Centene Uses CRM as a Company-wide Strategy, Not Just a “Product”

02 August 2012 | Dr. Dennis Schmuland, Chief health strategy officer, U.S. Health and Life Sciences, Microsoft

​The rise of health insurance exchanges and the trend for employers to replace defined benefit plans with defined contribution plans is changing the nature of the relationship that health plans have with their members, from a third-party relationship to a first-party relationship. For the consumer, this means that the power of health plan choice and financial accountability for co-pay and premium payments is shifting toward them and away from their employers. According to McKinsey & Company, the number of consumers who have a choice on health insurance was expected to reach 151 million by 2011—roughly half the entire U.S. population.


For health plans, 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.
And 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 …like Amazon, Costco, and Starbucks. In fact, a 2011 Accenture survey on attitudes toward the customer service practices of U.S.-based health insurance providers found that among respondents, expectations of customer service had increased. When asked how expectations increased, 80 percent said they expect customer service to be easier/more convenient to obtain, and 75 percent said they expect representatives to be more knowledgeable and better trained.
The consumer-centric wake up call for health plans is clear: The traditional call center and self-service portal models of the last decade are now relics of the past. Health plans unequipped to deliver exceptional customer experiences across the customer continuum—from marketing to sales to service and care management—will find that they are lagging further behind and eating the dust of their competitors who do.
The health plans most likely to gain share and retain customers better than their competitors are those that view CRM (customer relationship management) not as a product, but rather a company-wide strategy to develop longer, stronger, trust-based relationships with customers by understanding their needs, behaviors, and values. While there are many technological components to CRM, thinking about CRM in primarily technological terms is a mistake. Health plans that view CRM as a company-wide strategy optimally leverage CRM technologies as efficient vehicles to better understand their customers’ needs, meet or exceed those needs, and enhance their bottom line at the same time.
Centene Corporation is a great example of a health plan that views CRM as a company-wide strategy. And while they implemented Microsoft Dynamics CRM technology initially in their call center, they view the call center as just one of many customer touch points where they plan to leverage their company-wide CRM architecture to understand the needs of each customer and exceed their expectations. In the words of Centene’s CTO, Glen Schuster, “We were very impressed by the robust capabilities of Microsoft Dynamics CRM and its ability to grow with us. We could implement the solution rapidly a t a single call center, tailor it to meet our needs, and then roll it out across the company.”
And rapid the implementation was. In less than three months they rolled out the solution to a test group, along with a preconfigured call center template – the Customer Care Accelerator – to support call flow, reduce clicks, and autocomplete fields. Currently, 890 employees use the solution, but that number is expected to more than double within a year of deployment.
Don Imholz, CIO of Centene, cites the selection of Dynamics CRM for its rapid time-to-value and robust capabilities, as well as the fact that it’s cost effective, scalable, and easy-to-use.
In addition to the Customer Care Accelerator, the other reason the implementation went so quickly was that the Microsoft Dynamics CRM looked and felt like Outlook which was already familiar to every user. Jennifer Weigand, VP of Member and Provider Solutions, said it best, “Because Microsoft Dynamics CRM worked and looked similar to Microsoft Outlook, which employees were already familiar with, and we could provide access to all of the information they needed in one application, we were able to achieve widespread adoption.
With a broader view of member and provider information across a variety of systems, Centene customer service representatives are able to support more customers and resolve more inquiries in the first interaction. For members, they can help explain eligibility and benefits, track complaints, and even identify opportunities for preventative services. Customer service representatives can take more calls and are now able to incorporate reminders for preventative screenings. And for the provider, customer service representatives can now provide insight into the status of a claim or easily update practice information.
Early results with the implementation are showing clear benefits, including a 10 percent increase in productivity. Training time for new hires dropped by 30 percent, saving thousands of dollars per training session.
And, like many of our Dynamics CRM healthcare customers, Centene is adapting the solution to meet other business needs – for instance, eliminating the need for a third-party campaign vendor. For more information on how health plans are leveraging the Dynamics CRM platform to implement CRM as a corporate-wide strategy, see Health Plan Sales and Service.
What insights and innovations are you seeing or would you like to see in the area of customer experience?
Dr. Dennis Schmuland
Chief health strategy officer, U.S. Health and Life Sciences, Microsoft