understand what a great experience means for consumers and how everything the payer does affects it.

Healthcare Providers

Hospitals will see millions of formerly uninsured patients transformed from people who received treatment they couldn’t pay for into valuable customers who will be able to pay. Instead of being a cost of doing business that has to be managed, these patients will become a source of revenue that hospitals will want to attract.

That change will accelerate a movement to improve patient experience that’s already taken hold: Many healthcare providers have tuned in to the fact that providing a superior patient experience is important to a range of business benefits that include attracting new customers, not driving away their most valuable customers, and even improving outcomes. (See my post about the Cleveland Clinic Patient Experience Summit for more details.)

For hospitals, mastering the practices in the customer-centric culture discipline will represent the biggest opportunity as well as the greatest challenge. Imagine trying to change the perspective of surgeons who’ve been told that they’re the center of the universe and instead getting them to put patients first. Doing that will take every trick in the book, from hiring for customer-centric values to changing formal and informal rewards systems.

For most healthcare providers, making this pivot will require a committed CEO like Dr. “Toby” Cosgrove at Cleveland Clinic or Dr. Kurt Newman of Children’s National Medical Center. Even then, efforts to improve patient experience are more likely to succeed when driven by a chief experience officer like Cleveland Clinic’s Jim Merlino, who put all 42,000 clinic employees through training designed to help caregivers have empathy for the patient as an individual and to care about the patient’s family as well as the patient.

Pharmaceutical Companies

Drug companies face a staggering number of changes to their fundamental business models as a result of a shift to lower-priced versions of their brand-name drugs and an increase in the number of insured patients who can pay for drugs. They’re also on the hook for billions in fees and rebates under the new law.

The danger for pharmaceutical companies working to improve customer experience is that they will become paralyzed by these changes when taken in combination with the heavy regulation they already labored under. They run the risk of deciding that they can’t actually do anything to improve customer experience, then throwing up their hands and becoming professional victims. Quite reasonably, the ones I’ve talked to would love nothing better than to hear that one of their competitors figured out the answers to their problems and decided to share best practices.

But that won’t happen. Instead, the path forward for drug companies is to learn from industries with similar dynamics, like those that sell to a relatively small number of decision-makers who serve as intermediaries for a much larger number of end consumers — just as physicians do for patients.

That certainly describes tech vendors, whose real business model is not B2B but B2B2C. Drug companies should look to examples like the Voice of the Customer program at NetApp, which we profile in our book. That program gathers data from hard-to-survey decision-makers and uses it to both improve customer experience as well as galvanize the sales force. (If you want to get a little flavor of the commonalities between healthcare and the tech industry, you can check out this video from our 2011 Customer Experience Forum, when the current chief experience officer of Cleveland Clinic and the former chief customer officer of SAP North America were on the same main-stage panel.)

As always, I welcome your comments and questions.

Comments

Eye on Heathcare Customer Service

For many reasons the healthcare industry has been under the microscope the last few years. With technology, government mandates, and demographic shifts all changing at a rapid pace - now is the time for healthcare providers, insurance companies etc. to step up and become true service providers.

Rachel
http://www.impactlearning.com/health-insurance-call-volume-increasing-be...

Pain Relief- surprising fact

Well, I used to suffer from lower back pain, and the doctors suggested me to take calcium tablets for at least a month. Surprisingly, the pain started reducing gradually, and I began performing various sorts of physical activities without any difficulty. It proves that nutritional imbalances might be one of the reasons for pain and fatigue.
Regards,
Eric B.