AHIP 2013: Leading health insurers leveraging technology innovations to deliver exceptional and engaging customer experiences into the post reform market

11 June 2013 | Dr. Dennis Schmuland, Chief health strategy officer, U.S. Health and Life Sciences, Microsoft

As health insurance exchanges go live this fall, the third-party relationships that many health plans have had with their members will increasingly become first-party relationships. This means that competition for the same customer has never been more intense. Keeping customers is going to require exceptional customer service—not just excellent service—because customer loyalty will now be gained or lost with every customer experience. In other words, delivering excellent customer experiences at every touch point and across the channels each customer prefers—the phone, web, email, IVR, social media, chat, text, and web conferencing—is now just the price of entry. Delivering exceptional experiences at every touch point is now mission critical for health plans to retain and grow their customer base in today’s first-party customer relationship model.

Delivering exceptional and engaging customer experiences requires a deeper understanding of the needs, behaviors, and values of every customer. Microsoft and its partners are helping health plans meet these needs through new and innovative devices and services.  

Understanding, activating and engaging members and partners starts with creating a 360 degree view of their needs, communications, and how they prefer to engage on issues critical to their care and wellness. Leading health plans like Molina are leveraging Microsoft Dynamics CRM as a flexible platform to understand customer values and preferences and personalize their interactions with them across multiple communication channels. Juan Jose Orellana, Vice President of Investor Relations and Marketing at Molina Healthcare, Inc. explained, “At Molina Healthcare, our focus has always been on providing high quality care to families and individuals who face barriers to health care access. We believe that by leveraging a customer relationship management tool, we will strengthen customer service while improving health outcomes for our members.”

The more consumers see and pay the bills for their own premiums and health care services, the more they’ll expect and demand the same or better level of service that they do from retailers known for their exceptional customer service. As a result, best-in class customer service is now priority one for every health plan organization. Microsoft’s partner Colibrium Partners has lead the industry in providing sales, marketing and insurance marketplace integration. Providence Health Plans recently chose Colibrium’s Tuo Product Suite, with integrated Dynamics CRM, for their private exchange, with public exchange integration. The comprehensive solution platform provides a guided online experience, streamlined administrative processes, and will integrate with Oregon’s Public Exchange. “The Tuo turn-key platform will enable Providence to rapidly establish themselves as having best in class online capabilities for all of their constituents and provide a foundation for growth and the flexibility reform requires today,” explained Mark Poling, CEO, Colibrium.

Success in the post-reform requires organizations to acquire new flexibility to adapt quickly to shifting industry priorities while streamlining operations and increasing the productivity of employees and teams. Such organizational transformation includes strategic use of technologies that can provide reliable, secure and leading edge capabilities whether on premise or in the cloud. Microsoft and its partners have worked to assist leading health plans to transform their organizations to meet market flexibility and regulatory demands such as HIPAA 5010 and ICD 10 as well as to provide secure productivity and team collaboration cloud based services to supplement or replace their core communication and collaboration infrastructure. Health benefits company WellPoint chose Office 365 to provide a complete collaborative environment across both internal and external stakeholders, as well as to provide productivity gains necessary to meet medical loss ratio (MLR) targets. Office 365 enabled WellPoint to rapidly integrate their community of health providers, healthcare management and traditional insurance businesses. Further, WellPoint was able to reduce operating costs and increase reliability from 95 to 99.99 percent, improve coordination amongst its 37,000 employees, and enhance delivery of its services for the 34 million members in its affiliated health plans. George Zaruba, vice president of infrastructure, WellPoint, explained, “Microsoft Office 365 gave us capabilities that we needed and didn’t have in WellPoint. Larger mailboxes. Integrated collaboration tools. Great support from Microsoft. I’d recommend Office 365 to anyone.” These technologies also allow health plans comply with HIPAA security regulations, as Microsoft offers a HIPAA Business Associate Agreement to healthcare organizations leveraging its cloud products.

Technology solutions from Microsoft and its partners are enabling health plans of all sizes to communicate, collaborate and connect with their members, providers, employers and partners.  Adopting platforms such as Microsoft Dynamics CRM and Office 365 enables insurance providers to not merely adapt to the rapidly changing marketplace – but to raise the customer experience bar to new levels.

Visit Microsoft and our partners in booth #145 this week at AHIP’s Institute to talk more about how Microsoft can help your organization succeed in today’s market.

Have a comment or opinion on this post? Let me know. Have a question for the author? Please e-mail us at health@microsoft.com.  

Dr. Dennis Schmuland
Chief health strategy officer, U.S. Health and Life Sciences, Microsoft