Customer Satisfaction: The Key Driver for Success

I recently participated in an AHIP webinar, "Growth and Innovation with a Consumer-First Future," with HealthEdge customer Sal Gentile, CEO and Co-Founder of Friday Health Plans, along with UST HealthProof's CEO Kevin Adams and Healthproof President Raj Sundar.

During the webinar, we polled the audience of health plan employees about what metrics matter most. "Member and provider satisfaction scores" ranked at the top, even over financial metrics. This represents an evolving point of view for health plans, who are increasingly recognizing that "members" are customers and consumers of their services.

Health plans can measure how well they are doing in a number of different ways. Take a government program, for example. Success depends on keeping costs low, staying compliant, STAR ratings, etc. While all of those factors translate to financial health, they're built upon customer satisfaction.

For Sal Gentile, customer satisfaction is a key requirement for keeping their business growing, "Member satisfaction fuels our growth because the renewal rate is critical to our success. We can't count on always winning in a market and taking somebody else's members; we have to count on starting with renewing our own members first. And so, if we don't satisfy the customer, we won't last."

Kevin Adams weighed in about what is required for customer satisfaction, "Customers can be members, providers, brokers, whatever the constituent is. And being able to surface the information and the needed response in real-time, it is the fundamental piece that outlines success in providing a better customer experience."

Health plans need modern technology that offers transparency and provides access to real-time data and information across the entire enterprise. A customer service team cannot have a desk covered in sticky notes with exceptions and different rules outside the system. They need up-to-date information at their fingertips.

"Customers are satisfied a health plan can solve their problem on the first call," said Sal. "The tools and the plans we've put in place have allowed us to achieve a first call resolution of 99%. And when you can satisfy members and brokers and providers on the first call 99% of the time, you're going to have a really good outcome when the renewal process comes along, and with word of mouth for adding new members."

With increased importance on customer satisfaction, health plans realize that they are part of a larger ecosystem. They are not working in a silo by themselves anymore. Health plans with the tools that enable real-time data and offer transparency to the members and providers that are part of that healthcare ecosystem will achieve higher levels of customer satisfaction and ultimately growth and success.

Friday Health Plans Case Study
Building for Growth, Efficiency and a Consumer First Future

Download the one-page case study to learn how HealthRules Payor enabled Friday Health Plans to achieve outstanding customer experience metrics while being able to scale to meet lofty growth goals.

health plan Case study image

About the Author

Harry Merkin

Harry Merkin, VP, Marketing

Harry has worked with both payers and providers through many dynamic changes in healthcare for a number of years. He is currently responsible for Marketing at HealthEdge, including product marketing, demand generation and thought leadership. He previously had similar responsibilities at Evariant and NaviNet and has collaborated with many transformative entities across the healthcare landscape. Harry has helped introduce and promote innovative enterprise software solutions that enable payers to improve their competitive effectiveness, as well as perform valuable communications between payers and providers, and allow providers to effectively collaborate with patients and consumers as well as with each other. He is a frequent speaker at industry conferences and forums and contributor to the ‘Edge Report, the HealthEdge blog.

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