Health plans need human touch to boost member experience

Health plans need to focus on a humanized consumer experience in order to boost trust and, ultimately, member experience scores, according to a new assessment from healthcare experience advisory company Press Ganey.

The report shed light on where health plans fall short in member experience and how they can rebuild trust.

"Trust is earned, not assumed," Patrick T. Ryan, chairman and CEO of Press Ganey, said in a press release. "We now have a clear view of what erodes trust, and what can fix it. Health plans that lead with clarity, empathy, and follow-through will rebuild trust, improve member experience, and deliver results that last."

Currently, health plan member experience leaves a lot to be desired. Previous studies have found lapses in the digital member experience, while others have indicated that payers with poorer member engagement see lower satisfaction scores.

This latest report from Press Ganey adds to that, indicating that health plans that offer clear explanations of benefits, promote easier access to care and facilitate better access to medications have more engaged members.

In turn, those engaged members are four times more likely to report a positive health plan experience and 3.5 times more likely to recommend their plan. They are also more likely to be more confident navigating their health plan coverage, Press Ganey said.

But members aren't always having those good experiences, the report added.

For example, 60% of members told Press Ganey that they could not get the care they needed, in large part due to poor access and affordability. Another half said the information they have about their health plan coverage is difficult to understand, dampening trust and deepening confusion.

Finally, health plans are the target of many consumers' ire. Specifically, 55% of millennials say their deductibles are unaffordable, spurring anger that runs rampant across their social media.

Health plans need to rebuild trust with their members, and according to Press Ganey, that means leveraging more human connections. That is because members' chief complaints about their insurance plans -- confusion, anxiety and anger -- are emotional responses.

Ensuring access to person-to-person support, implementing emotional and situational awareness training for all communications and supporting better payer-provider coordination will be central to these efforts, Press Ganey concluded.

Sara Heath has reported news related to patient engagement and health equity since 2015.