Healthcare Customer Management July 2014
Healthcare Customer Management In the era of high insurance premiums and the advent of new health insurance customers in the coming years, payers are facing tremendous pressure to lower healthcare costs and improve patient outcomes. To successfully navigate this evolving business landscape, payers will need to significantly improve their operational efficiency while concurrently reducing administrative costs. One way health insurance companies are trying to mitigate these business challenges is by focusing more on corporate branding and looking to increase their Customer Relationship Management-related (CRM) investments to bolster their consumer-oriented capabilities. As compared to organizations in other industries such as retail, finance, and telecom, healthcare payers have been slow to expand investment in CRM for a number of reasons, such as cost, the complexity of data integration, and the existence of non-streamlined IT systems. But the emergence of consumer-driven healthcare and the need for better consumer engagement have created a strong necessity for the payers to enhance their CRM effectiveness. With individual consumers taking informed actions with regard to coverage, payment, health, and care decisions under evolving consumer models, payers will need to create customer relationships that help them identify and foster opportunities for better communication, efficiency, incentives, and care. CRM will enable health plans to deliver extensive consumer engagement enhancements and improvements in customer management. For example, CRM will help payers streamline and automate the renewal process while also reducing time and cost. The following are some of ways in which payers can enhance customer interaction, communication, and management: ď€ By replacing paper processes with guided online submission forms, the enrollment process can be greatly simplified for group administrators and insurance brokers ď€ Payers can also improve support capabilities for consumers with online personalized guidance tools to help maneuver consumers through challenges like coverage gaps, wellness management, etc. ď€ Payers can also use CRM to enhance many different areas, including the management and monitoring of sales, marketing, enrollment, underwriting, and member services While expanding CRM capabilities provides significant gains for healthcare payers, most payers today are still in the early stages of planning their CRM expansion. CRM initiatives demand proper planning and pinpoint execution. If done successfully, healthcare payers will realize significant benefits. Health payers should consider CRM not just as a technology, but also as a business strategy that is enabled and supported by technologies and personnel. CRM should be integrated with technologies and applications with optimal business processes across sales, marketing and customer service. Healthcare Customer Management
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The business processes that support CRM offer health care organizations the opportunity to enhance customer service and embrace one-to-one customer management. The following three business processes are critical to a successful CRM: ď€ Sales: This functional area should include technology to enable selling through all sales channels, including selling partners and the Web. The relevant processes should include business planning capabilities, forecasting, and account management system. ď€ Marketing: This functional area should involve capability to analyze the marketing process and automating it for the customer relationship cycle including customer selection, acquisition, and retention. The relevant tools in this area will help the organizations with data management, mining, analysis, and reporting. ď€ Customer Service: This functional area is responsible for retaining and extending customer relationships once a product is sold. This area should include business applications in front-office systems with back-end links to support a customer-centric environment. The ideal applications should be able to manage call tracking and escalation, workflow management, and problem resolution.
As CRM strategies evolve, it is important for payers to look at healthcare CRM trends and analyze the new concepts in the market place. To identify best practices, payers should look at the trends in retail and telecom industry where CRM has matured. Additionally, customer information is the foundation of any CRM strategy. The ability to cut through heaps of customer data and turning that data into action-oriented information will differentiate healthcare payers from their competitors and help them better manage their customer relationships.
Healthcare Customer Management
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