Sagility: Voice of the Consumer



September 23, 2022

Modernized, AI-enabled VoC to Meet Today’s Healthcare interactions

Today’s healthcare members will act on failure to meet their expectations, according to recent Forrester research, with 34% of dissatisfied customers changing health plans. Equipped with this knowledge, health insurance plans can renew their focus on measurement of Voice of the Customer survey feedback to improve customer engagement, loyalty and retention. But a truly effective and statistically significant VoC solution requires not only user-centric (design thinking) questions, tools, and technology—what’s also needed is the right volume and rich quality of data backed by NLP/AI interaction mining platform. Working together, the solutions and data can deliver meaningful and actionable insights to drive positive business outcomes. An Analytics CoE can serve as nerve center of healthcare interactions, using the following frameworks:

  • Journey mapping, measurement, and ownership (customer effort, sentiments, emotion analytics)
  • Insights-driven experience and process improvements to ease customer friction points by contact types, and reduce agent effort reduction by providing tools, with an increased engagement rate
  • Leveraging of technology to meet stated and unstated customer needs and experiences

Increasingly, the healthcare VoC survey is embraced as an essential driver of member/patient satisfaction and retention. In fact, Gartner forecasts that by 2025, 60% of organizations with VoC programs will supplement traditional surveys by analyzing real-time or near real-time voice and text interactions at every customer touchpoint.

Today’s optimized and AI-enabled VoC survey will meet the mark for improved member experience in two key areas across both commercial and Medicare member bases:

  • Commercial
    • Self-service channel friction: A section of healthcare customers expecting an Amazon-like experience will not get it when self-service engagement is not optimized. The right VoC survey will address this with questions that get to the heart of self-service misses with good failure modes and effects analysis (FMEA). Once self-service complexities with simple contact types are discovered, they can be addressed with fixes for a more seamless customer journey. Examples include fulfilment and eligibility contact types (Member ID cards, demographic updates and the routine office visit copay)
    • Contact deflection: On the opposite end of the complex calls are the simpler contacts that can be deflected with proactive digital solutions such as service automation. Deployment of post-call IVR voice of customer with NLP/AI enabled survey verbatim/sentiment mining will improve operational engagement, agent coaching opportunities and experience metrics. And once identified, a good deflection and prevention strategy can digitize the contact solution for millions in savings.  Examples include billing (Monthly Premium payment related contact type)
  • Medicare
    • Unresolved issues resulting in repeat contacts and complaint tracking module (CTM) issues: This is a crucial journey point to check in on with the Medicare member VoC survey. When plans discover root causes of CTM, unresolved issues can be addressed not just for one payer but for a wide demographic—for greater ROI and improvement. Without a team to reach out to a member at this escalation point, you aren’t closing the loop on those issues that cause a member to change health plans. With technology, process, and people in place to address survey-discovered escalations, the long-term gain is significant.
    • Call types that trend toward a higher propensity to appeals: Post-call VoCs can baseline and benchmark closure or the people/process/policy/tech gaps that drive appeals. Sagility has leveraged, for two leading payers with MAPD plans, our VoC solution in areas of transportation/ambulance, late enrollment penalty premium and policy disenrollment/reinstatement. Once value stream mapping is done and upstream/downstream mapping is conducted, pertinent solutions/resolutions are deployed at the upstream (customer service) area to reduce unnecessary downstream appeals.

In these areas and more, AI-empowered healthcare VoC can optimize survey distribution, feedback, and issue root cause analysis. We helped a leading payer to achieve results addressing these common weaknesses, delivering value empowered by automation. This tech enablement has helped expand VoC feedback from 1,000 surveys a year to 1,000 surveys a day. We also redesigned the survey, reducing it from 18 questions to 5, which reduced survey time from 10 minutes to 1 minute. Additional results included:

  • Improved Survey to Call Ratio 0.16% to 9%
  • Increased FCR by 26% (59-85%)
  • Increased ASAT by 22% (71% to 94%)
  • Reduced manual survey administration, achieving cost avoidance by $2 million

These results demonstrate how survey experts can drive to more impactful and much broader feedback, for the true impact and consultative value delivered by healthcare BPOs. These specialty BPOs in are experts with the required skills across tech, process, and teams of experts to make business process improvement recommendations with a VoC champion. With a solid structure in place to support an enhanced VoC survey process, ROI is heightened.  Today’s robust VoC framework builds in feedback that can drive real outcomes when addressing process, product, and engagement channel improvement opportunities.