Offering Easy Access to Care Is Key to Positive Member Experience, Retention

Member experience is key to member retention and, in order to boost member experience, payers must consider whether they are offering easy access to care and straightforward care navigation, according to an Accenture report.

The organization surveyed nearly 21,000 Americans who are consumers of both payers and providers.

Millennials are more attentive to member experience when selecting a health plan than older generations are. Experience factors included aspects such as customer service, convenience, reputability, and the availability of digital or mobile customer service options.

Nearly a quarter of respondents in the younger generation (23 percent) considered customer service when selecting a health plan, compared to eight percent of older adults. A little over 20 percent of younger adult respondents (22 percent) took convenience into consideration, compared to six percent of older adults.

Twenty-one percent of millennials considered the payer’s reputation and the same share assessed digital customer service options. In contrast, only five percent of older adults thought about the company’s reputation and four percent of them considered digital customer service.

“Younger people are less likely than older adults to consider price, medical benefits and network coverage to be top factors when selecting a health plan,” the survey added.

The researchers asked why respondents left their payers and found that patient navigation was a significant factor.

Nearly half of all respondents identified ease of navigation as a top factor that drove them to leave their payer. More specifically, respondents found that information was inaccurate or inconsistent, they had trouble getting help, the digital experience was poor, the customer service did not meet their expectations, and some respondents did not approve of their former payers’ personal data usage policy.

Other reasons that respondents left their health plans included the clinical experience (35 percent) and the access to care or network adequacy (32 percent). For the clinical experience, factors included prescription drug benefits and condition management programs that respondents found to be subpar. For access, members considered whether their preferred provider or hospital was in network and other aspects.

The survey determined that a payer’s ability to provide access to care was one of the paramount influences on a member’s experience.

“People who have a positive perception of payer access factors are far more likely to rate their overall healthcare experience positively,” the researchers stated.

Among consumers who gave their health plans positive healthcare ratings, 69 percent said that the payer made finding a new provider easy, 75 percent said that access to care involved little hassle, and 76 percent said that the payer was flexible on their treatment coverage.

Consumers were also more likely to stay at their health plans when they found that it was easy to do business with the payers.

Additionally, respondents who engaged with their health plans digitally were more likely to stay with their payers (64 percent) and more likely to find their payers easy to work with (74 percent).

Trust is a big commodity in healthcare. Over three-quarters of payers who trusted their payers said that they would stay with their payer.

“Trust is grounded in people’s experiences across many interactions. However, the experiences that have the biggest impact on trust for both providers and payers relate to clear communication and ease of engagement,” the report noted.

The researchers concluded by listing four keys to success for payers and providers alike.

First, they should create a strong foundation built on ease of access to care and patient navigation. Second, they should ensure an omnichannel experience to keep track of the member’s entire health journey. Third, they should understand their consumers by assessing consumer insights through data and analytics. And finally, they should balance their digital solutions with human interactions.

“The good news is that we know what people expect from their interactions—and the factors that are the top drivers of loyalty and engagement,” the researchers stated. “By finding meaningful ways to deliver on these expectations across the healthcare journey, healthcare organizations can set themselves apart—and set themselves up for success.”