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Leveraging Innovations in Healthcare Technology to Create a Frictionless Member Experience

08-Mar-2024 00:25:16 / by Matin Saiyed

Matin Saiyed

In an era where the fusion of healthcare and technology redefines consumer experience, healthcare payers face a pivotal challenge: delivering seamless member experiences.

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As highlighted by a recent Becker’s report, there is a gap in member engagement. It's a critical concern for an industry striving to meet the expectations set by consumer-centric sectors like retail, online shopping, and banking. The convergence of data, artificial intelligence (AI), and cloud technology presents an unprecedented opportunity to transform the way healthcare interacts with its members. 

Challenges for Payers 

Modern members demand experiences akin to those offered by e-commerce and banking industries. This necessitates a shift in focus towards member-centric strategies that encompass personalized, omni-channel engagement. A recent Forrester report on the topic shows great growth potential in increasing customer engagement through online channels (website, app, email) and 65% of healthcare payers who responded to Forrester’s survey said ensuring that members are reached at their channel of choice was a key priority. 

One of the main challenges to this transition is the critical nature of healthcare systems and their complexity. Any interruption to member services, even temporarily, can have serious consequences. Payer organizations are understandably wary of a complete system overhaul. At the same time, attempting piecemeal upgrades can be daunting to navigate. 

Call centers and self-service expansion are also key areas for modernization that come with their own set of implementation and integration difficulties. Demand to increase the channels through which members can interact with their health plan, access data, and find information is coming from both the regulatory and consumer sides – adding to the urgency and complexity around developing solutions in these areas.   

Data is Power for Personalized Engagement  

Health insurers have the opportunity to collect and maintain a huge amount of data across various member touchpoints. Raw data or siloed data is a wasted opportunity. Usable data is power. Once data is consolidated and made accessible across the customer journey, the overall member experience is improved, and providers can more easily identify and implement cost-saving measures. Accessing useful data in a timely manner also ensures better care for members, resulting in greater customer satisfaction.  

One of the pivotal areas where healthcare payers can enhance member experience lies in empowering better self-service. Leveraging cloud-based AI, healthcare organizations can ensure seamless authentication, quicker issue resolution, and tailored recommendations during member interactions. Because security and good data guardianship is a major concern for the healthcare industry, companies developing AI-driven solutions for healthcare are moving forward with an eye for integrity. 

Organizations like Salesforce are putting a lot of focus on how to responsibly integrate machine learning into their clients’ technology landscape and processes without comprising on security or member empowerment. Announcements and product reveals at Dreamforce this year revealed this major focus. Theirs – and many other orgs pioneering AI solutions – are working to ensure that member data isn’t treated as a product but a resource that ultimately leads to better care and coverage.  

These solutions empower healthcare leaders to harness the power of artificial intelligence in delivering personalized member experiences. Decision-makers can leverage Einstein AI to predict member behaviors, automate processes, and provide tailored recommendations, aligning with the preferences of the diverse healthcare consumer base.  

Case Study: Banner Health’s Self-Service Medicare Shop & Enroll Portal  

Banner Health's pioneering self-service Medicare Shop & Enroll portal epitomizes the transformative potential of cloud technology in modernizing the member experience. Developed by Mastek, powered by Salesforce, and launched for the 2022 Medicare enrollment period, this award-winning portal revolutionizes how members engage with their healthcare plans.   

By allowing members to seamlessly view plan options, compare drug prices, and access provider information through an intuitive interface, Banner Health's self-service portal empowers members with informed decision-making. The portal streamlines the enrollment process, offering a user-friendly experience while significantly reducing costs on customer care specialists. It’s a great foundation to not only create the frictionless member experience that consumers demand but also to expand from a healthcare organization’s continuing mission to bring forward care and coverage into a modern landscape.  

Banner Health continues to innovate the member and patient experience across the full spectrum of their business units, but they’re not going it alone. Bringing in a consultant to help architect, design, and deploy new technologies into an integrated technology landscape has been a major component of their success from the beginning. Knowing what to look for in a consulting partner can save a lot of time.  

Don’t Go It Alone - What to Look for in a Partner  

As mentioned earlier, one concern for the payer community is the lack of an all-in-one solution to their specific technology modernization needs. A trusted partner can help guide that transformation, and keep in mind big-picture goals while implementing practical improvements along the way to create a better member experience. What should health care providers look for when choosing a partner for their digital transformation?  

1. Proven Expertise 

The task of modernizing and improving the member experience is both complicated and tenuous—it’s not something to be entrusted to an unproven partner. Priority should be given to a company with years of experience and a number of successful ventures with similar organizations.  

2. Effective Discovery Process and Methodology 

How does the cloud services company go about forming a customized strategy for your organization? There must be an effective discovery process in place to make sure any solutions will function harmoniously and to ensure that all pain points and priorities are addressed. Additionally, the methodology of implementing solutions must be sound and effective.   

For example, Mastek’s signature 3-D process demonstrates effective discovery and methodology. Every partnership begins with Discovery—listening and learning in order to meet the right needs. Then the Design step means a customized solution that is everything the organization needs and nothing they don’t. And finally, they Develop and implement the solutions in a way that best fits the organizations schedule and budget.  

3. Long-term Partnership and Reputation for Success

Because digital transformation is an ongoing process, a cloud-services partner needs to be someone you can count on in the long term. Consider the results they’ve obtained for previous clients. Would they recommend the company to a friend? Do they have a proven track record and longevity?  

4. Custom-built Options

One important consideration when choosing a digital transformation partner is whether they can provide custom-built solutions to meet your needs, or if you’ll end up spending more for solutions that aren’t a tailored fit. You want a company that specializes in transforming out-of-the-box software to create a customized solution.  

Conclusion  

New cloud technology advancements make it possible for healthcare providers to meet their goal of improving member engagement and creating a true omni-channel experience for members, improving care standards, cutting costs, building trust, and ultimately enhancing member satisfaction. By engaging a proven partner in technology transformation, providers can utilize these advancements in a tailored way that meets their goals, budget, and timeline. 

Topics: Healthcare, Digital Transformation, AI, Data, Health Cloud

Matin Saiyed

Written by Matin Saiyed

Matin is Mastek’s Senior Director of HLS Alliances. He is renowned for his pioneering work in revolutionizing healthcare through innovation and strategic partnerships. With a keen focus on modernization and consumer-centric care, he drives transformative solutions to improve access, efficiency, and affordability across the healthcare ecosystem, leading Mastek's Healthcare and Life Sciences team towards a future defined by excellence and integration.

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