Health Plan Case Study
Three Steps (and Three E’s) to Improved Member Experience and Loyalty

Health plans know that member experience is even more important in times of intense market competition. But how can an organization that’s already doing a good job with member services measurably improve these interactions—and increase customer loyalty when it’s needed most?

A large Midwest health plan was facing this challenge as its business underwent a period of rapid change. The solution: Seek the help of a collaborative engagement partner and implement a multifaceted member loyalty initiative—an effort that including these three critical steps.

Step 1 – Measure health plan member loyalty

The health plan, using proprietary algorithms and an after-experience survey, developed an innovative Member Loyalty Index (MLI). The tool would measure and monitor these three E’s—key customer loyalty factors:

  • Emotion (how did the interaction make a member feel about the plan?)
  • Effort (how easy was it to interact with a representative?)
  • Education (how was the quality of information imparted during the interaction?)

Step 2 – Increase member survey feedback

Health plan leaders reached out to Carenet Healthcare Services, which already served the plan’s 24/7 flagship point of entry for member services, to ensure the viability of the measurement by increasing the number of members completing index surveys. (Read more about this in the full health plan case study.)

Step 3 – Enhancing the member experience

The health plan and Carenet also worked together with a renewed focus on improving member service and experience. The systemic effort leveraged Carenet’s deep experience working with the health plan and its teams, culture and customers. Other important elements of the work included:

  • Empathy-driven screening model for team hiring — Being great at passing along the right information was not enough.
  • Extensive experience training — This included not only program details and systems, but also listening, influence and cultivating member experience.
  • Performance monitoring and ownership — Individual, visual performance dashboards, weekly coaching and 50 daily interaction audits were key to empowering those engaging with health plans members.

Result: Better member experiences equaled better member loyalty

The work paid off. The health plan’s flagship member services program consistently achieved a composite loyalty index score above 90 (out of 100)—a substantial increase above baseline. In addition, scores in effort, education and emotion have all remained well over 8.0 (out of 10).

If you’d like to learn more about the MLI, the factors that led to success and how to increase member loyalty for your health plan, contact us or download the full case study today.