Close this search box.

Carenet Shares How to Turn Members Into Raving Fans


The more you pay for something, the more you expect from it. This is certainly the case in healthcare as consumers shoulder a larger share of their healthcare costs.

With more of their own money on the line—and greater decision-making power and higher service expectations—today’s healthcare consumers are becoming more discriminating customers who expect better value, better support and a better overall experience from their health plan. And if they don’t get it, they’ll take their business elsewhere.

Growing consumerism in the healthcare industry is prompting health plans to make customer experience a top priority—plans that realize the substantial impact an improved experience can have on their bottom line.

“As healthcare is highly complex and deeply personal, consumers will gravitate—if not run—toward the plans that simplify the healthcare journey and consistently deliver seamless, personalized customer experiences,” says Stacie Stoner, vice president of customer experience at Carenet Healthcare Services. “Meeting the demands of today’s healthcare consumer and optimizing the member experience will result in higher satisfaction, lower churn and increased revenue.”

The following four guiding principles will help you establish and shape your member experience strategy.

1/ Really know your members.
From health risk assessments and claims data to customer service histories, CAHPS surveys and social media posts, health plans have access to a treasure trove of rich data on the populations they serve.

Leveraging your data to produce analytics and insights will enable you to acquire a deeper understanding of the diversity and needs of your members (e.g., health status, health risks, engagement level, social determinants, expectations, preferences). As a result, you can effectively segment your members into discrete groups, create a 360-degree member view, and execute more targeted initiatives and relevant interactions that enrich their overall experience.

2/ Create a clear vision.
Get very clear on what you want your customer experience to look like. Ensure your vision is based on what matters most to your members. It should also align with your top business objectives and include measurable goals.

To support companywide adoption and execution of your vision, establish a set of customer experience principles that are easily understood and eagerly embraced by every single player on your team (especially frontline employees), and embed these principles into your company culture.

3/ Map key journeys.
Shift your focus from individual interactions to end-to-end journeys. Start by identifying the key journeys within each customer segment, then map out the multiple steps within each journey.

A map should include interactions with your plan, other healthcare stakeholders, and even entities outside healthcare that impact an individual’s journey. For each step, list your members’ needs, priorities, goals, barriers and emotional states. Ask: What’s the member’s perspective? What are his pain points? Where are his bottlenecks? What are his expectations? What is his feeling? Leverage your data assets and frontline employee feedback to best answer these questions.

For example, rather than focusing on a one-and-done member call to schedule a colonoscopy, consider everything that’s involved from educating a member on screening recommendations and overcoming adherence obstacles (e.g., fear, embarrassment, misconceptions, transportation issues) to scheduling the appointment, explaining exam preparation and providing decision support.

Outlining each step within a journey will help you see the world through the lens of your members and better understand where they are coming from before interacting with you and where they are going to afterward. This clarity and perspective will empower you to provide a more holistic, relevant, effective and satisfying experience.

4/ Make a plan.
Once you’ve created your journey maps, pinpoint the factors and improvement opportunities that will most strongly influence the member experience, produce the desired outcomes and yield the greatest financial return.

Next, determine what changes (e.g., operational, organizational, cultural) and resources are required to reshape, sustain and continuously track and improve the member experience. Realize that success will only come when your organization stays committed year-round to this process.

Carenet Can Help
As healthcare consumers take on more cost-sharing and decision-making responsibilities, they are becoming more savvy shoppers with greater influence and purchasing power. The health plans that embrace this rising consumerism, prioritize their member experience and provide higher value will be greatly rewarded.

“A true competitive advantage will go to the plans that differentiate their organization by delivering exceptional customer experiences throughout their members’ healthcare journey,” says Stoner. “This belief is deeply embedded in Carenet’s DNA; our goal is to ensure members rave about their plan.”

To learn how Carenet can help you improve your member experience, click here to contact us today.